Effects of Gong's Mobilization With and Without Nielasher Technique on in Adhesive Capsulitis

NCT07628335 | Recruiting

• 1 other identifier: REC/RCR & AHS/25/0109
• Study Type: interventional
• Target: 46
• Locations: 1 country
• Sites: 1

Brief Summary

Adhesive Capsulitis causes a progressive tightening of the glenohumeral joint capsule, restricting both active and passive movements and resulting in functional impairments. Joint mobilization is an essential component of physical therapy for managing adhesive capsulitis. Two new techniques are emerging in the treatment of Adhesive capsulitis; one of them is called Gong's Mobilization. This technique emphasizes correcting positional faults by applying controlled, dynamic movements to the glenohumeral joint. The other technique, known as Niel-Asher technique is a five-step trigger point therapy which offers a unique, non-invasive holistic approach to address adhesive capsulitis. This study, will be conducted as a randomized clinical trial at Ghurki Trust Teaching Hospital and Hope Rehabilitation Center, it aims to evaluate the effects of Gong's mobilization with and without Niel-Asher technique on shoulder pain, ROM and disability in Adhesive Capsulitis of patients aged 40-60 years. A non-probability convenience sampling method will recruit 46 participants meeting the inclusion criteria only. Participants will be randomly assigned to Group A (Gong's Mobilization) or Group B (Gong's mobilization and and Niel-Asher technique) with interventions given for four weeks. Pain severity will be measured using the Numeric Pain Rating Scale, Range of Motion will be assessed via goniometer, and disability will be evaluated using the SPADI. Statistical analysis using SPSS will compare outcomes between groups at baseline, at two weeks and post-treatment after 4 weeks.

Conditions

Adhesive Capsulitis

Keywords

Adhesive Capsulitis; goniometer

Outcome Measures

Primary Outcomes (2)

• Shoulder Pain and Disability Index (SPADI)

  SPADI is a 13 item Questionnaire to evaluate pain (5items) and disability (8 items) in shoulder joint. The patient is instructed to choose the number that best describes their level of pain and extent of difficulty using the involved shoulder. The pain scale is summed up to a total of 50 while the disability scale sums up to 80. The total SPADI score is expressed as a percentage. A score of 0 indicates best 100 indicates worst. A higher score shows more disability.

  6th week

• Universal Goniometer (UG)

  Universal goniometer is tool in orthopedics used to precisely measure angles at joints. Goniometer demonstrates good intra-rater and inter-rater reliability when used consistently with proper technique. It will measure the ranges at shoulder joint (Abduction, Adduction, Flexion, Extension, Internal rotation, External rotation

  6th week

Study Arms (2)

Gong's Mobilization

EXPERIMENTAL

Other: Gong's Mobilization

Gong's Mobilization and Niel-Asher technique

ACTIVE COMPARATOR

Other: Gong's Mobilization; Other: Gong's Mobilization and Niel-Asher technique

Interventions

Gong's Mobilization OTHER

It is performed in a side-lying position. * The therapist will stand on the affected side of the patient and push the head of humerus of the affected side in anterior to posterior direction parallel to the joint plane with the palm of his hand, simultaneously, with the other hand, the therapist will push the scapula from posterior to anterior direction realigning and stabilizing the humeral head within correct position. * The patient is asked to quickly and powerfully perform abduction while keeping the elbow straight. Meanwhile, the therapist will keep pressing the humeral head along the long axis of the humerus, maintaining the oscillatory glide in Maitland's grade (III, IV), following the movement of the patient's shoulder during abduction. * The speed of the movement is kept constant by the therapist while maintaining a little distraction at the Glenohumeral joint. * Therapist will accelerate the movement at the end range to gain Glenohumeral ROM.

Gong's Mobilization; Gong's Mobilization and Niel-Asher technique

Gong's Mobilization and Niel-Asher technique OTHER

1\. In Niel-Asher technique, the patient was made to lie sideways and several deep strokes with your hand, from elbow to humeral head were applied. Apply sustained pressure over the embedded nodules or over the fibrous band which you may feel when you move upwards. 2. Apply deep sustained pressure on the tender point over the posterior joint capsule area (teres minor). 3. Perform circumduction of shoulder with bent elbow repeatedly several times from small to large complete circles. 4\. Release the fascia up the long head biceps tendon and move upwards only. Pause on the nodules along the tendon; these are fascial tethering and may be inflamed. As you approach the shoulder, near the biceps tendon joins the capsule, hold the trigger point for up to three minutes until it is completely pain free. 5.In supine lying position, the middle fingers of your hand, presses deeply on the trigger point in the middle of the shoulder blade (infraspinatus)

Gong's 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:

• Individuals with age group of 40-60 years.
• Both Females and males individuals.
• Individuals diagnosed with Frozen shoulder (Adhesive Capsulitis) within stage II and III of frozen shoulder.
• Individuals with positive capsular pattern (ER\>Abd\> IR).
• Individuals with ROM loss ≥ 25% in at least two planes compared with the noninvolved shoulder

You may not qualify if:

• Individuals with rotator cuff tears and overuse injury
• Individuals with inflammatory diseases (Osteoarthritis, Rheumatoid Arthritis, Gout) and Malignancies
• Individuals Using Corticosteroid Injections or Medications

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Rabiya Noor

Lahore, Punjab Province, 54000, Pakistan

RECRUITING

Related Publications (1)

• Pattnaik S, Kumar P, Sarkar B, Oraon AK. Comparison of Kaltenborn mobilization technique and muscle energy technique on range of motion, pain and function in subjects with chronic shoulder adhesive capsulitis. Hong Kong Physiother J. 2023 Dec;43(2):149-159. doi: 10.1142/S1013702523500166. Epub 2023 Jun 21.

  PMID: 37583922 BACKGROUND

MeSH Terms

Conditions

Bursitis

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases

Study Officials

• summaya asim, MSPT(CP)

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Rabiya Noor, phd

CONTACT

03344355660; Rabiya.Noor@riphah.edu.pk

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: June 1, 2026
• First Posted: June 5, 2026
• Study Start: December 15, 2025
• Primary Completion: June 15, 2026
• Study Completion (Estimated): July 15, 2026
• Last Updated: June 5, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)