Adhesive CapsulitisNCT07203963
Additional Effects of Niel-asher Technique on Patients With Adhesive Capsulitis
A study testing Niel-Asher Technique + sleeper stretch and sleeper stretch + Conventional Treatment in people with Adhesive Capsulitis, run by Riphah International University at 1 site in Pakistan.
Trial summary
The aim of this randomized controlled trial is to find the additional effects of Niel-Asher technique along with sleeper stretch and conventional physical therapy on pain, shoulder ranges of motion and functional disability in patients with Adhesive capsulitis Read more about this study
- Who is it for?
- Ages 40 to 60 years
- Conditions the study is for
- Adhesive Capsulitis
- What is being tested?
- Niel-Asher Technique + sleeper stretch and sleeper stretch + Conventional Treatment
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 36 participants
- Where
- 1 sitePakistan
- Study dates
- 25 Oct 2025to 20 Sep 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 40 to 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age 40-60 years
- Both Genders: Male and Female
- Patient falls under diagnostic criteria for adhesive capsulitis which is Painful and limited active and passive glenohumeral ROM in capsular pattern (external rotation> abduction> internal rotation)
- Patient diagnosed with adhesive capsulitis by orthopedic or general physician
- Patient with phase two and three of adhesive capsulitis based on duration of symptoms
- Patients of adhesive capsulitis with presence of trigger points in rotator cuff muscles and deltoid muscle (trigger points present in at least 1 or 2 of these muscles) based on simon and travell's criteria of trigger points diagnosis.
Who cannot join
- Spinal Injuries and any other co- morbidity
- Any surgery, infection, trauma, pregnancy, fracture and fall
- Patient with intra articular steroidal therapy with in last 6 months
- Patient unwilling to comply follow up schedule
- Patient involvement in another intervention study
- Malignancy
Show all 9Show fewer
- Patient with thyroid disorders and RA and Glenohumeral OA
- History of previous surgery or manipulation under anesthesia of affected shoulder
- Patient with duration of symptoms of less than three months
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site, 1 recruiting
- Recruiting
Shafi International Hospital
Islamabad, Punjab Province, 46600
KINZA ANWAR, MS-OMPT, +92-3239735427, kinza.anwar@riphah.edu.pk
MARIA BARKAT, MS-OMPT*
About this study
Official title: Additional Effects of Niel Asher Technique Along With Sleeper Stretch on Posterior Capsule in Patients With Adhesive Capsulitis.
The aim of this randomized controlled trial is to find the additional effects of Niel-Asher technique along with sleeper stretch and conventional physical therapy on pain, shoulder ranges of motion and functional disability in patients with Adhesive capsulitis
Read the detailed description
Frozen shoulder is a musculoskeletal disorder and it is a painful shoulder condition, it is also known as adhesive capsulitis. This condition is usually caused by progressive fibrosis and contracture of glenohumeral joint capsule and it cause pain and stiffness in glenohumeral joint. In patients with adhesive capsulitis there is significant reduction of both active and passive ROMs. Adhesive capsulitis is more common in females than in males with the age range from 40-60 years. Most affected ROM in patient with adhesive capsulitis is external rotation but internal rotation and other range of motions of shoulder are also affected. Frozen shoulder is prevalent in 2-3% of general population, with variations across countries and regions. There are three stages of adhesive capsulitis. Patient in early stages usually present with inflammation which progressively changes into fibrotic changes. Its diagnosis is usually made on the basis of history and physical examination.
Shoulder joint capsule has different segments and each segment has some effect on shoulder ROMs in all directions. Thickness of joint capsule is primary restraint that cause reduction in ROMs in frozen shoulder patient. Fibrosis of glenohumeral joint capsule often cause effusion of long head of bicep brachi. Risk factor for adhesive capsulitis includes female gender specifically age greater than 45 and diabetes, Dupuytren contracture, immobilization of the shoulder, complex regional pain syndrome. Individuals with higher BMI with hyperlipidemia are at higher risk for adhesive capsulitis. A study on subjects with chronic non traumatic shoulder pain (n=72) showed high prevalence of MTrPs in all subjects; highest prevalence being in infraspinatus (78%) followed by upper trapezius (58%), middle trapezius (43%), deltoid and teres minor.
