Clinical Trial Details
— Status: Completed
Administrative data
NCT number |
NCT05924360 |
Other study ID # |
E-10840098-772.02-1672 |
Secondary ID |
|
Status |
Completed |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
June 23, 2023 |
Est. completion date |
August 26, 2023 |
Study information
Verified date |
August 2023 |
Source |
Istanbul Medipol University Hospital |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
The shoulder joint in the human body has a broader range of motion and opening compared to
other joints, resulting in a multitude of potential problems. The rotator cuff lesion is one
such issue. The rotator cuff is found in the subacromial space of the shoulder and results
from the compression of the subacromial bursa and the long head of the M.biceps muscle
between the humerus and the coracoacromial arch.
Upon reviewing the literature, therapeutic exercise and electrotherapy modalities are the
most preferred and studied areas. Alongside these, we also observe the usage of Mulligan and
Maitland techniques for the treatment of rotator cuff lesions.
The Mulligan technique was developed by Brian Mulligan in 1980, who lent his name to it. Also
known as mobilization with movement, this technique is often applied to the body's distal
joints. The Maitland mobilization technique is used to treat the relevant joint with specific
methods, particularly focusing on pain and stiffness in the joint. The technique's
application is graded from 1 to 4. Grade 1 is a small oscillation created without loading
throughout the joint movement. Grade 2 is performed with a slightly more oscillation from the
beginning of the movement. Grades 1 and 2 aim to restrict the pain stimulus going to the
central nervous system by stimulating the mechanoreceptor in the joint, thereby reducing the
sensation of pain.
Grade 3 is applied at a larger amplitude until a limitation is felt from the middle of the
joint movement. Lastly, grade 4 is applied to the limited small amplitude until tissue
resistance is felt. Grades 3 and 4 are used to alleviate joint stiffness by applying shorter
oscillation stimuli to a shorter tissue. The results of the use of Mulligan and Maitland
techniques have been demonstrated in different studies in the literature. However, as far as
we know, no study in the literature compares these two techniques in individuals with rotator
cuff lesions. Based on this gap in the literature, the purpose of this study is to
investigate the effects of the Mulligan technique and the Maitland method on pain, range of
joint motion, functionality, joint position sense, and quality of life in individuals with a
rotator cuff problem.
Description:
The aim of this study is to examine the effectiveness of the Mulligan and Maitland techniques
on pain, range of joint motion, functionality, joint position sense, and quality of life in
individuals diagnosed with rotator cuff lesions. Individuals diagnosed with a rotator cuff
lesion and admitted to Medipol University Hospital will be included in the study.
Participants will be randomly divided into three groups. A conventional treatment program
will be applied to individuals in all three groups five days a week for three weeks. The
first group will only receive conventional treatment. The second group will receive
conventional treatment plus the Mulligan technique. The third group will receive conventional
treatment plus the Maitland technique. The conventional treatment program will be applied to
all participants included in the study, consisting of wand, codman, active and passive
stretching exercises, and TENS. This program will be administered to all patients five days a
week. Wand exercises will be applied in the directions of flexion, abduction, extension,
internal and external rotation, and will consist of 10 repetitions. Codman exercises will be
applied in the directions of flexion, abduction, and circular, and will also consist of 10
repetitions. Active and passive stretching exercises will be applied in the directions of
flexion, abduction, and external rotation, and will consist of 10 repetitions. TENS
application will be administered for 20 minutes at 100Hz. All these exercises will be applied
to the control, Mulligan, and Maitland groups.
Mulligan Group: The mobilization with movement technique, a part of Mulligan applications,
will be performed twice a week in the directions of flexion, abduction, and external
rotation.
Maitland Group: The Maitland application will be applied in the anterior-posterior,
posterior-anterior, and caudal directions. The Maitland application will be administered at
grades 2-3. Patients in this group will receive the application in five sets of 30 seconds,
twice a week.