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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA
ANNEXURE-II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1. Name ! "#e $a%&'&a"e ( a&&)e** P.KHYATHI
K.T.G Girls Hostel,
Hegganahalli Cross, Vishwaneedam Post,
Sunkadakatte Via Magadi Road,
Bangalore 5!!"#.
+. Name ! "#e I%*"'""'% K.T.G COLLEGE OF PHYSIOTHERAPY
Hegganahalli Cross, Vishwaneedam Post,
Sunkadakatte Via Magadi Road,
Bangalore $ 5!!"#
. C)*e ! *"& a%& */0e$" MASTER OF PHYSIOTHERAPY
M*$2*3e2e"a2
D'*)&e)* ( S4)"* P#*'"#e)a45
6. Da"e ! A&m'**'% T C)*e
7. T'"2e ! T#e T4'$8
9COMPARITIVE EFFECT OF SPENCER TECHNI:UE VERSUS MULLIGAN;S
TECHNI:UE FOR SUBJECTS 8 A SINGLE
BLINDED STUDY.
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?. B)'e! )e*me ! "#e '%"e%&e& @)38
?.1 Nee& !) "#e *"&8
%dhesi&e 'a(sulitis or )ro*en shoulder is a s+ndrome de)ined in its (urest sense as
idio(athi' (ain)ul restri'tion o) the shoulder mo&ement that results in gloal restri'tion o) the
glenohumeral -oint. t is not asso'iated with a s(e'i)i' underl+ing 'ondition. t has also een
des'ried as a 'ondition o) unknown etiolog+ 'hara'teri*ed + graduall+ (rogressi&e, (ain)ul
restri'tion o) all -oint motions with s(ontaneous restoration o) (artial or 'om(lete motion o&er
months to +ears#, a))e'ting /051 o) the general adult (o(ulation and u( to /!1 o) the (atients
with diaetes
/
, mainl+ a))e'ts indi&iduals o) 2!0! +ears o) age with )emale (redominan'e. The
restri'tion o) the shoulder mo&ement is thought to e the result o) in)lammation and swelling in
the lining o) the shoulder -oint 3'a(sule4 and its asso'iated ligaments with resultant 'ontra'ture o)
the shoulder -oint 'a(sule. The lining loses its normal 'hara'teristi' o) the )leiilit+ and e'omes
sti)) and (ain)ul.6
The hallmarks o) )ro*en shoulder are sti))ness, di))i'ult+ slee(ing on the a))e'ted side,
(rogressi&e limitation o) the a'ti&e and (assi&e glenohumeral mo&ements es(e'iall+ adu'tion
and eternal rotation2.
7ro*en shoulder (rogressi&e through three 'lini'al (hases 3#4 (ain)ul (hase0 se&ere (ain
usuall+ worst at night and when l+ing on the a))e'ted side 3/0" months4 3/4 are sti))ening or )ro*en
(hase0 di))i'ult+ with sim(le a'ti&ities o) dail+ li&ing. Sti))ness (rogresses and leads to disused
atro(h+ 320#/ months4 364 Thawing (hase $ gradual in'rease in range o) motion and im(ro&ement
in (ain, although it ma+ rea((ear as sti))ness 'eases 350#/ months42.
Moili*ation is a (assi&e -oint mo&ement o) &ar+ing am(litudes o) low or high &elo'it+ when
a((lied to mus'uloskeletal tissue moili*es them de(ending on the desired e))e't. 8oint
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Moili*ation is im(ortant (art o) the treatment stimulating tissue heating, modulates (ain,
de'reases mus'le tone, in'rease nutrition to the tissues, in'reases -oint moilit+ and normali*es
(h+siologi'al mo&ement allowing etter )un'tion o) the mus'uloskeletal s+stem5.
S(en'er te'hni9ue is an arti'ulator+ te'hni9ue with se&en di))erent (ro'edures
used to treat shoulder restri'tion 'aused + adhesi&e 'a(sulitis. t is the high &elo'it+ low
am(litude te'hni9ue whi'h treats the restri'tions in glenohumeral -oint. n S(en'er te'hni9ue
(assi&e, smooth, rh+thmi' motion is designed to stret'h 'ontra'ted mus'les, ligaments and
'a(sules. Most o) the )or'e is a((lied at the end range o) motion. This te'hni9ue in'reases (ain
)ree range o) motion through stret'hing the tissues enhan'ing l+m(hati' )low and stimulating
in'reased -oint 'ir'ulation. Studies ha&e shown the e))e't o) S(en'er te'hni9ue on im(ro&ing
moilit+ and )un'tional ailit+ in su-e'ts with )ro*en shoulder.
