Additional Effects of Thoracic Mobilization Versus Manipulation Along With Standard Physical Therapy in Adhesive Capsulitis

NCT07838610 | Recruiting

• 1 other identifier: FUI/FUCP/CTR/MSMSK/TehminaTab
• Study Type: interventional
• Target: 38
• Locations: 1 country
• Sites: 1

Brief Summary

Participants will be divided into two groups, with both receiving conventional physical therapy along with their respective thoracic intervention. One group will receive thoracic manipulation at the identified T1-T7 segment using a controlled High-Velocity, Low-Amplitude thrust in the prone position at the end of full exhalation, while the other group will receive central PosterioAnterior thoracic mobilization in the prone position for 30 repetitions with a 1-minute rest between two sets. The most painful or stiffest segment will be identified using the Passive Accessory Intervertebral Movement (PAIVM) test; if no joint sign is present, mobilization will be performed at T6-T7.

Conditions

Adhesive Capsulitis

Outcome Measures

Primary Outcomes (3)

• Shoulder Pain Intensity

  Pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS), an 11-point scale ranging from 0 to 10, where 0 = no pain, 1-3 = mild pain, 4-6 = moderate pain, and 7-10 = severe pain.

  Baseline and after 4 weeks of intervention

• Shoulder range of motion

  Shoulder range of motion will be measured using a universal goniometer. Shoulder flexion, abduction, internal rotation, and external rotation will be assessed and recorded in degrees.

  Baseline and after 4 weeks of intervention.

• Functional disability

  Functional disability will be assessed using the Shoulder Pain and Disability Index (SPADI), consisting of 13 items assessing shoulder pain and functional limitations. with 5 items assessing pain and 8 items evaluating functional limitations. Each item is scored ranging from 0 (no pain/no difficulty) to 10 (worst pain imaginable/so difficult required help).

  Baseline and after 4 weeks of intervention

Study Arms (2)

Group A:Thoracic manipulation with standard physical therapy

EXPERIMENTAL

The intervention will be conducted over 4 weeks, with 3 sessions per week. The treatment protocol will include stretching, strengthening with manual resistance, glenohumeral mobilization, and thoracic manipulation (HVLA).

Procedure: Thoracic Manipulation

Group B:Thoracic Mobilization with standard physical therapy

EXPERIMENTAL

The intervention will be conducted over 4 weeks, with 3 sessions per week. The treatment protocol will include stretching, strengthening with manual resistance, glenohumeral mobilization, and thoracic mobilization.

Procedure: Thoracic mobilization

Interventions

Thoracic Manipulation PROCEDURE

Group A will receive thoracic thrust manipulation in addition to the conventional treatment program. The target thoracic segment (T1-T7) will be identified through posterior-to-anterior (PA) assessment. With the patient in a prone position, the therapist will position and preload the tissues at the identified segment and deliver a quick, controlled, high-velocity, low-amplitude (HVLA) thrust at the end of the patient's full expiration.

Group A:Thoracic manipulation with standard physical therapy

Thoracic mobilization PROCEDURE

Thoracic mobilization will be performed as an adjunct to the conventional physical therapy program. Central posterior-to-anterior oscillatory mobilization will be performed in the prone position. The treatment segment will be identified using the Passive Accessory Intervertebral Motion (PAIVM) test, with the most painful or stiffest segment selected; if no joint sign is present, mobilization will be applied at T6-T7.

Group B:Thoracic Mobilization with standard physical therapy

Eligibility Criteria

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

You may qualify if:

• Age range between 40 and 60 years.
• Both male and female patients with unilateral or bilateral shoulder pain.
• Pain persisting for at least 3 months.
• Decreased shoulder ROM, including external rotation, abduction, internal rotation, and flexion, with both active and passive ROM reduced by more than 50%.
• Clinically diagnosed with Stage 2 or Stage 3 adhesive capsulitis.

You may not qualify if:

• History of fracture, surgery, or dislocation in the affected shoulder.
• Shoulder pain resulting from systemic diseases such as rheumatoid arthritis, infection, or tumors, or conditions such as myelopathy (positive Hoffman's sign).
• Neurological conditions such as stroke or cervical radiculopathy (positive Spurling's test).
• Thoracic Outlet Syndrome (positive Roos test).
• Uncontrolled hypertension or cardiac instability, including unstable angina, recent myocardial infarction, or other cardiovascular conditions.

Sponsors & Collaborators

• Foundation University Islamabad: lead

Study Sites (1)

Foundation University College of Physical Therapy

Islamabad, Punjab Province, 44000, Pakistan

RECRUITING

MeSH Terms

Conditions

Bursitis

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases

Central Study Contacts

Tehmina Tabassum, DPT

CONTACT

03058520660; tabassumbhatti12143455@gmail.com

Marwa Asim, MS-OMPT

CONTACT

03335339457; marwa@fui.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 18, 2026
• First Posted: September 24, 2026
• Study Start: February 12, 2026
• Primary Completion (Estimated): December 18, 2026
• Study Completion (Estimated): January 18, 2027
• Last Updated: September 24, 2026

Record last verified: 2026-09

Locations

PA (1)