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Adhesive Capsulitis of ShoulderNCT07356947

The Combined Effect of Mulligan Technique and Scapular Mobilization in Shoulder Adhesive Capsulitis

A study testing Mulligan Technique with Scapular Mobilization and Conventional Physiotherapy in people with Adhesive Capsulitis of Shoulder and Frozen Shoulder, run by Deraya University at 1 site in Egypt.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The shoulder joint capsule is a fibrous sheath that encloses and stabilizes the structures of the shoulder joint, extending from the anatomical neck of the humerus to the rim of the glenoid fossa. It is normally lax, allowing a wide range of motion. Read more about this study

Who is it for?
Ages 30 to 60 years
What is being tested?
Mulligan Technique with Scapular Mobilization and Conventional Physiotherapy
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
38 participants
Where
1 siteEgypt
Study dates
15 Feb 2026to 15 Aug 2026
Phase
Interventional
Are there results?
None posted in the registry

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 30 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Medically stable and willing to provide informed consent to participate in the study.
  • Age between 30 and 60 years.
  • Both male and female participants.
  • Unilateral shoulder involvement with pain and limited active and passive range of motion in lateral rotation, abduction, and internal rotation for more than three months compared with the unaffected side.
  • Clinically diagnosed with adhesive capsulitis (frozen shoulder).

Who cannot join

  • History of shoulder surgery.
  • History of radiotherapy or chemotherapy.
  • Presence of acute infection in the area to be treated.
  • History of skin disease.
  • History of cervical radiculopathy within the past six months.
  • Secondary adhesive capsulitis, rotator cuff tears, shoulder fractures, or dislocations.

Trial locations and contacts

1 site in 1 country.

Egypt1 site
  • faculty of physical therapy, Deraya University

    Minya, Menia Governorate

Other trials in Egypt

About this study

The shoulder joint capsule is a fibrous sheath that encloses and stabilizes the structures of the shoulder joint, extending from the anatomical neck of the humerus to the rim of the glenoid fossa. It is normally lax, allowing a wide range of motion. Shoulder adhesive capsulitis, or frozen shoulder, is a common musculoskeletal condition characterized by pain and restricted movement due to thickening and contraction of this capsule. Proper coordination between the scapula and humerus-known as the scapulohumeral rhythm-is essential for normal shoulder motion. Disruption of this rhythm contributes to movement limitation and pain in adhesive capsulitis.

This randomized, single-blind clinical trial aims to investigate the combined effect of the Mulligan technique and scapular mobilization on improving shoulder range of motion, pain, disability, and scapulohumeral rhythm in patients with adhesive capsulitis. Thirty-eight participants aged 30 to 60 years, diagnosed with unilateral adhesive capsulitis, will be randomly assigned to two groups. Group A will receive Mulligan mobilization techniques for shoulder elevation, internal and external rotation, along with scapular mobilization. Group B will receive conventional physical therapy consisting of hot packs, ultrasound, stretching, and range-of-motion exercises. Both groups will undergo treatment three times per week for four weeks.

Primary outcomes include changes in shoulder range of motion (measured using a digital goniometer), pain and disability (measured by the Shoulder Pain and Disability Index [SPADI]), and scapulohumeral rhythm (assessed using tape measurement). The study is expected to provide clinical evidence on whether combining Mulligan and scapular mobilization techniques yields superior functional recovery compared with conventional physiotherapy alone in patients with shoulder adhesive capsulitis.

Read the detailed description

The shoulder joint capsule is a fibrous structure that surrounds the shoulder joint and connects the anatomical neck of the humerus to the rim of the glenoid fossa. It provides stability to the joint while allowing extensive mobility. In adhesive capsulitis, also known as frozen shoulder, the capsule becomes inflamed, thickened, and contracted, leading to pain, stiffness, and a progressive loss of both active and passive range of motion. This condition is most common in middle-aged individuals and can significantly limit daily function.

Normal shoulder motion depends on a coordinated movement pattern between the scapula and the humerus, known as the scapulohumeral rhythm. During shoulder elevation, approximately two degrees of glenohumeral motion are accompanied by one degree of scapulothoracic movement. Disruption of this rhythm contributes to movement dysfunction, altered biomechanics, and pain. Rehabilitation approaches that restore this coordination are therefore critical for effective management of adhesive capsulitis.

