Comparison of Theraband, Co-contraction and Isometric Exercises in Frozen Shoulder

Frozen Shoulder Clinical Trial

Official title:

Comparison of Theraband, Co-contraction and Isometric Exercises in Patients With Chronic Frozen Shoulder

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04603768
• Other study ID #: REC/RCRS/20/1021 Ayesha Zakir
• Status: Completed
• Phase: N/A
• Start date: December 30, 2019
• Est. completion date: September 30, 2020

Study information

• Verified date: October 2020
• Source: Riphah International University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This project was a Randomized control trial conducted to check the effects of in patients with chronic frozen shoulder theraband, isometric and co-contraction exercises so that we can have best treatment option for patients with chronic frozen shoulder. upper cross syndrome, duration was of 6months,convenient sampling was done, subject following eligibility criteria from DHQ hospital Sheikhupura, were randomly allocated in three groups via lottery method, baseline assessment was done, Group A participants were given baseline treatment along with theraband exercises , Group B participants were given baseline treatment along with co-contraction exercises and Group C were given baseline treatment along with isometric exercises on 3rd and 6th week, post intervention assessment was done via, Numeric pain rating scale(NPRS),Shoulder Pain And Disability Index (SPADI) and goniometric measurements of shoulder ranges ,3 sessions per week were given, data was analyzed by using SPSS version 26.

Description:

Frozen shoulder is among the most commonly reported problems to physicians, orthopedics and physical therapists. Even before reporting to clinics there is long history of using over the counter pain killers. Pain avoidance behaviors let the joint stiff so much that a clinician help is sought. Most times the cause of frozen shoulder is not known, therefore is termed as 'idiopathic frozen shoulder'.There is huge literature regarding the management of frozen shoulder and yet after the decades of research there are gaps in treatment options. In modern age of health care, it is common goal of every health care to make patient self-sufficient as early as possible. The self-care models have tremendous advantages. The current study has compared the use of theraband, co-contraction and isometric exercises. The current study was novel in a way that there is limited literature about treating shoulder hypomobility with physical strengthening exercises. All three methods were employed to see if they improve ranges along with accompanying pain and disability.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 36
• Est. completion date: September 30, 2020
• Est. primary completion date: August 30, 2020
• Accepts healthy volunteers: No
• Gender: All
• Age group: 30 Years to 70 Years

Eligibility

Inclusion Criteria:

• Idiopathic with 6 month chronicity.

• Patients with AROM/PROM less than or equal to 90 degrees.

• Affected shoulder has not more than 90 degrees of abduction & 50% decreased external rotation as compared to normal side/normal ROM values.

Exclusion Criteria:

• Traumatic & diabetic.

• Patient with any cervical or thoracic problem.

• Patients with any intra-articular injection in glenohumeral joint.

• Patients with rotator cuff complete tear.

• Patients with any other serious pathology/red flags

Related Conditions & MeSH terms

• Bursitis
• Frozen Shoulder

Intervention

Other:
• Theraband exercises
Group A performed theraband exercises for 6 weeks.In the first 2 weeks theraband with low resistance was used to perform exercises and then we proceeded gradually with higher resistance therabands.Theraband exercises was performed for Shoulder Flexion,Shoulder Extension Strengthening, Shoulder Internal Rotation Strengthening, Shoulder External Rotation Strengthening, Shoulder Abduction, Empty Can Exercise & Rowing Exercise with 8-10 reps, 3sec hold and 2-3 sets With each of these exercises
• Co-contraction exercises
Muscle co-contraction is the simultaneous contraction of the muscles acting around a joint. Subject stood upright & contracted both the groups (agonist and antagonist) simultaneously without bringing movement at shoulder joint with 6-8 reps , 3sets & 5- 15 seconds duration of sustained self-arm bracing or stiffening was maintained. On eligible participants baseline assessment was done,3 session were given 3days per week, post intervention assessment was taken at 3rd and 6th week
• Isometric exercises
Isometric exercises of shoulder were performed in subjects for 6 weeks which included isometric Shoulder flexion, shoulder abduction isometric exercise, isometric shoulder external rotation, isometric shoulder internal rotation & isometric shoulder extension with 8-10 reps, 5 sec hold and 2 sets. On eligible participants baseline assessment was done,3 session were given 3days per week, post intervention assessment was taken at 3rd and 6th week

