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Use of High Grade Mobilization Technique versus Cyriax Manipulation in Improving Abduction & External Rotation in Frozen Shoulder

Niraj Kumar, Associate Professor, Shri Guru Ram Rai Institute of Medical & Health Sciences, Patel Nagar, Dehradun, Uttarakhand 248001, India. , Shashank Kumar1 , Niraj Kumar2 , Jyoti Sharma3

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Physiotherapy and Occupational Therapy Journal 11(2):p 59-66, April-June 2018. | DOI: http://dx.doi.org/10.21088/potj.0974.5777.11218.3

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Abstract

Introduction: Shoulder pain is a common problem it is the third most common musculoskeletal complaint in the general population, and accounts for 5% of all general practitioner musculoskeletal consultation [1]. Frozen shoulder is a common cause of shoulder pain affecting 2–5% of the general population [2]. The term ‘‘frozen shoulder’’ was first coined by Codman and was subsequently defined as an idiopathic condition of the shoulder characterized by the spontaneous onset of pain in the shoulder with restriction of mobility at the glenohumeral joint in every direction [3,4]. Mobilization techniques can be performed as physiologic movements or accessory movements. In Maitland classification system, a concept of management in which accessory and physiologic passive movements of the joint are applied at various grades of intensity depending on a subject’s pain and joint stiffness [7].Massage has been used for alternatives therapy on musculoskeletal system a modern systematic and clinical technique called friction massage was employed by Cyriax [10].

Need of Study: To best of our knowledge no studies have been done on comparison of high grade mobilization and cyriax manipulation in subjects with frozen shoulder.

Methodology: Each subject was assigned into two groups by random sampling one Group A treated with High grade mobilization technique grade III & IV) with ultrasound and Group B receives Cyriax manipulation with ultrasound.

Conclussion: The study could be concluded as” There is no significant difference produced between the High grade mobilization technique and cyriax manipulation in reducing pain & increasing shoulder abduction and external rotation in frozen shoulder”.

Limitation: 1. The follow­up to see the long term effects of training is not done. 2. There is need to make an specific inclusion criteria to be developed that can identify which patients will most benefit from the HGMT. 3. This study has not taken into consideration of other than grade III & IV of Maitland mobilization grades. HGMT is not suitable for all kinds of patients. 4. Our sample size was small, and data were collected at only one hospital. 5. No control group. 

Future Research: 1. Future Studies should investigate whether HGMTs is effective in earlier stages of frozen shoulder in decreasing pain and improving ROM. 2. The duration of benefits from the cyriax manipulation may also be an important area for future study. 3. Sample size can be increased with inclusion of more number of subjects to generalize the effect in larger population. 4. Future study should consists of Randomized control TRAIL needed to know the long term effects of Cyriax over Maitland grade III and IV mobilization in frozen shoulder.

Kyewords: High Grade Mobilization Technique; Cyriax Manipulation; Therapeutic Ultrasound Machine; Universal Goniometry; Visual Analogue Scale & Ultra­Sonic Gel.

 

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DOI: http://dx.doi.org/10.21088/potj.0974.5777.11218.3

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