Effect of Maitland Mobilization with and without Spencer Muscle Energy Techniques in Treatment of Frozen Shoulder

Background: Frozen Shoulder, or Adhesive Capsulitis, is an inflammatory condition marked by shoulder stiffness, pain, and significant loss of passive range of motion. The condition predominantly affects individuals between 40 and 60 years of age, with a higher prevalence in women. Various treatment approaches have been explored, yet no single approach has been universally accepted as standard. Physiotherapeutic interventions, such as Maitland Mobilization and Muscle Energy Techniques (METs), have shown promise in managing this condition. Objective: To compare the effectiveness of Maitland Mobilization with and without Spencer Muscle Energy Techniques in treating frozen shoulder. Methods: This randomized controlled trial was conducted over four months at the physiotherapy departments of Allied Hospital and DHQ Hospital in Faisalabad. Forty patients with unilateral frozen shoulder, aged 40 to 60 years, were randomly assigned to two groups: Group A (Maitland Mobilization with Spencer METs) and Group B (Maitland Mobilization only). Each group received three treatment sessions per week for six weeks. Outcome measures included the Shoulder Pain and Disability Index (SPADI), Numeric Pain Rating Scale (NPRS), and goniometric assessment of shoulder range of motion (ROM). Data were collected at baseline and post-intervention. Statistical analysis was performed using SPSS version 25, with independent sample t-tests for between-group comparisons and paired sample t-tests for within-group differences. Results: The Group A showed a significant improvement in NPRS scores from 5.95 ± 1.96 to 2.25 ± 0.72 (p = 0.001), SPADI scores from 86.20 ± 9.37 to 45.00 ± 9.54 (p = 0.014), and IADL scores from 18.55 ± 5.46 to 8.55 ± 4.83 (p = 0.011). Group B also showed improvements, with NPRS scores from 5.40 ± 1.35 to 3.55 ± 1.28 (p = 0.001), SPADI scores from 81.55 ± 12.84 to 57.20 ± 18.93 (p = 0.014), and IADL scores from 18.75 ± 4.63 to 13.65 ± 6.94 (p = 0.011). Group A demonstrated superior outcomes in shoulder flexion, extension, abduction, adduction, internal rotation, and external rotation (all p < 0.05). Conclusion: Both Maitland Mobilization and Spencer METs effectively reduced pain and improved ROM and functional capacity in patients with frozen shoulder. However, the combined treatment of Maitland Mobilization with Spencer METs was more effective than Maitland Mobilization alone. These findings suggest that integrating both techniques into clinical practice could enhance treatment outcomes for patients with adhesive capsulitis. Keywords: Frozen Shoulder, Adhesive Capsulitis, Maitland Mobilization, Muscle Energy Techniques, Spencer Technique, Shoulder Pain, Range of Motion, Physiotherapy, Rehabilitation Management