Axillary Phonophoresis Versus Post Isometric Facilitation in the Treatment of Shoulder Adhesive Capsulitis
Adhesive Capsulitis of Shoulder
About this trial
This is an interventional treatment trial for Adhesive Capsulitis of Shoulder focused on measuring adhesive capsulitis, post isometric facilitation, axillary phonophoresis
Eligibility Criteria
Inclusion Criteria:
- The patient age will range from 30to 40years old from both sexes (male and female).
- All recruited subjects in the 2nd stage of adhesive capsulitis (transitional stage).
- The patient will be diagnosed and referred by orthopedist as Adhesive capsulitis.
- The diagnosis will be confirmed by shoulder MRI.
- The diagnosis will be confirmed by shrug test.
- The patient will be referred by anterior shoulder pain or anterolateral shoulder pain.
- Inclusion requirement include two or more of the following pain complaints: Grooming ones hair, Scratching your back and getting dressed, Overhead activities or Difficulty in the action of throwing the ball and giving a high -five.
- All patients will sign the informed consent before joining the study.
Exclusion Criteria:
- Previous fracture with or without internal fixation in the shoulder joint
- Any previous surgery in the shoulder joint and patient with tendon calcification
- Local corticosteroid injection to the affected shoulder within the last three months or recent ones (Michener et al, 2004).
- Neuromuscular disease
- Rotator cuff tear
- History of metastatic cancer or diagnosis of cancer within 12 months
- Unstable angina
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Active Comparator
axillary diclophenac phonophoresis ( diclophen gel "voltaren gel")
Post isometric Facilitation Techniques.
traditional physiotherapy (infrared, supervised exercise program, home exercise program)
the subject in the axillary diclophenac phonophoresis group will receive axillary diclophenac phonophoresis using ultrasound 1 MHz to increases the absorbtion. Diclofenac phonophoresis will be applied beside conventional therapy program ,Apply the diclophen gel (voltaren gel) on the head of the US in the axillary pouch of the capsule at 1.5 W\cm2 for 10 minutes as pulsed U.S. the group will be treated for 4weeks, 3 sessions per week and all patients will be assessed pre and post intervention.
the subject in the Post isometric Facilitation Techniques group will be treated by applying isometric contraction followed by isometric relaxation followed by stretching to the target muscle .when performing isometric facilitation with the shoulder in flexion , the patient was seated with his\her back supported and the therapist standing facing the patient's painful shoulder .the patient's shoulder joint was flexed to the maximum available range with the elbow completely flexed .the patient performed isometric contraction of the shoulder extensors against maximum resistance provided by the therapist .this contraction will last for 10 seconds followed by relaxation for 5 seconds .this contraction will allow the shortened shoulder extensors to relax and permit easier stretching.the group will be treated for 4weeks, 3 sessions per week and all patients will be assessed pre and post intervention.
The traditional physical therapy program, which includes Infrared (IR) lambs apply heat to deep joints such as shoulder joint. Avoid deltoid muscle; apply over thin, bony areas for maximum penetration. supervised exercise program are self-exercise included: 1-Codmans or pendulum exercise (circumduction): It should be done 5 times daily in 5 to 10 minute sessions Passive stretching exercise (for shoulder extensors, abductors, and internal rotator) home exercise program includes the same exercise as in supervised exercise program. The participant will instruct to perform exercises1-2 times/day within pain -free ROM. the group will be 4weeks, 3 sessions per week and all patients will be assessed pre and post intervention.