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The aim of this study was to evaluate the effects of adding osteopathic visceral manipulation (OVM) to a standard physical therapy program on pain, functional disability, and range of motion (ROM) in patients diagnosed with right shoulder adhesive capsulitis (AC). A total of 49 patients aged between 40 and 65 years who were diagnosed with right shoulder AC were included in the study. Randomized patients received a standard physical therapy program for three weeks, consisting of 15 sessions (5 days per week) in both treatment groups. The standard program included hot pack application to the shoulder region for 20 min, conventional transcutaneous electrical nerve stimulation (TENS) for 20 min, and ultrasound therapy at 1.5 W/cm² for 10 min. In addition to the standard physical therapy program, Group 1 (n=25) received OVM once weekly, while Group 2 (n=24) received sham OVM once weekly. Pain was evaluated using the Visual Analog Scale (VAS), while functional disability was evaluated using the Shoulder Pain and Disability Index (SPDI). The ROM values were also recorded.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1 (OVM group, n=28) received a standard physical therapy program | Experimental |
| |
| Group 2 (Sham group, n=28) received the same standard physical therapy program | Sham Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| physical therapy program | Other | In the OVM group, mobilization of the liver and diaphragm was performed. Liver mobilization was applied in three planes (coronal, transverse, and sagittal) for 5 min each, totaling 15 min, while the diaphragm technique was applied for 2 min. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain (VAS) | From enrollment to the end of treatment at 4 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Active shoulder ROM for abduction, flexion, internal rotation, and external rotation | From enrollment to the end of treatment at 4 weeks | |
| Shoulder Pain and Disability Index (SPADI) | From enrollment to the end of treatment at 4 weeks |
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Inclusion Criteria:
Age between 18 and 65 years
Presence of pain originating from the right shoulder region persisting for at least 6 weeks
Availability of two-view shoulder radiographs obtained prior to the study to exclude causes of shoulder pain other than AC
No local corticosteroid injection for shoulder pain within the previous 6 months
No physical therapy administered for shoulder pain within the previous 6 months
No use of non-steroidal anti-inflammatory drugs (NSAIDs) during the study period
Availability of laboratory assessments including:
Pain intensity score of at least 4 cm on the Visual Analog Scale (VAS, 0-10 cm)
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Goztepe Suleyman Yalcin Sehir Hastanesi Fiziksel Tıp ve Rehabilitasyon Klinigi | Istanbul | Turkey (Türkiye) |
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Single-center, single-blind, randomized-controlled study
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| Sham (No Treatment) | Other | In the sham OVM group, light pressure and touch were applied with the palm over the same points selected for OVM, without the intention of providing therapeutic effect. |
|
| ID | Term |
|---|---|
| D002062 | Bursitis |
| ID | Term |
|---|---|
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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| ID | Term |
|---|---|
| C005703 | salicylhydroxamic acid |
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