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Stiff shoulder is a painful and severely debilitating condition. The inflammatory contracture of the glenohumeral joint capsule in stiff shoulder restricts both active and passive range of motion, with loss of external rotation being especially characteristic of this condition (Dyer et al., 2023). Stiff shoulder is clinically described by the continuing onset of shoulder pain and advanced exacerbation of the shoulder joint leading to exertion in the higher extremity activity, significant disability, and functional restrictions. The most common symptom of a stiff shoulder is night pain, resulting in sleep impediment that leads to one-sided sleep on the uninfected shoulder (Mao et al., 2022).
Spencer technique is a standardized series of treatments with broad application to diagnose, treat and establish prognosis for restricted mobility in shoulder. It was developed by Spencer in 1961. It is a multistep technique that combines Spencer's positioning, sequencing, slow stretching of the shoulder complex within pain-free limits done by physical therapist while incorporating muscular energy with post-isometric contraction and relaxation (Babu And Putcha., 2022).
thirty diabetic female patients with Stiff shoulder with ages 45-55 years:
Group A(study group) :
15 patients received Spencer Muscle Energy Technique along with postural exercise 3 times a week for 8 week.
Group B (control group) :
15 patients received Classical physiotherapy treatment includes Transcutaneous Electrical Nerve Stimulation (TENS) for 15 minutes hotpack on the painful area for 15 minutes along with postural exercise 3 times per week for 8 week.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| spencer muscle energy technique | Experimental | Spencer muscle energy technique (SMET) attempts to re-establish functional relationship between soft and articular tissues of the shoulder region, minimizes inflammatory and later developing fibrotic process, and restores arterial, venous, and lymphatic flow. Like other OMT procedures, it not only restores joint functions, but enhances positive well-being and full expression of a patient's life. In this technique, passive, smooth, rhythmic motion of the shoulder joint is done by the therapist to stretch contracted muscles, ligaments, and capsule (Babu And Putcha.,2022). |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| spencer mscle energy technique | Procedure | The effectiveness of MET found in chronic capsulitis is due to its effect on relieving pain, ensuring ROM incretions, and developing functional activities due to the muscle contraction in a precise direction and in a monitored position over resistance to assist in improving joint range by advancing joint flexibility. This procedure is suggested for all joints with limited ROM (Butt & Tanveer, 2022). |
| Measure | Description | Time Frame |
|---|---|---|
| pain pressure threshold algometry | Algometers are devices that can be used to identify the pressure and/or force eliciting a pressure-pain threshold. | will be measured at baseline, and it will be measured after eight weeks |
| Visual Analogue Scale (VAS) | was used to assess the severity of pain before and after treatment for both groups | will be measured at baseline, and it will be measured after eight weeks |
| Measure | Description | Time Frame |
|---|---|---|
| goniometer | measures the available range of motion | will be measured at baseline, and it will be measured after eight weeks |
| SPADI (shoulder pain and disability index). | It is a self-revealed measure created to assess shoulder pathological conditions |
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Inclusion Criteria:
1) Women's age between 45 to 55 years old 2)Suffering from stiff shoulder for 2-12 months (stage 1 and 2) confirmed by an orthopaedic specialist.
3) Diagnosed as type 2 DM for at least 5 years. 4) No treatment other than analgesics
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Alaa El-moatasem, lecturer | Contact | 01006625054 | alaamotasem@cu.edu.eg |
| Name | Affiliation | Role |
|---|---|---|
| NESREEN GHAREEB, Vice Dean | Professor | Principal Investigator |
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| ID | Term |
|---|---|
| D002062 | Bursitis |
| ID | Term |
|---|---|
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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| will be measured at baseline, and it will be measured after eight weeks |