Mulligan in'or(orated kaltenorns (rin'i(les o) (assi&e moili*ation. t is a
'omination o) an a'ti&e mo&ement with simultaneous (assi&e a''essor+ moili*ations, to
a'hie&e (ainless mo&ement + restoring the redu'ed a''essor+ glide. There)ore termed as
Moili*ations with mo&ement 3M:M4. n essen'e, the limited (ain)ul (h+siologi'al mo&ement
is (er)ormed a'ti&el+ while the thera(ist a((lies a sustained a''essor+ glide at right angles or
(arallel to the -oint to restore a restri'ted, (ain)ul mo&ement to a (ain )ree and )ull range state.
The 'omination o) -oint Moili*ation with a'ti&e mo&ement ma+ e res(onsile )or the ra(id
return o) (ain )ree mo&ement;. The studies ha&e shown the e))e't o) M:M on im(ro&ing moilit+
and )un'tional ailities in su-e't with )ro*en shoulder.
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used e))e'ti&el+ in the treatment o) )ro*en shoulder. Howe&er there are no studies )ound in the
literature whi'h 'om(are the e))e'ts o) S(en'er te'hni9ue &ersus mulligan=s te'hni9ue.
There)ore there is a need to )ind the 'om(arati&e e))e't o) two treatment te'hni9ues
)or su-e'ts with )ro*en shoulder. Hen'e, the (ur(ose o) the stud+ is to 'om(are the e))e'ti&eness
o) the S(en'er te'hni9ue &ersus mulligan=s te'hni9ue on im(ro&ement o) (ain, moilit+ and
)un'tional ailit+ )or su-e'ts with )ro*en shoulder.
Re*ea)$# :e*"'%
:hether there is an+ di))eren'e etween S(en'er te'hni9ue &ersus mulligan=s te'hni9ue on
im(ro&ing (ain, moilit+ and )un'tional ailit+ in su-e'ts with )ro*en shoulder.
H4"#e*'*8
N22 #4"#e*'*
There will e no signi)i'ant di))eren'e in e))e't o) S(en'er te'hni9ue &ersus mulligan=s te'hni9ue
on (ain, moilit+ and )un'tional ailit+ in su-e'ts with )ro*en shoulder.
E4e)'me%"a2 #4"#e*'*
There will e a signi)i'ant di))eren'e in e))e't o) S(en'er te'hni9ue &ersus mulligan=s te'hni9ue
on (ain, moilit+ and )un'tional ailit+ in su-e'ts with )ro*en shoulder.
?.+ Re'e@ ! L'"e)a")e8
Re'e@ % F)e% S#2&e)
S#a#/a Na@a A%*a)', e".,a2. +1+5studied one))e'ti&eness etween the treatment modalities
o) ultra sound thera(+ and end range Moili*ation o&er 'r+othera(+ and stret'hing in alle&iating
(ain o) (atients with )ro*en shoulder and )ound the ultrasound thera(+ with end range
Moili*ation (rodu'ed a etter result than 'r+othera(+ with stret'hing in redu'ing (ain in )ro*en
shoulder>.
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J'%-Ia% a%, e"., a2. +1+5
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motion in (ain)ul shoulder and in restoring motion to a shoulder in&ol&ed in adhesi&e 'a(sulitis#6.
R/e)" C.
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grou(s were 'om(ared with res(e't to (ain &isual %nalogue s'ale 3V%S4, shoulder range o)
motion and shoulder (ain and disailit+ inde 3SP%A4 s'ore. Both the treatment te'hni9ues
im(ro&ed the (ain VS% s'ore, ut the res(onse to Mulligan=s was etter#>.
