Effect of Adding Latissimus Dorsi Myofascial Release to Scapular Proprioceptive Neuromuscular Facilitation on Pain, Disability, and Range of Motion in Adhesive Capsulitis
8 de mayo de 2026 actualizado por: 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.
Descripción general del estudio
Estado
Reclutamiento
Condiciones
Descripción detallada
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.
Tipo de estudio
Intervencionista
Inscripción (Estimado)
58
Fase
- No aplica
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Estudio Contacto
- Nombre: Hufsa Naseer, DPT, MS-PT MSK
- Número de teléfono: +3095166821
- Correo electrónico: hufsanaseer@gmail.com
Copia de seguridad de contactos de estudio
- Nombre: Fatima Amjad, DPT, MS-PT Sports, PHD Scholar
- Número de teléfono: +3330940975
- Correo electrónico: Fatima.amjad@uipt.iiui.edu.pk
Ubicaciones de estudio
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Punjab Province
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Islamabad, Punjab Province, Pakistán, 44000
- Reclutamiento
- • Ibadat international hospital • Shaafi international hospital • South East hospital • Fauji Foundation hospital
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Contacto:
- Hufsa Naseer, DPT, MS-PT MSK
- Número de teléfono: 03095166821
- Correo electrónico: hufsanaseer@gmail.com
-
Contacto:
- Fatima Amjad, DPT, MS-PT MSK Sports, PHD
- Número de teléfono: +923330940975
- Correo electrónico: Fatima.amjad@uipt.iiui.edu.pk
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-
Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
- Adulto
- Adulto Mayor
Acepta Voluntarios Saludables
No
Descripción
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.
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Único
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
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Experimental: 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).
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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 |
|
Comparador activo: 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),
|
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. |
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Pain Intensity
Periodo de tiempo: 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
|
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Shoulder Range of Motion (ROM)
Periodo de tiempo: baseline to 6 weeks
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Measured using a universal goniometer.
Shoulder flexion, abduction, external rotation, and internal rotation will be assessed at baseline and at 6 weeks.
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baseline to 6 weeks
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Latissimus Dorsi Length Test
Periodo de tiempo: baseline to 6 weeks
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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.
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baseline to 6 weeks
|
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Shoulder Pain and Disability Index (SPADI)
Periodo de tiempo: 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.
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baseline to 6 weeks
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Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Publicaciones y enlaces útiles
La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.
Publicaciones Generales
- Roach KE, Budiman-Mak E, Songsiridej N, Lertratanakul Y. Development of a shoulder pain and disability index. Arthritis Care Res. 1991 Dec;4(4):143-9.
- Page MJ, Green S, Kramer S, Johnston RV, McBain B, Chau M, Buchbinder R. Manual therapy and exercise for adhesive capsulitis (frozen shoulder). Cochrane Database Syst Rev. 2014 Aug 26;2014(8):CD011275. doi: 10.1002/14651858.CD011275.
- Teoli D, Sanvictores T, An J. SWOT Analysis. 2023 Sep 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK537302/
- Su S, Guo Y, Parnitzke B, Poerio T, Derosa J. A Voltage-Controlled Strategy for Modular Shono-Type Amination. J Am Chem Soc. 2024 Oct 23;146(42):28663-28668. doi: 10.1021/jacs.4c12520. Epub 2024 Oct 14.
- Elnaggar RK, Elbanna MF, Mahmoud WS, Alqahtani BA. Plyometric exercises: subsequent changes of weight-bearing symmetry, muscle strength and walking performance in children with unilateral cerebral palsy. J Musculoskelet Neuronal Interact. 2019 Dec 1;19(4):507-515.
- Fehd HM, Seiffert AE. Looking at the center of the targets helps multiple object tracking. J Vis. 2010 Apr 28;10(4):19.1-13. doi: 10.1167/10.4.19.
- Harnett G, Collins M. Nursing in rural, remote and isolated settings: a literature review. Rural Remote Health. 2023 Jan;23(1):8159. doi: 10.22605/RRH8159. Epub 2023 Jan 10.
- Khaled N, Kalbarczyk A, Zavala E, Rahman A, de Boer M, Chakraborty B, Rahman H, Ali H, Haque R, Ayesha K, Siddiqua TJ, Afsana K, Christian P, Thorne-Lyman AL. A formative study of the sociocultural influences on dietary behaviours during pregnancy in rural Bangladesh. Matern Child Nutr. 2024 Oct;20 Suppl 6(Suppl 6):e13713. doi: 10.1111/mcn.13713. Epub 2024 Aug 30.
- Zhang W, Xia K, Feng Z, Qin Y, Zhou Y, Feng G, Zhu H, Yao Q. Tomato plant growth promotion and drought tolerance conferred by three arbuscular mycorrhizal fungi is mediated by lipid metabolism. Plant Physiol Biochem. 2024 Mar;208:108478. doi: 10.1016/j.plaphy.2024.108478. Epub 2024 Feb 28.
- Thayaparan T, Petrovic RM, Achkova DY, Zabinski T, Davies DM, Klampatsa A, Parente-Pereira AC, Whilding LM, van der Stegen SJ, Woodman N, Sheaff M, Cochran JR, Spicer JF, Maher J. CAR T-cell immunotherapy of MET-expressing malignant mesothelioma. Oncoimmunology. 2017 Aug 14;6(12):e1363137. doi: 10.1080/2162402X.2017.1363137. eCollection 2017.
- Ahearn N, McCann PA, Tasker A, Sarangi PP. The influence of rotator cuff pathology on functional outcome in total shoulder replacement. Int J Shoulder Surg. 2013 Oct;7(4):127-31. doi: 10.4103/0973-6042.123509.
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio (Actual)
5 de abril de 2026
Finalización primaria (Estimado)
6 de junio de 2026
Finalización del estudio (Estimado)
8 de junio de 2026
Fechas de registro del estudio
Enviado por primera vez
2 de mayo de 2026
Primero enviado que cumplió con los criterios de control de calidad
8 de mayo de 2026
Publicado por primera vez (Actual)
14 de mayo de 2026
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
14 de mayo de 2026
Última actualización enviada que cumplió con los criterios de control de calidad
8 de mayo de 2026
Última verificación
1 de mayo de 2026
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- IIUI/RERC/ADT/2026/04/287
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
NO
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
No
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
No
producto fabricado y exportado desde los EE. UU.
No
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .