Effects of Nunchaku Exercise for Improving Frozen Shoulder

April 14, 2026 updated by: Angus Pak-Hung Yu, Chinese University of Hong Kong

Effects of Nunchaku Exercise on Adhesive Capsulitis (Frozen Shoulder) in Middle-aged and Older Adults: A Randomized Controlled Trial

The goal of this clinical trial is to investigate if nunchaku exercise works to treat adhesive capsulitis, or frozen shoulder in middle-aged or older adults. It will also learn about the adherence of this exercise intervention. The main questions it aims to answer are:

  • Does practicing nunchaku exercises help reduce shoulder pain and improve shoulder movement?
  • Do people stick with nunchaku exercises better, and spend more time practicing on their own, compared with standard exercises for alleviating frozen-shoulder?

Researchers will compare nunchaku exercise to standard exercises for alleviating frozen-shoulder to see if nunchaku exercise works to alleviate frozen shoulder.

Participants will:

  • Join small group exercise classes for 12 weeks, doing either nunchaku based exercises or standard exercises designed to help relieve frozen shoulder.

  • Have their shoulder pain and movement checked three times:

    • before training
    • after 6 weeks of training,
    • after finishing the 12 week program, and
    • 12 weeks after the program ends.
  • Keep a record of their home practice time.

Study Overview

Status

Status

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

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

Adhesive capsulitis, or frozen shoulder, is a progressive fibro-inflammatory condition characterized by synovitis, capsular thickening, and collagen remodeling, leading to substantial restrictions in active and passive shoulder motion. These movement limitations commonly result in impaired sleep, difficulties in self-care, and reduced capacity for work and leisure activities. Although conservative rehabilitation is the standard of care, real-world effectiveness is frequently constrained by poor adherence to home-based exercises, often due to discomfort and exercise monotony.

This randomized controlled trial investigates the effects of nunchaku exercise as a novel rehabilitative modality for individuals with adhesive capsulitis in the thawing phase. Nunchaku practice requires rhythmic, multiplanar arm motions, coordinated scapulohumeral control, and dynamic stabilization. These biomechanical characteristics align with therapeutic goals of end-range stretching, neuromuscular retraining, and rotator-cuff-based stabilization. The inherently rhythmic, skill-acquisition nature of nunchaku practice may also enhance intrinsic motivation and adherence relative to traditional exercise programs.

In this assessor-blinded, two-arm, parallel-group trial, 50 ethnic Chinese adults aged 45 years or older will be recruited and randomized 1:1 to either a standard shoulder mobilization and stretching exercise program (SMSE) or a nunchaku exercise program (NE). The nunchaku exercise program will adapt into a safe, soft-towel form suitable for older adults. Both interventions last 12 weeks and consist of twice-weekly, 60-minute, small-group sessions, supplemented by encouraged home practice. SMSE includes joint mobilization, end-range stretching, strengthening. NE follows the Level 1 nunchaku syllabus of the nunchaku system from the Hong Kong nunchaku association.

Outcomes will be assessed at baseline, week 6, week 12, and week 24. The primary outcome is the Shoulder Pain and Disability Index (SPADI). Secondary outcomes include the Visual Analog Scale for pain, Constant-Murley Score, pain-free range of motion, and intervention enjoyment (PACES-8). Adherence will be monitored through attendance, dropout rates, and weekly self-practice time.

This study aims to determine whether nunchaku exercise can improve adherence and produce superior clinical outcomes compared with standard rehabilitation in middle-aged and older adults with adhesive capsulitis.

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 (Estimated)

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.
50

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 Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Hong Kong
      • Hong Kong, Hong Kong
        • Recruiting
        • Department of Sports Science and Physical Education, The Chinese University of Hong Kong
        • Contact:

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
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Ethnic Chinese;
  • Age 45 years or above;
  • Diagnosed with Adhesive Capsulitis (Frozen Shoulder) and currently in the thawing stage.

