Comparative Effects of Spencer Techniques and Movement With Mobilization in Improving Pain, Range of Motion, and Functional Disability in Rotator Cuff Syndrome.

NCT07458711 | Completed DMC

• 1 other identifier: UOL/IREB/25/12/0014
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This study will be randomised clinical trial conducted at the University of Lahore Teaching Hospital, Lahore, Pakistan. A total of 60 participants will be selected and randomly allocated into two treatment groups (30 participants in each group) using the lottery method. All screened and willing participants who meet the eligibility criteria will be assigned to either Group A or Group B. Group A: Spencer Technique with Conventional Therapy Participants allocated to Group A will receive the Spencer Technique in combination with conventional physiotherapy. The intervention will follow a structured and progressive protocol for 6 weeks. Conventional Therapy (15 minutes per session) Conventional treatment will be administered prior to manual therapy and will include: Moist Hot Pack (5 minutes): A moist hot pack will be applied to the affected shoulder at a comfortable therapeutic temperature. A towel layer will be placed between the hot pack and the skin to prevent burns. Shoulder Stretching Exercises (10 minutes): Passive stretching will be performed to improve flexibility, reduce muscle tightness, and enhance shoulder range of motion. Each stretch will be held for 20-30 seconds and repeated 3-5 times. Stretching will include: Shoulder flexion and extension (supine position) Shoulder abduction Shoulder adduction (cross-body stretch) Internal and external rotation at 90° abduction Stretching will be performed five sessions per week. Spencer Technique (20 minutes per session) Following conventional therapy, the Spencer technique will be administered in seven sequential steps: Shoulder extension with elbow flexion to the point of restriction Shoulder flexion with elbow extension Circumduction with compression at 90° abduction Circumduction with distraction at 90° abduction Abduction with internal rotation (hand placed behind hip) Adduction with external rotation Stretching with fluid pumping maneuver (5-10 repetitions) Dosage and Progression: Frequency: 5 sessions per week Weeks 1-3: 2 sets of 10 repetitions per step (1-minute rest between sets) Weeks 4-6: 3 sets of 10 repetitions per step Total session duration: 35 minutes 5 minutes hot pack 10 minutes stretching 20 minutes Spencer technique Group B: Mobilization with Movement (MWM) with Conventional Therapy Participants allocated to Group B will receive Mobilization with Movement combined with conventional physiotherapy for 6 weeks. Conventional Therapy (15 minutes per session) The same conventional therapy protocol as Group A will be administered prior to mobilization: 5 minutes moist hot pack 10 minutes passive shoulder stretching Mobilization with Movement (20 minutes per session) MWM will be performed in the directions of: External rotation Internal rotation Abduction Flexion The participant will be positioned in sitting on a high chair. The therapist will stabilize the shoulder girdle with one hand while applying a sustained glide to the humeral head using the thenar eminence of the other hand. The glide will be maintained perpendicular to the plane of movement and adjusted according to the participant's pain-free direction. Participants will be instructed to actively move the shoulder through the available range while the glide is sustained. Movement will continue until the onset of pain or discomfort. Dosage: 3 sets of 10 repetitions 30-second rest between sets Frequency: 3 sessions per week Duration: 6 weeks Total session duration: 35 minutes 5 minutes hot pack 10 minutes stretching 20 minutes mobilization with movement

Conditions

Rotator Cuff Syndrome

Keywords

rotator cuff impingement or syndrome

Outcome Measures

Primary Outcomes (1)

• Pain Intensity (Visual Analogue Scale)

  Visual Analogue Scale The Visual Analogue Scale (VAS) is a subjective measure in which individuals rate their pain on an eleven-point numerical scale. The scale is composed of 0 (no pain at all) to 10 (worst imaginable pain). According to researches VAS shows excellent reliability (0.97 and 0.99, respectively) for the measurement of musculoskeletal pain.

  baseline, 3rd week , 6th week

Secondary Outcomes (2)

• range of motion

  baseline, 3rd week, 6th week

• for function (DASH)

  Baseline, 3rd week, 6th week

Study Arms (2)

Spencer technique + conventional physical therapy

EXPERIMENTAL

The technique will be administered in seven sequential steps: Shoulder extension with elbow flexion to restriction Shoulder flexion with elbow extension Circumduction with compression at 90° abduction Circumduction with distraction at 90° abduction Abduction with internal rotation Adduction with external rotation Stretching with fluid pumping maneuver (5-10 repetitions) Dosage progression: Weeks 1-3: 2 sets of 10 repetitions per step (1-minute rest between sets) Weeks 4-6: 3 sets of 10 repetitions per step Total session duration: 35 minutes (5 minutes hot pack, 10 minutes stretching, 20 minutes Spencer technique).