Niel-Asher technique mainly based on the principle of body's natural healing mechanisms. It targets adherent structures to release fibrosis. It also stimulates specific neural pathways by activating mechanoreceptors and helps CNS to enhance pain reduction and functional improvement. This technique remodels the shoulder capsule by relieving soft tissue adhesions. It also decreases nociceptive sensitivity, improves circulation that leads to pain relief and restoration of range of motion of shoulder joint. This technique employed deep stroking massage and compression of trigger points in five steps on major muscles such as rotator cuff muscles/ teres minor, Infraspinatus and deltoid muscle.
Sleeper stretch technique isolates the soft tissue restraints in the posterior shoulder to correct mobility and flexibility deficit. Sleeper stretch targets infraspinatus and teres minor muscles and improve shoulder ROMs and internal rotation by decreasing stiffness of the posterior capsule and muscle tendon tension.
This study aims to find the additional effect of Niel-Asher technique along with sleeper stretch and conventional therapy (which include exercise therapy and ischemic compression to release trigger points )on minimizing pain, improving shoulder ranges of motion and functional activities in individuals affected by Adhesive capsulitis.
- Conditions
- Adhesive Capsulitis
- Being tested
- Niel-Asher Technique + sleeper stretch, sleeper stretch + Conventional Treatment
- Keywords
- Niel-Asher Technique (NAT), Sleeper stretch, trigger points
- Medical subject headings
- Bursitis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Niel-Asher Technique + sleeper stretchOther
Niel-Asher Technique, Manual Soft Tissue releaser, Neuro-muscular release technique for adhesive capsulitis ( This manual technique will be applied for 3 days a week for 4 weeks).Sleeper stretch will be applied passively by investigator, pressure of the stretch will be held for 30 seconds (repeated twice with 30 seconds break for 3 days a week) Conventional PT including 1: shoulder anteroposterior, posteroanterior and inferior glides ( 3 times a week for 4 week) 2: active and active assisted ROM exercises of shoulder joint (frequency: 1 set of 10 repetitions twice a day). 3: Shoulder Isometric exercises, Codman's exercises and pulley and finger ladder exercises (frequency: 1 set of 10 repetitions twice a day), 4: trigger points will be released by applying ischemic pressure (90 seconds) on trigger points found in rotator cuff muscles.
sleeper stretch + Conventional TreatmentOther
Sleeper stretch will be applied passively by investigator, pressure of the stretch will be held for 30 seconds (repeated twice with 30 seconds break for 3 days a week). Conventional PT including 1: shoulder anteroposterior, posteroanterior and inferior glides ( 3 times a week for 4 week) 2: active and active assisted ROM exercises of shoulder joint (frequency: 1 set of 10 repetitions twice a day). 3: Shoulder Isometric exercises, Codman's exercises and pulley and finger ladder exercises (frequency: 1 set of 10 repetitions twice a day) 4: ischemic compression (90seconds hold) on trigger points found in rotator cuff muscles
| Study group | Role | What they receive |
|---|---|---|
| Niel-Asher Technique+ sleeper stretch+ Conventional PT | Other | Niel-Asher Technique Receives: Other: Niel-Asher Technique + sleeper stretch |
| sleeper stretch + Conventional Treatment | Other | Sleeper stretch+ Conventional Receives: Other: sleeper stretch + Conventional Treatment |
What is being measured
The primary outcome is the main question the study is designed to answer.
Visual Analogue scale VAS
It is a pain rating scale. The findings suggested that 100-mm VAS ratings of 0 to 4 mm can be considered no pain; 5 to 44 mm, mild pain; 45 to 74 mm, moderate pain; and 75 to 100 mm, severe pain. Patient will be asked to verbally report the pain score
Measured: 4 weeks
Shoulder pain and disability Index (SPADI)
The shoulder pain and disability index (SPADI) was developed to measure Current shoulder pain and disability, it is widely used valid and reliable tool. The SPADI contains 13 items that assess two domains, a 5-item subscale that measures pain and 8-item subscale that measures disability.
Measured: 4 weeks
Goniometer
A goniometer will be used to measure the range of motion (ROM) of the Shoulder joint. Goniometer is an instrument that measures the available range of motion at a joint
Measured: 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Oct 2025
- Study start25 Oct 2025
- Primary completion15 Sep 2026 (estimated)
- Study completion20 Sep 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Adhesive CapsulitisStudies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 36 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- KINZA ANWAR, MS-OMPT, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07203963
- Sponsor's protocol ID
- Maria Barket
- Status last verified
- Nov 2025
- First submitted
- 25 Sep 2025
- Last updated
- 24 Nov 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 24 Nov 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Additional Effects of Niel Asher Technique Along With Sleeper Stretch on Posterior Capsule in Patients With Adhesive Capsulitis.
