The effectiveness of Spencer muscle energy technique on pain, function and range of motion in patients with frozen shoulder: Systematic Reviews and Meta-analyses.

BACKGROUND

Frozen shoulder, also clinically known as adhesive capsulitis, is characterized by pain, stiffness, and gradual loss of passive or active glenohumeral range of motion. It leads to marked reduction in shoulder mobility, impacting daily activities and quality of life. This study aims to evaluate the effectiveness of the Spencer muscle energy technique (SMET) for frozen shoulder patients.

METHODS

For this systematic review and meta-analysis, we used PubMed, Cochrane Library, Embase, and Physiotherapy Evidence Database (PEDro) for searching from inception to January 20, 2025. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and independent authors selected clinical control trials that compare the effect of the Spencer muscle energy technique and comparative treatment in individuals with frozen shoulder. The outcomes were pain, function, and shoulder range of motion (ROM). Two authors independently did data extraction. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool, and the overall quality of the evidence was evaluated using the PEDro scale.

RESULTS

Nine studies were included in this review, and eight studies were included in the meta-analysis. Results indicated that SMET and other comparative treatments showed no statistical difference in the pain, flexion ROM, and abduction ROM standard mean difference (SMD). -0.19; 95% CI (-0.83, 0.45); I²=84%, (MD), 7.65; 95% CI (-11.7, 26.9); I²=95%, MD, 11.32; 95% CI (-9.10, 31.74); I²=96%, respectively. SMET was a statistically significant effect for shoulder function, SMD - 0.5; 95% CI (-0.78, -0.22); I² = 41%. SMET had an inferior effect on shoulder external rotation and extension ROM MD, 9.74; 95% CI (2.38, 17.10) I = 92, MD, 2.55; 95% CI (1.14, 3.96); I = 0 respectively.

CONCLUSION

This systematic review and meta-analysis indicates that SMET shows promise in improving shoulder function in patients with frozen shoulder; however, evidence is inconsistent for pain and ROM outcomes compared to other manual therapies. Further studies should explore the effect of SMET across different phases of frozen shoulder to determine the optimal timing for intervention through large, high-quality, and well-designed randomized control trials.

PROSPERO REGISTRATION NUMBER

CRD42024605780.