Effects of Gong's Mobilization With and Without Nielasher Technique on in Adhesive Capsulitis

Effects of Gong's Mobilization With and Without Niel Asher Technique on Shoulder Pain, Range of Motion and Disability in Adhesive Capsulitis

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.

Study Overview

• Status: Recruiting
• Conditions: Adhesive Capsulitis
• Intervention / Treatment: Other: Gong's Mobilization; Other: Gong's Mobilization and Niel-Asher technique

• Study Type: Interventional
• Enrollment (Estimated): 46
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: iqbal Tariq, phd; Phone Number: 03338236752; Email: iqbal.tariq@riphah.edu.pk
• Study Contact Backup: Name: Rabiya Noor, phd; Phone Number: 03344355660; Email: Rabiya.Noor@riphah.edu.pk

Study Locations

• Pakistan
  • Punjab Province
    • Lahore, Punjab Province, Pakistan, 54000
      • Recruiting
      • Rabiya Noor
      • Contact: iqbal Tariq, phd; Phone Number: 03338236752; Email: iqbal.tariq@riphah.edu.pk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Individuals with age group of 40-60 years.
• Both Females and males individuals.
• Individuals diagnosed with Frozen shoulder (Adhesive Capsulitis) within stage II and III of frozen shoulder.
• Individuals with positive capsular pattern (ER>Abd> IR).
• Individuals with ROM loss ≥ 25% in at least two planes compared with the noninvolved shoulder

Exclusion Criteria:

• Individuals with rotator cuff tears and overuse injury
• Individuals with inflammatory diseases (Osteoarthritis, Rheumatoid Arthritis, Gout) and Malignancies
• Individuals Using Corticosteroid Injections or Medications

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: Gong's Mobilization	Other: Gong's Mobilization; It is performed in a side-lying position.; The therapist will stand on the affected side of the patient and push the head of humerus of the affected side in anterior to posterior direction parallel to the joint plane with the palm of his hand, simultaneously, with the other hand, the therapist will push the scapula from posterior to anterior direction realigning and stabilizing the humeral head within correct position.; The patient is asked to quickly and powerfully perform abduction while keeping the elbow straight. Meanwhile, the therapist will keep pressing the humeral head along the long axis of the humerus, maintaining the oscillatory glide in Maitland's grade (III, IV), following the movement of the patient's shoulder during abduction.; The speed of the movement is kept constant by the therapist while maintaining a little distraction at the Glenohumeral joint.; Therapist will accelerate the movement at the end range to gain Glenohumeral ROM.
Active Comparator: Gong's Mobilization and Niel-Asher technique	Other: Gong's Mobilization; It is performed in a side-lying position.; The therapist will stand on the affected side of the patient and push the head of humerus of the affected side in anterior to posterior direction parallel to the joint plane with the palm of his hand, simultaneously, with the other hand, the therapist will push the scapula from posterior to anterior direction realigning and stabilizing the humeral head within correct position.; The patient is asked to quickly and powerfully perform abduction while keeping the elbow straight. Meanwhile, the therapist will keep pressing the humeral head along the long axis of the humerus, maintaining the oscillatory glide in Maitland's grade (III, IV), following the movement of the patient's shoulder during abduction.; The speed of the movement is kept constant by the therapist while maintaining a little distraction at the Glenohumeral joint.; Therapist will accelerate the movement at the end range to gain Glenohumeral ROM.; Other: Gong's Mobilization and Niel-Asher technique; 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)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	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

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: summaya asim, MSPT(CP), Riphah International University

Publications and helpful links

General Publications

• 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.

Study record dates

Study Major Dates

• Study Start (Actual): December 15, 2025
• Primary Completion (Estimated): June 15, 2026
• Study Completion (Estimated): July 15, 2026

Study Registration Dates

• First Submitted: June 1, 2026
• First Submitted That Met QC Criteria: June 4, 2026
• First Posted (Actual): June 5, 2026

Study Record Updates

• Last Update Posted (Actual): June 5, 2026
• Last Update Submitted That Met QC Criteria: June 4, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Adhesive Capsulitis; goniometer
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Joint Diseases; Bursitis
• Other Study ID Numbers: REC/RCR & AHS/25/0109

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