Effect of Mulligan Mobilization With or Without Niel Asher Technique in Patients With Adhesive Capsulitis

NCT06985836 | Recruiting

• 1 other identifier: REC/RCR & AHS/24/0180
• Study Type: interventional
• Target: 42
• Locations: 1 country
• Sites: 1

Brief Summary

Adhesive capsulitis is a prevalent condition characterized by pain and stiffness in shoulder joint and surrounding muscles shows decrease range and strength in patients with adhesive capsulitis. This study aims to determine the effect of mulligan mobilization with or without Niel Asher technique on pain, range of motion and disability in patients with adhesive capsulitis. This study will be a randomized controlled trial and will be conducted in Ibne-siena Hospital Multan and Multicare physiotherapy clinic. Non-probability convenience sampling will be used to collect the data. Sample size of subjects with age group between 40 to 60 years will be taken. Data will be collected from the patients having present complaint of adhesive capsulitis. Outcome measures used will be Numeric pain rating scale (NPRS) for shoulder pain and SPADI for shoulder disability and Universal Goniometer (GU) for Range of motion. An informed consent will be taken. Subjects will be selected on the basis of inclusion and exclusion criteria. Subjects will be divided into two groups by random number generator table. Both the Groups will receive heating pad, TENS. Group A will receive Mulligan Mobilizations and Neil Asher technique, and Group B will receive Mulligan mobilization and Conventional Treatment. Outcome measures will be measured at baseline and after 4 weeks. Data analysis will be done by SPSS version 26.

Conditions

Adhesive Capsulitis

Keywords

adhesive capsulitis; frozen shoulder; mannual therapy

Outcome Measures

Primary Outcomes (3)

• Numerical Pain Rating Scale (NPRS)

  Patient level of pain will be assessed using this scale. This scale ranges from 0 to 10. 0 indicates " no pain" and 10 indicates " worst pain" . NPRS have shown high test- retest reliability (r = 0.96 and 0.95, respectively)

  baseline and fourth week

• Universal Goniometer (UG)

  The range of motion will be measured using universal goniometer that has an inter-rater reliability (ICC2, 2 = 0.79 to 0.92) for shoulder.

  baseline and fourth week

• Shoulder disability and shoulder Index SPADI

  The Shoulder Pain and Disability Index (SPADI) is a self-administered questionnaire that consists of two dimensions, one for pain and the other for functional activities. The pain dimension consists of five questions regarding the severity of an individual's pain. Functional activities are assessed with eight questions designed to measure the degree of difficulty an individual has with various activities of daily living that require upper- extremity use. The SPADI takes 5 to 10 minutes for a patient to complete and is the only reliable and valid region-specific measure for the shoulder. The reliability coefficient is ICC \>0.89 for Shoulder.

  baseline and fourthweek

Study Arms (2)

Mulligan Mobilization and Niel Asher technique

EXPERIMENTAL

Shoulder mobilization that includes: * Mulligan mobilization technique for shoulder external rotation and abduction as described by Mulligan. 3 sets of 10 repetitions with 1 minute rest between sets, 3 times a week for 4 weeks are performed * Niel Asher technique provided for 3 sessions a week for 4 weeks

Other: Mulligan Mobilization and Niel Asher technique; Other: Mulligan Mobilization and Conventional physiotherapy.

Mulligan Mobilization and Conventional physiotherapy.

ACTIVE COMPARATOR

Group B Will receive Baseline Physical therapy treatment and mulligan mobilization. Standardized Physiotherapy treatment will be: * Modalities i.e. heating pad and TENS for ten Minutes * Postural correction exercises / Scapular retraction * Therapeutic Exercise : Codman' s, finger ladder, wand exercises * End Range Gleno-humeral joint stretching Both groups will come four times per week for a total of 4 weeks. Pre and post treatment values of both groups will be analyzed

Other: Mulligan Mobilization and Conventional physiotherapy.

Interventions

Mulligan Mobilization and Niel Asher technique OTHER

* Mulligan mobilization technique for shoulder external rotation and abduction as described by Mulligan. 3 sets of 10 repetitions with 1 minute rest between sets, 3 times a week for 4 weeks are performed * Niel Asher technique provided for 3 sessions a week for 4 weeks

Mulligan Mobilization and Niel Asher technique

Mulligan Mobilization and Conventional physiotherapy. OTHER

* Modalities i.e. heating pad and TENS for ten Minutes * Postural correction exercises / Scapular retraction * Therapeutic Exercise : Codman' s, finger ladder, wand exercises * End Range Gleno-humeral joint stretching Both groups will come four times per week for a total of 4 weeks. Pre and post treatment values of both groups will be analyzed.

Mulligan Mobilization and Conventional physiotherapy.; Mulligan Mobilization and Niel Asher technique

Eligibility Criteria

• Age: 40 Years - 60 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Age group 40-60 year
• Both gender male and female
• Stage 2 primary adhesive capsulitis with capsular pattern of restriction (rotation\>abduction\>flexion)
• Pain in shoulder should be ≤7 on NPRS
• Patient is willing to perform.

You may not qualify if:

• Diabetes
• Malignancy
• Infection
• Arthoplasty
• Pregnancy
• Neurological disorders
• Fracture
• Thyroid diseases

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Ibne Siena hospital Multan.

Multan Khurd, Punjab Province, 59300, Pakistan

RECRUITING

Related Publications (2)

• Doner G, Guven Z, Atalay A, Celiker R. Evalution of Mulligan's technique for adhesive capsulitis of the shoulder. J Rehabil Med. 2013 Jan;45(1):87-91. doi: 10.2340/16501977-1064.

  PMID: 23037929 BACKGROUND

• Childs JD, Piva SR, Fritz JM. Responsiveness of the numeric pain rating scale in patients with low back pain. Spine (Phila Pa 1976). 2005 Jun 1;30(11):1331-4. doi: 10.1097/01.brs.0000164099.92112.29.

  PMID: 15928561 BACKGROUND

MeSH Terms

Conditions

Bursitis

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases

Study Officials

• Rabiya Noor, PHD

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Iqbal Tariq, PHD

CONTACT

03338236752; Iqbal.tariq@riphah.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 15, 2025
• First Posted: May 22, 2025
• Study Start: December 15, 2024
• Primary Completion: May 15, 2025
• Study Completion: June 15, 2025
• Last Updated: May 22, 2025

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)