Effectiveness оf Mobilization аnd Ischemic Compression in Adhesive Capsulitis and Myofascial Pain Syndrome

Abstract

The purpose of the study was to investigate the effect of end- range mobilization and ischemic compression on the range of motion and pain scores in patients with adhesive capsulitis of the shoulder joint and myofascial pain syndrome in the thoracic spine. Materials and methods. 20 patients participated in the study. Goniometry of the shoulder joint, pain assessment on a numerical scale at the endpoints of the range of motion and trigger points (when applying a pressure of 2.5 kg×cm-2) were performed before the intervention, at the end of the first week of therapy, at the end of the second and third week. Physical therapy began after an examination and consultation with an orthopedic traumatologist. All patients received intensive end-range mobilization performed by a physical therapist and ischemic compression performed by the patient 5 times a week (3 weeks). Mobilization techniques from I to V degrees of intensity according to the Maitland classification system were used. Localization of active and latent trigger points was determined, their marking was carried out on an individual map, which was provided to the patient. The patient was instructed in techniques and methods of influencing trigger points of various locations. Compression was performed with an average or above average pain level and a duration of 30 seconds for each trigger point. Results and discussion. The existence of differences in the results of the amplitude was established, taking into account the time factor. The median score for active abduction increased by 65.5° and for flexion – by 115.5°. The amplitude of active internal rotation increased by 73°, and external – by 72°. According to Friedman's test, similar results were obtained when comparing pain indicators, which were assessed at the endpoints of the range of motion. The dynamics of medians was from 5 to 6 points. The median trigger point pain score decreased by 5.5 points after three weeks of physical therapy. The results obtained when studying the effectiveness of ischemic compression in patients with adhesive capsulitis of the shoulder joint and myofascial pain syndrome are consistent with the conclusions of previous studies and complement the data presented in the literature. Conclusion. Physical therapy, which consists of a combination of end-range mobilization and ischemic compression, is effective in increasing passive and active range of motion in the shoulder joint, reducing pain at the end of the range of motion, and reducing pain at trigger points