This study is a randomised control trial and the purpose of this study is to determine the additional effects of mobilization with movement with upper quadrant core strengthening in rotator cuff related pain
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Age 18-65 years
Both genders
Unilateral shoulder pain of traumatic origin
Scoring should be less than 8 on numeric pain rating scale
History and Clinical presentation compatible with complete rotator cuff or bicep brachia rupture
Adhesive capsulitis
History of dislocation
Glenohumeral osteoarthritis
Parallel
Upper Quadrant Core Strengthening protocol
Procedure/SurgeryUpper Quadrant Core Strengthening protocol Core strengthening protocol will comprise of following four week protocol. 1. Week one Scapular postural correction and shoulder shrugging exercises 2. Week two External rotation at 0 degree 3. Week three Internal rotation at 0 degree 4. Week four Standing row at 45 and 90 degree , Anterior shoulder stretch and Thoracic exercise in sitting
Mobilization with movement
Procedure/SurgeryIn addition to upper quadrant core strengthening protocol participants will also perform mobilization with movement. Mobilization with movement protocol will comprise of following forms. 1. Acromioclavicular joint glides 2. Scapular glides 3. Glenohumeral joint glides ( inferior glides, postero-lateral glides, postero-inferior)
Pain intensity
Pain will be measured on Numerical Pain rating scale. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable").
Range of motion
A universal goniometer will be used to measure the shoulder ROM in external \& internal rotation, abduction and flexion and their normal ranges are 90, 80, 0-180, 0-180 degree respectively.
Proprioception
The laser pointer method for assessing Shoulder Joint Position Sense (JPS) involves the patient using a laser pointer to target a 1 meter distanced scoreboard while performing arm movements. Patient will be asked to perform flexion, abduction and external rotation to 90 degree or alternatively to maximum possible pain free range below 90 degree. After three practice rounds with eyes open, four attempt with eye closed will be performed and shoulder range will be measured. We will measure JPSE for flexion, abduction and external rotation by using mobile app inclinometer.
Kinesiophobia
The Tampa Scale of Kinesiophobia (TSK) is a 17-item self-report tool with a 4-point Likert scale, measuring fear of movement due to injury or pain, and somatic focus on underlying medical issues. Scores range from 17 to 68, with higher scores (≥37) indicating significant kinesiophobia and poorer health outcomes.
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