Volume 8, Issue 2, February – 2023 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165

The Effectiveness of the Combination of

Neuromuscular Taping (NMT) and Codman
Pendulum Exercise to Improve the Functional Ability
of the Shoulder in Patients with Frozen Shoulders
Yose Rizal1, Ayu Permata2, Nova Relida Samosir3, Sari Triyulianti4, Tyagita Widya Sari5
1,2,3,4
Vocational Program of Physiotherapy
Faculty of Pharmacy and Health Sciences, Abdurrab University
5
Faculty of Medicine, Abdurrab University
Pekanbaru, Indonesia

Abstract:- The primary symptoms of frozen shoulder, one periarticular tissues, synovial joint thickening, articular surface
of the most prevalent disorders or complaints affecting the adhesions, etc [3], and is associated with prolonged and often
shoulder joint, are pain and restricted range of motion. marked disability of the shoulder with severe pain, loss of
Several conditions, including diabetes and movement, and sleep disturbance [4].
hyperthyroidism, are thought to be connected to the
development of frozen shoulder. Other causes of frozen Frozen Shoulder (FS) is a common shoulder disease that
shoulder include degeneration or stiffness of the shoulder has a progressive loss of shoulder motion and affects 2-5% of
joint capsule tissue. the general population [5]. The prevalence among the diabetic
population and those with thyroid gland pathologies,
The goal of this study is to determine how well particularly hypothyroidism, may increase to 10 to 38% [2].
patients with frozen shoulder may improve their
shoulder's functional capacities by combining the use of The incidence among women is 1.6 to 4 times higher than
Neuromuscular Taping (NMT) and Codman Pendulum that of men. Blacks/African Americans and Hispanics/Latinos
Exercise technique. This study aims to prove the also show a higher prevalence [2]. The peak age is 56 years,
effectiveness of Neuromuscular Taping (NMT) and and the condition occurs slightly more frequently in women
Codman Pendulum Exercise as a physiotherapeutic than men. This condition is rare before the age of 35 and is
approach in managing to improve shoulder functional uncommon in patients over 70 years of age [1].
ability in frozen shoulder. Quasi-experimental research
with pre and post tests but no control group design is the Arthroscopic and imaging studies have shown that the
methodology employed. Research shows a value P = 0.000 capsular tissue of the glenohumeral joint including the rotator
(P<0.05) with a mean value of 13.227±4.995, which means interval is the main pathological part [6]. For those who have
that the intervention of Neuromuscular Taping (NMT) shoulder pain, aches or stiffness, there is a significant
and Codman Pendulum Exercise was significant for proportion that has been detected as a risk factor for idiopathic
improving shoulder functional ability in frozen shoulder. frozen shoulder, such as diabetes, thyroid dysfunction,
hypercholesterolemia, and hypertension [1].
Keywords:- Frozen Shoulder, Physiotherapy, Neuromuscular
Taping, Codman Pendulum Exercise. The exact pathophysiological mechanism is unknown, but
is thought to be a chronic inflammatory process of the
I. INTRODUCTION synovium and soft tissue followed by a fibrotic picture similar
to Dupuytren's disease, due to increased collagen formation,
Active and passive shoulder movement are functionally myofibroblasts and fibroplasia. Several arthroscopic and
restricted in people with frozen shoulder [1]. Pain, stiffness, histological studies have shown that this condition is caused by
and a progressive loss of motion are indications of frozen contractures of the glenohumeral capsule, particularly the
shoulder (FS), which develops suddenly. It sometimes, but not coracohumeral ligaments in the rotator interval [7].
always, manifests as a fibrotic state with capsule and ligament
involvement as well as inflammation-based contractures that Codman Pendular Exercises are known as Codman
shorten the shoulder's range of motion [2]. exercises. This exercise is used to passively mobilize the
glenohumeral joint. This exercise involves the patient to
Frozen Shoulder (FS) is a disease caused by tissue perform movements such as moving the hands or arms without
degeneration, thickening of the joint capsule, and reduced contracting [8].
volume of the glenoid cavity. It is one of the most frequently
observed shoulder diseases in clinical management that has
various aetiologies such as degenerative changes in

