Effectiveness of Scapular Mobilization Combined with TENS in Post-Stroke Frozen Shoulder: A Randomized Controlled Trial

Abstract

Background: One of the most common disabilities associated with cerebrovascular disease is shoulder discomfort following a stroke. The quality of life might be affected. A cerebrovascular accident causes impairments to the upper motor neurons, which can lead to a variety of muscular paralysis around the shoulder joint, soft tissue abnormalities, and changes in muscle tone. The shoulder joint condition known as "frozen shoulder" is characterized by discomfort and a constant restriction of joint mobility in all directions, which leads to physical issues and a reduction in functional activity.
Objectives: This review sought to provide an overview of stroke, explain the origins and contributing factors of hemiplegic shoulder pain, and demonstrate the impact of scapular mobilization using TENS methods on shoulder pain following a stroke.
Methods: 45 individuals with a history of stroke and a diagnosis of frozen shoulder participated in a randomized clinical study. At ANS Hospital in Jaipur, participants were divided into three equal groups at random. Group C got both scapular mobilization (half of the time Gp-A) and TENS (half of the period Gp-B), whereas Group A received scapular mobilization and Group B received TENS. For six weeks, each group received daily supervised therapy sessions in addition to shoulder exercises. The Shoulder Pain and Disability Index (SPADI) for functional evaluation, the Numeric Pain Rating Scale (NPRS) for pain assessment, and goniometric measurement for shoulder range of motion were among the outcome measures. At baseline, three weeks, and six weeks, assessments were conducted. For significant changes (p < 0.05), an ANOVA was performed.
Results: Over the course of the trial, all groups showed substantial within-group gains in all end measures (p < 0.05). Group C outperformed Groups A and B in both the NPRS pain ratings and the SPADI disability index, according to between-group comparison.
Conclusion: For people with frozen shoulder, both the scapular mobilization and TENS technique were successful in reducing discomfort, shoulder mobility, and functional impairment. However, only TENS has been shown to be more helpful in relieving pain, while the scapular mobilization approach showed considerably greater success in increasing shoulder range of motion. Therefore, combining the two approaches may be beneficial as a focused manual therapy intervention for the treatment of frozen shoulder.

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