Evaluating the Effectiveness of Cyriax Manipulation Technique Versus Conventional Physiotherapy Exercises in the Improvement of Function and Quality of Life in Type 2 Diabetic Individuals with Frozen Shoulder

Abstract

Background: Frozen Shoulder (Adhesive capsulitis) is a common musculoskeletal complication in individuals with Type 2 Diabetes Mellitus, often leading to chronic pain, restricted shoulder mobility, function and decreased quality of life. Cyriax Manipulation Technique, involving Deep transverse friction massage and Capsular stretching, is a manual therapy approach aimed at breaking soft tissue adhesions, restoring joint mobility and function.

Objective: To evaluate and compare the effectiveness of Cyriax Manipulation Technique versus Conventional Physiotherapy Exercises in improving shoulder function and overall quality of life in Type 2 Diabetic individuals with Frozen Shoulder.

Methods: A randomized controlled trial was conducted involving 30 participants diagnosed with Type 2 Diabetes Mellitus and Frozen shoulder. Participants were randomly allocated into two groups:

• Experimental Group received Cyriax Deep transverse friction massage combined with Capsular stretch or manipulation.
• Controle Group received Conventional Physiotherapy Exercises including pendulum exercises (Codmann exercises), active-assisted ROM (Pulley Exercises, Finger ladder exercise), Isometric strengthening exercise and Passive stretching.

Both groups underwent treatment sessions over a 4-week period, with adjunct Moist heat provided to all the participants.

Outcome measures included:

• Shoulder Pain and Disability Index (SPADI) for Functional assessment
• Short Form Health Survey (SF-36) for Quality-of-Life evaluation

Assessments were recorded at baseline and after 4 weeks of intervention.

Results: Both groups showed significant improvements in SPADI scores and SF-36 indices post-intervention (p < 0.05). However, Experimental Group (Cyriax Manipulation Technique) demonstrated significantly greater improvements in Shoulder function (SPADI score reduction) and several domains of Quality of life including physical functioning and pain subscales of the SF-36 (p < 0.01). This suggests that Cyriax Manipulation Technique may offer a more effective short-term benefit in reducing disability and improving perceived well-being among Type 2 Diabetic individuals with Frozen shoulder.

Conclusion: Cyriax Manipulation Technique is more effective than Conventional Physiotherapy Exercises in improving Shoulder function and enhancing Quality of Life in Type 2 Diabetes Mellitus individuals with Frozen shoulder. Cyriax Manipulation technique should be considered as an adjunct in physiotherapy rehabilitation protocols for this population.