Exclusion Criteria:

  • Presence of secondary causes of shoulder stiffness, including recent trauma, post-surgical stiffness, or structural lesions such as full-thickness rotator cuff tears or severe glenohumeral arthritis;
  • Receipt of recent shoulder treatments known to influence short-term outcomes, including corticosteroid injections within the past three months, hydrodilatation, manipulation under anesthesia, arthroscopic capsular release within the past six months, or structured shoulder physiotherapy within the past three months;
  • Presence of somatic conditions that limit their ability to participate safely in exercise (e.g., inability to walk without an assistive device).

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.
Active Comparator: Shoulder Mobilization and Stretching Exercise (SMSE)
Behavioral: Shoulder Mobilization and Stretching Exercise (SMSE)
Participants in this group will be offered a 12-week rehabilitation program consisting of two 60-minute sessions per week. This program has been designed by a registered physiotherapist in accordance with the Hospital Authority of Hong Kong's self-care guidelines. Each session includes joint mobilization exercises, end-range stretching using a towel or stick, and muscle-strengthening and stabilizing exercises. The training will be conducted in small groups by trained exercise instructors, and you will be encouraged to continue practicing these exercises independently at home between sessions.
Experimental: Nunchaku Exercise
Behavioral: Nunchaku Exercise
Participants randomized to the Nunchaku Exercise group will participate in a 12-week training program consisting of two 60-minute sessions per week. To prioritize safety and minimize the risk of injury, you will use a soft towel with a knot at each end to simulate nunchaku movements (Figure 1). The training focuses on the level one syllabus of the standard nunchaku system, which involves rhythmic multi-angle movements, such as figure-eight trajectories and alternating hand transfers. Classes will be conducted in small groups by certified coaches from the Hong Kong Nunchaku Association, and you will be encouraged to perform these exercises independently at home between sessions.

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
Shoulder Pain and Disability Index (SPADI)
Time Frame: From enrollment to the end of follow-up period at 24 weeks
SPADI will be used to assess shoulder pain and functional limitations during daily living activities. SPADI, comprising 5 items to assess pain and 8 to assess disability, is widely used to evaluate the negative impact of frozen shoulder. Its Chinese version has been validated in China with good internal consistency and reliability
From enrollment to the end of follow-up period at 24 weeks

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
Visual Analog Scale for Pain (VAS)
Time Frame: From enrollment to the end of follow-up period at 24 weeks
The perception of pain during resting, and ordinary daily activities will be assessed using VAS. Participants will be instructed to draw a mark on a 10-cm line, with one end indicating no pain and the other indicating worst pain imaginable, to indicate their pain level
From enrollment to the end of follow-up period at 24 weeks
Constant-Murley Score (CMS)
Time Frame: From enrollment to the end of follow-up period at 24 weeks
Overall shoulder function will be assessed using the CMS. CMS assesses 4 domains, including pain, how shoulder function affects daily activity, pain-free range of motion, and muscle strength. This instrument has been validated in China. This assessment will be conducted by a registered physiotherapist.
From enrollment to the end of follow-up period at 24 weeks
Pain-free Range of Motion (ROM)
Time Frame: From enrollment to the end of follow-up period at 24 weeks
The pain-free ROM of forward and lateral elevation during flexion and abduction will be measured using a goniometer. The assessment will be conducted by a registered physiotherapist.
From enrollment to the end of follow-up period at 24 weeks
Enjoyment of intervention
Time Frame: From mid-intervention at 6 weeks to to the end of follow-up period at 24 weeks
Enjoyment of intervention will be assessed using the Eight-Item Physical Activity Enjoyment Scale (PACES-8).
From mid-intervention at 6 weeks to to the end of follow-up period at 24 weeks

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.
Chinese University of Hong Kong

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.
April 14, 2026

Primary Completion (Estimated)

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.
December 31, 2026

Study Completion (Estimated)

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.
December 31, 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 17, 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 17, 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 20, 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.
April 17, 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.
April 14, 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.
April 1, 2026

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.
  • FS_nun_1

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

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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