- ClinicalTrials.gov ID
- NCT07203963
- Acronym / sponsor ID
- Maria Barket
- Conditions
- Adhesive Capsulitis
- Keywords
- Niel-Asher Technique (NAT), Sleeper stretch, trigger points
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 36 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 25 Oct 2025 (actual)
- Primary completion
- 15 Sep 2026 (estimated)
- Study completion
- 20 Sep 2026 (estimated)
- First posted
- 2 Oct 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of this randomized controlled trial is to find the additional effects of Niel-Asher technique along with sleeper stretch and conventional physical therapy on pain, shoulder ranges of motion and functional disability in patients with Adhesive capsulitis
Detailed description
Frozen shoulder is a musculoskeletal disorder and it is a painful shoulder condition, it is also known as adhesive capsulitis. This condition is usually caused by progressive fibrosis and contracture of glenohumeral joint capsule and it cause pain and stiffness in glenohumeral joint. In patients with adhesive capsulitis there is significant reduction of both active and passive ROMs. Adhesive capsulitis is more common in females than in males with the age range from 40-60 years. Most affected ROM in patient with adhesive capsulitis is external rotation but internal rotation and other range of motions of shoulder are also affected. Frozen shoulder is prevalent in 2-3% of general population, with variations across countries and regions. There are three stages of adhesive capsulitis. Patient in early stages usually present with inflammation which progressively changes into fibrotic changes. Its diagnosis is usually made on the basis of history and physical examination.
Shoulder joint capsule has different segments and each segment has some effect on shoulder ROMs in all directions. Thickness of joint capsule is primary restraint that cause reduction in ROMs in frozen shoulder patient. Fibrosis of glenohumeral joint capsule often cause effusion of long head of bicep brachi. Risk factor for adhesive capsulitis includes female gender specifically age greater than 45 and diabetes, Dupuytren contracture, immobilization of the shoulder, complex regional pain syndrome. Individuals with higher BMI with hyperlipidemia are at higher risk for adhesive capsulitis. A study on subjects with chronic non traumatic shoulder pain (n=72) showed high prevalence of MTrPs in all subjects; highest prevalence being in infraspinatus (78%) followed by upper trapezius (58%), middle trapezius (43%), deltoid and teres minor.
Niel-Asher technique mainly based on the principle of body's natural healing mechanisms. It targets adherent structures to release fibrosis. It also stimulates specific neural pathways by activating mechanoreceptors and helps CNS to enhance pain reduction and functional improvement. This technique remodels the shoulder capsule by relieving soft tissue adhesions. It also decreases nociceptive sensitivity, improves circulation that leads to pain relief and restoration of range of motion of shoulder joint. This technique employed deep stroking massage and compression of trigger points in five steps on major muscles such as rotator cuff muscles/ teres minor, Infraspinatus and deltoid muscle.
Sleeper stretch technique isolates the soft tissue restraints in the posterior shoulder to correct mobility and flexibility deficit. Sleeper stretch targets infraspinatus and teres minor muscles and improve shoulder ROMs and internal rotation by decreasing stiffness of the posterior capsule and muscle tendon tension.
