Effect of Adding Latissimus Dorsi Myofascial Release to Scapular Proprioceptive Neuromuscular Facilitation on Pain, Disability, and Range of Motion in Adhesive Capsulitis

Effect of Adding Latissimus Dorsi Myofascial Release to Scapular Proprioceptive Neuromuscular Facilitation on Pain, Disability, and Range of Motion in Adhesive Capsulitis: A Randomized Controlled Trial

This randomized controlled trial aims to compare the effects of scapular proprioceptive neuromuscular facilitation (PNF) alone versus PNF combined with latissimus dorsi myofascial release on pain, range of motion, and functional disability in patients with stage II adhesive capsulitis; a condition characterized by capsular stiffness, pain, and restricted shoulder mobility, with outcomes assessed using NPRS, goniometry, and SPADI over a 6-week intervention period.

Participants diagnosed with stage II adhesive capsulitis will be randomly allocated into two groups. The experimental group will receive latissimus dorsi myofascial release combined with scapular proprioceptive neuromuscular facilitation (PNF) hold-relax technique, while the control group will receive scapular PNF hold-relax technique only. Both interventions will be administered for 6 weeks, with 3 sessions per week. Outcome measures will include Numeric Pain Rating Scale (NPRS) for pain intensity, goniometry for shoulder range of motion, latissimus dorsi length test for muscle tightness, and Shoulder Pain and Disability Index (SPADI) for functional disability. Data will be analyzed using IBM SPSS version 26.

Inclusion Criteria:

• 1. Age between 35 and 70 years.
• Both male and female participants.
• Stiffening (Stage II) phase of frozen shoulder.
• Pain intensity ≥ 4/10 on NPRS during shoulder movement.
• Unilateral shoulder involvement.
• Presence of capsular pattern:ER > ABD > IR limitation
• Apley's Scratch Test
• Limited both ROMs
• Symptom duration between 3 and 9 months.(Di Mascio et al., 2024)

Exclusion Criteria:

• Secondary adhesive capsulitis due to trauma or surgery
• History of shoulder fracture or dislocation.
• Bilateral frozen shoulder.
• Active systemic inflammatory or neurological disease
• Recent intra-articular corticosteroid injection (within last 3 months)
• Current anticoagulation therapy or bleeding disorders.
• Pregnant females.