Evalution of Mulligan's technique for adhesive capsulitis of the shoulder.

Abstract

OBJECTIVE: To evaluate Mulligan's technique for relieving pain and improving functional capacity of the shoulder in patients with adhesive capsulitis in the stiffness phase. DESIGN: Randomized controlled study. METHODS: A total of 40 subjects were randomly allocated into 2 groups: (i) group 1 (n_=_20) were treated with hot pack, transcutaneous electrical nerve stimulation, and passive stretching exercises (ii) group 2 (n_=_20) were treated with hot pack, transcutaneous electrical nerve stimulation and Mulligan's technique. Mulligan's technique combines the sustained application of a manual "gliding" force to a joint, with the aim of repositioning bone positional faults while enabling concurrent physiological (osteo-kinematic) motion of the joint. All cases were evaluated using visual analogue scales for pain, passive and active range of motion, Constant score, Shoulder Disability Questionnaire, and patient and therapist satisfaction at baseline, after completion of treatment sessions and at the end of 3 months of follow-up. RESULTS: Marked improvement was noted in both groups after completion of treatment sessions and at the third month of follow-up compared with baseline. The improvements in outcome measures, namely pain, range of motion, shoulder scores, and patient and physiotherapist satisfaction, were significantly greater in subjects in group 2, who were treated with Mulligan's technique. CONCLUSION: Mulligan's technique and passive stretching exercises are both effective in reducing pain, and restoring range of motion and function. However, compared with stretching exercises, Mulligan's technique led to better improvements in terms of pain, range of motion, shoulder scores, and patient and physiotherapist satisfaction.