Restoration of Normal Length of Upper Trapezius and Levator Scapulae in Subjects with Adhesive Capsulitis
Subscribe/Renew Journal
Objective: To find the effect of restoration of length of the shortened upper trapezius and levator scapula muscle with muscle energy technique and sustained passive stretching techniques along with Maitland joint mobilization for glenohumeral joint as compared to Maitland joint mobilization alone on range of motion and scapular position at rest in subjects with unilateral adhesive capsulitis.
Background: The glenohumeral hypomobility in adhesive capsulitis causes excessive scapular motion to compensate for the reduced gleno-humeral motion. The resulting tightness of upper trapezius and levator scapula causes an altered scapular position at rest. Restoring normal length of upper trapezius and levator scapulae will help to restore an optimal length-tension relationship and scapular position resulting in better improvement of glenohumeral range of motion.
Methods and measures: 60 male subjects with unilateral adhesive capsulitis were divided into group I and group II of 30 each. Baseline outcome measures assessed were shoulder ROM of flexion, abduction and external rotation and resting position of the scapula using the Lennie test. Group I received Muscle Energy Technique (MET) for upper trapezius and levator scapula along with Maitland joint mobilization for the glenohumeral joint. Group II received Maitland mobilization for the gleno-humeral joint. Outcomes were reassessed at 6 weeks.
Results: The results showed statistically significant improvement ROM in both groups with improvement being more in group I as compared to group II. However scapular position showed statistically significantly improvement only in group I with no improvement in group II.
Conclusion: Adding muscle energy techniques to the treatment of adhesive capsulitis gives better outcomes compared to treating with joint mobilization alone.
Keywords
- Norkin C. and Levangie P. 3rd edition. Jaypee Brothers 2001.
- Donatelli R.A. Physical therapy of the shoulder, 3rd edition; Churchill Livingstone 1997.
- Reeves B. Arthrographic changes in frozen shoulder and post traumatic stiff shoulders. Proc Soc Med 59:827, 1966.
- Neviaser J. S. Adhessive capsulitis of the shoulder: A study of the pathological findings in periarthritis of the shoulder. JBJS Am. 1945;27:211-222.
- Vermeulen H.M. Stokdijk M. Eilers P.H.C. Meskers C.G.M. Rozing P.M. Vliet Vlieland T.PM. Measurement of three dimensional shoulder movement patterns with an electromagnetic tracking device in patients with a frozen shoulder. Ann. rheum. Dis. 2002;61:115-120
- Jiu-Jenq Lin. Ying-Tai Wu. Shwu-Fen Wang. Shiau- Yee Chen. Trapezius muscle imbalance in individuals suffering from frozen shoulder syndrome. Clin Rheumatol 2005;24:569–575.
- Chaitow L. Muscle energy techniques, 3rd edition; Churchill Livingstone 2006.
- Sobush D. C. Simoneau G.G. Deitz K.E. Levene J.A. Grossman R.E. Smith W.B. The Lennie Test for measuring scapular position in healthy young adult females: A reliability and validity study, JOSPT Vol. 23 No. 1 Jan 1996.
- Maitland G.D. Peripheral manipulation, 3rd edition.
- Michlovitz S. Thermal agents in rehabilitation. 3rd edition FA Davis Co. Philadelphia 1990
- Kisner C. and Colby L. Therapeutic exercise, 5th edition 2007.
- 15 Babyar S. R. Excessive scapular motion in individuals recovering from painful and stiff shoulders: Causes and treatment strategies, Phys Ther. 1996;76:3.226-238.
- Vermeulen H.M. Obermann W.R. Burger B.J. Kok G.L. Rozing P.M. van den Ende C.HM. End-range mobilization techniques in adhesive capsulitis of the shoulder joint: A multiple-subject case report. Phys Ther. 2000;80:12.1204-1213.
Abstract Views: 663
PDF Views: 0