BACKGROUND: Adhesive capsulitis is a debilitating condition which causes the capsule of the gleno-humeral joint to thicken and contract progressively. The effectiveness of various non-operative methods has been demonstrated to improve the pain, range of motion (ROM) and functional status of patients with adhesive capsulitis. OBJECTIVE: This study aims to review recent evidence on the efficacy of physiotherapy interventions in the treatment of adhesive capsulitis. METHODS: PubMed, Physiotherapy Evidence Database (PEDro), Science Direct and Cochrane databases were searched for studies published since 2013. The search terms included: Frozen shoulder, adhesive capsulitis, physical therapy, rehabilitation, manual therapy, mobilization, exercise, education, and electrotherapy. The search was limited to studies published in English and studies that used human subjects. RESULTS: Quality scores of 33 articles were reviewed according to the Sackett’s critical appraisal criteria and the grades of recommendation were determined for physiotherapy interventions used in the studies. CONCLUSION: The empirical evidence suggests that certain physical therapy techniques and modalities are strongly recommended for pain relief, improvement of ROM, and functional status in patients with adhesive capsulitis, while others are either moderately or mildly recommended. However, the efficacy of one treatment modality over another is uncertain. The poor methodological rigors demonstrated in most of the reviewed studies emphasize the urgent need of properly conducted, adequately sampled randomized controlled trials with adequate follow up to determine the superior combination of treatment.

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Background: Handgrip strength (HGS) not only reflects the strength of the upper limb muscles; it also reflects the overall strength of the skeletal muscles and physical fitness. Further, it is being used as an indicator of nutritional status too. Undergraduate students have been described as having low physical fitness due to their sedentary lifestyle in many studies. Therefore, this study describes the HGS and its association with gender, hand dominance, Body Mass Index (BMI), hand and forearm anthropometries in a group of young undergraduate students of the University who do not participate in regular physical training.Methods: This is a cross-sectional descriptive study, and was conducted among healthy first-year residential undergraduate student population (n= 524, 350 females, 174 males, mean age= 21.31 ± 0.93). Main outcome measures were HGS, gender, hand dominance, BMI, hand length, hand span, handbreadth, forearm length, forearm girth, and wrist circumference.Results: HGS of the dominant hand of male students was 35.27 ± 5.91 kg, which is significantly higher (p< 0.05) than that of the females (19.52 ± 4.34 kg). However, it has a significant but weakly positive correlation with other variables measured except for forearm length. Conclusion:This study has provided an insight into the association of low HGS with physical inactivity in an academically oriented group where the BMI is within the normal range and the association of higher HGS with hand dominance and male gender.

Adhesive Capsulitis is a debilitating condition which causes the capsule of the Gleno-humeral joint to get thickened and contracted progressively. The prevalence of the disease is much higher in the middle aged and elderly community. It is characterized by pain in the shoulder, and advance towards the restriction of the active and passive glenohumeral motions and thereby obstructing the overall functional activities of the daily living. The effectiveness of various non-operative methods in the treatment of Adhesive Capsulitis has been demonstrated in the literature. Corticosteroid injections and the oral medications are known to be alleviating the pain levels and the inflammatory reactions but not the mobility of the affected joint. Joint mobilization techniques, electrotherapeutic modalities and other manual treatment methods are also found to be effective. In summary, this review focuses on the pathophysiology of the adhesive capsulitis, stages of the condition progress and various manual therapy interventions. Keywords: Gleno-humeral joint, frozen shoulder, rehabilitation, active and passive movements, functional activities.

Background: Distraction techniques are identified as cognitive processes that interfere with pain perception by preventing transmission of pain signals to the brain. The focus of these techniques is to direct the attention of the patient to a different stimulus other than the pain sensation. Dry needling (DN) is a mildly invasive technique which is used to treat pain associated with Myofacial trigger points (MTrPs). Even though previous studies have evaluated the influence of distraction techniques on the pain perception during various interventions, the effects during DN are not available in literature. Objectives: This study evaluated the influence of distraction technique on the perception of pain during MTrP-DN technique and also the influence of age and gender on the differences of pain perception. Methods: Sixty patients with non-specific neck pain were randomly assigned to either the control or interventional groups. Only DN was performed for the control group, while patients in the intervention group, were asked to count backwards from 10 to 1 while slowly breathing in and out without letting their attention be distracted during the DN. The level of pain perception was evaluated immediately after DN by using numeric rating scale (NRS). The ethical approval was obtained by the Ethics Committee of the National Hospital, Kandy. Results: A significant difference was noted (p<0 0.05) in NRS pain scores between control and the intervention groups regardless of the gender and the age category. Conclusion: The counting down distraction technique appears to be effective in improving pain perception during DN in the patients with non-specific neck pain.