COMPARISON BETWEEN PHONOPHORESIS WITH THERABAND EXERCISES AND PHONOPHORESIS WITH SCAPULAR STABILIZATION EXERCISES IN SECONDARY FROZEN SHOULDER AFTER MASTECTOMY: A COMPARATIVE STUDY

Abstract

Background: Secondary frozen shoulder (adhesive capsulitis) is prevalent and disabling postmastectomy complication that greatly impairs the mobility of the shoulder and functional independence. The use of physical therapy modalities like phonophoresis, TheraBand resistance exercises, and scapular stabilization has been shown to have clinical promise in treating these impairments, but their relative efficacy in patients postmastectomy is not well studied. Objective: To determine the comparative effectiveness of phonophoresis with TheraBand exercises and phonophoresis with scapular stabilization exercises in enhancing pain, range of motion (ROM), and function in patients with secondary frozen shoulder after mastectomy. Methods: 32 subjects diagnosed with secondary adhesive capsulitis post-mastectomy were randomly assigned to two groups. Group 1 underwent phonophoresis with TheraBand exercises, and Group 2 underwent phonophoresis with scapular stabilization exercises. Treatment was given three times a week for six weeks. Outcome measures were Visual Analogue Scale (VAS) for pain, Disabilities of the Arm, Shoulder, and Hand (DASH) score, and ROM measurements for flexion, abduction, external and internal rotation. Paired t-tests were used for intra-group analysis with correlation and confidence intervals estimated. Results: Both groups exhibited statistically significant improvements for all the measurements of outcome (p < 0.05). Group 2 had better improvement in DASH and ROM values with higher correlations (r = 0.66 to 0.79) and higher effect sizes. Reduction in pain was better in the scapular stabilization group (VAS mean post-treatment: 2.01 ± 0.60 vs. 3.45 ± 0.72 in Group 1). Conclusion: Phonophoresis along with scapular stabilization exercises was superior to when paired with TheraBand training in increasing ROM, pain, and upper extremity function in secondary frozen shoulder following mastectomy. The addition of scapular-based rehabilitation could result in improved clinical outcomes in such patients.