ORIGINAL PAPER
Comparative effect of Gong’s mobilization and Spencer technique to manage frozen shoulder
 
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1
Physiofit Physiotherapy Clinic, Vadakara, Kerala, India
 
2
Department of Physiotherapy, Co-operative Institute of Health Sciences, Thalassery, Kerala, India
 
3
Government Medical College, Kozhikode, Kerala, India
 
4
Department of Physiotherapy, Chairman, Quality Assurance Department, Deanship of Quality & Academic Accreditation, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
 
5
Department of Physical Therapy, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia
 
 
Submission date: 2021-11-28
 
 
Acceptance date: 2022-02-04
 
 
Publication date: 2022-05-17
 
 
Physiother Quart. 2023;31(3):57-64
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Physical therapy plays a significant role in managing frozen shoulder (FS), and it includes applying manual mobilization techniques to reduce pain, restore the extensibility of the shoulder capsule and increase range of motion (ROM). Objective: To compare the effectiveness of Gong's mobilization (GM) and Spencer technique (ST) in reducing pain, functional disability, and improving shoulder ROM on FS patients.

Methods:
A pre-and-post-test experimental study design was adopted, where thirty patients (n = 30) diagnosed with unilateral FS were selected and randomized into two groups of 15 using a simple random technique. Subjects in experimental group 1(EG-I) received ST technique and ultrasound therapy (US), with Codman’s pendular exercise (CPE). Whereas experimental group II (EG-II) received GM technique and US, with CPE. The intervention lasted five days and consisted of one session every day. Three variables were assessed to study the treatment effectiveness both at the pre-intervention and at the end of the first week: (i) pain intensity as measured by the Visual Analogue Scale; (ii) shoulder ROM as measured by a goniometer (abduction, flexion, and medial rotation (MR)); and (iii) functional disability as measured by SPADI (Shoulder Pain Disability Index).

Results:
The EG-II showed a better reduction in pain intensity (mean difference (MD) of 0.87), SPADI (MD of 7), and increase in shoulder ROM (MD: 'abduction': 15.76; ‘Flexion’: 15.67; ‘MR’: 10.33) than the EG-I at 0.05 levels of significance.

Conclusions:
Gong’s mobilization was found to be more effective than Spencer's technique with ultrasound therapy and CPE in treating patients with FS.

 
REFERENCES (37)
1.
Khyathi P, Vinod Babu K, Sai Kumar N, Asha D. Comparative effect of Spencer technique versus Mulligan’s technique for subjects with frozen shoulder – a single blind study. Int J Physiother. 2015;2(2):448–458; doi: 10.15621/ijphy/2015/v2i2/65255.
 
2.
Neviaser AS, Neviaser RJ. Adhesive capsulitis of the shoulder. J Am Acad Orthop Surg. 2011;19(9):536–542; doi: 10.5435/00124635-201109000-00004.
 
3.
Nagy MT, Macfarlane RJ, Khan Y, Waseem M. The frozen shoulder: myths and realities. Open Orthop J. 2013;7:352–355; doi: 10.2174/1874325001307010352.
 
4.
De la Serna D, Navarro-Ledesma S, Alayón F, López E, Pruimboom L. A comprehensive view of frozen shoulder: a mystery syndrome. Front Med. 2021;8:663703; doi: 10.3389/fmed.2021.663703.
 
5.
Wadsworth CT. Frozen shoulder. Phys Ther. 1986;66(12):1878–1883; doi: 10.1093/ptj/66.12.1878.
 
6.
Doly EA. Prevalence of frozen shoulder among diabetes mellitus patients: a cross cut survey. Ortho Rheum Open Access J. 2017;9(2):555759; doi: 10.19080/OROAJ.2017.09.555759.
 
7.
Chan HBY, Pua PY, How CH. Physical therapy in the management of frozen shoulder. Singapore Med J. 2017;58(12):685–689; doi: 10.11622/smedj.2017107.
 
8.
Hsu JE, Anakwenze OA, Warrender WJ, Abboud JA. Current review of adhesive capsulitis. J Shoulder Elbow Surg. 2011;20(3):502–514; doi: 10.1016/j.jse.2010.08.023.
 
9.
Kelly MJ, McClure PW, Leggin BG. Frozen shoulder: evidence and a proposed model guiding rehabilitation. J Orthop Sports Phys Ther. 2009;39(2):135–148; doi: 10.2519/jospt.2009.2916.
 
10.
Sun KO, Chan KC, Lo SL, Fong DYT. Acupuncture for frozen shoulder. Hong Kong Med J. 2001;7(4):381–391.
 
11.
Park SW, Lee HS, Kim JH. The effectiveness of intensive mobilization techniques combined with capsular distension for adhesive capsulitis of the shoulder. J Phys Ther Sci. 2014;26(11):1767–1770; doi: 10.1589/jpts.26.1767.
 
12.
Gong W, Lee H, Lee Y. Effects of Gong’s mobilization applied to shoulder joint on shoulder abduction. J Phys Ther Sci. 2011;23(3):391–393; doi: 10.1589/jpts.23.391.
 
13.
Yang J-L, Chang C-W, Chen S-Y, Wang S-F, Lin J-J. Mobilization techniques in subjects with frozen shoulder syndrome: randomized multiple-treatment trial. Phys Ther. 2007;87(10):1307–1315; doi: 10.2522/ptj.20060295.
 
