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Effect of Adding Latissimus Dorsi Myofascial Release to Scapular Proprioceptive Neuromuscular Facilitation on Pain, Disability, and Range of Motion in Adhesive Capsulitis

8. maj 2026 opdateret af: Ibadat International University, Islamabad

Effect of Adding Latissimus Dorsi Myofascial Release to Scapular Proprioceptive Neuromuscular Facilitation on Pain, Disability, and Range of Motion in Adhesive Capsulitis: A Randomized Controlled Trial

This randomized controlled trial aims to compare the effects of scapular proprioceptive neuromuscular facilitation (PNF) alone versus PNF combined with latissimus dorsi myofascial release on pain, range of motion, and functional disability in patients with stage II adhesive capsulitis; a condition characterized by capsular stiffness, pain, and restricted shoulder mobility, with outcomes assessed using NPRS, goniometry, and SPADI over a 6-week intervention period.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Participants diagnosed with stage II adhesive capsulitis will be randomly allocated into two groups. The experimental group will receive latissimus dorsi myofascial release combined with scapular proprioceptive neuromuscular facilitation (PNF) hold-relax technique, while the control group will receive scapular PNF hold-relax technique only. Both interventions will be administered for 6 weeks, with 3 sessions per week. Outcome measures will include Numeric Pain Rating Scale (NPRS) for pain intensity, goniometry for shoulder range of motion, latissimus dorsi length test for muscle tightness, and Shoulder Pain and Disability Index (SPADI) for functional disability. Data will be analyzed using IBM SPSS version 26.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

58

Fase

  • Ikke anvendelig

Kontakter og lokationer

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Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

  • Pakistan
    • Punjab Province
      • Islamabad, Punjab Province, Pakistan, 44000
        • Rekruttering
        • • Ibadat international hospital • Shaafi international hospital • South East hospital • Fauji Foundation hospital
        • Kontakt:
        • Kontakt:

Deltagelseskriterier

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Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

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Beskrivelse

Inclusion Criteria:

  • 1. Age between 35 and 70 years.
  • Both male and female participants.
  • Stiffening (Stage II) phase of frozen shoulder.
  • Pain intensity ≥ 4/10 on NPRS during shoulder movement.
  • Unilateral shoulder involvement.
  • Presence of capsular pattern:ER > ABD > IR limitation
  • Apley's Scratch Test
  • Limited both ROMs
  • Symptom duration between 3 and 9 months.(Di Mascio et al., 2024)

Exclusion Criteria:

  • Secondary adhesive capsulitis due to trauma or surgery
  • History of shoulder fracture or dislocation.
  • Bilateral frozen shoulder.
  • Active systemic inflammatory or neurological disease
  • Recent intra-articular corticosteroid injection (within last 3 months)
  • Current anticoagulation therapy or bleeding disorders.
  • Pregnant females.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Latissimus dorsi myofascial release and Scapular PNF hold-relax technique. ( Experimental)
Received latissimus dorsi myofascial release (10-15 minutes, sustained pressure with 90-120 sec holds) combined with scapular PNF hold-relax (posterior elevation-anterior depression pattern; 3 sets × 5 reps, 5-7 sec contraction, 10-15 sec stretch).
Andet: Myofascial release+ Scapular Proprioceptive Neuromuscular Facilitation (PNF) hold-relax technique

Participants in the experimental group will receive a combination of latissimus dorsi myofascial release (MFR) and scapular proprioceptive neuromuscular facilitation (PNF) using the hold-relax technique. Myofascial release will be applied to the latissimus dorsi muscle with the patient positioned in side-lying (affected side up) or supine with the shoulder in flexion. The therapist will apply slow, sustained pressure along the posterior axillary fold and lateral border of the scapula, following the muscle fibers toward the thoracolumbar fascia. The technique will include sustained pressure, longitudinal gliding, and passive shoulder elevation until a tissue resistance barrier is reached. Each stretch will be maintained for 90-120 seconds, with a total MFR duration of approximately 10-15 minutes per session.

Following MFR, scapular PNF will be performed using the posterior elevation to anterior depression pattern. The hold-relax technique will involve isometric contractions of 5-7 seco
Aktiv komparator: Scapular PNF hold-relax only (control)
Received scapular PNF hold-relax only (same pattern and dosage: 3 sets × 5 reps, 5-7 sec contraction, 10-15 sec stretch),
Andet: Scapular PNF hold-relax only

Participants in the control group will receive scapular proprioceptive neuromuscular facilitation (PNF) using the hold-relax technique without the addition of myofascial release. The intervention will follow the scapular posterior elevation to anterior depression pattern. Each repetition will include an isometric contraction lasting 5-7 seconds followed by a passive stretch of 10-15 seconds. A total of 3 sets with 5 repetitions per set will be performed in each session, with an overall duration of approximately 20 minutes.

In addition, a hot pack will be applied to the affected area for 10-15 minutes prior to the exercise session to promote muscle relaxation. Treatment sessions will be conducted three times per week for a duration of 6 weeks.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Pain Intensity
Tidsramme: baseline to 6 weeks
Numeric Pain rating scale(NPRS) will be used. It is the numeric version of visual analogue scale used to assess the intensity of pain. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme. it has moderate to excellent reliability and good validity
baseline to 6 weeks
Shoulder Range of Motion (ROM)
Tidsramme: baseline to 6 weeks
Measured using a universal goniometer. Shoulder flexion, abduction, external rotation, and internal rotation will be assessed at baseline and at 6 weeks.
baseline to 6 weeks
Latissimus Dorsi Length Test
Tidsramme: baseline to 6 weeks
It is used to check the tightness of latissimus dorsi muscle. The patient is in supine lying with knees bend and back flattened to the floor, arm elevated overhead. if there is tightness of this muscle person's unable to flexed his arm by 180° and compensated by arching its back also with the help of goniometer measurement starts with axis at the humeral head , stationary arm midline to the body and moveable arm parallel to the longitudinal axis of the humerus a normal full length muscle allows the arms to touch the table while shortened muscle not allow them to touch the table.
baseline to 6 weeks
Shoulder Pain and Disability Index (SPADI)
Tidsramme: baseline to 6 weeks
The Shoulder Pain and Disability Index (SPADI) is a self-administered questionnaire used to assess pain and functional disability associated with shoulder conditions. It consists of 13 items divided into two subscales: pain (5 items) and disability (8 items). Each item is scored on a scale from 0 to 10, where 0 indicates no pain or difficulty and 10 indicates the worst pain or maximum difficulty. The total score is calculated by averaging the scores of both subscales and converting them into a percentage ranging from 0 to 100, with higher scores indicating greater pain and disability.
baseline to 6 weeks

Samarbejdspartnere og efterforskere

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Sponsor

Ibadat International University, Islamabad

Publikationer og nyttige links

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Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

5. april 2026

Primær færdiggørelse (Anslået)

6. juni 2026

Studieafslutning (Anslået)

8. juni 2026

Datoer for studieregistrering

Først indsendt

2. maj 2026

Først indsendt, der opfyldte QC-kriterier

8. maj 2026

Først opslået (Faktiske)

14. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

14. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

8. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • IIUI/RERC/ADT/2026/04/287

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