Spinal Mobilization With Arm Movement and Kaltenborn Mobilization in Adhesive Capsulitis (SMWAM)

July 23, 2026 updated by: Riphah International University

Effects of Spinal Mobilization With Arm Movement and Kaltenborn Mobilization on Pain, Range of Motion, Functional Reaching, and Disability in Adhesive Capsulitis

To compare the effects of spinal mobilization with arm movement and Kaltenborn Mobilization on pain, range of motion, functional reaching, and disability in patients with Adhesive Capsulitis.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

A randomized clinical trial compared the effectiveness of Kaltenborn mobilization and muscle energy techniques in individuals with adhesive capsulitis. Seventy-six participants were randomly allocated into two treatment groups. Pain, shoulder range of motion, and disability were assessed using the Numeric Pain Rating Scale (NPRS), goniometry, and the Shoulder Pain and Disability Index (SPADI) at baseline and after four weeks of treatment. The findings demonstrated that Kaltenborn mobilization produced greater improvements in pain reduction, shoulder range of motion, and functional ability.

A quasi-experimental study evaluated the effects of Kaltenborn mobilization and muscle energy techniques in patients with chronic adhesive capsulitis. Participants received their respective manual therapy interventions in combination with conventional rehabilitation. Shoulder external rotation, shoulder abduction, pain intensity, and functional disability were assessed before and after treatment. The results indicated that Kaltenborn mobilization was more effective than muscle energy techniques in improving shoulder mobility, reducing pain, and enhancing functional outcomes.

A randomized controlled trial compared muscle energy techniques with Kaltenborn mobilization for improving shoulder range of motion in individuals with adhesive capsulitis. Outcomes were assessed at baseline and during follow-up using goniometric measurements. The findings showed that muscle energy techniques produced greater improvements in shoulder flexion and abduction, whereas rotational movements demonstrated no clear advantage over Kaltenborn mobilization.

A randomized clinical trial investigated the effects of Spinal Mobilization with Arm Movement (SMWAM) compared with the Maitland mobilization technique on shoulder function. Pain, shoulder range of motion, and muscle activity were evaluated before and after treatment. The results demonstrated that spinal mobilization with arm movement effectively reduced pain, normalized shoulder muscle activity, and increased shoulder range of motion.

A randomized controlled trial compared the effects of anterior and posterior Grade III Kaltenborn glides on shoulder function in patients with adhesive capsulitis. External rotation and functional ability were evaluated using goniometric measurements and the Shoulder Pain and Disability Index (SPADI). The findings indicated that posterior gliding mobilization resulted in greater improvements in external rotation and shoulder function than anterior gliding.

A randomized controlled trial examined the immediate effects of Spinal Mobilization with Arm Movement (SMWAM) on shoulder performance. The intervention involved cervical spinal mobilization combined with repeated active arm abduction. The study reported immediate improvements in shoulder movement and suggested that SMWAM enhances shoulder function by correcting cervical spinal alignment and stimulating joint mechanoreceptors.

Although both Spinal Mobilization with Arm Movement (SMWAM) and Kaltenborn Mobilization have demonstrated beneficial effects in reducing pain and improving shoulder mobility, existing evidence has primarily evaluated these techniques independently or compared them with other manual therapy approaches. Direct comparative evidence between SMWAM and Kaltenborn Mobilization in individuals with adhesive capsulitis remains limited, particularly regarding their effects on pain, range of motion, functional reaching, and disability. Therefore, further comparative research is warranted to determine the more effective intervention for optimizing functional recovery in patients with adhesive capsulitis.

