Effect of Adding Latissimus Dorsi Myofascial Release to Scapular Proprioceptive Neuromuscular Facilitation on Pain, Disability, and Range of Motion in Adhesive Capsulitis

NCT07588087 | Recruiting

• 1 other identifier: IIUI/RERC/ADT/2026/04/287
• Study Type: interventional
• Target: 58
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial aims to compare the effects of scapular proprioceptive neuromuscular facilitation (PNF) alone versus PNF combined with latissimus dorsi myofascial release on pain, range of motion, and functional disability in patients with stage II adhesive capsulitis; a condition characterized by capsular stiffness, pain, and restricted shoulder mobility, with outcomes assessed using NPRS, goniometry, and SPADI over a 6-week intervention period.

Conditions

Adhesive Capsulitis

Outcome Measures

Primary Outcomes (4)

• Pain Intensity

  Numeric Pain rating scale(NPRS) will be used. It is the numeric version of visual analogue scale used to assess the intensity of pain. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme. it has moderate to excellent reliability and good validity

  baseline to 6 weeks

• Shoulder Range of Motion (ROM)

  Measured using a universal goniometer. Shoulder flexion, abduction, external rotation, and internal rotation will be assessed at baseline and at 6 weeks.

  baseline to 6 weeks

• Latissimus Dorsi Length Test

  It is used to check the tightness of latissimus dorsi muscle. The patient is in supine lying with knees bend and back flattened to the floor, arm elevated overhead. if there is tightness of this muscle person's unable to flexed his arm by 180° and compensated by arching its back also with the help of goniometer measurement starts with axis at the humeral head , stationary arm midline to the body and moveable arm parallel to the longitudinal axis of the humerus a normal full length muscle allows the arms to touch the table while shortened muscle not allow them to touch the table.

  baseline to 6 weeks

• Shoulder Pain and Disability Index (SPADI)

  The Shoulder Pain and Disability Index (SPADI) is a self-administered questionnaire used to assess pain and functional disability associated with shoulder conditions. It consists of 13 items divided into two subscales: pain (5 items) and disability (8 items). Each item is scored on a scale from 0 to 10, where 0 indicates no pain or difficulty and 10 indicates the worst pain or maximum difficulty. The total score is calculated by averaging the scores of both subscales and converting them into a percentage ranging from 0 to 100, with higher scores indicating greater pain and disability.

  baseline to 6 weeks

Study Arms (2)

Latissimus dorsi myofascial release and Scapular PNF hold-relax technique. ( Experimental)

EXPERIMENTAL

Received latissimus dorsi myofascial release (10-15 minutes, sustained pressure with 90-120 sec holds) combined with scapular PNF hold-relax (posterior elevation-anterior depression pattern; 3 sets × 5 reps, 5-7 sec contraction, 10-15 sec stretch).

Other: Myofascial release+ Scapular Proprioceptive Neuromuscular Facilitation (PNF) hold-relax technique

Scapular PNF hold-relax only (control)

ACTIVE COMPARATOR

Received scapular PNF hold-relax only (same pattern and dosage: 3 sets × 5 reps, 5-7 sec contraction, 10-15 sec stretch),

Other: Scapular PNF hold-relax only

Interventions

Myofascial release+ Scapular Proprioceptive Neuromuscular Facilitation (PNF) hold-relax technique OTHER

Participants in the experimental group will receive a combination of latissimus dorsi myofascial release (MFR) and scapular proprioceptive neuromuscular facilitation (PNF) using the hold-relax technique. Myofascial release will be applied to the latissimus dorsi muscle with the patient positioned in side-lying (affected side up) or supine with the shoulder in flexion. The therapist will apply slow, sustained pressure along the posterior axillary fold and lateral border of the scapula, following the muscle fibers toward the thoracolumbar fascia. The technique will include sustained pressure, longitudinal gliding, and passive shoulder elevation until a tissue resistance barrier is reached. Each stretch will be maintained for 90-120 seconds, with a total MFR duration of approximately 10-15 minutes per session. Following MFR, scapular PNF will be performed using the posterior elevation to anterior depression pattern. The hold-relax technique will involve isometric contractions of 5-7 seco

Latissimus dorsi myofascial release and Scapular PNF hold-relax technique. ( Experimental)

Scapular PNF hold-relax only OTHER

Participants in the control group will receive scapular proprioceptive neuromuscular facilitation (PNF) using the hold-relax technique without the addition of myofascial release. The intervention will follow the scapular posterior elevation to anterior depression pattern. Each repetition will include an isometric contraction lasting 5-7 seconds followed by a passive stretch of 10-15 seconds. A total of 3 sets with 5 repetitions per set will be performed in each session, with an overall duration of approximately 20 minutes. In addition, a hot pack will be applied to the affected area for 10-15 minutes prior to the exercise session to promote muscle relaxation. Treatment sessions will be conducted three times per week for a duration of 6 weeks.

Scapular PNF hold-relax only (control)

Eligibility Criteria

• Age: 35 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• \. Age between 35 and 70 years.
• Both male and female participants.
• Stiffening (Stage II) phase of frozen shoulder.
• Pain intensity ≥ 4/10 on NPRS during shoulder movement.
• Unilateral shoulder involvement.
• Presence of capsular pattern:ER \> ABD \> IR limitation
• Apley's Scratch Test
• Limited both ROMs
• Symptom duration between 3 and 9 months.(Di Mascio et al., 2024)

You may not qualify if:

• Secondary adhesive capsulitis due to trauma or surgery
• History of shoulder fracture or dislocation.
• Bilateral frozen shoulder.
• Active systemic inflammatory or neurological disease
• Recent intra-articular corticosteroid injection (within last 3 months)
• Current anticoagulation therapy or bleeding disorders.
• Pregnant females.

Sponsors & Collaborators

• Ibadat International University, Islamabad: lead

Study Sites (1)

• Ibadat international hospital • Shaafi international hospital • South East hospital • Fauji Foundation hospital

Islamabad, Punjab Province, 44000, Pakistan

RECRUITING

Related Publications (11)

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MeSH Terms

Conditions

Bursitis

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases

Central Study Contacts

Hufsa Naseer, DPT, MS-PT MSK

CONTACT

+3095166821; hufsanaseer@gmail.com

Fatima Amjad, DPT, MS-PT Sports, PHD Scholar

CONTACT

+3330940975; Fatima.amjad@uipt.iiui.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Outcome assessor will be blinded to group allocation.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Two-arm parallel group randomized controlled trial

Study Record Dates

• First Submitted: May 2, 2026
• First Posted: May 14, 2026
• Study Start: April 5, 2026
• Primary Completion (Estimated): June 6, 2026
• Study Completion (Estimated): June 8, 2026
• Last Updated: May 14, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)