Scapular Repeated Contractions Facilitation Versus Hold-relax Techniques in Patients With Adhesive Capsulitis

NCT07403409 | Completed

• 1 other identifier: REC/RCR & AHS/24/0196
• Study Type: interventional
• Target: 66
• Locations: 1 country
• Sites: 1

Brief Summary

The study was conducted to determine the effects of scapular repeated contractions facilitation versus hold-relax techniques on pain, range of motion and functional disability in patients with adhesive capsulitis

Conditions

Adhesive Capsulitis of the Shoulder

Keywords

Adhesive Capsulitis; Scapula Repeated Contraction Facilitation Technique; scapular Hold-Relax Technique; Proprioceptive Neuromuscular Facilitation

Outcome Measures

Primary Outcomes (2)

• Numeric Pain Rating Scale

  Patient level of pain was assessed using this scale. This scale ranges from 0 to 10. 0 indicates "no pain" ,1- 3 indicates mild pain ,4-6 indicates moderate pain and 7-10 indicates "worst pain". NPRS have shown high test-retest reliability (r = 0.96 and 0.95, respectively) MCID value of NPRS is 2-3

  At base line and end of 4 weeks

• Shoulder Pain And Disability Index

  SPADI was used to assess functional disability. It has 13 items, with 5 items for pain and 8 items for disability

  from baseline to end of 4 weeks

Secondary Outcomes (4)

• ROM shoulder flexion

  4th week

• ROM shoulder abduction

  4th week

• ROM shoulder external rotation

  4th week

• ROM shoulder internal rotation

  4th week

Study Arms (2)

Scapular Repeated Contraction Facilitation Technique

EXPERIMENTAL

Other: Repeated Contraction Facilitation Technique; Other: Conventional Physical therapy Treatment for Adhesive Capsulitis

Scapular Hold-Relax Technique

ACTIVE COMPARATOR

Other: Hold-Relax Technique; Other: Conventional Physical therapy Treatment for Adhesive Capsulitis

Interventions

Repeated Contraction Facilitation Technique OTHER

Repeated contraction facilitation on scapula in two diagonal patterns (D1\&D2) were performed .D1 consisted of anterior elevation and posterior depression and D2 consisted of posterior elevation and anterior depression. Isotonic contraction of muscles against the resistance throughout the active ROM was performed.3 sets of 10 repetitions were performed with 20 seconds of rest interval.

Scapular Repeated Contraction Facilitation Technique

Hold-Relax Technique OTHER

Hold -Relax on scapula in two diagonal patterns (D1\&D2) were performed .D1 consisted of anterior elevation and posterior depression and D2 consisted of posterior elevation and anterior depression in which restricted muscles were contracted isometrically with 5 sec hold followed by relaxation into new range .3 sets of 10 repetitions were performed with 20 seconds of rest interval.

Scapular Hold-Relax Technique

Conventional Physical therapy Treatment for Adhesive Capsulitis OTHER

Moist heat pack for 15-20 mins Therapeutic Ultrasound at 1MHz for 8-10 mins in continuous mode with the intensity of 1.5W/cm2 Active Assisted Shoulder for abduction, flexion, internal rotation and external rotation with 3 sets of 15 repetitions 4days/week for 4 weeks Wall slides, Finger ladder exercises, Wand exercises and home exercises were performed.3x15 repetitions with 2 min rest interval for 4 sessions per week for four weeks for each exercise Maitland Glenohumeral Joint Mobilization with 2-3 oscillations per second for 30 seconds for 5 sets 4 times a week in caudal and posteroanterior direction was applied for 4 weeks.

Scapular Hold-Relax Technique; Scapular Repeated Contraction Facilitation Technique

Eligibility Criteria

• Age: 40 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Diagnosed stage 2 of Adhesive Capsulitis (\>4-12 months)
• Difficulties in 2 or more movements: external rotation, abduction, flexion or internal rotation presenting limitation of more than 30 degrees
• Patients having diagnosed Diabetes Mellitus type 2
• Capsular pattern of restriction
• Unilateral involvement of the shoulder
• Patients who are not taking any pain killer

You may not qualify if:

• Surgical history of affected shoulder
• History of trauma or fracture in affected shoulder
• Cervical neuropathy or any other disorders of cervical spine, elbow and wrist
• Any Neurological disorders such as stroke or parkinsonism
• Any systemic disease such as rheumatoid arthritis, osteoporosis and malignancies in shoulder region
• Intra-articular injection
• Open wound or skin infection
• Manipulation under anesthesia
• Recurrent dislocation or subluxation
• Shoulder injuries such as rotator cuff tear, or tendon calcification

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Rasool Medical Complex Gujrat

Dhok Gujra, Punjab Province, 50700, Pakistan

Location

Related Publications (13)

• Joshi D, Chitra J. Effect of scapular proprioceptive neuromuscular facilitation on shoulder pain, range of motion, and upper extremity function in hemiplegic patients: A randomized controlled trial. Indian Journal of Health Sciences and Biomedical Research KLEU. 2017;10(3):276-82.

