Effect of Adding Latissimus Dorsi Myofascial Release to Scapular Proprioceptive Neuromuscular Facilitation on Pain, Disability, and Range of Motion in Adhesive Capsulitis
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Myofascial release+ Scapular Proprioceptive Neuromuscular Facilitation (PNF) hold-relax technique, Scapular PNF hold-relax only.
- Who it may be relevant to
- Registry conditions: Adhesive Capsulitis. Basic parameters: 35 years — 70 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Pakistan
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
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
Overview
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.
Detailed description
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.
Interventions
- Other 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 - Other 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
Primary outcome measures
- Pain Intensity [Time frame: baseline to 6 weeks]
- Shoulder Range of Motion (ROM) [Time frame: baseline to 6 weeks]
- Latissimus Dorsi Length Test [Time frame: baseline to 6 weeks]
- Shoulder Pain and Disability Index (SPADI) [Time frame: baseline to 6 weeks]
Eligibility criteria
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.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Treatment
Study locations
Pakistan · 1 center
- • Ibadat international hospital • Shaafi international hospital • South East hospital • Fa — Islamabad
Publications
- 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/ PMID 30725987
- 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. PMID 39401528
- 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. PMID 31789302
- 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. PMID 11188601
- 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. PMID 25157702
- 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. PMID 20465338
- 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. PMID 36802815
- 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. PMID 39212336
Identifiers
NCT: NCT07588087 · IIUI/RERC/ADT/2026/04/287