Comparative Effects of Spencer Techniques and Movement With Mobilization in Improving Pain, Range of Motion, and Functional Disability in Rotator Cuff Syndrome.

March 4, 2026 updated by: University of Lahore

Spencer Technique and Movement With Mobilization in Rotator Cuff Syndrome

This study will be randomised clinical trial conducted at the University of Lahore Teaching Hospital, Lahore, Pakistan. A total of 60 participants will be selected and randomly allocated into two treatment groups (30 participants in each group) using the lottery method. All screened and willing participants who meet the eligibility criteria will be assigned to either Group A or Group B. Group A: Spencer Technique with Conventional Therapy

Participants allocated to Group A will receive the Spencer Technique in combination with conventional physiotherapy. The intervention will follow a structured and progressive protocol for 6 weeks.

Conventional Therapy (15 minutes per session)

Conventional treatment will be administered prior to manual therapy and will include:

Moist Hot Pack (5 minutes):

A moist hot pack will be applied to the affected shoulder at a comfortable therapeutic temperature. A towel layer will be placed between the hot pack and the skin to prevent burns.

Shoulder Stretching Exercises (10 minutes):

Passive stretching will be performed to improve flexibility, reduce muscle tightness, and enhance shoulder range of motion. Each stretch will be held for 20-30 seconds and repeated 3-5 times. Stretching will include:

Shoulder flexion and extension (supine position)

Shoulder abduction

Shoulder adduction (cross-body stretch)

Internal and external rotation at 90° abduction

Stretching will be performed five sessions per week.

Spencer Technique (20 minutes per session)

Following conventional therapy, the Spencer technique will be administered in seven sequential steps:

Shoulder extension with elbow flexion to the point of restriction

Shoulder flexion with elbow extension

Circumduction with compression at 90° abduction

Circumduction with distraction at 90° abduction

Abduction with internal rotation (hand placed behind hip)

Adduction with external rotation

Stretching with fluid pumping maneuver (5-10 repetitions)

Dosage and Progression:

Frequency: 5 sessions per week

Weeks 1-3: 2 sets of 10 repetitions per step (1-minute rest between sets)

Weeks 4-6: 3 sets of 10 repetitions per step

Total session duration: 35 minutes

5 minutes hot pack

10 minutes stretching

20 minutes Spencer technique

Group B: Mobilization with Movement (MWM) with Conventional Therapy

Participants allocated to Group B will receive Mobilization with Movement combined with conventional physiotherapy for 6 weeks.

Conventional Therapy (15 minutes per session)

The same conventional therapy protocol as Group A will be administered prior to mobilization:

5 minutes moist hot pack

10 minutes passive shoulder stretching

Mobilization with Movement (20 minutes per session)

MWM will be performed in the directions of:

External rotation

Internal rotation

Abduction

Flexion

The participant will be positioned in sitting on a high chair. The therapist will stabilize the shoulder girdle with one hand while applying a sustained glide to the humeral head using the thenar eminence of the other hand. The glide will be maintained perpendicular to the plane of movement and adjusted according to the participant's pain-free direction.

Participants will be instructed to actively move the shoulder through the available range while the glide is sustained. Movement will continue until the onset of pain or discomfort.

Dosage:

3 sets of 10 repetitions

30-second rest between sets

Frequency: 3 sessions per week

Duration: 6 weeks

Total session duration: 35 minutes

5 minutes hot pack

10 minutes stretching

20 minutes mobilization with movement

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Study Design and Procedures

This study is a single-blinded, randomized controlled trial designed to compare the effectiveness of the Spencer Technique combined with conventional therapy versus Mobilization with Movement combined with conventional therapy in individuals with shoulder dysfunction.

Screening and Recruitment

Participants who meet the predefined inclusion criteria will be recruited using a purposive sampling technique. Individuals who are readily available and willing to participate will be screened for eligibility.

Eligible participants will be informed about the study objectives, procedures, potential risks, and benefits. Written informed consent will be obtained prior to enrollment.

Sample Size and Allocation

A total sample of 52 participants will be included in the study. After baseline assessment, participants will be randomly allocated into two groups (Group A and Group B) using the lottery method.

Randomization

Randomization will be performed using a simple lottery method to ensure equal allocation into the two intervention groups.

Blinding

This study will follow a single-blinded design. Participants will be blinded to group allocation.

Intervention Duration and Assessment

Both groups will receive treatment for 6 weeks. Sessions will be conducted 3 times per week. Outcome assessments will be performed at baseline and at the end of the 6th week.

Each treatment session for both groups will have a total duration of 35 minutes.

