The Combined Effect of Mulligan Technique and Scapular Mobilization in Shoulder Adhesive Capsulitis
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age30-60
SponsorDeraya University
About this trial
The shoulder joint capsule is a fibrous sheath that encloses and stabilizes the structures of the shoulder joint, extending from the anatomical neck of the humerus to the rim of the glenoid fossa. It is normally lax, allowing a wide range of motion. Shoulder adhesive capsulitis, or frozen shoulder, is a common musculoskeletal condition characterized by pain and restricted movement due to thickening and contraction of this capsule. Proper coordination between the scapula and humerus-known as the scapulohumeral rhythm-is essential for normal shoulder motion. Disruption of this rhythm contributes to movement limitation and pain in adhesive capsulitis.
This randomized, single-blind clinical trial aims to investigate the combined effect of the Mulligan technique and scapular mobilization on improving shoulder range of motion, pain, disability, and scapulohumeral rhythm in patients with adhesive capsulitis. Thirty-eight participants aged 30 to 60 years, diagnosed with unilateral adhesive capsulitis, will be randomly assigned to two groups. Group A will receive Mulligan mobilization techniques for shoulder elevation, internal and external rotation, along with scapular mobilization. Group B will receive conventional physical therapy consisting of hot packs, ultrasound, stretching, and range-of-motion exercises. Both groups will undergo treatment three times per week for four weeks.
Primary outcomes include changes in shoulder range of motion (measured using a digital goniometer), pain and disability (measured by the Shoulder Pain and Disability Index \[SPADI\]), and scapulohumeral rhythm (assessed using tape measurement). The study is expected to provide clinical evidence on whether combining Mulligan and scapular mobilization techniques yields superior functional recovery compared with conventional physiotherapy alone in patients with shoulder adhesive capsulitis.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Medically stable and willing to provide informed consent to participate in the study.
Age between 30 and 60 years.
Both male and female participants.
Unilateral shoulder involvement with pain and limited active and passive range of motion in lateral rotation, abduction, and internal rotation for more than three months compared with the unaffected side.
Disqualifiers
History of shoulder surgery.
History of radiotherapy or chemotherapy.
Presence of acute infection in the area to be treated.
History of skin disease.
Trial design
Design model
Parallel
Treatments tested in this trial
Mulligan Technique with Scapular Mobilization
Other interventionParticipants in this group will receive the Mulligan mobilization technique for shoulder elevation, internal rotation, and external rotation combined with scapular mobilization. Each session will include three sets of ten repetitions with a two-minute rest between sets. Treatment sessions will be conducted three times per week for four weeks. The intervention aims to improve shoulder joint mobility, reduce pain, and enhance scapulohumeral rhythm.
Conventional Physiotherapy
Other interventionStandard physiotherapy including hot packs, ultrasound, posterior capsule stretching, and active/assisted range-of-motion exercises. Three sessions per week for four weeks.
Treatment groups
38 Participants
are divided into 2 treatment groupsGroup A: Conventional PhysiotherapyActive comparator 1 intervention
Group B: Mulligan Technique with Scapular MobilizationExperimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
Change in Shoulder Range of Motion (Flexion, Internal Rotation, External Rotation, and Abduction)
Shoulder joint range of motion (flexion, internal rotation, external rotation, and abduction) will be assessed using a digital goniometer. Each movement will be measured three times, and the mean value will be used for analysis.
Time frame
Baseline and at 4 weeks post-intervention2
Change in Shoulder Pain and Disability (SPADI Score)
Pain and functional disability will be assessed using the Shoulder Pain and Disability Index (SPADI). The SPADI includes 13 items: a 5-item pain subscale and an 8-item disability subscale. Each item is scored on a 0-10 scale, with higher scores indicating greater pain and disability.
Time frame
Baseline and at 4 weeks post-intervention3
Change in Scapulohumeral Rhythm
Scapulohumeral rhythm will be evaluated using a tape measurement method during shoulder elevation to assess the coordination between scapular and humeral motion.
Time frame
Baseline and at 4 weeks post-interventionSponsors and contacts
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Source ClinicalTrials.gov
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