Effectiveness of General Range of Motion Exercises and Scapular Stabilization Exercises along with Capsular Stretching among Diabetic Adhesive Capsulitis: A Quasi - Experimental Study

Introduction : Adhesive shoulder capsulitis, also known as frozen shoulder or arthrofibrosis, is a disabling musculoskeletal condition characterized by pain, progressive stiffness, and marked restriction of both active and passive shoulder movements due to inflammation and fibrosis of the glenohumeral joint capsule. The condition significantly affects activities of daily living and quality of life. In 1945, Julius Neviaser redefined the condition as adhesive capsulitis based on the inflammatory and fibrotic changes occurring within the joint capsule Objective: To compare the effectiveness of general range of motion exercises and scapular stabilization exercises along with capsular stretching with diabetic adhesive capsulitis. Materials and Methods: A quasi-experimental study was conducted in the department of physiotherapy at Mohamed Sathak AJ college of Physiotherapy, Chennai from January to August 2026. A total of 60 participants with Type 2 Diabetes Mellitus presenting with Stage 2 adhesive capsulitis. Participants were assigned to two equal experimental groups (n = 30 per group): Group A received general shoulder ROM exercises with manual capsular stretching, while Group B received targeted scapular stabilization exercises with manual capsular stretching. Interventions were administered 3 sessions per week for 4 consecutive weeks. Outcome parameters measured at baseline and post-intervention included active ROM (abduction, external rotation, internal rotation via universal goniometry), pressure pain threshold over periscapular and deltoid musculature (PPT via digital algometry), Shoulder Pain and Disability Index (SPADI), and the Short Form-36 Health Survey (SF-36 PCS and MCS). Within-group and between-group changes were analysed using paired and independent samples t-tests. Results: Scapular Stabilization Exercises with Capsular Stretching demonstrated statistically significant improvement across all primary clinical parameters compared to General ROM Exercises with Capsular Stretching (p = 0.000). Conclusion: While both protocols effectively treat diabetic adhesive capsulitis, Scapular Stabilization combined with Capsular Stretching is significantly more effective than General ROM exercises in relieving localized pain, restoring shoulder kinematics, reducing disability, and enhancing overall quality of life.