Effectiveness of Proprioceptive Neuromuscular Facilitation (PNF) pattern for Adhesive capsulitis patients.

1. Proprioceptive Neuromuscular Facilitation Technique for Upper extremity: Patient position: The patent will in a supine lying position with the arms beside their body. They will be asked to relax their shoulders. Therapist position: The therapist will stand beside the affected side of the patient. Technique: “Flexion-abduction-external rotation” (D2F pattern) with elbow straight pattern of PNF with “hold relax” technique. It is a relaxing tool based on isometric contractions against maximum resistance to improve passive ROM and decrease pain. Isometric contractions for 5-8 seconds will be performed against maximum resistance for not balking antagonist muscles to contract, including a rotation at the limitation point. The technique is repeated a few times at the edge limitation point and then, proceeded. While applying the D2F pattern with elbow straight pattern of PNF, the therapist will use his hand to hold the patient’s upper limb on the opposite side of the hip in a posture of shoulder extension/ adduction/internal rotation, elbow extension, and forearm pronation. The physiotherapist then asks the patient to raise his hand overhead. The patient will attempt to perform this movement, by doing shoulder flexion/abduction/external rotation. During these movements, the therapist will support the patient’s arm with his other hand. Duration of treatment time: 5 to 7 minutes. Repetitions: 5 repetitions Hold time: 5 seconds Rest time: 2 seconds Treatment session: Total 4 weeks, 2 sessions per week. 2. Proprioceptive Neuromuscular Facilitation Technique for Scapula: A) Anterior Elevation & Posterior Depression Patient position: The patient lies on the unaffected side Therapist Position: Standing behind the patient, placing one hand superior border of scapula and other on inferior angle of the scapula Procedure: The patient is instructed to Push up and Push down the scapula against the manual resistance given by the therapist. Repetitions: 5 repetitions Hold time: 5 seconds Rest time: 2 seconds Session/Day: 2 times per week B) Posterior Elevation & Anterior Depression Patient position: Patient lies on the unaffected side. Therapist Position: Standing behind the patient, placing one hand on the superior border of the scapula and the other on the inferior angle of the scapula Procedure: The patient is instructed to Push back and Push the front of the scapula against the manual resistance given by the therapist. Repetitions: 5 repetitions Hold time: 5 seconds Rest time: 2 seconds Session/Day: 2 times per week This group also will receive 8 sessions of 30 minutes of treatment. The total duration of the study will be 4 weeks.