This study aims to find the additional effect of Niel-Asher technique along with sleeper stretch and conventional therapy (which include exercise therapy and ischemic compression to release trigger points )on minimizing pain, improving shoulder ranges of motion and functional activities in individuals affected by Adhesive capsulitis.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Niel-Asher Technique+ sleeper stretch+ Conventional PT | Other | Other: Niel-Asher Technique + sleeper stretchNiel-Asher Technique |
| sleeper stretch + Conventional Treatment | Other | Other: sleeper stretch + Conventional TreatmentSleeper stretch+ Conventional |
Who may qualify
- Ages
- 40 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (6 listed)
- Age 40-60 years
- Both Genders: Male and Female
- Patient falls under diagnostic criteria for adhesive capsulitis which is Painful and limited active and passive glenohumeral ROM in capsular pattern (external rotation> abduction> internal rotation)
- Patient diagnosed with adhesive capsulitis by orthopedic or general physician
- Patient with phase two and three of adhesive capsulitis based on duration of symptoms
Key exclusion criteria (9 listed)
- Spinal Injuries and any other co- morbidity
- Any surgery, infection, trauma, pregnancy, fracture and fall
- Patient with intra articular steroidal therapy with in last 6 months
- Patient unwilling to comply follow up schedule
- Patient involvement in another intervention study
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Niel-Asher Technique + sleeper stretchNiel-Asher Technique, Manual Soft Tissue releaser, Neuro-muscular release technique for adhesive capsulitis ( This manual technique will be applied for 3 days a week for 4 weeks).Sleeper stretch will be applied passively by investigator, pressure of the stretch will be held for 30 seconds (repeated twice with 30 seconds break for 3 days a week) Conventional PT including 1: shoulder anteroposterior, posteroanterior and inferior glides ( 3 times a week for 4 week) 2: active and active assisted ROM exercises of shoulder joint (frequency: 1 set of 10 repetitions twice a day). 3: Shoulder Isometric exercises, Codman's exercises and pulley and finger ladder exercises (frequency: 1 set of 10 repetitions twice a day), 4: trigger points will be released by applying ischemic pressure (90 seconds) on trigger points found in rotator cuff muscles. | Other | Niel-Asher Technique+ sleeper stretch+ Conventional PT |
| sleeper stretch + Conventional TreatmentSleeper stretch will be applied passively by investigator, pressure of the stretch will be held for 30 seconds (repeated twice with 30 seconds break for 3 days a week). Conventional PT including 1: shoulder anteroposterior, posteroanterior and inferior glides ( 3 times a week for 4 week) 2: active and active assisted ROM exercises of shoulder joint (frequency: 1 set of 10 repetitions twice a day). 3: Shoulder Isometric exercises, Codman's exercises and pulley and finger ladder exercises (frequency: 1 set of 10 repetitions twice a day) 4: ischemic compression (90seconds hold) on trigger points found in rotator cuff muscles | Other | sleeper stretch + Conventional Treatment |
Primary outcome
Visual Analogue scale VAS
Time frame: 4 weeks
It is a pain rating scale. The findings suggested that 100-mm VAS ratings of 0 to 4 mm can be considered no pain; 5 to 44 mm, mild pain; 45 to 74 mm, moderate pain; and 75 to 100 mm, severe pain. Patient will be asked to verbally report the pain score
Shoulder pain and disability Index (SPADI)
Time frame: 4 weeks
The shoulder pain and disability index (SPADI) was developed to measure Current shoulder pain and disability, it is widely used valid and reliable tool. The SPADI contains 13 items that assess two domains, a 5-item subscale that measures pain and 8-item subscale that measures disability.
Goniometer
Time frame: 4 weeks
A goniometer will be used to measure the range of motion (ROM) of the Shoulder joint. Goniometer is an instrument that measures the available range of motion at a joint
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 24 Nov 2025.
- Individual participant dataSharing planned: No
Related trials for Adhesive Capsulitis
Not yet recruiting
Effects of Clinic Versus mHealth Application-Based Shoulder Rehabilitation in Patients With Adhesive Capsulitis
Adhesive Capsulitis
Not yet recruiting
Effect of Hormone Replacement Therapy on Physiotherapy Outcomes in Postmenopausal Women With Frozen Shoulder
Frozen Shoulder, Adhesive Capsulitis
Not yet recruiting
Effects of Posterior Capsular Stretching With and Without Dynamic Neuromuscular Stabilization Exercises in Frozen Shoulder
Frozen Shoulder
Active, not recruiting
Spencer vs. Ola Grimsby Techniques With Scapular Motor Training in Idiopathic Adhesive Capsulitis
Idiopathic Adhesive Capsulitis
Not yet recruitingPhase 4
OMT for Adhesive Capsulitis
Adhesive Capsulitis of the Shoulder, Frozen Shoulder
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
KINZA ANWAR, MS-OMPT principal investigator
Riphah International University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Niel-Asher Technique + sleeper stretch and sleeper stretch + Conventional Treatment in people with Adhesive Capsulitis, run by Riphah International University at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 24 Nov 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact KINZA ANWAR, MS-OMPT (+92-3239735427, kinza.anwar@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Visual Analogue scale VAS (time frame: 4 weeks). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Nov 2025.