Pame2a Te*, e".,a2. +5 studied to in&estigate the initial e))e'ts o) Mulligan=s moili*ation
with mo&ements 3M:M4 te'hni9ue on shoulder range o) motion in the (lane o) s'a(ula and (ain
(ressure threshold in (arti'i(ants with anterior shoulder (ain. Range o) motion and (ain (ressure
threshold were measured e)ore and a)ter the a((li'ation o) moili*ation with mo&ement, sham
and 'ontrol 'onditions. The+ )ound that this s(e'i)i' manual thera(+ treatment has an immediate
(ositi&e e))e't on oth Range o) Motion and (ain in su-e'ts with (ain)ul limitation o) shoulder
mo&ement#".
J'% Ia% Ya%, e".,a2. +5 'om(ared the use o) 6 moili*ation te'hni9ues end range
moili*ation 3
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R'$#a)& L Ga0&*'3, e".,a2. 15'arried out a stud+ on re&iew o) goniometr+ em(hasi*ing
reliailit+ and &alidit+ o) goniometri' measurements o) etremities s(e'ial em(hasis is (la'ed on
how the reliailit+ o) goniometr+ is in)luen'ed + instrumentation and (ro'edures, di))erent
among -oint a'tions and od+ regions (assi&e &ersus a'ti&e measurements, intratester &ersus
interester measurements, and di))erent (atient t+(es. n their re&iew the+ stated that 'lini'ians
should ado(t standardi*ed methods o) testing and should inter(ret and re(ort goniometri' results
as range o) motion measurements onl+, not as measurements o) )a'tors the+ ma+ a))e't range o)
motion//.
R'&&2e DL, e".,a2.15 'ondu'ted this stud+ to eamine the intratester and inter tester
reliailities )or 'lini'al goniometri' measurements )or shoulder (assi&e range o) motion 3PR@M4
using two di))erent si*es o) uni&ersal goniometers. Re(eated (assi&e range o) mo&ement
measurements o) shoulder )leion, etension, adu'tion shoulder hori*ontal adu'tion, hori*ontal
addu'tion, lateral rotation and medial rotation were taken o) / grou(s o) 5! su-e'ts ea'h
goniometri' (assi&e range o) mo&ement measurements )or the shoulder a((ear to e highl+
reliale when taken + the same (h+si'al thera(ist, regardless o) the si*e o) the goniometers
used/6.
B)e$3e%)'&e ID, e"., a2 +115 the shoulder (ain and disailit+ inde 3SP%A4 was de&elo(ed to
measure 'urrent shoulder (ain and disailit+ in an out(atient setting. There are / &ersions o) the
SP%A, the original &ersion has ea'h item s'ored on a Visual %nalog+ S'ale 3V%S4 and a se'ond
&ersion has items s'ored on a umeri'al Rating S'ale 3RS4. The 9uestionnaire was de&elo(ed
and initiall+ tested in a Mied diagnosis grou( o) male (atients (resenting to amulator+ 'are
re(orting shoulder (ain. The SP%A demonstrates good 'onstru't &alidit+, 'orrelating well with
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other region0s(e'i)i' shoulder 9uestionnaires. t is res(onsi&e to 'hange o&er time, in a &ariet+ o)
(atient (o(ulations and is ale to dis'riminate ade9uatel+ etween (atients with im(ro&ing and
deteriorating 'onditions. Some 'aution is ad&ised with regard to re(eated use o) instrument on the
same (atient/2.
A Pa2, e".,a2.+65 'ondu'ted a stud+ to 'om(are the &alidit+, res(onsi&eness to 'hange, and
user )riendliness o) )our sel) 'om(leted, shoulder s(e'i)i' 9uestionnaires in (rimar+ 'are. % 'ross
se'tional assessment o) &alidit+ and a longitudinal assessment o) &alidit+ and a longitudinal
assessment o) res(onsi&eness to 'hange o) )our shoulder 9uestionnaires was 'arried out.SP%A
and SR were most res(onsi&e to 'hange/5.
?. O/0e$"'e* ! "#e *"&8
P)'ma) /0e$"'e8
#. To determine the 'om(arati&e e))e't etween S(en'er te'hni9ue and Mulligan=s te'hni9ue on
im(ro&ing (ain, moilit+ and )un'tional ailit+ in the su-e'ts with )ro*en shoulder.
Se$%&a) /0e$"'e*8
/. To e&aluate the e))e't o) S(en'er te'hni9ue + anal+*ing (re and (ost inter&ention (ain,
moilit+ and )un'tional disailit+ in su-e'ts with )ro*en shoulder.