Other: Spencer technique; Other: conventional physical therapy

movement with mobilization + conventional physical therapy

EXPERIMENTAL

The technique will be administered in seven sequential steps: Shoulder extension with elbow flexion to restriction Shoulder flexion with elbow extension Circumduction with compression at 90° abduction Circumduction with distraction at 90° abduction Abduction with internal rotation Adduction with external rotation Stretching with fluid pumping maneuver (5-10 repetitions) Dosage progression: Weeks 1-3: 2 sets of 10 repetitions per step (1-minute rest between sets) Weeks 4-6: 3 sets of 10 repetitions per step Total session duration: 35 minutes (5 minutes hot pack, 10 minutes stretching, 20 minutes Spencer technique).

Other: Movement with mobilization; Other: conventional physical therapy

Interventions

Spencer technique OTHER

Spencer Technique (20 minutes per session) The technique will be administered in seven sequential steps: Shoulder extension with elbow flexion to restriction Shoulder flexion with elbow extension Circumduction with compression at 90° abduction Circumduction with distraction at 90° abduction Abduction with internal rotation Adduction with external rotation Stretching with fluid pumping maneuver (5-10 repetitions) Weeks 1-3: 2 sets of 10 repetitions per step (1-minute rest between sets) Weeks 4-6: 3 sets of 10 repetitions per step

Spencer technique + conventional physical therapy

Movement with mobilization OTHER

Mobilization will be performed in: External rotation Internal rotation Abduction Flexion Participants will actively move the shoulder during sustained glide until the onset of pain or discomfort. Dosage: 3 sets of 10 repetitions 30-second rest between sets 3 sessions per week for 6 weeks Conventional Therapy (15 minutes per session) Moist Hot Pack (5 minutes): A moist hot pack will be applied to the affected shoulder at a therapeutic temperature, with a towel placed between the pack and the skin. Shoulder Stretching (10 minutes): Passive stretching exercises will be performed to improve flexibility and range of motion. Each stretch will be held for 20-30 seconds and repeated 3-5 times. Stretching will include: Shoulder flexion and extension Shoulder abduction Shoulder adduction Internal and external rotation at 90° abduction Total session duration: 35 minutes (5 minutes hot pack, 10 minutes stretching, 20 minutes mobilization).

movement with mobilization + conventional physical therapy

conventional physical therapy OTHER

Conventional Therapy (15 minutes per session) Moist Hot Pack (5 minutes): A moist hot pack will be applied to the affected shoulder at a therapeutic temperature, with a towel placed between the pack and the skin. Shoulder Stretching (10 minutes): Passive stretching exercises will be performed to improve flexibility and range of motion. Each stretch will be held for 20-30 seconds and repeated 3-5 times. Stretching will include: Shoulder flexion and extension Shoulder abduction Shoulder adduction Internal and external rotation at 90° abduction

Spencer technique + conventional physical therapy; movement with mobilization + conventional physical therapy

Eligibility Criteria

• Age: 30 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Patient from the age of 30 to 60.
• Patient suffering from rotator cuff syndrome. Patient with a history of pain in shoulder for more than 3 month.
• Patient with grade 1 and grade 2 of rotator cuff syndrome which doesn't require surgery.
• Patient with 2 positive Neers and Hawkins Kennedy test.
• Patient who haven't gone under any physical therapy treatment in the past 6 months.

You may not qualify if:

• Patient with any cardiac problem like myocardial infarction.
• Patient with diagnosis of fibromyalgia.
• Patient with ongoing pregnancy.
• Patient with pain related to shoulder trauma.
• Patient with history of shoulder injury or shoulder surgery.
• Patient with associated symptoms like numbness and tingling.
• Patient who have taken corticosteroids injections of shoulder within a year.

Sponsors & Collaborators

• University of Lahore: lead
• University of Lahore Hospital (ULH): collaborator

Study Sites (1)

University of Lahore Teaching Hospital

Lahore, Punjab Province, 55150, Pakistan

Location

MeSH Terms

Conditions

Shoulder Impingement Syndrome

Interventions

Movement

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases; Shoulder Injuries; Wounds and Injuries

Intervention Hierarchy (Ancestors)

Physiological Phenomena; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Asim Arif, PhD scholar

  University of Lahore

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: This study used a single-blind approach. This means that while the researchers knew which treatment each person was getting, the patients did not know if they were in the group A or group B. They were not told which exercise protocol was the main focus of the study or which one was expected to be more effective. This helps ensure that the patients' expectations did not influence the results or their reporting of pain levels.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 4, 2026
• First Posted: March 9, 2026
• Study Start: September 26, 2025
• Primary Completion: February 28, 2026
• Study Completion: March 3, 2026
• Last Updated: March 9, 2026

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)