EFFECT OF GONGS MOBILIZATION WITH NEUROMUSCULAR ELECTRICAL STIMULATION VS CONSERVATIVE EXCERCISES AMONG ADHESIVE CAPSULITIS

Abstract

Background: Adhesive capsulitis, also known as frozen shoulder, is a self-limiting yet functionally disabling condition marked by progressive pain and reduced gleno-humeral joint mobility. It severely compromises daily function and quality of life. Conservative interventions such as physiotherapy and electrotherapy are commonly used to manage symptoms. However, combining manual therapy with neuromuscular stimulation may yield superior outcomes in pain relief and functional restoration.

Objective: To compare the effectiveness of Gong’s mobilization combined with neuromuscular electrical stimulation (NMES) versus conservative exercise therapy in reducing pain and improving functional mobility in patients with adhesive capsulitis.

Methods: A randomized controlled trial was conducted over six weeks at Gosha-e-Shifa Hospital, involving 36 participants aged 41–60 years diagnosed with stage II or III adhesive capsulitis. Participants were allocated into two groups: the experimental group received Gong’s mobilization with NMES, while the control group received conservative physiotherapy including TENS, hot/cold packs, ultrasound, and range of motion exercises. Pain intensity and shoulder disability were evaluated using the Visual Analogue Scale (VAS) and Shoulder Pain and Disability Index (SPADI), while range of motion (ROM) was measured using a goniometer. Statistical analysis was performed using SPSS-23 with paired and independent t-tests.

Results: The Gong’s mobilization with NMES group showed a mean post-treatment VAS score of 2.48 (mean difference = 0.853) and SPADI score of 20.89 (mean difference = 11.33). Post-intervention ROM improved significantly with flexion 164.28±11.2°, extension 45.28±4.7°, abduction 164.28±11.2°, internal rotation 72.67±5.2°, and external rotation 78.06±8.6°. The conservative group also showed improvement, but to a lesser extent: VAS 5.05 (mean difference = 2.572), SPADI 42.89 (mean difference = -22.0), and post-ROM flexion 131.50±15.7°, extension 39.22±3.62°, abduction 131.5±15.7°, internal rotation 59.56±3.82°, and external rotation 66.72±13.4°.

Conclusion: Both interventions were effective; however, Gong’s mobilization with NMES demonstrated superior improvements in pain reduction, shoulder mobility, and functional outcomes.