The Effect of Osteopathic Visceral Manipulation on Pain, Mobility and Functional Disability in Patients With Right Shoulder Adhesive Capsulitis

July 14, 2026 updated by: Bilinç Doğruöz Karatekin, Istanbul Medeniyet University
The aim of this study was to evaluate the effects of adding osteopathic visceral manipulation (OVM) to a standard physical therapy program on pain, functional disability, and range of motion (ROM) in patients diagnosed with right shoulder adhesive capsulitis (AC). A total of 49 patients aged between 40 and 65 years who were diagnosed with right shoulder AC were included in the study. Randomized patients received a standard physical therapy program for three weeks, consisting of 15 sessions (5 days per week) in both treatment groups. The standard program included hot pack application to the shoulder region for 20 min, conventional transcutaneous electrical nerve stimulation (TENS) for 20 min, and ultrasound therapy at 1.5 W/cm² for 10 min. In addition to the standard physical therapy program, Group 1 (n=25) received OVM once weekly, while Group 2 (n=24) received sham OVM once weekly. Pain was evaluated using the Visual Analog Scale (VAS), while functional disability was evaluated using the Shoulder Pain and Disability Index (SPDI). The ROM values were also recorded.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

56

Phase

  • 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

  • Turkey (Türkiye)
      • Istanbul, Turkey (Türkiye)
        • Goztepe Suleyman Yalcin Sehir Hastanesi Fiziksel Tıp ve Rehabilitasyon Klinigi

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

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age between 18 and 65 years
  • Presence of pain originating from the right shoulder region persisting for at least 6 weeks
  • Availability of two-view shoulder radiographs obtained prior to the study to exclude causes of shoulder pain other than AC
  • No local corticosteroid injection for shoulder pain within the previous 6 months
  • No physical therapy administered for shoulder pain within the previous 6 months
  • No use of non-steroidal anti-inflammatory drugs (NSAIDs) during the study period

  • Availability of laboratory assessments including:

    • Complete blood count (CBC)
    • Erythrocyte sedimentation rate (ESR)
    • Liver function tests (AST, ALT)
    • C-reactive protein (CRP)
  • Pain intensity score of at least 4 cm on the Visual Analog Scale (VAS, 0-10 cm)

Exclusion Criteria:

  • History of shoulder fracture on the affected side
  • Prior shoulder surgery
  • History of traumatic shoulder instability (subluxation or dislocation)
  • History of shoulder or visceral organ surgery within the past 6 months
  • History of systemic or inflammatory disease or malignancy
  • Presence of metabolic or endocrine bone disease
  • Pregnancy
  • Neurological disorders affecting upper extremity function
  • Psychiatric disorders that could interfere with treatment compliance or symptom evaluation
  • Use of antiplatelet medication
  • Previous osteopathic treatment

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
Intervention / Treatment
Experimental: Group 1 (OVM group, n=28) received a standard physical therapy program
Other: physical therapy program
In the OVM group, mobilization of the liver and diaphragm was performed. Liver mobilization was applied in three planes (coronal, transverse, and sagittal) for 5 min each, totaling 15 min, while the diaphragm technique was applied for 2 min.
Sham Comparator: Group 2 (Sham group, n=28) received the same standard physical therapy program
Other: Sham (No Treatment)
In the sham OVM group, light pressure and touch were applied with the palm over the same points selected for OVM, without the intention of providing therapeutic effect.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Pain (VAS)
Time Frame: From enrollment to the end of treatment at 4 weeks
From enrollment to the end of treatment at 4 weeks

Secondary Outcome Measures

Outcome Measure
Time Frame
Active shoulder ROM for abduction, flexion, internal rotation, and external rotation
Time Frame: From enrollment to the end of treatment at 4 weeks
From enrollment to the end of treatment at 4 weeks
Shoulder Pain and Disability Index (SPADI)
Time Frame: From enrollment to the end of treatment at 4 weeks
From enrollment to the end of treatment at 4 weeks

Collaborators and Investigators

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

Sponsor

Istanbul Medeniyet 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)

January 10, 2023

Primary Completion (Actual)

May 15, 2024

Study Completion (Actual)

March 20, 2025

Study Registration Dates

First Submitted

July 6, 2026

First Submitted That Met QC Criteria

July 14, 2026

First Posted (Actual)

July 15, 2026

Study Record Updates

Last Update Posted (Actual)

July 15, 2026

Last Update Submitted That Met QC Criteria

July 14, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2022/0670

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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