Effects of Gongs Mobilization and Proprioceptive Neuromuscular Facilitation in Patients With Adhesive Capsulitis

Обзор

The randomized controlled trail aims is to evaluate the outcome of Gongs mobilization and PNF in patients with adhesive capsulitis. The significance of this study is to compare Gong's mobilization technique with proprioceptive neuromuscular facilitation (PNF) compare their effects on pain, range of motion, and functional disability. The sample size was calculated with G-power. This study would include total 44 female participants aged 40-60 years will be recruited and randomly assigned to two groups. Group A(Gongs mobilization+ conventional therapy)and Group B(PNF+ Conventional therapy). Intervention will be provided for 4 weeks 3 session per week. Primary outcome measures are pain, ROM and functional disability via NPRS, Goniometer and U-SPADI. Outcomes will be reassessed at baseline, after 2nd week, and after 4th week.

Подробное описание

Adhesive capsulitis ,which is also referred as frozen shoulder is described as a progressive and self-limiting condition leading to gradual onset of pain and loss of shoulder Range of motion. It restricts both Active and Passive movements due to adhesions in Glenohumeral(GH) joint capsule. which leads to fibrosis, scarring and contracture of joint capsule. As fibrosis progresses restricting the shoulder normal Range of motion. ultimately impacting person's daily activities and frequently interfering with sleep and making basic activities like combing hair , dressing and overhead activities difficult.

Gong's Mobilization(GM) serves as an effective technique in the treatment of Frozen shoulder, it was introduced by W. Gong, the mainstay of this mobilization is to correct the positional fault of the humeral head that is often medially rotated and dragged forward due to muscular tension of Subscapularis and Pectoralis Major along with the tightness of posterior capsule. Gong mobilization intends to keep the humeral head in its correct position during dynamic motion of the GH joint by keeping the affected scapula in anterior to posterior position and the humeral head in posterior to anterior direction at the same time. Proprioceptive neuromuscular facilitation (PNF) stretch is a technique commonly used in clinical environments to enhance both active and passive range of motion (ROM), with the ultimate goal of optimizing motor performance and rehabilitation

Вмешательства

• Поведенческое Gongs Mobilization
  Glenohumeral mobilization (GM) will be performed in a side-lying position with the therapist standing on the affected side. An anterior-to-posterior glide will be applied to the humeral head parallel to the joint plane while the opposite hand stabilizes the scapula from posterior to anterior. The patient will perform quick shoulder abduction movements with the elbow extended as the therapist applies Maitland's Grade III-IV oscillatory glides, maintaining slight joint distraction and following th
• Поведенческое Proprioceptive Neuromuscular Facilitation
  The therapist will use proprioceptive neuromuscular facilitation (PNF) techniques specifically employing the hold-relax method followed by the D2 pattern of flexion-extension movement. Each session will last 15 minutes, comprising 10 sets of PNF. Each set will include 5 repetitions, with a 5-second hold and a 2-second rest between repetitions. This protocol will be administered over 12 sessions.

Первичные конечные точки

• Numeric Pain Rating Scale [Срок оценки: 4 weeks]
• Goniometer [Срок оценки: 4 weeks]
• Shoulder pain and Disability Index Urdu version(SPADI-U) [Срок оценки: 4 weeks]

Критерии участия

Критерии включения

• Females in the age group between 40-60 years.
• Diagnosed with Unilateral frozen shoulder.
• Patients in frozen stage (progressive loss of ROM, marked stiffness with gradual pain reduction).
• More than 25% painful limitation of GH ROM in two planes, more than 50% in external rotation(arm at 0 degree of abduction).

Критерии исключения

• History of surgery on the affected shoulder.
• Patients having any cervical or thoracic problem.
• Painful, stiff shoulder after severe trauma, inflammatory diseases such as rheumatoid arthritis and malignancies.
• Recent fractures in and around the shoulder.
• Rotator cuff disorder.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Простое слепое

Основная цель

Лечение

Центры проведения

Пакистан · 1 центр

• Pakistan Railway General Hospital — Rawalpindi

Публикации

• Kim DH. Outcome Measurement in Shoulder Diseases: Focus on Shoulder Pain and Disability Index (SPADI). Ann Rehabil Med. 2023 Oct;47(5):315-317. doi: 10.5535/arm.23130. Epub 2023 Oct 25. No abstract available. PMID 37907222
• Khan AH, Bhuiyan MSH, Kabir MF, Hossain MZ, Jahan S, Hossain KMA, Rahman E. Effectiveness of proprioceptive neuromuscular facilitation pattern on upper extremity and scapula in patients with adhesive capsulitis: a single-centre assessor-blinded randomised controlled trial (RCT). Trials. 2025 May 3;26(1):146. doi: 10.1186/s13063-025-08848-0. PMID 40317031
• Fernandes MR. Adhesive capsulitis: current concepts. Musculoskelet Surg. 2026 Mar;110(1):1-10. doi: 10.1007/s12306-025-00897-7. Epub 2025 Mar 17. PMID 40095380
• Amjad F, Asghar H. Comparative effects of gong's mobilization and mobilization with movement in patients with adhesive capsulitis: a randomized clinical trial. Sci Rep. 2025 Feb 4;15(1):4272. doi: 10.1038/s41598-025-88422-5. PMID 39905175

Идентификаторы

NCT: NCT07576127 · REC/02277 Fatima

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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