6. To e&aluate the e))e't o) mulligan=s te'hni9ue + anal+*ing (re and (ost inter&ention (ain,
moilit+ and )un'tional disailit+ in su-e'ts with )ro*en shoulder.
Ma"e)'a2* a%& Me"#&
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.1 S"& De*'%
Pre to (ost test e(erimental stud+ design with two grou(s0 S(en'er grou( and Mulligan=s grou(.
.+ Me"#&2
S"& S/0e$"*8
Patients with )ro*en shoulder with limited adu'tion and eternal rotation.
Sam42e *'e
The stud+ will e 'arried on 2! su-e'ts. /! su-e'ts will e taken in S(en'er grou( and /!
su-e'ts in Mulligan=s grou(.
S)$e ! &a"a
Stud+ will e 'arried out at KTG Hos(ital Bangalore.
Sam42'% Me"#&
Sim(le Random Sam(ling method
S"& D)a"'%
@ne week inter&ention, 5 sessions in a week.
Sam42e Se2e$"'%
I%$2*'% C)'"e)'a
Su-e'ts with age o) 2! to ! +ears.
Both male and )emale su-e'ts.
Dnilateral Primar+ %dhesi&e 'a(sulitis.
Su-e'ts ha&ing a (ain)ul sti)) shoulder )or at least 6 months.
Su-e'ts with more than 5!1 loss o) (assi&e mo&ement o) shoulder -oint 'om(ared to the
una))e'ted side.
E$2*'% C)'"e)'a
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Su-e'ts with re'ent histor+ o) surger+ on (arti'ular shoulder.
Rheumatoid arthritis.
Su-e'ts with histor+ o) )ra'ture around shoulder 'om(le.
Aiaetes Mellitus.
@steo(orosis or malignan'ies in the shoulder )un'tion.
eurologi'al de)i'its a))e'ting shoulder )un'tion.
Post traumati' su-e'ts.
Su-e'ts with rotator 'u)) ru(ture and, tendon 'al'i)i'ation.
Pain or disorders o) 'er&i'al s(ine, elow, wrist or hand.
Ma"e)'a2* *e&8
Pa(er
Pen
Pillow
Treatment 'ou'h
Chair
Dni&ersal goniometer
Shoulder (ain and disailit+ inde3SP%A4
Mulligan=s moili*ation elt
O"$me mea*)e*
Pain will e measured using Visual %nalogue S'ale 3V%S4. Reliailit+ o) V%S )or a'ute
(ain measurement as assessed + the ntra'lass Correlation Coe))i'ients 3CC4 a((ears to
e high/;.
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Moilit+ su'h as a'ti&e and (assi&e range o) motion 3R@M4 o) shoulder adu'tion and
eternal rotation will e measured using goniometer in degrees. Goniometri' range o)
motion measurements )or the shoulder a((ears to e highl+ reliale when taken + the
same (h+si'al thera(ist/6.
7un'tional disailit+ o) shoulder will e measured using shoulder (ain disailit+ inde
3SP%A4. SP%A demonstrates good 'onstru't &alidit+ and is res(onsi&e to 'hange
o&ertime/2.
Va)'a/2e*
I%&e4e%&e%" Va)'a/2e
S(en'er te'hni9ue, Mulligan=s te'hni9ue.
De4e%&e%" Va)'a/2e
Pain, shoulder adu'tion and eternal rotation R@M and )un'tional ailit+.
.. Me"#& ! &a"a $22e$"'%
E"#'$a2 $2ea)a%$e a%& $%*e%"
%s the stud+ in'ludes human su-e'ts ethi'al 'learan'e is otained )rom ethi'al 'ommittee o)
K.T.G. College o) Ph+siothera(+. %ll the su-e'ts )ul)illing the in'lusion 'riteria will e in)ormed
aout the stud+ and written 'onsent 3%
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ea'h su-e't was asked to withdraw a (a(er. /! su-e'ts with the letter F% were enlisted under
S(en'er grou( and the other /! su-e'ts with the letter FB under mulligan=s grou(. Com(lete
e(lanations were gi&en to oth the grou(s se(aratel+ ut the su-e'ts were unaware to whi'h
grou( the+ elonged. @n'e the su-e't agrees to (arti'i(ate in the stud+, an in)ormed written
'onsent 3%nneure0#4 was taken )rom the su-e'ts.
