Effects of Gongs Mobilization and Proprioceptive Neuromuscular Facilitation in Patients With Adhesive Capsulitis

Effects of Gongs Mobilization and Proprioceptive Neuromuscular Facilitation in Patients With Adhesive Capsulitis

The randomized controlled trail aims is to evaluate the outcome of Gongs mobilization and PNF in patients with adhesive capsulitis. The significance of this study is to compare Gong's mobilization technique with proprioceptive neuromuscular facilitation (PNF) compare their effects on pain, range of motion, and functional disability. The sample size was calculated with G-power. This study would include total 44 female participants aged 40-60 years will be recruited and randomly assigned to two groups. Group A(Gongs mobilization+ conventional therapy)and Group B(PNF+ Conventional therapy). Intervention will be provided for 4 weeks 3 session per week. Primary outcome measures are pain, ROM and functional disability via NPRS, Goniometer and U-SPADI. Outcomes will be reassessed at baseline, after 2nd week, and after 4th week.

Adhesive capsulitis ,which is also referred as frozen shoulder is described as a progressive and self-limiting condition leading to gradual onset of pain and loss of shoulder Range of motion. It restricts both Active and Passive movements due to adhesions in Glenohumeral(GH) joint capsule. which leads to fibrosis, scarring and contracture of joint capsule. As fibrosis progresses restricting the shoulder normal Range of motion. ultimately impacting person's daily activities and frequently interfering with sleep and making basic activities like combing hair , dressing and overhead activities difficult.

Gong's Mobilization(GM) serves as an effective technique in the treatment of Frozen shoulder, it was introduced by W. Gong, the mainstay of this mobilization is to correct the positional fault of the humeral head that is often medially rotated and dragged forward due to muscular tension of Subscapularis and Pectoralis Major along with the tightness of posterior capsule. Gong mobilization intends to keep the humeral head in its correct position during dynamic motion of the GH joint by keeping the affected scapula in anterior to posterior position and the humeral head in posterior to anterior direction at the same time. Proprioceptive neuromuscular facilitation (PNF) stretch is a technique commonly used in clinical environments to enhance both active and passive range of motion (ROM), with the ultimate goal of optimizing motor performance and rehabilitation

Inclusion Criteria:

• Females in the age group between 40-60 years.
• Diagnosed with Unilateral frozen shoulder.
• Patients in frozen stage (progressive loss of ROM, marked stiffness with gradual pain reduction).
• More than 25% painful limitation of GH ROM in two planes, more than 50% in external rotation(arm at 0 degree of abduction).

Exclusion Criteria:

• History of surgery on the affected shoulder.
• Patients having any cervical or thoracic problem.
• Painful, stiff shoulder after severe trauma, inflammatory diseases such as rheumatoid arthritis and malignancies.
• Recent fractures in and around the shoulder.
• Rotator cuff disorder.