IJISRT23FEB772 www.ijisrt.com 950

Volume 8, Issue 2, February – 2023 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Pendulum exercises, known as Codman exercises, have The findings of the Shapiro-Wilk test-based Normality
been used extensively for decades with the intention of test is presented in Table 2. The average SPADI Index Score
passively mobilizing the glenohumeral (GH) joint without value before treatment was 72.05+5.305 with a P value of
harm to recently injured or repaired tissue. Using this 0.921, whereas the average value after treatment was
technique, the arms can be moved back and forth, side to side 58.828.045 with a P value of 0.415. As P> 0.05 indicated that
or in a circular motion. These exercises have become an the data was normally distributed, the Paired Sample T-Test
integral part of many rehabilitation protocols. [9] was applied to this treatment group.

When Neuromuscular Taping (NMT) is administered Table 3: Shoulder Pain and Disability Index (SPADI) Value
appropriately, it can alleviate pain and make it easier for Before and After Intervention Neuromuscular Taping (NMT)
lymphatic fluid to pass through skin folds. It is a procedure and Codman Pendulum Exercise
that includes putting elastic adhesive tape to the skin. As the Samples (n = 22) Mean±SD P
tape is put on, the skin becomes wrinkled as the body moves. Before and after 13.227±4.995 0.000
These folds enhance posture, lymphatic drainage, blood flow,
pain relief, and muscle and joint action [10]. With a significant value of P = 0.000 (P0.05) and a mean
value of 13.227±4.995, Table 3 details the outcomes of the
II. RESEARCH METHOD variations before and after the intervention.
In order to compare the effectiveness of Neuromuscular Research by Kimberi [11], who explains that patients
Taping (NMT) and the Codman Pendulum Exercise before with frozen shoulder can be successfully treated with
and after the intervention, a Quasi experimental research with physiotherapy, but that the combination of neuromuscular
a single group treatment was used in this study. Before and taping with stretching exercises leads to better outcomes in
after receiving therapy eight times in one month, the Shoulder rehabilitation of patients with frozen shoulder, supports the
Pain and Disability Index (SPADI) was used to measure the findings of this study.
functional abilities of the shoulder. The implementation period
from January 9 to February 4, 2023, has ended. Another study conducted by Bintang [8] on 14 people
who suffer from frozen shoulder who come to the
III. RESULT S AND DISCUSSION Physiotherapy Unit at Grandmed Lubuk Pakam Hospital
shows that there is an effect of giving Codman Pendular
Tables 1 and 2 provide a description of the characteristics Exercises and Mulligan Mobilization with Movement to
of the research sample subjects, including information on their Increasing the Range of Motion in Patients with Frozen
age (years), weight (kg), and height (cm), as well as the results Shoulder because the movement from the Codman Pendulum
of a descriptive analysis performed using SPSS. Exercise being able to provide mobilization movements with
active movements of the patient will restore mobility and
Table 1: Distribution of Samples Based on Descriptive Data function of the shoulder by eliminating pain which will
Variables N Mean Std. Deviation provide relaxation so that ROM limitations occur in the
Age 22 57.55 6.780 shoulder joint (glenonohumeral, sternoclavicular,
Height 22 158.45 4.329 acromeoclavicular, scapulothoracal) reduced.
Weight 22 76.00 4.771
SPADI Index Score 22 72.05 5.305 IV. CONCLUSION
Before
SPADI Index Score After 22 58.82 8.045 The value of P = 0.000 (P 0.05) indicates that there is a
significant difference in the value before and after the
According to their age (years), weight (kg), height (cm), intervention of neuromuscular taping (NMT) and Codman
and SPADI Score, respondents are listed in Table 1. 22 Pendulum Exercise based on hypothesis testing utilising the
persons made up the study's sample size (n = 22), and it was sample paired sample test. It demonstrates that the Shoulder
discovered that their average ages were 57.55+67.80, their Pain and Disability Index (SPADI) Score has improved as a
average heights were 158.45+4.329, and their average weights result of the Codman Pendulum Exercise and Neuromuscular
were 76.00+4.771. Taping (NMT) interventions.

