International Journal of New Technology and Research (IJNTR) ISSN:2454-4116, Volume-3, Issue-9, September 2017 Pages 71-74 71 www.ijntr.org Comparative Study Between Ultrasound Therapy with Combination of Elastic Band and Conventional Therapy for Anterior Shoulder Instability Sajjad Alam, Suraj Kumar Abstract- Background: Shoulder joint has the greatest range of motion so shoulder instability occurs between 10-30% total populations.Objective: The purpose of the study is to investigate the effect of ultrasound therapy along with elastic band over conventional therapy in subjects with anterior shoulder instability. Study Design: Randomized clinical trials.Method: The study is randomized controlled study, the total subjects were ten for each group. The assessment of pain and ROM were taken before starting the treatment of both the groups. The patient were randomly assigned for both the group, assessment were taken on 0 day and 21 day of pain by VAS, ROM by goniometer.Result:The scores of variables VAS and ROM were improved significantly better in the subjects treated with ultrasound therapy and elastic bands.Conclusion: The study concludes that the elastic band exercise in combination with ultrasound therapy is more beneficial than the manual conventional therapy in shoulder instability condition. Index Terms: shoulder instability, elastic band, ultrasonic, ROM, VAS. I. INTRODUCTION The shoulder instability refers to the inability to maintain the humeral head 1 . The glenohumeral joint is a multiaxial, ball and socket, synovial joint that depends primary on the muscles and ligaments 2 rather than bones for its support, stability, and integrity 3 .The primary ligaments of the glenohumeral joint the superior, middle, and inferior glenohumeral ligaments 4 play an important role in stabilizing the shoulder. The primary ligament of the glenohumeral joint the superior, middle, and inferior glenohumeral ligaments plays an important role in stabilizing the shoulder.it is a pathological condition, rather than a normal physiologic variant such as loose join physiotherapy has been found effective 5 in reducing pain and disability in patients with shoulder instability 6 .the success rate of an average is about 35.5% that require aggressive rehabilitation programe until the goal is achieved 7 . In this study ultrasound is used in soft tissue injuries 8 and there are rational theories for its use, sound evidence for its effectiveness in such conditions, the dose of therapeutic ultrasound is determined by many factors, the thermal effect decreases the tissue stiffness 9 of trigger point, in therapeutic application of ultrasound, non- ionizing radiation is delivered to the desired tissue in mechanical wave form, several researcher have indicated the beneficial results of low frequency ultrasound, in this Sajjad Alam, Research Scholar, Monad University Hapur, UP Dr Suraj Kumar, Head and Associate Professor, Department of Physiotherapy, UPUMS, Saifai, Etawah, UP frequency, high intensities lead to cell death, whereas at low intensities useful effect has emerged 10 . Elastic resistance devices such as elastic band are being increasingly used for muscular conditioning for shoulder instability, this devices allow for a larger range of motion with both concentric and eccentric muscle contraction 11 . Elastic band resistance has been proven to increase strength, mobility and function as well as reduce joint pain. Elastic band rehabilitate injuries improve the function ability of shoulder 12 . The W.Z. Burkhead found has found good results in shoulder instability 13 . The aim of this study is to assess the effectiveness of ultrasound therapy when added to elastic band exercise in the rehabilitation of patients with anterior shoulder instability. This study hypothesized that the ultrasound therapy is beneficial when combined with elastic band and exercise in the physiotherapy management of patients with anterior shoulder instability to reduce pain, increase range of motion and strength to reduce shoulder instability. II. METHODOLOGY A. Study design Total 20 subjects were taken 10 in each group (Group A and Group B). This study is randomized controlled study, subject where selected by simple sampling method from the Ojjus Goodwill hospital outpatient department. The entire subjects diagnosed with anterior shoulder instability by Orthopedics doctor. All the patients were explained about the objective of the study along with duration and nature of the study. Informed consent were taken from subjects. The study was approved by the ethical committee for research. B. Inclusion criteria The subject included must be diagnosed with anterior shoulder instability, aged 18 to 55 year, and shoulder was painful in external rotation, internal rotation, abduction and flexion. One of the instability test should be positive from anterior drawerstest 14 or load and shift test. The patient should be available for three months; the patient should understand the language and instructions 15 . C. Exclusion criteria Patient with past history of shoulder surgery, diagnosed with rotator cuff, primary scapulothoracic dysfunction due to paresis, pain due to adhesive capsulitis and any involvement with sensory and muscular deficit were excluded.