COMPARE THE EFFECTIVENESS OF CAPSULAR STRETCHING AND MAITLAND MOBILIZATION IN REDUCING PAIN AND DISABILITY AND IN IMPROVING RANGE OF MOTION IN DIABETIC PATIENTS WITH CHRONIC FROZEN SHOULDER (FREEZING STAGE)

Abstract

Background: Frozen shoulder (adhesive capsulitis) is a prevalent musculoskeletal disorder characterized by progressive pain and global restriction of shoulder movement. The incidence is notably higher in patients with type II diabetes mellitus, often resulting in prolonged disability. Capsular stretching and Maitland mobilization are common physiotherapeutic interventions used to manage this condition, yet their comparative effectiveness in diabetic populations remains under-investigated.

Objective: To evaluate and compare the effectiveness of capsular stretching and Maitland mobilization in reducing pain and disability and in improving range of motion in diabetic patients with chronic frozen shoulder (freezing stage).

Methods: Thirty diabetic patients diagnosed with chronic frozen shoulder were randomly divided into two groups receiving either capsular stretching (Group A) or Maitland mobilization (Group B). Both interventions were administered over four weeks. Outcome measures included the Shoulder Pain and Disability Index (SPADI) and goniometric measurements of shoulder flexion, abduction, and external rotation recorded pre- and post-intervention.

Results: Both groups showed statistically significant improvement in SPADI scores and shoulder range of motion after intervention (p < 0.05). Group A showed a reduction in mean SPADI scores from 54.6 to 36.3 and an increase in abduction from 71.8° to 112.6°, whereas Group B improved in SPADI from 55.1 to 32.4 and abduction from 72.1° to 118.7°. No statistically significant differences were observed between the two groups post-intervention, suggesting comparable efficacy.

Conclusion: Capsular stretching and Maitland mobilization are equally effective physiotherapy techniques for improving pain, function, and range of motion in diabetic patients with chronic frozen shoulder. Selection between these techniques can be based on therapist expertise and patient preference.