Effects of Deltoid Strengthening Exercises in Patients With Adhesive Capsulitis

NCT07644884 | Not Yet Recruiting

• 1 other identifier: REC/RCR&AHS/25/0115 Noha
• Study Type: interventional
• Target: 48
• Locations: 0 countries
• Sites: N/A

Brief Summary

Adhesive capsulitis, also known as frozen shoulder, is a musculoskeletal condition that causes significant shoulder pain and restricted joint mobility. It affects the glenohumeral joint and is commonly seen in individuals between the ages of 40 and 60 year. It affects 3 to 5% of the general population with a higher prevalence among females and patients with diabetes or thyroid disorders. Adhesive capsulitis progresses in four stages: painful, freezing, frozen, and thawing, and the condition may persist for 1 to 2 years. This study aims to determine the effects of Deltoid Strengthening Exercises on pain, range of motion, muscle strength and disability in patients with Adhesive Capsulitis.

Conditions

Frozen Shoulder

Outcome Measures

Primary Outcomes (3)

• Pain-Numeric Pain Rating Scale

  In current study, patients with Adhesive Capsulitis having Numeric Pain Rating Scale (NPRS) score of greater or equal to 3 and less than 7 will be included. Numeric Pain Rating Scale (NPRS) is used to measure pain levels in all subjects. NPRS is self-reported, single-dimensional 11 point scale between 0 and 10. The NPRS has a moderate test-retest reliability in patients with a primary complaint of shoulder pain with ICC=0.74, MCID of 1.1 points and MDC of 2.5 points.

  upto 4 weeks

• Disability-Shoulder Pain and Disability Index

  Patients with Adhesive Capsulitis having Shoulder Pain and Disability Index (SPADI) score of 41 to 60 will be included in the current study. The Shoulder Pain and Disability Index (SPADI) is used for measuring the level of disability in patients. This self-administered index consists of 13 items divided into two subscales: 5 items for pain and 8 items for disability. It is a practical outcome measure that will be completed by patients in less than 5 min and will be scored by clinician. It has a high internal consistency with Cronbach α typically exceeding 0.90 and a good test-retest reliability with ICC values ranging from 0.84 to 0.95. When the SPADI is used more than once on the same subject i.e. at initial consultation and then at discharge, the minimal detectible change (MDC 95%) is 18 points

  upto 4 weeks

• Range of motion-Universal Goniometer

  Adhesive capsulitis' patients have a capsular pattern of restriction of glenohumeral joint. Universal goniometer (UG) will be used to measure external rotation, internal rotation, abduction and flexion. Universal Goniometer is defined as a high-resolution plastic goniometer that permits observation of the axis of motion and ROM of the joint being measured. UG has been considered the gold standard for clinical assessment of ROM. It has a good reliability for AROM with ICC ranging from 0.53 to 0.65, and SEM calculated to be 14-25.

  upto 4 weeks

Study Arms (2)

Deltoid strengthening exercises

EXPERIMENTAL

Deltoid Strengthening Exercises: * Deltoid Isometrics * Dumb bell Strengthening Exercises * Theraband Strengthening Exercises

Other: Exercises

Standard Physical therapy

ACTIVE COMPARATOR

Ultrasound Glenohumeral Distraction Manual therapy Codman's Pendulum Exercise Finger Ladder exercise Wand Exercise

Other: Standard Physical therapy

Interventions

Exercises OTHER

a) Deltoid Isometrics The following isometrics of Deltoid will be performed: * Anterior Deltoid: Front Raise Isometrics Isometrics of Anterior Deltoid will be performed. The arm is raised to 90 shoulder flexion. The elbows are slightly flexed (5 degrees) while the subject is pushing isometric upward against manual resistance provided by the therapist * Middle Deltoid: Lateral Raise Isometrics The arm will be abducted to the horizontal position. The humerus is slightly flexed about thirty degrees while the elbows are kept in a static, slightly flexed position. The arms are lifted isometric upward against resistance provided by the therapist * Posterior Deltoid: Reverse Fly Isometrics The participant sits on a chair with trunk bent from the horizontal with the arms pointing toward the floor. The arms are raised until the upper arms are horizontal, while the elbows were in a static, slightly flexed position. The subject pushes upward against resistance provided by the therapist

