A case study on the effect of extracorporeal shock wave therapy (ESWT) combined with spencer muscle energy technique and home exercise program in alleviating the symptoms of adhesive capsulitis

Back ground: Adhesive Capsulitis (AC) or Frozen Shoulder, is a condition marked by pain and restricted range of motion in the glenohumeral joint, often linked to factors like diabetes, trauma, and autoimmune diseases. It progresses through three phases: Freezing, Adhesive, and Resolution. AC affects 2-5% of the population, with women being most commonly affected. Extracorporeal Shock Wave Therapy (ESWT) and Spencer Muscle Energy Technique (SME Technique) are used to treat AC. ESWT promotes tissue healing and pain relief, while SME Technique improves joint mobility through soft tissue manipulation. This study evaluates the combined effectiveness of ESWT, SME Technique, and a Home Exercise Program in reducing pain, improving ROM, and decreasing functional disability in AC participant. Aim of the Study: The aim of this case study was to evaluate the effect of combining Extracorporeal Shock Wave Therapy (ESWT), Spencer Muscle Energy Technique & a Home Exercise Program in alleviating the symptoms of Adhesive Capsulitis, with a focus on pain reduction, improvement in Range of Motion (ROM), and reduction in functional disability. Methodology: This case study had evaluated the combined effects of ESWT, SME Technique, and a Home Exercise Program on a 45-year-old female with right side shoulder pain & restricted ROM experiencing symptoms from past 4 months, with difficulty in preforming daily activities and was diagnosed with Adhesive Capsulitis by an Orthopaedician. Inclusion criteria included participant aged 35-60 years with pain and restricted ROM and experiencing symptoms for more than 2 months. The participant was excluded from the study if they had active infection on affected shoulder, history of any prior shoulder surgery or pregnancy. Treatment consisted of ESWT (8 Hz, 2000 pulses, 0.06-0.14 mJ/mm2), with SME Technique (7 steps of it), and a daily Home Exercise Program. The participant had received 3 sessions per week for 2 weeks. Outcome measures, including NPRS for pain, ROM via Goniometer and SPADI for functional disability, was assessed at baseline and after 2 weeks of intervention. Result: After 2 weeks of intervention, the participant demonstrated significant improvements: in NPRS score: pain intensity decreased from 7.5 to 3, with a reduction of 4.5 points in intensity, improvement in ROM: Flexion (+40°), Extension (+20°), Abduction (+40°), External Rotation (+30°), and Internal Rotation (+30°) and reduction in Functional Disability (SPADI): The score improved from 70% to 30%, a 40% reduction. These results indicate substantial pain relief, enhanced ROM, and improved functional capacity. Conclusion: This case study shows that combining ESWT, SME Technique, and a Home Exercise Program effectively reduces pain, improves ROM, and decreases functional disability in Adhesive Capsulitis, enhancing their quality of life.