The purpose of this study is to determine the effect of capacitive resistive energy transfer therapy on postmenopausal women with frozen shoulder.
Sedentary, ambulatory, non-smoking women.
Postmenopausal women with at least one-year amenorrhea.
Having natural menopause at least one year prior to participating in the study.
No history of bilateral surgical removal of the ovaries and/or the uterus.
Diabetes.
Osteoporosis.
Previous shoulder surgeries.
History of tumor.
Parallel
Conventional physical therapy
Other interventionThe treatment will involve stretching exercises for the levator scapulae, upper trapezius, pectoralis minor, and pectoralis major muscles. It will also include strengthening exercises for the middle and lower trapezius and the rotator cuff muscles, along with manual therapy techniques such as anteroposterior, posteroanterior, and inferior glides of the shoulder joint.
Capacitive Resistive Energy Transfer (TECAR) therapy
DeviceThis equipment contains a mobile electrode handled by the therapist, which treats the part affected by the pathology, and a fixed electrode that is in contact with the patient's skin, serving as a conductor. Each patient will be seated in a comfortable position with the affected shoulder exposed, ensuring adequate support and stability throughout the treatment session. The affected shoulder was prepared with a conductive gel to enhance energy transfer. During the session, the capacitive electrode was initially applied, targeting the superficial muscles and tendons around the shoulder joint using circular or linear movements for 5 min. Following this, the resistive electrode was employed to target deeper structures, focusing on the joint capsule and rotator cuff muscles for 10 min. The output power was adjusted based on the patient's tolerance, ensuring a comfortable warm sensation without causing discomfort or burning feeling or pain
Assessment of shoulder pain intensity
It will be evaluated before and after treatment program by using visual analogue scale (VAS), which is a linear scale that measures the magnitude of pain severity. It encompasses a horizontal line scaled as a spectrum from mild pain beginning from the left to increasing severity to the right end of the horizontal line. The line is 10 cm in length, with each side of the line ending in extremes either no pain or intense pain. In terms of utilization, each participant will mark her pain on the line of the spectrum of the scale.
Assessment of pressure pain threshold
It will be measured with an algometer on the sub-occipitalis, levator scapulae, subscapularis, and pectoralis minor. These four muscle groups were evaluated on the painful side of the body in particular, the suboccipital muscles were evaluated in their insertional component at the level of the occiput, the levator scapulae muscle in its distal portion at the level of the insertion of the superomedial angle of the scapula, the subscapularis muscle on its muscle belly, and the pectoralis minor muscle near its insertion on the coracoid process. The algometer was placed with the probe against the muscle belly
Measurement of shoulder external rotation range of motion (ROM)
It will be measured before and after treatment program by using goniometer. place the patient supine or seated with the shoulder abducted to 90° and elbow flexed to 90°. Align the goniometer axis over the olecranon process, keep the stationary arm parallel or perpendicular to the floor/trunk, and align the moving arm with the ulnar styloid process as the arm rotates back. Normal range is approximately 90 degrees.
Shoulder abduction range of motion
It will be measured before and after treatment program by using goniometer. place the patient supine, align the fulcrum at the anterior acromion, set the stationary arm parallel to the sternum, and align the moving arm with the anterior humerus as the arm moves outward up to a normal range of 0-180
Disability assessment
The level of disability caused by the shoulder joint pain will be assessed, through shoulder pain and disability index (SPADI). The SPADI consists of 13 items that evaluate two domains; one is a 5-item subscale that assesses pain and the other is an 8-item subscale that measures disability on a Likert scale. The results of each subscale will be added up and converted into a score out of 100: the closer the score is to 100, the greater the pain and disability.
Assessment of Health-Related Quality of Life
It will be assessed before and after treatment program using Free online short form 36- health survey questionnaire (SF-36) score calculator. The SF-36 measures eight scales: physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health. Component analyses showed that there are two distinct concepts measured by the SF-36: a physical dimension, represented by the Physical Component Summary (PCS), and a mental dimension, represented by the Mental Component Summary (MCS).
Serum C-reactive protein level
It is a pentameric protein synthesized by the liver, whose level rises in response to inflammation.
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