Comparative Effects of Spencer Techniques and Movement With Mobilization in Improving Pain, Range of Motion, and Functional Disability in Rotator Cuff Syndrome.

Study Design and Procedures

This study is a single-blinded, randomized controlled trial designed to compare the effectiveness of the Spencer Technique combined with conventional therapy versus Mobilization with Movement combined with conventional therapy in individuals with shoulder dysfunction.

Screening and Recruitment

Participants who meet the predefined inclusion criteria will be recruited using a purposive sampling technique. Individuals who are readily available and willing to participate will be screened for eligibility.

Eligible participants will be informed about the study objectives, procedures, potential risks, and benefits. Written informed consent will be obtained prior to enrollment.

Sample Size and Allocation

A total sample of 52 participants will be included in the study. After baseline assessment, participants will be randomly allocated into two groups (Group A and Group B) using the lottery method.

Randomization

Randomization will be performed using a simple lottery method to ensure equal allocation into the two intervention groups.

Blinding

This study will follow a single-blinded design. Participants will be blinded to group allocation.

Intervention Duration and Assessment

Both groups will receive treatment for 6 weeks. Sessions will be conducted 3 times per week. Outcome assessments will be performed at baseline and at the end of the 6th week.

Each treatment session for both groups will have a total duration of 35 minutes.

Data will be analyzed using Statistical Package for the Social Sciences (SPSS) version 27.0.

Interventions Group A: Spencer Technique with Conventional Therapy

Participants allocated to Group A will receive the Spencer Technique in combination with conventional physiotherapy.

Conventional Therapy (15 minutes per session)

Moist Hot Pack (5 minutes):

A moist hot pack will be applied to the affected shoulder at a therapeutic temperature, with a towel placed between the pack and the skin.

Shoulder Stretching (10 minutes):

Passive stretching exercises will be performed to improve flexibility and range of motion. Each stretch will be held for 20-30 seconds and repeated 3-5 times. Stretching will include:

Shoulder flexion and extension

Shoulder abduction

Shoulder adduction

Internal and external rotation at 90° abduction

Spencer Technique (20 minutes per session)

The technique will be administered in seven sequential steps:

Shoulder extension with elbow flexion to restriction

Shoulder flexion with elbow extension

Circumduction with compression at 90° abduction

Circumduction with distraction at 90° abduction

Abduction with internal rotation

Adduction with external rotation

Stretching with fluid pumping maneuver (5-10 repetitions)

Dosage progression:

Weeks 1-3: 2 sets of 10 repetitions per step (1-minute rest between sets)

Weeks 4-6: 3 sets of 10 repetitions per step

Total session duration: 35 minutes (5 minutes hot pack, 10 minutes stretching, 20 minutes Spencer technique).

Group B: Mobilization with Movement with Conventional Therapy

Participants allocated to Group B will receive Mobilization with Movement (MWM) combined with conventional physiotherapy.

Conventional Therapy (15 minutes per session)

5 minutes moist hot pack

10 minutes passive shoulder stretching

Mobilization with Movement (20 minutes per session)

Participants will be positioned in sitting. The therapist will stabilize the shoulder girdle with one hand and apply a sustained glide to the humeral head using the thenar eminence of the other hand. The glide will be maintained perpendicular to the plane of movement and adjusted to remain pain-free.

Mobilization will be performed in:

External rotation

Internal rotation

Abduction

Flexion

Participants will actively move the shoulder during sustained glide until the onset of pain or discomfort.

Dosage:

3 sets of 10 repetitions

30-second rest between sets

3 sessions per week for 6 weeks

Total session duration: 35 minutes (5 minutes hot pack, 10 minutes stretching, 20 minutes mobilization).

Inclusion criteria

• • Patient from the age of 30 to 60.

• Patient suffering from rotator cuff syndrome. Patient with a history of pain in shoulder for more than 3 month.
• Patient with grade 1 and grade 2 of rotator cuff syndrome which doesn't require surgery.
• Patient with 2 positive Neers and Hawkins Kennedy test.
• Patient who haven't gone under any physical therapy treatment in the past 6 months.

Exclusion criteria

• • Patient with any cardiac problem like myocardial infarction.

• Patient with diagnosis of fibromyalgia.
• Patient with ongoing pregnancy.
• Patient with pain related to shoulder trauma.
• Patient with history of shoulder injury or shoulder surgery.
• Patient with associated symptoms like numbness and tingling.
• Patient who have taken corticosteroids injections of shoulder within a year.