  BACKGROUND

• Chitra J, Joshi D. Effect of scapular hold-relax technique on shoulder pain in hemiplegic subjects: A randomized controlled trial. Physiotherapy-The Journal of Indian Association of Physiotherapists. 2017;11(2):49-52.

  BACKGROUND

• Mishra N, Mishra A, Charaniya P. Effect of scapular proprioceptive neuromuscular facilitation on pain and disability in patients with adhesive capsulitis. Int J Yogic Hum Mov Sports Sciences. 2019;4(1):995-1000.

  BACKGROUND

• Saeed M, Hafeez S, Asad F, Haider W, Nawaz S, Kocub S. Comparison of scapular proprioceptive neuromuscular facilitation and myofascial release techniques on pain and function in scapular dyskinesia associated with adhesive capsulitis: Scapular dyskinesia associated with adhesive capsulitis. Pakistan BioMedical Journal. 2022:123-7.

  BACKGROUND

• Bhavika PG, Vinosh Kumar P. Effect of Scapular Proprioceptive Neuromuscular Facilitation versus Scapular Mobilization on Pain and function in adhesive capsulitis-A Pragmatic Randomized Clinical Trial. INTI JOURNAL. 2023;2023(64):1-6.

  BACKGROUND

• Akgüller T, Akbaba YA, Taşkıran H. The effect of scapular proprioceptive neuromuscular facilitation techniques on pain and functionality in patients with subacromial impingement syndrome: a randomized controlled trial. Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin. 2023;33(03):149-61.

  BACKGROUND

• Shaikh SB, Ganvir SS. Effect of 4 Weeks of Scapular Proprioceptive Neuromuscular Facilitation on Scapular Alignment and Upper Extremity Motor Performance in Patients with Stroke: A Repeated Measure Design. Medical Journal of Dr DY Patil Vidyapeeth. 2023;16(Suppl 2):S228-S34.

  BACKGROUND

• Ragapriyaa R, Kamalakannan M, Anitha A, Ramana K. Effect of Scapular Clock Exercise Versus Scapular PNF Exercise on Pain and ROM for Anterior Capsular Stiffness of Shoulder Joint. Indian Journal of Physiotherapy & Occupational Therapy. 2024;18.

  BACKGROUND

• Cellatoğlu H, Kaygısız BB. Effect of proprioceptive neuromuscular facilitation (PNF) technique on posture, balance and gait characteristics of older adults with scapular dyskinesis: a randomized controlled trial. PeerJ. 2025;13:e19718.

  BACKGROUND

• Butt MS, Tanveer F. Effects of scapular proprioceptive neuromuscular facilitation techniques in addition to routine physical therapy on clinical outcomes in patients with adhesive capsulitis: A randomized controlled trial. The Healer Journal of Physiotherapy and Rehabilitation Sciences. 2022;2(1):78-87.

  BACKGROUND

• Ghias S, Saeed H, Ahmed M, Faisal M, Solangi TA, Asim HAB, et al. Effectiveness of PNF Pattern in Regular Physical Therapy Sessions on Functional Mobility in Frozen Shoulder: PNF Pattern in Frozen Shoulder Therapy. THE THERAPIST (Journal of Therapies & Rehabilitation Sciences). 2024:46-50.

  BACKGROUND

• Lin P, Yang M, Huang D, Lin H, Wang J, Zhong C, et al. Effect of proprioceptive neuromuscular facilitation technique on the treatment of frozen shoulder: a pilot randomized controlled trial. BMC musculoskeletal disorders. 2022;23(1):367

  BACKGROUND

• Zhang EJX, Lam YX, Lim WSR, Lie DTT. Effect of proprioceptive neuromuscular facilitation on efficacy and pain relief for symptomatic shoulder conditions: a meta-analysis. Journal of Orthopaedic Reports. 2025;4(1):100541.

  BACKGROUND

MeSH Terms

Conditions

Bursitis

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases

Study Officials

• Ameena Amjad, Ph.D

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

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

Study Record Dates

• First Submitted: February 4, 2026
• First Posted: February 11, 2026
• Study Start: January 18, 2025
• Primary Completion: May 31, 2025
• Study Completion: October 30, 2025
• Last Updated: February 11, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)