P)$e&)e ! B2'%&'%
Su-e'ts were linded on either t+(e o) inter&ention and to whi'h grou( the+ were elonged.
Throughout the treatment sessions, su-e'ts )rom oth the grou(s were not allowed to ha&e an+
intera'tion to ea'h other and the su-e'ts were not aware o) what kind o) treatment the+ re'ei&ed
and its e))e'ts.
P)e-"e*" "$me mea*)eme%"
Pain will e measured using V%S 3Visual analogue s'ale4.
7un'tional disailit+ will e measured using SP%A 3Shoulder (ain disailit+ inde4.
Range o) motion )or shoulder adu'tion and eternal rotation will e measured using
goniometer.
Pro'edure )or measuring R@M
Patient (ositionsu(ine l+ing or sitting.
Thera(ist (ositionside o) the (atient staili*ing the s'a(ula.
Pro'edure )or measuring the shoulder adu'tion
7ul'rum o) goniometer will e (la'ed o&er anterior as(e't o) a'romion (ro'ess. The stationar+
arm will e (arallel to the 'la&i'le and mo&ale arm along the middle o) the sha)t o) the humerus.
Then the (atient will e asked to adu't the arm. The mo&ement o) the humerus will e )ollowed
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with the mo&ale arm o) the goniometer until the su-e't ends the mo&ement. 7or (assi&e R@M
measurement the thera(ist will hold the (atient=s arm along with the mo&ale arm and (er)orm the
mo&ement (assi&el+. Both a'ti&e and (assi&e R@M is measured.
Pro'edure )or measuring the shoulder eternal rotation
) the su-e't will e in su(ine l+ing, a))e'ted shoulder will e out o) 'ou'h then the su-e't will
e asked to )le the elow and adu't the shoulder su'h that the+ are in "!o0"!o(osition. 7ul'rum
o) goniometer will e (la'ed o&er the ole'ranon (ro'ess o) the elow. Mo&ale arm will e (la'ed
(arallel to the )ore arm and stale arm will e (la'ed in the straight line to the mo&ale arm. Then
the su-e't will e asked to do eternal rotation o) the arm. The mo&ement o) the )orearm will e
)ollowed with the mo&ale arm o) goniometer till the su-e't ends the mo&ement. 7or (assi&e
R@M measurement the thera(ist will hold the )orearm o) the (atient along with mo&ale arm o)
the goniometer and (er)orm eternal rotation (assi&el+. Both a'ti&e and (assi&e R@M is noted.
P)$e&)e ! '%"e)e%"'% !) S4e%$e) )4
S4e%$e) "e$#%'e$ The S(en'er te'hni9ue will e (er)ormed when the (atient is l+ing on his
una))e'ted side with the a))e'ted shoulder )a'ing u(. Thera(ist will stand at his tale alongside
(atient, )a'ing the (atient. Thera(ist will use the 'e(hali' hand to staili*e 'la&i'le and s'a(ula
against thora and 'audal hand to introdu'e the mo&ements/>.
T '%$)ea*e "#e e"e)%a2 )"a"'%8
C')$m&$"'% @'"# $m4)e**'% "e$#%'e8 the (atient=s elow will e )leed and shoulder
will e adu'ted to "!o. Patients elow will e used as a (i&ot to rotate humerus 'lo'kwise and
anti 'lo'kwise. Slight 'om(ression will e a((lied on the glenohumeral -oint. The 'on'entri'it+ o)
the 'ir'les will e (er)ormed to the maimum toleran'e o) the (atient. The (ro'edure will e
re(eated >0#! times/>.
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C')$m&$"'% @'"# ")a$"'% "e$#%'e8 the (atient=s elow will e )leed and shoulder will e
maintained in adu'ted (osition. Tra'tion )or'e will e a((lied on glenohumeral -oint while
rotating the humerus in 'lo'k wise and 'ounter 'lo'k wise 'ir'les. The 'on'entri'it+ o) the 'ir'les
will e (er)ormed to the maimum toleran'e o) the (atient. This te'hni9ue 'an also e done with
elow in etension. the thera(ist will hold the (atient=s shoulder with his 'audal hand and mo&e
the (atients arm in the same (rogressi&e 'on'entri' 'ir'les. The (ro'edure will e re(eated >0#!
times/>.
