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.
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).
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.
Parallel
Gongs Mobilization
BehavioralGlenohumeral mobilization (GM) will be performed in a side-lying position with the therapist standing on the affected side. An anterior-to-posterior glide will be applied to the humeral head parallel to the joint plane while the opposite hand stabilizes the scapula from posterior to anterior. The patient will perform quick shoulder abduction movements with the elbow extended as the therapist applies Maitland's Grade III-IV oscillatory glides, maintaining slight joint distraction and following the motion through the abduction phase. Each session will include two sets of five repetitions with a five-minute rest between sets, for a total of twelve sessions
Proprioceptive Neuromuscular Facilitation
BehavioralThe therapist will use proprioceptive neuromuscular facilitation (PNF) techniques specifically employing the hold-relax method followed by the D2 pattern of flexion-extension movement. Each session will last 15 minutes, comprising 10 sets of PNF. Each set will include 5 repetitions, with a 5-second hold and a 2-second rest between repetitions. This protocol will be administered over 12 sessions.
Numeric Pain Rating Scale
Numeric pain rating scale is Subjective Assessment Tool used to assess level of discomfort patients are experiencing. It is eleven-point scale (0-10).whereas 0 indicates(no pain at all) and 10 indicates(worst imaginable pain).
Goniometer
Universal goniometer is used to assess active and passive Range of motion
Shoulder pain and Disability Index Urdu version(SPADI-U)
SPADI-U was Created to assess degree of pain and discomfort in carrying out activities of daily living by patients without any assistance. In the recent version 11-Point Numeric pain rating scale is used to rate each item. It has total 13 items, 5-items for evaluating pain and 8-items for disability.
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