Vol. 6, Issue 7, Part D (2020)

Background: Adhesive Capsulitis is characterized by painful, progressive and disabling loss of Active & Passive ROM of Glenohumeral joint in multiple planes. Adhesive Capsulitis in Diabetes Mellitus (DM) may be attributed to increase in connective tissue stiffness and may be linked to non-enzymatic oxidative reaction of glucose and collagen causing formation of advanced glycation end products(AGE), resulting in changes in the biomechanical properties of tendon and capsule. The prevalence of Adhesive capsulitis in Diabetic patient is high. Reverse distraction technique involves distraction of scapula with Glenohumeral joint at various angles of ROM to stretch the contracted peri-articular structures. Post Isometric Relaxation (PIR) is the effect of increase in muscle relaxation and the decrease in muscle tone, after a brief period of sub maximal isometric contraction of the same muscle leading to pain relive and improved function.

Objective: To find the individual effect and Compare the effects of Reverse Distraction technique and Post Isometric Relaxation on Shoulder Flexion, Abduction External rotation ROM, Pain and Disability in patients with Diabetic Adhesive Capsulitis.

Method: 40 subjects within the age group of 40-60 years from in and around OPD & hospitals of Pune city were included in the study. Study design was Comparative study and Study duration was 6 months.

Procedure: Subjects were selected based on inclusion and exclusion criteria and divided into 2 groups, A and B by Random Allocation with Chit Method. Group A - Reversed Distraction technique with conventional exercises and Group B - Post-Isometric Relaxation with conventional exercises for 4 weeks with 3session/week.

Outcome Measure: ROM using Goniometer, Pain using Visual Analogue Scale and Disability using SPADI score.

Results: Intergroup analysis was done using unpaired t-test which showed significant improvement in Group B in relieving pain (p=<0.001),improving flexion and abduction (p=<0.005) and reducing disability (p=<0.001) whereas for external rotation it was not statistically significant (p=<0.577)

Conclusion: This study concluded that Post Isometric Relaxation Technique was more effective than Reverse Distraction Technique in improving Shoulder Flexion, Abduction ROM, reducing pain and decreasing Disability, whereas it was equally effective as Reverse Distraction Technique in improving External Rotation ROM.