T '%$)ea*e "#e *#2&e) a/&$"'% "e$#%'e8 The (atient=s elow will e )leed and the
shoulder will e adu'ted to "!
o
. Thera(ist will hold the elow o) the (atient with one hand and
shoulder with the other hand and eert u(ward or 'e(halad (ressure on elow to in'rease
adu'tion till the end range is )elt and then he will ring the arm a'k to the neutral (osition.
The (ro'edure will e re(eated )or > to #! times />.
P)$e&)e ! '%"e)e%"'% !) m22'a%;* "e$#%'e
.M22'a%;* Te$#%'e00The M:M te'hni9ue will e (er)ormed on the in&ol&ed shoulder as
des'ried + Mulligan. The su-e't will e in a relaed sitting (osition. Mulligan elt will e
(la'ed around the head o) the humerus to glide the humerus head a((ro(riatel+ 3(osterolateral and
slightl+ in)erior4. :ith one hand the thera(ist will hold the elt in (la'e sustaining the glide. :ith
other hand he will staili*e the s'a(ula inside the elt. The (atient will e asked to (er)orm slow
a'ti&e shoulder mo&ements 3adu'tion and eternal rotation4 to the end o) (ain )ree range. The
glide will e sustained during the mo&ement and released a)ter returning to the starting (osition.
The (ro'edure will e (er)ormed three sets o) #! re(etitions, with # minute rest etween sets. The
same (ro'edure will e (er)ormed 5 sessions in a week )or # week/",6!.
P*" "e*" "$me mea*)e*
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Pain will e measured using Visual %nalogue S'ale 3V%S4.
7un'tional disailit+ will e measured + shoulder (ain and disailit+ will measured +
shoulder (ain and disailit+ inde 3SP%A4.
Range o) motion will e measured using uni&ersal goniometer.
S"a"'*"'$a2 Te"*.
Statisti'al anal+sis will e (er)ormed + using SPSS so)tware )or window 3&ersion#4 and ( &alue
will e set as !.!5 3#0tailed h+(othesis4.
Aes'ri(ti&e statisti's and Chi s9uare test will e used to anal+*e aseline data )or demogra(hi'
data.
Dn(aired t test and :il'o on signed ranked test will e used to )ind the signi)i'an'e o)
(arameters (re to (ost test.
nde(endent t test and Mann :hitne+ D test will e used to )ind the signi)i'an'e o) (arameters
etween the grou(s.
.6 E"#'$a2 C2ea)a%$e
%s this stud+ in&ol&e human su-e'ts, the ethi'al 'learan'e has een otained )rom resear'h and
ethi'al 'ommittee o) K.T.G 'ollege o) (h+siothera(+, Bangalore as (er the ethi'al guidelines )or
Bio0Medi'al, resear'h on human su-e'ts, /!!! CMR, ew Aelhi.
L'*" ! Re!e)e%$e*
#. Iori B. Siegel, orman 8. Cohen, and
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%meri'an 7amil+ Ph+si'ian #""" %(ril #J 5"3;4#>2605!.
/. i'holas Shah, Mark Iewis. Shoulder adhesi&e 'a(sulitis s+stemati' re&iew o) randomi*ed
trials using multi(le 'orti'osteroid in-e'tions. Br 8 Gen Pra't /!!; %ugust #J 5;352#4/0;.
6. Management o) 7ro*en Shoulder a s+stemati' re&iew and de'ision anal+ti'al model 3HT%
o!"?#64.
2. :ong PIK, Tan HC%. % re&iew on 7ro*en shoulder. Singa(ore Medi'al 8ournal. /!#!J 5#3"4
"2.
5. Veli Pekka Si(ila. The rationale )or -oint moili*ation as a manual te'hni9ue. @rthos(ort
Ph+si'al Thera(+ /!#!.
. Roert C. :ard. 7oundations )or @steo(athi' Medi'ine. /nded. Ii((in'ott :illiams :ilkinsJ
/!!6.
;. Iinda 0#/.
>. Shaha* awa* %nsari, .Iourdhura-, Shiksha Shah, ikitha Patel. 0;6.