14.
Roach KE, Budiman-Mak E, Songsiridej N, Lertratana­kul Y. Development of a shoulder pain and disability index. Arthritis Care Res. 1991;4(4):143–149; doi: 10.1002/art.1790040403.
 
15.
Maitland GD. Treatment of the glenohumeral joint by passive movement. Physiotherapy. 1983;69(1):3–7.
 
16.
Carlsson AM. Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain. 1983;16(1):87–101; doi: 10.1016/0304-3959(83)90088-X.
 
17.
Gong W, Jeong H, Kim E. The effects of Gong’s mobilization applied to the shoulder joint on shoulder medial rotation. J Phys Ther Sci. 2012;24(3):279–281; doi: 10.1589/jpts.24.279.
 
18.
Dilip JR, Vinod Babu K, Sai Kumar N, Akalwadi A. Effect of Gong’s mobilization versus Mulligan’s mobilization on shoulder pain and shoulder medial rotation mobility in frozen shoulder. Int J Physiother. 2016;3(1):132–139; doi: 10.15621/ijphy/2016/v3i1/88928.
 
19.
Patriquin DA. The evolution of osteopathic manipulative technique: the Spencer technique. J Am Osteopath Assoc. 1992;92(9):1134–1136, 1139–1146; doi: 10.7556/jaoa.1992.92.9.1134.
 
20.
Challoumas D, Biddle M, McLean M, Millar NL. Comparison of treatments for frozen shoulder: a systematic review and meta-analysis. JAMA Netw Open. 2020;3(12):e2029581; doi: 10.1001/jamanetworkopen.2020.29581.
 
21.
Ansari SN, Lourdhuraj I, Shah S, Patel N. Effect of ultrasound therapy with end range mobilization over cryotherapy with capsular stretching on pain in frozen shoulder – a comparative study. Int J Curr Res Rev. 2012;4(24):68–73.
 
22.
Balci TO, Turk AC, Sahin F, Kotevoglu N, Kuran B. Efficacy of therapeutic ultrasound in treatment of adhesive capsulitis: a prospective double blind placebo-controlled randomized trial. J Back Musculoskelet Rehabil. 2018;31(5):955–961; doi: 10.3233/BMR-150482.
 
23.
Dogru H, Basaran S, Sarpel T. Effectiveness of therapeutic ultrasound in adhesive capsulitis. Joint Bone Spine. 2008;75(4):445–450; doi: 10.1016/j.jbspin.2007.07.016.
 
24.
Sakpal TV. Sample size estimation in clinical trial. Perspect Clin Res. 2010;1(2):67–69.
 
25.
Boonstra AM, Schiphorst Preuper HR, Reneman MF, Posthumus JB, Stewart RE. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. Int J Rehabil Res. 2008;31(2):165–169; doi: 10.1097/MRR.0b013e3282fc0f93.
 
26.
Antonietti L, Luna N, Nogueira G, Ito A, Santos M, Alonso A, et al. Reliability index of inter- and intra-rater of manual goniometry and computerized biophotogrammetry to assess the range of motion of internal and external shoulder rotation. Med Exp. 2014;1(2):95–99; doi: 10.5935/MedicalExpress.2014.02.08.
 
27.
Breckenridge JD, McAuley JH. Shoulder Pain and Disability Index (SPADI). J Physiother. 2011;57(3):197; doi: 10.1016/S1836-9553(11)70045-5.
 
28.
Nicholas NS. Atlas of osteopathic techniques, 2nd ed. Philadelphia: Philadelphia College of Osteopathic Medicine; 1974.
 
29.
Knebl JA, Shores JH, Gamber RG, Gray WT, Herron KM. Improving functional ability in the elderly via the Spencer technique, an osteopathic manipulative treatment: a randomized, controlled trial. J Am Osteopath Assoc. 2002;102(7):387–396; doi: 10.7556/jaoa.2002.102.7.387.
 
30.
Cohen J. Statistical power analysis for the behavioral sciences. New York: Lawrence Erlbaum Associates; 1988.
 
31.
Goulet-Pelletier J-C, Cousineau D. A review of effect sizes and their confidence intervals. Part 1: The Cohen’s d family. Quant Methods Psychol. 2018;14(4):242–265; doi: 10.20982/tqmp.14.4.p242.
 
32.
Sutton RM, McDonald EL, Shakked RJ, Fuchs D, Raikin SM. Determination of minimum clinically important difference (MCID) in visual analog scale (VAS) pain and Foot and Ankle Ability Measure (FAAM) scores after hallux valgus surgery. Foot Ankle Int. 2019;40(6):687–693; doi: 10.1177/1071100719834539.
 
33.
Harsulkar SG, Rao K, Iyer C, Khatri SM. Effectiveness of Gong’s mobilization on shoulder abduction in adhesive capsulitis: a case study. Indian J Basic Appl Med Res. 2013;2(8):984–989.
 
34.
Haveela B, Dowle P, Chandrashekar P. Effectiveness of Mulligan’s technique and Spencer’s technique in adjunct to conventional therapy in frozen shoulder: a randomised controlled trial. Int J Adv Res Develop. 2018;3(1):253–260.
 
35.
Ward RC. Foundations for osteopathic medicine, 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2003.
 
36.
Kuchera WA, Kuchera ML. Osteopathic principles in practice, 2nd ed. Dayton: Greyden Press, LLC; 1994.
 
37.
Chaitow L. Muscle energy techniques, 4th ed. Edinburgh: Churchill Livingstone; 2013.
 
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