Study Type

Interventional

Enrollment (Estimated)

50

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 Contact

Study Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
      • Lahore, Punjab Province, Pakistan, 54000

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

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age 35-50 years
  • Both male and female genders
  • Pain rating 3 to 7 on NPRS for at least 3 months
  • Idiopathic frozen shoulder
  • Stage II and III frozen shoulder
  • Positive Apley's Scratch test
  • Unilateral frozen shoulder
  • Frozen shoulder with at least 25% restricted ROM
  • Presence of global restriction in passive range of motion (PROM) in a capsular pattern (ER > ABD > IR)

Exclusion Criteria:

  • Arthritic shoulder
  • Rotator cuff disease
  • Post-traumatic stiff shoulder
  • Post-CABG shoulder-hand syndrome
  • Post-stroke frozen shoulder
  • Bilateral frozen shoulder
  • Complex Regional Pain Syndrome
  • Any fracture or other injury
  • Any systemic illness
  • Any inflammatory disease (Rheumatoid arthritis, gout)
  • Any neurological disease
  • Frozen Shoulder secondary to Brachial Plexus Injury, Parkinsonism, Ankylosis, Infection, or Arthroplasty
  • Tendon calcification

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
Active Comparator: Spinal Mobilization with Arm Movement
Participants will be seated upright while the therapist applies a sustained transverse glide to the C4 spinous process toward the side opposite the affected shoulder. The glide will be maintained as the participant actively abducts the affected arm to the pain-free or maximum tolerated range and returns to the starting position. The technique will be performed for 10 repetitions per session, ensuring controlled movement, proper posture, and patient comfort throughout the intervention.
Other: Spinal Mobilization with Arm Movement
Intervention: Spinal Mobilization with Arm Movement (SMWAM) Position: Participant seated upright with neutral spine and head posture Technique: Sustained transverse glide applied to the C4 spinous process toward the side opposite the affected shoulder during active shoulder abduction Movement: Active shoulder abduction to the pain-free or maximum tolerated range, followed by return to the starting position while maintaining the glide Dosage: 10 repetitions per session Purpose: To reduce pain, improve shoulder mobility, and enhance functional movement.
Other Names:
  • SMWAM
Experimental: Kaltenborn Mobilization
Following the application of a moist hot pack, participants will receive Kaltenborn Grade I glenohumeral traction followed by Grade III ventral glide and Grade III caudal glide in the same treatment session. Each mobilization will be performed for 15 repetitions, with a 30-second sustained hold and 10-second rest between repetitions, for a total treatment time of approximately 10 minutes. The techniques will be applied in standardized patient positions with appropriate scapular stabilization to improve glenohumeral joint mobility, reduce pain, and increase shoulder range of motion.
Other: Kaltenborn Mobilization
Intervention: Kaltenborn Mobilization Technique (KMT) Pre-treatment: Moist hot pack application Techniques: Grade I glenohumeral traction, Grade III ventral glide, and Grade III caudal glide Dosage: 15 repetitions of each technique with a 30-second hold and 10-second rest between repetitions Duration: Approximately 10 minutes per session Purpose: To improve glenohumeral joint mobility, reduce pain, and increase shoulder range of motion.
Other Names:
  • KMT

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain by Numeric Pain Rating Scale (NPRS)
Time Frame: 6 weeks
The Numeric Pain Rating Scale (NPRS) is an 11-point self-reported scale (0 = no pain, 10 = worst imaginable pain) used to assess pain intensity in clinical and research settings.
6 weeks
Range of Motion (External Rotation, Abduction, Internal Rotation)
Time Frame: 6 weeks
A goniometer is a standard clinical instrument used to measure joint range of motion (ROM)
6 weeks
Functional Disability
Time Frame: 6 weeks
The Shoulder Pain and Disability Index (SPADI) is a 13-item self-administered questionnaire used to assess shoulder pain and functional disability.
6 weeks

Collaborators and Investigators

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

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Annum Manzoor, MS OMPT, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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)

July 1, 2026

Primary Completion (Estimated)

August 1, 2026

Study Completion (Estimated)

September 1, 2026

Study Registration Dates

First Submitted

July 21, 2026

First Submitted That Met QC Criteria

July 23, 2026

First Posted (Actual)

July 24, 2026

Study Record Updates

Last Update Posted (Actual)

July 24, 2026

Last Update Submitted That Met QC Criteria

July 23, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/RCR & AHS/25/0142

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

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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