Effect of HVLA vs MET on Shoulder Mobility and Pain in Adhesive Cpsulitis (HVLA-MET-AC)

May 14, 2026 updated by: Memoona Saleem, Green International University

COMPARATIVE EFFECTS OF HIGH-VELOCITY LOW-AMPLITUDE (HVLA) THRUST AND MUSCLE ENERGY TECHNIQUE (MET) ON SHOULDER MOBILITY AND PAIN IN PATIENTS WITH ADHESIVE CAPSULITIS

This study compared the effects of High-Velocity Low-Amplitude (HVLA) thrust and Post-Isometric Relaxation Muscle Energy Technique (PIR-MET) on pain and shoulder mobility in patients with adhesive capsulitis. Sixty-six participants received either HVLA or PIR-MET with conventional physiotherapy for four weeks. Both treatments improved pain and range of motion, but PIR-MET showed significantly greater improvement, making it a more effective approach for managing frozen shoulder symptoms.

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

This study compared the effectiveness of High-Velocity Low-Amplitude (HVLA) thrust and Post-Isometric Relaxation Muscle Energy Technique (PIR-MET) in treating adhesive capsulitis (frozen shoulder). Sixty-six patients received either HVLA or PIR-MET along with conventional physiotherapy for four weeks. Both treatments improved pain and shoulder mobility, but PIR-MET showed significantly better results in reducing pain and increasing range of motion. The study concluded that PIR-MET is a more effective manual therapy technique for managing adhesive capsulitis and improving patients' functional recovery and quality of life.

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.
66

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, 54000
        • Principal Investigator

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:

  • Participants diagnosed with Stage II or III Adhesive Capsulitis Age between 40 and 65 years Both male and female participants Presence of shoulder pain and restricted range of motion for at least 3 months Limitation of active and passive shoulder movements, particularly external rotation Willingness to participate and provide informed consent Ability to attend treatment sessions for four weeks

Exclusion Criteria:

  • History of shoulder fracture, dislocation, or recent trauma Previous shoulder surgery Neurological disorders affecting shoulder function Rheumatoid arthritis or other systemic inflammatory conditions Cervical radiculopathy or referred pain from the cervical spine Rotator cuff tear or severe shoulder instability Malignancy or infection involving the shoulder joint Participants receiving other concurrent shoulder treatments Contraindications to manual therapy or physiotherapy interventions Unwillingness to participate or inability to complete the treatment protocol

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: Group A- HVLA Thrust
Participants in this group received high velocity, low amplitude thrust manipulation to the glenohumeral joint. Treatment was delivered by a trained physical therapist. The intervention aimed to restore joint mobility and reduce pain in patients diagnosed with adhesive capsulitis. Sessions were conducted 3 times per week for 12 weeks, in addition to a standardized home exercise program.
Behavioral: High Velocity Low Amplitude Thrust
A manual therapy technique involving a quick, controlled thrust applied to the glenohumeral joint at the end of the available range of motion. The goal is to improve joint play and mobility. Each session lasted approximately 10-15 minutes. The intervention was performed 3 times per week for 12 weeks. Adverse events were monitored throughout the study.
Other Names:
  • HVLA Thrust
Experimental: Group-B MET
Participants in this group received muscle energy technique applied to the shoulder muscles to improve range of motion and decrease pain. The technique involved active contraction of the patient against manual resistance followed by stretching. Sessions were conducted 3 times per week for 12 weeks, in addition to a standardized home exercise program.
Behavioral: Muscle Energy Technique
An active manual therapy technique where the patient contracts the shoulder muscles against the therapist's resistance, followed by a passive stretch. Target muscles included the posterior capsule, pectoralis major, and rotator cuff as indicated. Each session lasted approximately 15-20 minutes. The intervention was performed 3 times per week for 12 weeks.
Other Names:
  • MET

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
Visual Analogue Scale (VAS) for Pain
Time Frame: Baseline and after 4 weeks of intervention
Pain intensity was assessed using the Visual Analogue Scale (VAS), a 10 cm scale ranging from 0 (no pain) to 10 (worst imaginable pain). Participants marked their perceived shoulder pain level before and after the four-week intervention period.
Baseline and after 4 weeks of intervention

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.
Green International University

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.
November 9, 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.
April 29, 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.
May 6, 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).
May 14, 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.
May 14, 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.
May 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.
May 20, 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.
May 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.
May 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.
  • GIU/REC/26-24

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Only IPD used in the result publication will be shared

IPD Sharing Time Frame

It will be available after the completion of study

IPD Sharing Access Criteria

De-identified participant data, including demographic details, pain scores, shoulder range-of-motion data, study protocol, and analysis information, will be available to qualified researchers upon reasonable request and approval. Access will be provided through secure electronic sharing while maintaining participant confidentiality and ethical standards.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF
  • CSR

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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Sponsors and Collaborators

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Drug Interventions

Conditions

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Drug Interventions

Dietary Supplements

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