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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
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
Studie Overzicht
Toestand
Conditie
Gedetailleerde beschrijving
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Hufsa Naseer, DPT, MS-PT MSK
- Telefoonnummer: +3095166821
- E-mail: hufsanaseer@gmail.com
Studie Contact Back-up
- Naam: Fatima Amjad, DPT, MS-PT Sports, PHD Scholar
- Telefoonnummer: +3330940975
- E-mail: Fatima.amjad@uipt.iiui.edu.pk
Studie Locaties
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Punjab Province
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Islamabad, Punjab Province, Pakistan, 44000
- Werving
- • Ibadat international hospital • Shaafi international hospital • South East hospital • Fauji Foundation hospital
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Contact:
- Hufsa Naseer, DPT, MS-PT MSK
- Telefoonnummer: 03095166821
- E-mail: hufsanaseer@gmail.com
-
Contact:
- Fatima Amjad, DPT, MS-PT MSK Sports, PHD
- Telefoonnummer: +923330940975
- E-mail: Fatima.amjad@uipt.iiui.edu.pk
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-
Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
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.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Enkel
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Experimenteel: 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 |
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Actieve vergelijker: 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),
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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. |
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Pain Intensity
Tijdsspanne: baseline to 6 weeks
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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
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baseline to 6 weeks
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Shoulder Range of Motion (ROM)
Tijdsspanne: 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
Tijdsspanne: 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)
Tijdsspanne: baseline to 6 weeks
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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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Medewerkers en onderzoekers
Publicaties en nuttige links
Algemene publicaties
- 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.
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Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- IIUI/RERC/ADT/2026/04/287
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