TECAR Therapy Combined with Proprioceptive Neuromuscular Facilitation for Adhesive Capsulitis: An Exploratory Comparison of Two Multimodal Rehabilitation Programs on Pain, Disability, and Shoulder Mobility

Vollständiger Abstract

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Adhesive capsulitis is characterized by shoulder pain, stiffness, and limited range of motion. Although multimodal rehabilitation is commonly used, it is unclear which combination of physiotherapy interventions is optimal. The aim of this exploratory study was to compare the short-term effects of TECAR therapy combined with proprioceptive neuromuscular facilitation (PNF) with those of standard physiotherapy in women with stage II adhesive capsulitis. This was a prospective, longitudinal, non-randomized, and exploratory study in which participants were assigned either the TECAR + PNF group or the standard physiotherapy group. Both intervention groups were given treatment three times a week for four weeks. Pain intensity and upper-limb disability were measured using the Visual Analog Scale (VAS) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Shoulder flexion, abduction, internal rotation and external rotation were measured using goniometry. Within-group changes were analyzed with the Wilcoxon signed-rank test, and exploratory baseline-adjusted analyses were conducted with ANCOVA. Both groups showed statistically significant improvements in pain and disability as a result of treatment. The median reduction on the VAS was about 5.00 points in the TECAR + PNF group and 2.00 points in the standard physiotherapy group. The median DASH scores fell by about 43.25 points and 16.00 points, respectively. Exploratory ANCOVA models showed that the TECAR + PNF group had more favourable adjusted VAS and DASH scores after treatment. Nevertheless, the groups differed at baseline in abduction, internal rotation, and external rotation, and a full pre–post analysis of changes in range of motion was not available. Therefore, the mobility results cannot be regarded as providing evidence of treatment superiority. We can conclude that in this small, non-randomised pilot study, the combination of TECAR and PNF led to greater short-term reductions in pain and upper-limb disability compared with standard physiotherapy. Nevertheless, these findings are still only preliminary and hypothesis-generating, and it is essential to carry out larger, adequately powered randomised controlled trials with concealed allocation, balanced baseline characteristics, complete analyses of changes in range of motion, and longer follow-up periods in order to confirm their clinical relevance and determine their comparative effectiveness.