PTOtherHong Kong physiotherapy journal : official publication of the Hong Kong Physiotherapy Association Limited = Wu li chih liao2023

Comparison of Kaltenborn mobilization technique and muscle energy technique on range of motion, pain and function in subjects with chronic shoulder adhesive capsulitis.

Sandeep Pattnaik, Pravin Kumar, Bibhuti Sarkar and 1 others

PMID 37583922

WHAT IT FOUND

Both groups improved shoulder movement, pain and function after 10 sessions.

With heat, supervised exercises and home exercises, muscle energy technique gave better pain and function scores than Kaltenborn mobilization; movement scores were similar.

Key findings

01After 10 sessions, both groups improved: Kaltenborn group pain score moved from 6.25 to 3.00 and SPADI from 64.85 to 38.60 percent; muscle energy group pain score moved from 5.88 to 1.75 and SPADI from 62.27 to 30.01 percent.

02Between groups after 10 sessions, muscle energy group had lower pain score (1.75 vs 3.00) and lower SPADI percentage (30.01 vs 38.60), while external rotation and abduction passive range scores were similar.

03Both groups also received moist hot pack, supervised exercises and home exercises, so the paper cannot separate the effect of Kaltenborn mobilization or muscle energy technique from the other treatments.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The study was single-centred and had no untreated control group. Outcomes were measured only at the end of 10 sessions, with no follow-up for a condition where flare-ups and natural recovery are possible. The treating physiotherapist could not be blinded, and subjects were blinded only to allocation and outcome assessment. Analysis was per-protocol, not intention-to-treat, and 3 of 35 selected subjects were excluded from analysis. Both groups received moist hot pack, supervised exercises and home exercises, so the contribution of Kaltenborn mobilization or muscle energy technique alone cannot be isolated. The sample was limited to chronic frozen-stage adhesive capsulitis with more than 30% passive range limitation and moderate pain, so results may not apply to acute adhesive capsulitis or other stages. A single measurement of passive range was taken with a goniometer, and the SPADI was orally translated for Hindi or Bengali speakers.

Declared interests

The authors declared no conflict of interest and no funding. A separate funding line named the Singapore Institute of Technology as funder.

The easy way to misread this

Do not conclude that muscle energy technique alone caused the better pain and function scores. Every participant also received moist hot pack, supervised shoulder exercises and home exercises, and the study had no untreated control group. Only 32 participants completed the protocol, and outcomes were measured only after 10 sessions.

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