Comparison of Niel-Asher and Spencer Techniques in Frozen Shoulder Patients

Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age35-65
SponsorRiphah International University

About this trial

This study aims to compare the effectiveness of two manual therapy techniques-Niel-Asher Technique and Spencer Technique-when combined with conventional physiotherapy in treating patients with frozen shoulder (adhesive capsulitis). Frozen shoulder is a painful condition that limits movement and function of the shoulder joint. The study will include 44 adults aged 35 to 65 years who have been diagnosed with stage II frozen shoulder. Participants will be randomly assigned to one of two groups. Both groups will receive standard physiotherapy, including heat therapy, TENS, and stretching exercises. In addition, one group will receive the Niel-Asher Technique, while the other group will receive the Spencer Technique. Pain, range of motion, and shoulder function will be measured before and after a 4-week treatment period using validated tools such as the Visual Analogue Scale (VAS), a goniometer, and the Shoulder Pain and Disability Index (SPADI). The goal is to determine which manual therapy technique is more effective in improving symptoms and function in patients with frozen shoulder.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Age group between 35-65 years diagnosed with primary Adhesive Capsulitis.

Both gender male and female.

Both Active and passive Range of Motion is limited.

Stage II Frozen Shoulder patients (Freezing Stage,3-9 months).

Disqualifiers

Diabetes Mellitus, Thyroid disorders.

Rheumatoid Arthritis, Malignancy.

Rotator Cuff injury, Ligamentous Injuries.23

Previous Surgery or Manipulation under Anesthesia.

Trial design

Design model

Parallel

Treatments tested in this trial

  • Niel-Asher Technique

    Other intervention

    Participants in this group will receive the Niel-Asher Technique, a manual therapy approach focusing on trigger point release and myofascial decompression of the shoulder girdle. Treatment will involve structured pressure techniques applied to specific muscular trigger points including the infraspinatus, supraspinatus, subscapularis, and levator scapulae. The intervention will be delivered in side-lying and sitting positions. Conventional physiotherapy, includes a 10-minute hot pack, 15-minute TENS, Codman exercises, finger ladder exercises (2-3 sets, 3-5 repetitions), and capsular stretching (20-30 sec hold, 2-4 repetitions). Sessions will be conducted 3 times per week for 4 weeks.

  • Spencer Technique

    Other intervention

    Participants in this group will receive the Spencer Technique, an osteopathic manual therapy consisting of eight mobilization steps: extension, flexion, circumduction with compression, circumduction with distraction, abduction, adduction with external rotation, internal rotation, and traction stretch. Each movement will be performed with patient participation using muscle energy techniques. Conventional physiotherapy, includes a 10-minute hot pack, 15-minute TENS, Codman exercises, finger ladder exercises (2-3 sets, 3-5 repetitions), and capsular stretching (20-30 sec hold, 2-4 repetitions). Sessions will be conducted 3 times per week for 4 weeks.

Treatment groups

44 Participants
are divided into 2 treatment groups
Group A: Niel-Asher TechniqueExperimental treatment 1 intervention
Group B: Spencer TechniqueExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

Numeric Pain Rating Scale

Pain intensity in the affected shoulder will be assessed using the Visual Analogue Scale (VAS), a validated 10-point scale where 0 indicates "no pain" and 10 indicates "worst imaginable pain." A decrease in score indicates pain reduction.

Time frame
Baseline and 4 Weeks Post-Treatment
2

Shoulder Range of Motion (ROM)

Shoulder joint range of motion, including flexion, abduction, and external rotation, will be measured using a universal goniometer. ROM will be recorded in degrees. An increase in ROM values indicates functional improvement.

Time frame
Baseline and 4 Weeks Post-Treatment
3

Shoulder Pain and Disability Index (SPADI)

Shoulder function will be evaluated using the Shoulder Pain and Disability Index (SPADI), a self-reported questionnaire assessing pain and disability. Scores range from 0 (no pain/disability) to 100 (maximum pain/disability). A reduction in score indicates functional improvement.

Time frame
Baseline and 4 Weeks Post-Treatment

Secondary outcomes

Other outcomes

Sponsors and contacts

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