Comparative effect of Gong’s mobilization and Spencer technique to manage Frozen Shoulder

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. frozen shoulder, a wide range of beneficial treatments, both surgical and non-surgical, are available. The therapeutic management of frozen shoulder frequently differs significantly across clinicians and is based on personal experience rather than published research. This study contributed to the body of knowledge that both Gong's mobilization and the Spencer technique are found to have short-term effects on pain, functional disability, and shoulder range of motion. Further, Gong's mobilization is found to be more clinically significant than Spencer's approach, with greater improvements in shoulder flexion, abduction, medial rotation ROM, and functional disability. In addition, the study also provides evidence to the clinicians that Gong's mobilization with ultrasound therapy and a unique set of Codman pendular exercises can be used in combination with the physiotherapy treatment plan for patients with frozen shoulders. From the patients’ perspectives, this study’s findings will help understand the causes of frozen shoulder and how to manage it physiotherapeutically with the latest advanced techniques with pain-free, immediate, and short-term improvement. This study will also add evidence to the researcher’s knowledge of combined therapeutic interventions' effectiveness in managing