". 8ing0an Lang Mei0Hwa 8an, Chein0wei Chang, 8iu0-eng Iin. J#!>3##450>.
##. 8 Ii''iardoneJ R GamerJ K Cardarelli. Patient satis)a'tion 'lini'al out'omes asso'iated
with osteo(athi' mani(ulati&e treatment. 8ournal o) %meri'an @steo(athi' %sso'iation /!!/J
17
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#!/3#4#60/!.
#/. Knel 8%, Shores 8H, Gamer RG, Gra+ :T, Herron KM. m(ro&ing )un'tional ailit+ in the
elderl+ &ia the s(en'er te'hni9ue, an osteo(athi' mani(ulati&e treatment % randomi*ed 'ontrolled
trial. 8ournal o) %meri'an @steo(athi' %sso'iation /!!/J #!/3;46>;0".
#6..
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/#. Ieighann Iit'hr Kell+, Sharon %. Martino, 8oan 3#/4"!0"#6.
// Ri'hard I Ga-dosik and Ri'hard : Bohannon. Re&iew o) goniometr+ em(hasi*ing reliailit+
and &alidit+. 8ournal o) the %meri'an Ph+si'al Thera(+ %sso'iation #">;J ;3#/4#>;0;/.
/6. Riddle AI, Rothstein 8M, Iam RI, Goniometri' reliailit+ in a 'lini'al setting. Shoulder
measurements. Ph+si'al Thera(+ #">;J ;354>0;6.
/2. Bre'kenridge 8A, M' %ule+ 8H. Shoulder (ain and disailit+ inde 3SP%A4. 8ournal o)
Ph+siothera(+ /!##J 5;364#";.
/5. % Paul, M Iewis, M7 Shad)orth, PR Cro)t, A%:M Vander :indt, . i'holas S. i'holas. %tlas o) @steo(athi' Te'hni9ues. /nded. Classi' @steo(athi' Medi'al
:orksJ #";2.
/". 8ing0an Lang, Chein0wei Chang, Shiau0Lee Chen, Shwn07en :ang and 8iu0-eng Iin.
Moili*ation Te'hni9ues in su-e'ts with )ro*en shoulder s+ndrome Randomi*ed multi(le
treatment trial. 8ournal o) the %meri'an Ph+si'al Thera(+ %sso'iation /!!;J >;3#!4#6!;0#5.
19
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6!.%imie 7.Ka'hingwe, Beth Philli(s, S'ott :. Plunkett. Com(arison o) manual thera(+
te'hni9ues with thera(euti' eer'ise in the treatment o) shoulder im(ingement Randomi*ed
'ontrolled (ilot 'lini'al trial. The 8ournal o) Manual and Mani(ulati&e thera(+ /!!>J #324/6>0
/2;.
9 S'%a")e ! Ca%&'&a"e
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10 Rema)3* ! "#e G'&e
11
.
Name a%& De*'%a"'% !
11.1 G'&e 8 ASHA. D
ASSOCIATE PROFESSOR
11.+ S'%a")e
11. C-G'&e 8 VINOD BABU.K
ASSISTANT PROFESSOR
11.6 S'%a")e
11.7 Hea& ! De4a)"me%" 8
11.? S'%a")e
12
.
1+.1 Rema)3* ! "#e C#a')ma% ( P)'%$'4a2
1+.+ S'%a")e
ANNEXURE -1
CONSENT FORM
P.KHL%TH has e(lained to........... 3Su-e't name4 ...........the (ur(ose o) the resear'h, the
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(ro'edures re9uired, and the (ossile risks and ene)its to the est o) m+ ailit+.
......................................... ...............................................
n&estigator Signature Aate
College
Pla'e
CONSENT TO PARTICIPATE IN THE STUDY
P)4*e ! Re*ea)$#
ha&e een in)ormed that this stud+ is )or shoulder -oint (ain like
mine. %ll test measures are a''e(tale (h+siothera(+ inter&entions )or this (rolem. This stud+
will hel( (h+siothera(+ etter to understand the use o)
7/25/2019 Khyathi Final Synopsis
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treatment.
