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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 maggio 2026 aggiornato da: 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.

Panoramica dello studio

Stato

Reclutamento

Condizioni

Capsulite adesiva

Intervento / Trattamento

Descrizione dettagliata

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 di studio

Interventistico

Iscrizione (Stimato)

Fase

Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Nome: Hufsa Naseer, DPT, MS-PT MSK
Numero di telefono: +3095166821
Email: hufsanaseer@gmail.com

Backup dei contatti dello studio

Nome: Fatima Amjad, DPT, MS-PT Sports, PHD Scholar
Numero di telefono: +3330940975
Email: Fatima.amjad@uipt.iiui.edu.pk

Luoghi di studio

Pakistan
- Punjab Province
  - Islamabad, Punjab Province, Pakistan, 44000
    - Reclutamento
    - • Ibadat international hospital • Shaafi international hospital • South East hospital • Fauji Foundation hospital
    - Contatto:
      
      Hufsa Naseer, DPT, MS-PT MSK
      
      Numero di telefono: 03095166821
      
      Email: hufsanaseer@gmail.com
    - Contatto:
      
      Fatima Amjad, DPT, MS-PT MSK Sports, PHD
      
      Numero di telefono: +923330940975
      
      Email: Fatima.amjad@uipt.iiui.edu.pk

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Adulto
Adulto più anziano

Accetta volontari sani

Descrizione

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.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

Scopo principale: Trattamento
Assegnazione: Randomizzato
Modello interventistico: Assegnazione parallela
Mascheramento: Separare

Numero di armi

Armi e interventi

Gruppo di partecipanti / Arm	Intervento / Trattamento
Sperimentale: 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).	Altro: 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
Comparatore attivo: 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),	Altro: 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.

Gruppo di partecipanti / Arm

Intervento / Trattamento

Sperimentale: 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).

Altro: 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

Comparatore attivo: 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),

Altro: 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.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato	Misura Descrizione	Lasso di tempo
Pain Intensity Lasso di tempo: 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) Lasso di tempo: 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 Lasso di tempo: 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) Lasso di tempo: 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

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Ibadat International University, Islamabad

Pubblicazioni e link utili

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Pubblicazioni generali

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Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

5 aprile 2026

Completamento primario (Stimato)

6 giugno 2026

Completamento dello studio (Stimato)

8 giugno 2026

Date di iscrizione allo studio

Primo inviato

2 maggio 2026

Primo inviato che soddisfa i criteri di controllo qualità

8 maggio 2026

Primo Inserito (Effettivo)

14 maggio 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

14 maggio 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

8 maggio 2026

Ultimo verificato

1 maggio 2026

Maggiori informazioni

Termini relativi a questo studio

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

IIUI/RERC/ADT/2026/04/287

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Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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