Data will be analyzed using Statistical Package for the Social Sciences (SPSS) version 27.0.

Interventions Group A: Spencer Technique with Conventional Therapy

Participants allocated to Group A will receive the Spencer Technique in combination with conventional physiotherapy.

Conventional Therapy (15 minutes per session)

Moist Hot Pack (5 minutes):

A moist hot pack will be applied to the affected shoulder at a therapeutic temperature, with a towel placed between the pack and the skin.

Shoulder Stretching (10 minutes):

Passive stretching exercises will be performed to improve flexibility and range of motion. Each stretch will be held for 20-30 seconds and repeated 3-5 times. Stretching will include:

Shoulder flexion and extension

Shoulder abduction

Shoulder adduction

Internal and external rotation at 90° abduction

Spencer Technique (20 minutes per session)

The technique will be administered in seven sequential steps:

Shoulder extension with elbow flexion to restriction

Shoulder flexion with elbow extension

Circumduction with compression at 90° abduction

Circumduction with distraction at 90° abduction

Abduction with internal rotation

Adduction with external rotation

Stretching with fluid pumping maneuver (5-10 repetitions)

Dosage progression:

Weeks 1-3: 2 sets of 10 repetitions per step (1-minute rest between sets)

Weeks 4-6: 3 sets of 10 repetitions per step

Total session duration: 35 minutes (5 minutes hot pack, 10 minutes stretching, 20 minutes Spencer technique).

Group B: Mobilization with Movement with Conventional Therapy

Participants allocated to Group B will receive Mobilization with Movement (MWM) combined with conventional physiotherapy.

Conventional Therapy (15 minutes per session)

5 minutes moist hot pack

10 minutes passive shoulder stretching

Mobilization with Movement (20 minutes per session)

Participants will be positioned in sitting. The therapist will stabilize the shoulder girdle with one hand and apply a sustained glide to the humeral head using the thenar eminence of the other hand. The glide will be maintained perpendicular to the plane of movement and adjusted to remain pain-free.

Mobilization will be performed in:

External rotation

Internal rotation

Abduction

Flexion

Participants will actively move the shoulder during sustained glide until the onset of pain or discomfort.

Dosage:

3 sets of 10 repetitions

30-second rest between sets

3 sessions per week for 6 weeks

Total session duration: 35 minutes (5 minutes hot pack, 10 minutes stretching, 20 minutes mobilization).

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
60

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 55150
        • University of Lahore Teaching Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • • Patient from the age of 30 to 60.

    • Patient suffering from rotator cuff syndrome. Patient with a history of pain in shoulder for more than 3 month.
    • Patient with grade 1 and grade 2 of rotator cuff syndrome which doesn't require surgery.
    • Patient with 2 positive Neers and Hawkins Kennedy test.
    • Patient who haven't gone under any physical therapy treatment in the past 6 months.

Exclusion Criteria:

  • • Patient with any cardiac problem like myocardial infarction.

    • Patient with diagnosis of fibromyalgia.
    • Patient with ongoing pregnancy.
    • Patient with pain related to shoulder trauma.
    • Patient with history of shoulder injury or shoulder surgery.
    • Patient with associated symptoms like numbness and tingling.
    • Patient who have taken corticosteroids injections of shoulder within a year.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Spencer technique + conventional physical therapy

The technique will be administered in seven sequential steps:

Shoulder extension with elbow flexion to restriction

Shoulder flexion with elbow extension

Circumduction with compression at 90° abduction

Circumduction with distraction at 90° abduction

Abduction with internal rotation

Adduction with external rotation

Stretching with fluid pumping maneuver (5-10 repetitions)

Dosage progression:

Weeks 1-3: 2 sets of 10 repetitions per step (1-minute rest between sets)

Weeks 4-6: 3 sets of 10 repetitions per step

Total session duration: 35 minutes (5 minutes hot pack, 10 minutes stretching, 20 minutes Spencer technique).
Other: Spencer technique

Spencer Technique (20 minutes per session)

The technique will be administered in seven sequential steps:

Shoulder extension with elbow flexion to restriction

Shoulder flexion with elbow extension

Circumduction with compression at 90° abduction

Circumduction with distraction at 90° abduction

Abduction with internal rotation

Adduction with external rotation Stretching with fluid pumping maneuver (5-10 repetitions) Weeks 1-3: 2 sets of 10 repetitions per step (1-minute rest between sets) Weeks 4-6: 3 sets of 10 repetitions per step

Other: conventional physical therapy

Conventional Therapy (15 minutes per session)

Moist Hot Pack (5 minutes):

A moist hot pack will be applied to the affected shoulder at a therapeutic temperature, with a towel placed between the pack and the skin.

