Effect of HVLA vs MET on Shoulder Mobility and Pain in Adhesive Cpsulitis

NCT07600372 | Completed DMC

• 1 other identifier: GIU/REC/26-24
• Study Type: interventional
• Target: 66
• Locations: 1 country
• Sites: 1

Brief Summary

This study compared the effects of High-Velocity Low-Amplitude (HVLA) thrust and Post-Isometric Relaxation Muscle Energy Technique (PIR-MET) on pain and shoulder mobility in patients with adhesive capsulitis. Sixty-six participants received either HVLA or PIR-MET with conventional physiotherapy for four weeks. Both treatments improved pain and range of motion, but PIR-MET showed significantly greater improvement, making it a more effective approach for managing frozen shoulder symptoms.

Conditions

Adhesive Capsulitis

Keywords

Adhesive Capsulitis, Frozen Shoulder, HVLA Thrust, PIR-MET, Shoulder Pain, Shoulder Mobility, Manual

Outcome Measures

Primary Outcomes (1)

• Visual Analogue Scale (VAS) for Pain

  Pain intensity was assessed using the Visual Analogue Scale (VAS), a 10 cm scale ranging from 0 (no pain) to 10 (worst imaginable pain). Participants marked their perceived shoulder pain level before and after the four-week intervention period.

  Baseline and after 4 weeks of intervention

Study Arms (2)

Group A- HVLA Thrust

EXPERIMENTAL

Participants in this group received high velocity, low amplitude thrust manipulation to the glenohumeral joint. Treatment was delivered by a trained physical therapist. The intervention aimed to restore joint mobility and reduce pain in patients diagnosed with adhesive capsulitis. Sessions were conducted 3 times per week for 12 weeks, in addition to a standardized home exercise program.

Behavioral: High Velocity Low Amplitude Thrust

Group-B MET

EXPERIMENTAL

Participants in this group received muscle energy technique applied to the shoulder muscles to improve range of motion and decrease pain. The technique involved active contraction of the patient against manual resistance followed by stretching. Sessions were conducted 3 times per week for 12 weeks, in addition to a standardized home exercise program.

Behavioral: Muscle Energy Technique

Interventions

High Velocity Low Amplitude Thrust BEHAVIORAL

A manual therapy technique involving a quick, controlled thrust applied to the glenohumeral joint at the end of the available range of motion. The goal is to improve joint play and mobility. Each session lasted approximately 10-15 minutes. The intervention was performed 3 times per week for 12 weeks. Adverse events were monitored throughout the study.

Also known as: HVLA Thrust

Group A- HVLA Thrust

Muscle Energy Technique BEHAVIORAL

An active manual therapy technique where the patient contracts the shoulder muscles against the therapist's resistance, followed by a passive stretch. Target muscles included the posterior capsule, pectoralis major, and rotator cuff as indicated. Each session lasted approximately 15-20 minutes. The intervention was performed 3 times per week for 12 weeks.

Also known as: MET

Group-B MET

Eligibility Criteria

• Age: 40 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Participants diagnosed with Stage II or III Adhesive Capsulitis Age between 40 and 65 years Both male and female participants Presence of shoulder pain and restricted range of motion for at least 3 months Limitation of active and passive shoulder movements, particularly external rotation Willingness to participate and provide informed consent Ability to attend treatment sessions for four weeks

You may not qualify if:

• History of shoulder fracture, dislocation, or recent trauma Previous shoulder surgery Neurological disorders affecting shoulder function Rheumatoid arthritis or other systemic inflammatory conditions Cervical radiculopathy or referred pain from the cervical spine Rotator cuff tear or severe shoulder instability Malignancy or infection involving the shoulder joint Participants receiving other concurrent shoulder treatments Contraindications to manual therapy or physiotherapy interventions Unwillingness to participate or inability to complete the treatment protocol

Sponsors & Collaborators

• Green International University: lead

Study Sites (1)

Principal Investigator

Lahore, Punjab Province, 54000, Pakistan

Location

MeSH Terms

Conditions

Bursitis; Shoulder Pain

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases; Arthralgia; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: This study was single-blinded. Participants were unaware of their treatment group allocation throughout the intervention period to minimize performance and response bias. Care providers and investigators administering the interventions were not blinded due to the nature of the manual therapy techniques.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal InvestigatorG

Model Details: This study used a parallel-group randomized controlled trial design. A total of 66 participants diagnosed with Stage II or III Adhesive Capsulitis were randomly allocated into two equal groups. Group A received High-Velocity Low-Amplitude (HVLA) thrust manipulation combined with conventional physiotherapy, while Group B received Post-Isometric Relaxation Muscle Energy Technique (PIR-MET) combined with conventional physiotherapy. Both groups underwent treatment sessions for four weeks. Conventional physiotherapy included moist heat application, range-of-motion exercises, stretching, and strengthening exercises. Outcome measures included pain intensity assessed by the Visual Analogue Scale (VAS) and shoulder range of motion measured using a universal goniometer before and after the intervention period.

Study Record Dates

• First Submitted: May 14, 2026
• First Posted: May 20, 2026
• Study Start: November 9, 2025
• Primary Completion: April 29, 2026
• Study Completion: May 6, 2026
• Last Updated: May 20, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR
• Time Frame: It will be available after the completion of study
• Access Criteria: De-identified participant data, including demographic details, pain scores, shoulder range-of-motion data, study protocol, and analysis information, will be available to qualified researchers upon reasonable request and approval. Access will be provided through secure electronic sharing while maintaining participant confidentiality and ethical standards.

Locations

PA (1)