Deltoid strengthening exercises

Standard Physical therapy OTHER

Ultrasound Glenohumeral Distraction Manual therapy Codman's Pendulum Exercise Finger Ladder exercise Wand Exercise

Standard Physical therapy

Eligibility Criteria

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

You may qualify if:

• Both male and female gender
• Subjects with age ranging from 40 to 60 years
• Subjects with stage II and III adhesive capsulitis

You may not qualify if:

• Subjects with rotator cuff tears
• Subjects with glenohumeral arthritis

Sponsors & Collaborators

• Riphah International University: lead

Related Publications (9)

• Nakandala P, Nanayakkara I, Wadugodapitiya S, Gawarammana I. The efficacy of physiotherapy interventions in the treatment of adhesive capsulitis: A systematic review. J Back Musculoskelet Rehabil. 2021;34(2):195-205. doi: 10.3233/BMR-200186.

  PMID: 33185587 BACKGROUND

• Seher Z, Goher N, Hamid A, Latif U, Bukhari A, Rafique H, et al. Prevalence of adhesive capsulitis among diabetics and non-diabetics with shoulder pain in general population: prevalence of adhesive capsulitis. Pakistan Journal of Health Sciences. 2023:67-71.

  BACKGROUND

• Rawat P, Eapen C, Seema KP. Effect of rotator cuff strengthening as an adjunct to standard care in subjects with adhesive capsulitis: A randomized controlled trial. J Hand Ther. 2017 Jul-Sep;30(3):235-241.e8. doi: 10.1016/j.jht.2016.10.007. Epub 2016 Nov 21.

  PMID: 27884497 BACKGROUND

• Sung JH, Lee JM, Kim JH. The Effectiveness of Ultrasound Deep Heat Therapy for Adhesive Capsulitis: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022 Feb 7;19(3):1859. doi: 10.3390/ijerph19031859.

  PMID: 35162881 BACKGROUND

• Ramirez J. Adhesive Capsulitis: Diagnosis and Management. Am Fam Physician. 2019 Mar 1;99(5):297-300.

  PMID: 30811157 BACKGROUND

• Heinecke ML, Thuesen ST, Stow RC. Graston technique on shoulder motion in overhead athletes. J Undergrad Kinesiol Res. 2014;10(1):27-39.

  BACKGROUND

• Mustafa Z, Zafar MA, Zafar S, Aslam F, Nasir A, Ahmad M, et al. Prevalence of adhesive capsulitis in non-diabetic participants within age 50-70 years in Multan. International Journal of Natural Medicine and Health Sciences. 2024;3(2):40-2.

  BACKGROUND

• Reinold MM, Macrina LC, Wilk KE, Fleisig GS, Dun S, Barrentine SW, Ellerbusch MT, Andrews JR. Electromyographic analysis of the supraspinatus and deltoid muscles during 3 common rehabilitation exercises. J Athl Train. 2007 Oct-Dec;42(4):464-9.

  PMID: 18174934 BACKGROUND

• Moser T, Lecours J, Michaud J, Bureau NJ, Guillin R, Cardinal E. The deltoid, a forgotten muscle of the shoulder. Skeletal Radiol. 2013 Oct;42(10):1361-75. doi: 10.1007/s00256-013-1667-7. Epub 2013 Jun 20.

  PMID: 23784480 BACKGROUND

MeSH Terms

Conditions

Bursitis

Interventions

Exercise

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases

Intervention Hierarchy (Ancestors)

Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Noha Arshad, MSPT*

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Sumrod Akram

CONTACT

03324806143; samrood.akram@riphah.edu.pk

Study Design

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

Study Record Dates

• First Submitted: June 1, 2026
• First Posted: June 12, 2026
• Study Start: June 6, 2026
• Primary Completion (Estimated): October 6, 2026
• Study Completion (Estimated): November 6, 2026
• Last Updated: June 12, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share