Shoulder Stretching (10 minutes):

Passive stretching exercises will be performed to improve flexibility and range of motion. Each stretch will be held for 20-30 seconds and repeated 3-5 times. Stretching will include:

Shoulder flexion and extension

Shoulder abduction

Shoulder adduction

Internal and external rotation at 90° abduction
Experimental: movement with mobilization + conventional physical therapy

The technique will be administered in seven sequential steps:

Shoulder extension with elbow flexion to restriction

Shoulder flexion with elbow extension

Circumduction with compression at 90° abduction

Circumduction with distraction at 90° abduction

Abduction with internal rotation

Adduction with external rotation

Stretching with fluid pumping maneuver (5-10 repetitions)

Dosage progression:

Weeks 1-3: 2 sets of 10 repetitions per step (1-minute rest between sets)

Weeks 4-6: 3 sets of 10 repetitions per step

Total session duration: 35 minutes (5 minutes hot pack, 10 minutes stretching, 20 minutes Spencer technique).
Other: conventional physical therapy

Conventional Therapy (15 minutes per session)

Moist Hot Pack (5 minutes):

A moist hot pack will be applied to the affected shoulder at a therapeutic temperature, with a towel placed between the pack and the skin.

Shoulder Stretching (10 minutes):

Passive stretching exercises will be performed to improve flexibility and range of motion. Each stretch will be held for 20-30 seconds and repeated 3-5 times. Stretching will include:

Shoulder flexion and extension

Shoulder abduction

Shoulder adduction

Internal and external rotation at 90° abduction

Other: Movement with mobilization

Mobilization will be performed in:

External rotation

Internal rotation

Abduction

Flexion

Participants will actively move the shoulder during sustained glide until the onset of pain or discomfort.

Dosage:

3 sets of 10 repetitions

30-second rest between sets

3 sessions per week for 6 weeks Conventional Therapy (15 minutes per session)

Moist Hot Pack (5 minutes):

A moist hot pack will be applied to the affected shoulder at a therapeutic temperature, with a towel placed between the pack and the skin.

Shoulder Stretching (10 minutes):

Passive stretching exercises will be performed to improve flexibility and range of motion. Each stretch will be held for 20-30 seconds and repeated 3-5 times. Stretching will include:

Shoulder flexion and extension

Shoulder abduction

Shoulder adduction

Internal and external rotation at 90° abduction Total session duration: 35 minutes (5 minutes hot pack, 10 minutes stretching, 20 minutes mobilization).

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Pain Intensity (Visual Analogue Scale)
Time Frame: baseline, 3rd week , 6th week
Visual Analogue Scale The Visual Analogue Scale (VAS) is a subjective measure in which individuals rate their pain on an eleven-point numerical scale. The scale is composed of 0 (no pain at all) to 10 (worst imaginable pain). According to researches VAS shows excellent reliability (0.97 and 0.99, respectively) for the measurement of musculoskeletal pain.
baseline, 3rd week , 6th week

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
range of motion
Time Frame: baseline, 3rd week, 6th week

Goniometer Range of motion is measured using a goniometer at baseline and end point measurements. Range of motion of joints are usually assessed by a device known as universal goniometer. goniometer has two arms stationary as well as movable arm. The centre of the goniometer is known as fulcrum. Through goniometer in each plane joint ranges are measured.

Goniometer Positioning for Shoulder Joint Assessment For Goniometer assessment fulcrum with be place on the shoulder joint. On the other hand it was in aligned with frontal axis in terms of assessing flexion and extension and add sagittal axis in terms of assessing abduction and abduction and in longitudinal axis for internal and external rotation.
baseline, 3rd week, 6th week
for function (DASH)
Time Frame: Baseline, 3rd week, 6th week
Disability of Arm, Shoulder, and Hand (DASH) questionnaire The Disability of Arm, Shoulder, and Hand (DASH) questionnaire consists of 30 items designed to evaluate self-reported disability. It measures both symptoms and physical abilities related to upper musculoskeletal conditions. Additionally, it assesses upper limb impairment by tracking changes in symptoms and functionality over time. The questionnaire demonstrates strong reliability (0.96) and solid validity (0.70).
Baseline, 3rd week, 6th week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
University of Lahore

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
University of Lahore Hospital (ULH)

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Asim Arif, Phd scholar, University of Lahore

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
September 26, 2025

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
February 28, 2026

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
March 3, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
March 4, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 4, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
March 9, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 9, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 4, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
September 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • UOL/IREB/25/12/0014

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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