Efficacy of Mulligan vs. GROM in Diabetic Adhesive Capsulitis: Does GROM Excels in Pain Relief and Functional Recovery

Abstract Introduction Adhesive Capsulitis is a chronic inflammatory condition of the shoulder capsule, characterized by progressive pain and restricted active and passive range of motion (ROM), predominantly affecting individuals aged 40-65. Its prevalence is 2% - 5% in the general population and rising to 20% among patients with diabetes mellitus. The condition progresses through a four-stages- painful onset, freezing, frozen, and thawing and significantly impairs activities of daily living and quality of life. The manual therapies like the Mulligan Technique and Gentle Range of Motion (GROM) exercises aim to restore mobility, and reduce pain/discomfort. However, comparative evidence in diabetic populations remains limited. This study evaluates the relative effectiveness of these two interventions in diabetic patients with Adhesive Capsulitis. Methodology A total of 40 patients (aged 45–65) with unilateral shoulder involvement and clinically confirmed ROM restriction were selected via convenience sampling and randomized into two equal groups. Group A received Mulligan Mobilization, while Group B underwent GROM Exercises. Outcomes were assessed based on pain scores and shoulder ROM (flexion, abduction, external rotation). Results Group B demonstrated GROM Exercises in which ROM improvements were statistically significant (p< 0.005) with a mean difference of 3.5 compared with Group A which is about 2.5. For shoulder flexion, Group B had a mean of 136.30 whereas 113.25 in Group A (mean difference is 23.05, p<0.005). Similarly, shoulder abduction and external rotation were significantly better in Group B, with mean differences of 19.00 and 11.80 respectively (p< 0.005). Conclusion Both interventions were effective in alleviating symptoms of Adhesive capsulitis. However, GROM exercises yielded greater improvements in pain relief, functional ability, shoulder mobility, suggesting this intervention will contribute to better functional outcomes, positively influencing activities of daily living and health-related quality of life in diabetic patients with adhesive capsulitis.