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

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: Completed
• Conditions: Adhesive Capsulitis
• Intervention / Treatment: Behavioral: High Velocity Low Amplitude Thrust; Behavioral: Muscle Energy Technique

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: Interventional
• Enrollment (Actual): 66
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Lahore, Punjab Province, Pakistan, 54000
      • Principal Investigator

Participation Criteria

Eligibility Criteria

• 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

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
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

Outcome Measure	Measure Description	Time Frame
Visual Analogue Scale (VAS) for Pain	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

• Sponsor: Green International University

Study record dates

Study Major Dates

• Study Start (Actual): November 9, 2025
• Primary Completion (Actual): April 29, 2026
• Study Completion (Actual): May 6, 2026

Study Registration Dates

• First Submitted: May 14, 2026
• First Submitted That Met QC Criteria: May 14, 2026
• First Posted (Actual): May 20, 2026

Study Record Updates

• Last Update Posted (Actual): May 20, 2026
• Last Update Submitted That Met QC Criteria: May 14, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Adhesive Capsulitis, Frozen Shoulder, HVLA Thrust, PIR-MET, Shoulder Pain, Shoulder Mobility, Manual
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Musculoskeletal Diseases; Joint Diseases; Arthralgia; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Bursitis; Shoulder Pain
• Other Study ID 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