Osteopathic Manipulative Treatment (OMT), Shoulder Adhesive Capsulitis
Conditions
Keywords
Adhesive capsulitis, osteopathic visceral manipulation, physical therapy, visceral dysfunction
Brief summary
The aim of this study was to evaluate the effects of adding osteopathic visceral manipulation (OVM) to a standard physical therapy program on pain, functional disability, and range of motion (ROM) in patients diagnosed with right shoulder adhesive capsulitis (AC). A total of 49 patients aged between 40 and 65 years who were diagnosed with right shoulder AC were included in the study. Randomized patients received a standard physical therapy program for three weeks, consisting of 15 sessions (5 days per week) in both treatment groups. The standard program included hot pack application to the shoulder region for 20 min, conventional transcutaneous electrical nerve stimulation (TENS) for 20 min, and ultrasound therapy at 1.5 W/cm² for 10 min. In addition to the standard physical therapy program, Group 1 (n=25) received OVM once weekly, while Group 2 (n=24) received sham OVM once weekly. Pain was evaluated using the Visual Analog Scale (VAS), while functional disability was evaluated using the Shoulder Pain and Disability Index (SPDI). The ROM values were also recorded.
Interventions
OTHERphysical therapy program
In the OVM group, mobilization of the liver and diaphragm was performed. Liver mobilization was applied in three planes (coronal, transverse, and sagittal) for 5 min each, totaling 15 min, while the diaphragm technique was applied for 2 min.
OTHERSham (No Treatment)
In the sham OVM group, light pressure and touch were applied with the palm over the same points selected for OVM, without the intention of providing therapeutic effect.
Sponsors
Istanbul Medeniyet University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Intervention model description
Single-center, single-blind, randomized-controlled study
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age between 18 and 65 years * Presence of pain originating from the right shoulder region persisting for at least 6 weeks * Availability of two-view shoulder radiographs obtained prior to the study to exclude causes of shoulder pain other than AC * No local corticosteroid injection for shoulder pain within the previous 6 months * No physical therapy administered for shoulder pain within the previous 6 months * No use of non-steroidal anti-inflammatory drugs (NSAIDs) during the study period * Availability of laboratory assessments including: * Complete blood count (CBC) * Erythrocyte sedimentation rate (ESR) * Liver function tests (AST, ALT) * C-reactive protein (CRP) * Pain intensity score of at least 4 cm on the Visual Analog Scale (VAS, 0-10 cm)
Exclusion criteria
* History of shoulder fracture on the affected side * Prior shoulder surgery * History of traumatic shoulder instability (subluxation or dislocation) * History of shoulder or visceral organ surgery within the past 6 months * History of systemic or inflammatory disease or malignancy * Presence of metabolic or endocrine bone disease * Pregnancy * Neurological disorders affecting upper extremity function * Psychiatric disorders that could interfere with treatment compliance or symptom evaluation * Use of antiplatelet medication * Previous osteopathic treatment
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Pain (VAS) | From enrollment to the end of treatment at 4 weeks |
Secondary
| Measure | Time frame |
|---|---|
| Active shoulder ROM for abduction, flexion, internal rotation, and external rotation | From enrollment to the end of treatment at 4 weeks |
| Shoulder Pain and Disability Index (SPADI) | From enrollment to the end of treatment at 4 weeks |
Countries
Turkey (Türkiye)
Outcome results
None listed