Locations

Country	Name	City	State
Pakistan	DHQ hospital	Sheikhupura	Punjab

Sponsors (1)

Lead Sponsor	Collaborator
Riphah International University

Country where clinical trial is conducted

Pakistan, 

References & Publications (9)

Alptekin HK, Aydin T, Iflazoglu ES, Alkan M. Evaluating the effectiveness of frozen shoulder treatment on the right and left sides. J Phys Ther Sci. 2016 Jan;28(1):207-12. doi: 10.1589/jpts.28.207. Epub 2016 Jan 30. — View Citation

Chan HBY, Pua PY, How CH. Physical therapy in the management of frozen shoulder. Singapore Med J. 2017 Dec;58(12):685-689. doi: 10.11622/smedj.2017107. — View Citation

Cho CH, Bae KC, Kim DH. Treatment Strategy for Frozen Shoulder. Clin Orthop Surg. 2019 Sep;11(3):249-257. doi: 10.4055/cios.2019.11.3.249. Epub 2019 Aug 12. Review. — View Citation

Hanchard N. Exercise classes supervised by a physiotherapist may be better at restoring function after frozen shoulder than individual physiotherapy. J Physiother. 2014 Dec;60(4):236. doi: 10.1016/j.jphys.2014.08.011. Epub 2014 Oct 23. — View Citation

Lin HC, Li JS, Lo SF, Shih YF, Lo CY, Chen SY. Isokinetic characteristics of shoulder rotators in patients with adhesive capsulitis. J Rehabil Med. 2009 Jun;41(7):563-8. doi: 10.2340/16501977-0378. — View Citation

Moradi M, Hadadnezhad M, Letafatkar A, Khosrokiani Z, Baker JS. Efficacy of throwing exercise with TheraBand in male volleyball players with shoulder internal rotation deficit: a randomized controlled trial. BMC Musculoskelet Disord. 2020 Jun 13;21(1):376. doi: 10.1186/s12891-020-03414-y. — View Citation

Roach KE, Budiman-Mak E, Songsiridej N, Lertratanakul Y. Development of a shoulder pain and disability index. Arthritis Care Res. 1991 Dec;4(4):143-9. — View Citation

Sato H, Maruyama H. The Effects of Indirect Treatment of Proprioceptive Neurosmuscular Facilitation. Journal of Physical Therapy Science. 2009;21(2):189-

Shishir M, Abraham MM, Kanagasabai R, Najimudeen S, Gnanadoss JJ. Home Based Exercise Program for Frozen Shoulder-Follow-up of 36 Idiopathic Frozen Shoulder Patients. Indian Journal of Physiotherapy and Occupational Therapy. 2013;7(3):221.

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Goniometric measurement of Shoulder ROM	A goniometer is an instrument which measures the available range of motion at a joint.Flexion, Extension,Adduction,Abduction, Internal Rotation,External Rotation	3rd day
Primary	Numeric Pain rating scale (NPRS)	Changes from base Line Numeric Pain rating scale is a scale for pain starting from 0-10. where 0 indicate no pain and 10 indicate severe pain	3rd day
Secondary	SPADI	The Shoulder Pain and Disability Index (SPADI) is a self-administered questionnaire that consists of two dimensions, one for pain and the other for functional activities. The pain dimension consists of five questions regarding the severity of an individual's pain. Functional activities are assessed with eight questions designed to measure the degree of difficulty an individual has with various activities of daily living that require upper-extremity use. The SPADI takes 5 to 10 minutes for a patient to complete and is the only reliable and valid region-specific measure for the shoulder.	3rd day