1. Research Article Critique Jill Garcia, SPTA
Efficacy of Scapular Stabilization Techniques in Improving Range of Motion and Functional Ability in Patients with Phase II Adhesive Capsulitis of the Shoulder Joint.
Research Article Critique
Jill Garcia, SPTA

2. Article Overview Authors of research:
Mithen, lecturer in physiotherapy and
Nizar, head of department of physiotherapy- both from Kerala state, India
Date published:
2012 Indian Journal of Physiotherapy & Occupational Therapy
Sources: 6 used ranging from

3. Common cause of shoulder pain
Painful
Gradual onset
Common cause of shoulder pain
Restricting
Adhesive Capsulitis

4. Definition:
“A condition of uncertain etiology characterized by significant restriction of both active and passive shoulder motion that occurs in the absence of a known intrinsic shoulder disorder.” -American Shoulder and Elbow Surgeons

5. Effects of Adhesive Capsulitis
Leads to tight pectoralis major, lattisimus dorci, teres major
Stretched & weakened middle/lower traps and rhomboids

6. Leading to early scapulothoracic motion…

7. Which decreases shoulder flexion

8. So…
Purpose of the research: “To find out the effect of scapular stabilization techniques along with conventional physiotherapy, in improving range of motion and functional ability in patients with phase 2 adhesive capsulitis.”

9. Sample: Research Design: Non-probability sampling method.
randomly split into a control group and experimental group
6 days a week over a 2 week period.
measurements were taken before and after.
30 participants
Unilateral Phase II capsulitis (4-12 months)
55-65 years old
Residing in Kerala state, India
All male

10. Treatments Control group Experimental group
“Conventional physiotherapy”
short wave diathermy
passive stretching
mobilization
ROM exercise and teaching HEP’s
“Conventional physiotherapy” along with
scapular strengthening

11. Scapular Strengthening Exercises
Scapular Clock exercise
Towel Slide
Lawnmower
Ball Stabilization
Serratus Anterior Punch

12. Results (refer to table 3-5)
*SPADI- experimental group improved by 54% and control group by 43%
*ABD ROM- experimental group increased 35 degrees and control 21 degrees
*ER ROM- experimental group increased 21 degrees and control 10 degrees

13. The research found:
a correlation between a stable scapula and improved ROM exists
that by strengthening the muscles around the scapula, this can lead to significantly better outcomes when treating patients with adhesive capsulitis

14. Article Critique

15. Strengths Weaknesses Recently performed (2 years) Credible authors
Good explanation of rationale for research
Both inclusion and exclusion criteria were listed in the article
Valid and reliable measurement tools
Small sample
All male (selection error)
Sources date back to 1975
Doesn’t include explanation for why each scapular exercise was chosen

16. Questions to Consider
What ROM/stretching exercises were included in the Home Exercise Programs? (it would be nice to know what the patients were doing at home
Who performed the measurements? And were they done accurately?
Who was supervising the exercises to make sure they were done accurately?
Did the before and after measurements happen by the same person? Was there good inter-rater reliability?
Were the chosen scapular exercises appropriate?
Is 2 weeks long enough?

17. How can we implement this article into our clinic?
External stabilization technique when stretching glenohumeral (pt supine)
Don’t forget the scapula
Incorporate scapular strengthening exercises
Any other exercises to consider?
Integrate the entire kinetic chain

18. Questions?
Comments?