Abstract
Objective
To systematically review the literature for efficacy of isolated articular mobilization
techniques in patients with primary adhesive capsulitis (AC) of the shoulder.
Data Sources
PubMed and Web of Science were searched for relevant studies published before November
2014. Additional references were identified by manual screening of the reference lists.
Study Selection
All English language randomized controlled trials evaluating the efficacy of mobilization
techniques on range of motion (ROM) and pain in adult patients with primary AC of
the shoulder were included in this systematic review. Twelve randomized controlled
trials involving 810 patients were included.
Data Extraction
Two reviewers independently screened the articles, scored methodologic quality, and
extracted data for analysis. The review was conducted and reported according to the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. All
studies were assessed in duplicate for risk of bias using the Physiotherapy Evidence
Database Scale for randomized controlled trials.
Data Synthesis
The efficacy of 7 different types of mobilization techniques was evaluated. Angular
mobilization (n=2), Cyriax approach (n=1), and Maitland technique (n=6) showed improvement
in pain score and ROM. With respect to translational mobilizations (n=1), posterior
glides are preferred to restore external rotation. Spine mobilizations combined with
glenohumeral stretching and both angular and translational mobilization (n=1) had
a superior effect on active ROM compared with sham ultrasound. High-intensity mobilization
(n=1) showed less improvement in the Constant Murley Score than a neglect group. Finally,
positive long-term effects of the Mulligan technique (n=1) were found on both pain
and ROM.
Conclusions
Overall, mobilization techniques have beneficial effects in patients with primary
AC of the shoulder. Because of preliminary evidence for many mobilization techniques,
the Maitland technique and combined mobilizations seem recommended at the moment.
Keywords
List of abbreviations:
AC (adhesive capsulitis), MeSH (Medical Subjects Heading), PEDro (Physiotherapy Evidence Database), ROM (range of motion)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 15, 2015
Footnotes
Disclosures: none.
Identification
Copyright
© 2015 The American Congress of Rehabilitation Medicine.
