Effects of Maitland and Mulligan’s Mobilization Technique in Treatment of Post-CABG Adhesive Capsulitis

Background: Adhesive capsulitis is a condition characterized by pain and restriction of the shoulder range of motion. This may be predisposed by cardiac surgery, as patients need to immobilize their upper limbs after surgery. Objective: Effects of Maitland and Mulligan’s mobilization techniques in the treatment of post-CABG adhesive capsulitis. Methodology: In this randomized clinical trial, participants were recruited using convenience sampling, with a total of 48 individuals enrolled. Random allocation into two groups was carried out through a simple lottery method, assigning patients with post-CABG adhesive capsulitis from Faisalabad Institute of Cardiology to two groups. Males and females between 40 and 60 years of age presented with shoulder pain, restricted range of motion, and limited movements in abduction and external rotation were included, and those with neurological conditions, traumatic injuries, osteoarthritis, or bony abnormalities, history of surgery, or musculoskeletal disorders were excluded. Screening procedures included baseline evaluation using the numeric pain rating scale and shoulder pain and disability index scores to assess pain and shoulder disability, respectively. The therapist applied the Mulligan technique to Group A with three sets of 10 repetitions, with 30 sec' rest between sets, and the Maitland technique to Group B at the rate of 2-3 glides per second for 30 seconds, and each glide was given for 5 sets to meet the requirement of this treatment. Within-group analysis was done using a paired sample t-test. Between-group analysis was done using the Mann-Whitney U and independent t-tests. Results: Both of the treatment groups showed significant improvement in frozen shoulder patients with a p-value of numeric pain rating scale and shoulder pain and disability index, p=0.00, which is less than 0.05 (p<0.05). The comparison between both groups showed that the Mulligan mobilization showed more improvements than the Maitland mobilization, with a p-value (p<0.05). Conclusion: This indicates a significant improvement in treatment outcomes with both Mulligan and Maitland mobilization techniques for managing pain and disability in post-CABG adhesive capsulitis. However, the Mulligan mobilization demonstrates comparatively greater effectiveness than the Maitland mobilization.