Effects of Spencer Technique Following Hydrodilation in Patients With Adhesive Capsulitis

Foundation University Islamabad

Status: Enrolling

Conditions: Adhesive Capsulitis

Treatments: Procedure: Passive Stretching; Procedure: Spencer muscle energy technique; Procedure: Hydro dilation

Study type: Interventional

Funder types: Other

Identifiers

NCT06668415

FUI/CTR/2024/47

Details and patient eligibility

About

Adhesive Capsulitis is a common Musculoskeletal disorder characterized by pain and progressive joint restriction in capsular pattern. Adhesive capsulitis can be managed by both conservative and non conservative treatment. The Spencer technique and hydrodilation are two treatment approaches used to restore range of motion in adhesive capsulitis.

The Spencer technique is a form of physical therapy that involves joint mobilizations and manual stretching exercises. It aims to improve shoulder mobility and reduce pain by addressing the tightness and stiffness in the shoulder capsule and surrounding tissues.

Hydrodilation, on the other hand, is a procedure where a saline solution is injected into the shoulder joint to distend the capsule. This distention helps stretch the tight tissues and break up adhesions, facilitating improved range of motion.

Full description

Adhesive capsulitis, also subsequently known as Frozen shoulder is a musculoskeletal disorder characterized by painful and progressive joint restriction in capsular pattern. It has a prevalence of 2 to 5% in general population and the incidence is more in females mostly aged 40 to 60 years mostly suffering from Diabetes Mellitus. Adhesive Capsulitis can be classified into three phases; Freezing (painful), Frozen (stiffening) and Thawing (resolution phase). The treatment protocol is planned such to improve the range of motion and reduce pain. Various treatment regimes are followed for treatment of adhesive capsulitis, either it be in medical field, physical therapy or in worst cases surgical treatments too.

Hydrodilation, a medical procedure which involves injecting a fluid (mainly normal saline) into the joint space which expands the space breaking up scar tissue and loosening the joint. This method is being widely used in isolation or in combination with other methods to treat Adhesive capsulitis.

Spencer technique on another hand is a physical therapy technique which in isolation or in conjunction with other treatments is used to treat patients with adhesive capsulitis. Spencer muscle energy technique is a seven 7 step procedure which consists of shoulder extension with elbow flexed, shoulder flexion with elbow flexed, circumduction with compression, circumduction with traction, Abduction then adduction with external rotation and glenohumeral pump.

Hence the current study will investigate the effects of Spencer technique following hydrodilation in patients with Adhesive Capsulitis.

The study includes subjects with unilateral adhesive capsulitis, 40-60 years of age both male and female and have undergone Hydrodilation. The selction of subjects will be using non probability purposive sampling technique. Participants will be randomized using sealed envelope method and allocated to one of two groups.

The data collection tool for pain is VAS, for ROM is Goniometer and for disability is SPADI.

The time duration for treatment protocol is total of 12 sessions, 3 sessions per week. Exercise is done 3 to 5 times with rest periods.

Enrollment: 30 estimated patients

Sex: All

Ages: 40 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

• Patients with diagnosed unilateral Adhesive Capsulitis and have undergone Hydrodilation. --Includes both genders
• Age 40 to 60 years. Exclusion Criteria
• Population who have recently undergone major shoulder injury or surgery, had fracture or open wound or there is reduction of Glen humeral ROM due to any other cause other than Adhesive Capsulitis

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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30 participants in 2 patient groups

Group A (Hydrodilation+Spencer Technique )

Active Comparator group

Description:

Patients in this group will be followed by Spencer Technique after Hydrodilation for the duration of 4 weeks which includes 12 sessions in total. Spencer muscle energy technique is a seven 7 step procedure which consists of shoulder extension with elbow flexed, shoulder flexion with elbow flexed, circumduction with compression, circumduction with traction, Abduction then adduction with external rotation and glenohumeral pump. Following the complete action, patients will be encouraged to use their muscles for 3 to 5 seconds against little resistance provided by the therapist

Treatment:

Procedure: Hydro dilation

Procedure: Spencer muscle energy technique

Group B (Hydro dilation+ Passive Stretching)

Experimental group

Description:

This group will undergo Passive Stretching followed by Hydrodilation. The low intensity stretches will be given in supine for all the movements ie Flexion ,Abduction , Internal Rotation and External Rotation for 5 repititions with 30 sec hold. (7)

Treatment:

Procedure: Hydro dilation

Procedure: Passive Stretching