Be%e!'"*
understand that m+ (arti'i(ation in the stud+ will ha&e no dire't ene)it to me other than
(otential ene)it o) the treatment whi'h is (lanned to redu'e m+ (ain and in'rease moilit+ in
su-e't with 7ro*en Shoulder. The ma-or (otential ene)it is to )ind out whi'h treatment
(rogram is more e))e'ti&e.
C%!'&e%"'a2'"
understand that the in)ormation (rodu'ed + this stud+ will e'ame (art o) m+ resear'h
re'ord and will e su-e't to the 'on)identialit+ and (ri&a'+ regulation, ut will e stored in
the in&estigator=s resear'h )ile.
) the data are used )or (uli'ation in the literature or )or the tea'hing (ur(ose, no names will
e used, and other identi)iers, su'h as (hotogra(hs and audio or &ideota(es, will e used with
m+ s(e'ial written (ermission.
Re!*a2 )
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read and understand this 'onsent )orm. There)ore, agree to gi&e m+ 'onsent to (arti'i(ate as
a su-e't in this resear'h (ro-e't.
............................................... ..........................................
Parti'i(ant Signature Aate
.............................................. ..........................................
:itness to Signature Aate
ANNEXURE - +
V'*a2 A%a2 S$a2e VAS58
V%S is (resented as #!'m line.
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o (ain at one end and worst imaginale (ain at other end.
Patient is asked to mark a #!!mm line to indi'ate (ain intensit+.
I------------------------------------------------------------------------------------------------------I
o Pain Pain as ad as it 'ould (ossil+ e
) used as a gra(hi' rating s'ale, a #! 'm aseline is re'ommended
% #! 'm aseline is re'ommended )or V%S s'ale.
ANNEXTURE-
S#2&e) Pa'% a%& D'*a/'2'" I%&e SPADI5
Please (la'e a mark on the line that est re(resents +our e(erien'e during the last week
attriutale to +our shoulder (rolem.
Pa'% *$a2e
H@ *ee)e '* ) 4a'%
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Cir'le the numer that est des'ries +our (ain where ! N no (ain and #! N the worst (ain
imaginale.
%t its worstO ! # / 6 2 5 ; > " #!
:hen l+ing on the in&ol&ed sideO ! # / 6 2 5 ; > " #!
Rea'hing )or something on a high shel)O ! # / 6 2 5 ; > " #!
Tou'hing the a'k o) +our ne'kO ! # / 6 2 5 ; > " #!
Pushing with the in&ol&ed armO ! # / 6 2 5 ; > " #!
D'*a/'2'" *$a2e
H@ m$# &'!!'$2" & #ae
Cir'le the numer that est des'ries +our e(erien'e where ! N no di))i'ult+ and #! N so
di))i'ult it re9uires hel(.
:ashing +our hairO ! # / 6 2 5 ; > " #!
:ashing +our a'kO ! # / 6 2 5 ; > " #!
Putting on an undershirt or -um(erO ! # / 6 2 5 ; > " #!
Putting on a shirt that uttons down the)rontO
! # / 6 2 5 ; > " #!
Putting on +our (antsO ! # / 6 2 5 ; > " #!
Pla'ing an o-e't on a high shel)O ! # / 6 2 5 ; > " #!
Carr+ing a hea&+ o-e't o) #! (ounds
32.5 kilograms4
! # / 6 2 5 ; > " #!
Remo&ing something )rom +our a'k
(o'ketO
! # / 6 2 5 ; > " #!
I%"e)4)e"a"'% ! *$)e*
T"a2 4a'% *$)e8 7 1
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3ote ) a (erson does not answer all 9uestions di&ide + the total (ossile s'ore, eg. i) #
9uestion missed di&ide + 2!4
T"a2 &'*a/'2'" *$)e8 1
3ote ) a (erson does not answer all 9uestions di&ide + the total (ossile s'ore, eg. i) #
9uestion missed di&ide + ;!4
T"a2 S4a&' *$)e8 1 1
3ote ) a (erson does not answer all 9uestions di&ide + the total (ossile s'ore, eg. i) #
9uestion missed di&ide + #/!4
The means o) the two sus'ales are a&eraged to (rodu'e a total s'ore ranging )rom ! 3est4 to
#!! 3worst4.
Minimum Aete'tale Change 3"!1 'on)iden'e4 N #6 (oints
3Change less than this ma+ e attriutale to measurement error4