MIRM Versus PIRT in Athletes With Glenohumeral Internal Rotation Deficit

Summary

Glenohumeral internal rotation deficit (GIRD) is common physical deficiency found both teenager and overhead many sports for example baseball, cricket, and tennis. GIRD is generally categorized as simultaneous deficits of internal rotation (IR) and total arc of motion in the dominant side. GIRD causes increase muscle stiffness, capsular changes ( hyperplasia) , muscle imbalance leads to humeral retroversion. The objective of the study will be to Compare the effects of Mulligan internal rotation Mobilization and post isometric relaxation technique on Pain, Range of motion and function in athletes with Glenohumeral Internal Rotation Deficit

This study will be a Randomise Control trial and will be conducted Pakistan cricket board acedmy and in outpatient department of physical therapy, AL REHMAN Hospital Lahore . The study will be completed within the time duration of six months . Convenient sampling technique will be used to collect the data. A sample size of 14 patients will be taken in this study Comparison of Mulligan internal rotation Mobilization and post isometric relaxation technique on Pain and function in athletes with Glenohumeral Internal Rotation Deficit. Patients will be divided into two groups. (Group A will be treated with mulligan MWM AND Sleeper stretch whereas Group B will be treated with post isometic relaxtion technique and sleeper stretch ). SPADI score will be used to ask some questions related to patients symptoms and daily activities and Numeric pain rating scale will be used to measure pain intensity. UNIVERSAL GONIOMETER will be used to measure ROM of shoulder joint All participants of the study will fill the SPADI score and Numeric pain rating scale on day 1 as pre treatment values and at the end of week 2 as post treatment values respectively . The collected data will be analyzed on SPSS 25.

Conditions

• Glenohumeral Internal Rotation Deficit
• Rotator Cuff Impingement
• Internal Rotation Contracture-shoulder

Interventions

OTHER

Mulligan Internal Rotation Mobilization

Mulligan Internal Rotation Mobilization (MIRM) Sleeper Stretch The therapist places a web of his one hand around patient's axilla and thumb of another hand in the bent elbow and the glide will be applied to the head of the humerus down in the glenoid fossa using thumb while stabilizing the scapula with another hand. Therapist will ensures that the other hand is stabilizing up and inwards. While this distraction is taking place the patient internally rotated his shoulder with the help of another hand, at the same time his affected upper arm will abduct by therapist abdomen distracting the head of the humerus laterally. The hand in axilla acts as a fulcrum. Mulligan MWM will be applied for 3 days alternate days by following the rule of 3

OTHER

Post Isometric Relaxation Technique

Post Isometric Relaxation Technique (PIRT) Sleeper Stretch The subject will be positioned supine on the treatment table with the shoulder and elbow, at 90 degree of abduction and flexion. The shoulder will be stabilized at the acromion process with one hand, and the other hand will be used to passively move the arm into internal rotation until the first barrier of motion will reached. The subject will be then instructed to perform a 5second isometric contraction of approximately 25% maximal effort in the direction of external rotation, against an opposing force provided at the distal forearm. Following the contraction, the subject will be instructed to internally rotate the arm toward the ground as a 30-second active assisted stretch will be applied. The subject will be instructed to relax, and a new movement barrier will then engage.

Sponsors & Collaborators

• Riphah International University

  lead OTHER

Principal Investigators

• Saima Zahid, PhD* · Riphah International University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

35 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2021-03-01

Primary Completion

2021-09-05

Completion

2021-09-10

Countries

• Pakistan

Study Locations