Axillary Phonophoresis Versus Post Isometric Facilitation in the Treatment of Shoulder Adhesive Capsulitis

Axillary Phonophoresis Versus Post Isometric Facilitation in the Treatment of Shoulder Adhesive Capsulitis

the aim of this study is to compare the effect of Axillary Phonophoresis versus Post isometric facilitation in subjects with Adhesive capsulitis

Adhesive Capsulitis is a common cause of shoulder pain and disability and also a condition involving glen humeral pain and loss of motion. It is characterized by significant restriction of both active and passive motion that occurs in the absence of a known intrinsic shoulder disorder. The intervention strategies for AC include a trial of conservative therapy followed by more invasive procedures.it may be primary-onset is generally idiopathic or Secondary- results from known cause. Clinically, patients may present with pain and mild restriction of movement which can lead to a gross loss of function predisposing factor or surgical event . it is most frequent in women, diabetic population and patient older than 40 years .It is described as having 3 stages. Stage Ⅰ involves pain (freezing or painful stage) and lasts from 3 to 9 months and is characterized by an acute synovitis of the glen humeral joint. Stage Ⅱ (frozen or transitional stage) includes pain and restricted movement and lasts from 4 to 12 months. Stage Ⅲ (thawing stage) involves painless restriction and lasts from 12 to 42 months. Contributing factors include diabetes mellitus, stroke, thyroid disorder, dupuytren disease, complex regional pain syndrome and metabolic syndrome.

Axillary Phonophoresis and Post isometric facilitation play a major role in the treatment of adhesive capsulitis so this trial was conducted to determine which one has superiority. this trial has three groups. two experimental and one control group. pain ,function, pressure pain threshold will be measured.

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