Table 2: Normality Test REFERENCES

Shapiro Wilk Normality Test
Samples (n = 22) SPADI Index Score [1]. S. P. Brun, “Idiopathic frozen shoulder,” Aust. J. Gen.
Pract., vol. 48, no. 11, pp. 757–761, 2019.
Mean±SD P [2]. D. de la Serna, S. Navarro-Ledesma, F. Alayón, E.
Before 72.05±5.305 0.921 López, and L. Pruimboom, “A Comprehensive View of
After 58.82±8.045 0.415 Frozen Shoulder: A Mystery Syndrome,” Front. Med.,
vol. 8, no. May, pp. 1–10, 2021, doi:
10.3389/fmed.2021.663703.

IJISRT23FEB772 www.ijisrt.com 951

Volume 8, Issue 2, February – 2023 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
[3]. G. Do Moon, J. Y. Lim, D. Y. Kim, and T. H. Kim,
“Comparison of Maitland and Kaltenborn mobilization
techniques for 1. Moon G Do, Lim JY, Kim DY, Kim
TH. Comparison of Maitland and Kaltenborn
mobilization techniques for improving shoulder pain and
range of motion in frozen shoulders. J Phys Ther Sci.
201,” J. Phys. Ther. Sci., vol. 27, no. 5, pp. 1391–1395,
2015.
[4]. C. Minns Lowe, E. Barrett, K. McCreesh, N. De Búrca,
and J. Lewis, “Clinical effectiveness of non-surgical
interventions for primary frozen shoulder: A systematic
review,” J. Rehabil. Med., vol. 51, no. 8, pp. 539–556,
2019, doi: 10.2340/16501977-2578.
[5]. C. H. Cho, K. C. Bae, and D. H. Kim, “Treatment
strategy for frozen shoulder,” CiOS Clin. Orthop. Surg.,
vol. 11, no. 3, pp. 249–257, 2019, doi:
10.4055/cios.2019.11.3.249.
[6]. C. H. Cho, K. S. Song, B. S. Kim, D. H. Kim, and Y. M.
Lho, “Biological Aspect of Pathophysiology for Frozen
Shoulder,” Biomed Res. Int., vol. 2018, 2018, doi:
10.1155/2018/7274517.
[7]. E. Cavalleri, A. Servadio, A. Berardi, M. Tofani, and G.
Galeoto, “The effectiveness of physiotherapy in
idiopathic or primary frozen shoulder: A systematic
review and meta-analysis,” Muscles. Ligaments Tendons
J., vol. 10, no. 1, pp. 24–39, 2020, doi:
10.32098/mltj.01.2020.04.
[8]. S. S. B. S. Bintang, S. Berampu, M. Saleha, M. Zannah,
S. Sinuhaji, and L. S. Silaban, “Seminar Pemberian
Codman Pendular Exercise Terhadap Peningkatan
Lingkup Gerak Sendi Penderita Frozen Shoulder Di
Rumah Sakit Grandmed Lubuk Pakam,” J. Pengmas
Kestra, vol. 1, no. 1, pp. 163–167, 2021, doi:
10.35451/jpk.v1i1.759.
[9]. G. Cunningham, C. Charbonnier, A. Lädermann, S.
Chagué, and D. H. Sonnabend, “Shoulder Motion
Analysis During Codman Pendulum Exercises,”
Arthrosc. Sport. Med. Rehabil., vol. 2, no. 4, pp. e333–
e339, 2020, doi: 10.1016/j.asmr.2020.04.013.
[10]. D. Blow, NeuroMuscular Taping: From Theory to
Practice, English Ed. Milan: Edi-Ermes Medical
Publisher, 2012.
[11]. F. Kamberi, “THE EFFECTS OF TAPING
NEUROMUSCULAR COMPARE TO PHYSICAL
THERAPIES MODALITIES IN PATIENTS WITH
ADHESIVE CAPSULITIS OF THE SHOULDER
Enkeleda Sinaj , PhD Student Vjollca Ndreu , PhD
Student Ermir Sinaj , MsC Student Tatjana Nurka ( Cina
), Ass / Prof,” Eur. Sci. J., vol. 2, no. February, pp. 181–
188, 2015.

IJISRT23FEB772 www.ijisrt.com 952