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Adhesive Capsulitis causes a progressive tightening of the glenohumeral joint capsule, restricting both active and passive movements and resulting in functional impairments. Joint mobilization is an essential component of physical therapy for managing adhesive capsulitis. Two new techniques are emerging in the treatment of Adhesive capsulitis; one of them is called Gong's Mobilization. This technique emphasizes correcting positional faults by applying controlled, dynamic movements to the glenohumeral joint. The other technique, known as Niel-Asher technique is a five-step trigger point therapy which offers a unique, non-invasive holistic approach to address adhesive capsulitis. This study, will be conducted as a randomized clinical trial at Ghurki Trust Teaching Hospital and Hope Rehabilitation Center, it aims to evaluate the effects of Gong's mobilization with and without Niel-Asher technique on shoulder pain, ROM and disability in Adhesive Capsulitis of patients aged 40-60 years. A non-probability convenience sampling method will recruit 46 participants meeting the inclusion criteria only. Participants will be randomly assigned to Group A (Gong's Mobilization) or Group B (Gong's mobilization and and Niel-Asher technique) with interventions given for four weeks. Pain severity will be measured using the Numeric Pain Rating Scale, Range of Motion will be assessed via goniometer, and disability will be evaluated using the SPADI. Statistical analysis using SPSS will compare outcomes between groups at baseline, at two weeks and post-treatment after 4 weeks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Gong's Mobilization | Experimental |
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| Gong's Mobilization and Niel-Asher technique | Active Comparator |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Gong's Mobilization | Other | It is performed in a side-lying position.
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| Measure | Description | Time Frame |
|---|---|---|
| Shoulder Pain and Disability Index (SPADI) | SPADI is a 13 item Questionnaire to evaluate pain (5items) and disability (8 items) in shoulder joint. The patient is instructed to choose the number that best describes their level of pain and extent of difficulty using the involved shoulder. The pain scale is summed up to a total of 50 while the disability scale sums up to 80. The total SPADI score is expressed as a percentage. A score of 0 indicates best 100 indicates worst. A higher score shows more disability. | 6th week |
| Universal Goniometer (UG) | Universal goniometer is tool in orthopedics used to precisely measure angles at joints. Goniometer demonstrates good intra-rater and inter-rater reliability when used consistently with proper technique. It will measure the ranges at shoulder joint (Abduction, Adduction, Flexion, Extension, Internal rotation, External rotation | 6th week |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Rabiya Noor, phd | Contact | 03344355660 | Rabiya.Noor@riphah.edu.pk | |
| Iqbal Tariq, phd | Contact | 03338236752 | Iqbal.tariq@riphah.edu.pk |
| Name | Affiliation | Role |
|---|---|---|
| summaya asim, MSPT(CP) | Riphah International University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Rabiya Noor | Recruiting | Lahore | Punjab Province | 54000 | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37583922 | Background | Pattnaik S, Kumar P, Sarkar B, Oraon AK. Comparison of Kaltenborn mobilization technique and muscle energy technique on range of motion, pain and function in subjects with chronic shoulder adhesive capsulitis. Hong Kong Physiother J. 2023 Dec;43(2):149-159. doi: 10.1142/S1013702523500166. Epub 2023 Jun 21. |
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| ID | Term |
|---|---|
| D002062 | Bursitis |
| ID | Term |
|---|---|
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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| Gong's Mobilization and Niel-Asher technique | Other | 1. In Niel-Asher technique, the patient was made to lie sideways and several deep strokes with your hand, from elbow to humeral head were applied. Apply sustained pressure over the embedded nodules or over the fibrous band which you may feel when you move upwards. 2. Apply deep sustained pressure on the tender point over the posterior joint capsule area (teres minor). 3. Perform circumduction of shoulder with bent elbow repeatedly several times from small to large complete circles. 4. Release the fascia up the long head biceps tendon and move upwards only. Pause on the nodules along the tendon; these are fascial tethering and may be inflamed. As you approach the shoulder, near the biceps tendon joins the capsule, hold the trigger point for up to three minutes until it is completely pain free. 5.In supine lying position, the middle fingers of your hand, presses deeply on the trigger point in the middle of the shoulder blade (infraspinatus) |
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