Adhesive Capsulitis, Mirror Therapy, Range of Motion
Conditions
Keywords
post stroke patients, Range of motion correction, mirror therapy exercises
Brief summary
The estimated annual incidence of stroke in Pakistan is 250/100, 000. Upper limb impairments and post-stroke musculoskeletal complications such as pain, subluxation and restricted joint range of motion are commonly reported. Among many other shoulder impairments, adhesive capsulitis is a leading cause of limited mobility, reduced range of motion, and pain in stroke patients. The aim of the current study will benefit the clinicians and physiotherapists as it provide an insight to treat post stroke adhesive capsulitis. Effects of mirror therapy have been established but the literature does not provide best treatment approaches or modalities for different types of Hemiplegic shoulder pain. This study will address the limitations in treatment approaches concerning the shoulder joint and its mobility in post-stroke adhesive capsulitis. The study will be non-blinded randomized control trial, consisting of two groups. Study will be conducted over a period of 1 year. Subjects will be selected via non-probability purposive sampling technique using coin toss method followed by randomization into two groups (A and B).Ethical approval will be obtained from ERC FUMC. One group will receive mirror therapy while other will receive conventional exercises treatment for period of 6 weeks. Baseline tests will be performed before and after the intervention of mirror therapy & outcome measure assessments will be done after every 3 weeks for a total period of 6 weeks intervention period. Data will be entered and analyzed on SPSS version 22.
Detailed description
OBJECTIVES OF STUDY 1. To determine the effects of mirror therapy along with conventional therapy on improving shoulder joint range of motion in post-stroke adhesive capsulitis patients. 2. To determine the effects of mirror therapy along with conventional therapy on improving shoulder joint function in post-stroke adhesive capsulitis patients. 3. To compare the difference between the effects of mirror therapy with conventional therapy alone for improving shoulder mobility and function in post stroke adhesive capsulitis patients. HYPOTHESIS ALTERNATE HYPOTHESIS 1. There is a statistically significant effect of mirror therapy in improving the shoulder joint Range Of Motion in post-stroke adhesive capsulitis patients. (p \> 0.05). 2. There is a statistically significant effect of mirror therapy in improving the shoulder joint function in post-stroke adhesive capsulitis patients. (p \> 0.05). NULL HYPOTHESIS 1. There is a statistically significant effect of mirror therapy in improving the shoulder joint Range Of Motion in post-stroke adhesive capsulitis patients. (p \> 0.05). 2. There is a statistically significant effect of mirror therapy in improving the shoulder joint function in post-stroke adhesive capsulitis patients. (p \> 0.05).
Interventions
PROCEDUREMirror therapy along with conventional therapy
The experimental group will receive 20 minutes of conventional therapy followed by 20 minutes of mirror therapy training including 3 minutes of rest period between the interventions. WEEK OF INTERVENTION: TASK PERFORM IN FRONT OF MIRROR: WEEK :1-2 ACTIVE SHOULDER ROM: flexion, abduction, external-internal rotation movements of the intact extremity Increase the number of repetition according to the patient progression WEEK:3-4 ACTIVITIES TARGETING SHOULDER ROM: Cleaning the mirror with a towel(internal rotation+ abduction) Lifting a glass to drink ( flexion + abduction) Holding a brush to comb hair (external rotation WEEK:5-6 Overhead reaching (pasting stickers on the mirror)(internal rotation / abduction) Lifting a bottle overhead. ( flexion/abduction) Throwing a ball (external rotation) PROGRESSION OF TASK SPECIFIC MIRROR THERAPY: WEEK: 1-2 Increase the number of repetition according to the patient progression WEEK:3-4 Add water in glass Transfer glass
PROCEDUREControl Group
Details: Weeks wise: The control group will receive 20 mints of conventional therapy . 1. Heat pack & TENS to alleviate pain for 15 minutes 2. Shoulder isometric exercises 10 reps 3. Active and passive Range of Motion exercises 10 reps each 4. Codman exercises 10 reps each 5. Wand exercises 10 reps each
Sponsors
Foundation University Islamabad
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
40 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Both genders male and female * Age 40-70 years * Ability to understand and follow simple verbal instructions * Patients able to stand for at least 10-15 mins. * Ability to participate in a therapy session by coming to hospital. * Chronic Stroke (ischemic) patients (6 months-1year) with adhesive capsulitis (capsular pattern :external rotation\> abduction \> internal rotation) * Scores of \>24 on Montreal Cognitive assessment scale.
Exclusion criteria
* Upper limb fractures or cervical spine pathology or radiculopathy * History of upper limb surgery or trauma * Rotator cuff pathology or prolonged immobilization of upper limb * Rheumatic disease, fibromyalgia or any other musculoskeletal disorder that is altering upper extremity movement * Any other neurological condition
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Range of motion | 6 weeks | Goniometer will be used to assess range of motion at the shoulder |
| cognitive impairment | 6 weeks | Montreal cognitive assessment test that was used to detect mild cognitive impairment |
Countries
Pakistan
Outcome results
None listed