The Mulligan mobilization technique involves the application of sustained accessory glides by the therapist concurrent with the patient's active movement. This technique aims to correct positional faults, reduce pain, and improve joint mobility without provoking discomfort. Scapular mobilization is a manual therapy approach designed to restore normal motion of the scapula on the thoracic cage and to improve the scapulohumeral rhythm during shoulder elevation.

This study is designed as a randomized, single-blind clinical trial to evaluate the combined effect of Mulligan mobilization and scapular mobilization in patients with adhesive capsulitis. Thirty-eight participants aged between 30 and 60 years with unilateral adhesive capsulitis will be randomly assigned into two groups. Group A will receive Mulligan techniques for shoulder elevation, internal rotation, and external rotation in addition to scapular mobilization. Group B will receive conventional physical therapy consisting of hot packs, pulsed ultrasound at 1 MHz and 0.8 W/cm² for five minutes, posterior capsule stretching, and range-of-motion exercises. Both groups will receive therapy three times per week for four weeks.

Outcome assessments will include shoulder range of motion using a digital goniometer, pain and disability using the Shoulder Pain and Disability Index (SPADI), and scapulohumeral rhythm using a tape measurement method. Measurements will be taken before and after the four-week intervention period. It is hypothesized that the combined Mulligan and scapular mobilization protocol will produce greater improvements in pain reduction, joint range, and scapulohumeral coordination compared to conventional physiotherapy alone.

Being tested
Mulligan Technique with Scapular Mobilization, Conventional Physiotherapy
Keywords
Adhesive Capsulitis, Frozen Shoulder, Shoulder Joint, Shoulder Pain, Scapulohumeral Rhythm, Mulligan Technique, Mobilization with Movement, Scapular Mobilization
Medical subject headings
Bursitis, Shoulder Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Mulligan Technique with Scapular MobilizationOther

    Participants in this group will receive the Mulligan mobilization technique for shoulder elevation, internal rotation, and external rotation combined with scapular mobilization. Each session will include three sets of ten repetitions with a two-minute rest between sets. Treatment sessions will be conducted three times per week for four weeks. The intervention aims to improve shoulder joint mobility, reduce pain, and enhance scapulohumeral rhythm.

  • Conventional PhysiotherapyOther

    Standard physiotherapy including hot packs, ultrasound, posterior capsule stretching, and active/assisted range-of-motion exercises. Three sessions per week for four weeks.

Study groups in NCT07356947
Study groupRoleWhat they receive
Conventional PhysiotherapyActive comparatorParticipants in this group will receive conventional physiotherapy consisting of: Hot pack application for 10 minutes Ultrasound therapy in pulsed mode (1 MHz frequency, 0.8 W/cm²) for 5 minutes Posterior capsule stretching (2 sets × 3 repetitions, 30-second holds) Active and active-assisted range of motion exercises for elevation, internal rotation, external rotation, and pendulum exercises. Treatment will be administered three times per week for four weeks. This intervention represents standard physiotherapy care for adhesive capsulitis.
Receives: Other: Conventional Physiotherapy
Mulligan Technique with Scapular MobilizationExperimentalParticipants in this group will receive the Mulligan mobilization technique for shoulder elevation, internal and external rotation, combined with scapular mobilization. Each session will include three sets of ten repetitions with a two-minute rest between sets. Treatment sessions will occur three times per week for four weeks.
Receives: Other: Mulligan Technique with Scapular Mobilization

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Shoulder Range of Motion (Flexion, Internal Rotation, External Rotation, and Abduction)

    Shoulder joint range of motion (flexion, internal rotation, external rotation, and abduction) will be assessed using a digital goniometer. Each movement will be measured three times, and the mean value will be used for analysis.

    Measured: Baseline and at 4 weeks post-intervention

  2. Change in Shoulder Pain and Disability (SPADI Score)

    Pain and functional disability will be assessed using the Shoulder Pain and Disability Index (SPADI). The SPADI includes 13 items: a 5-item pain subscale and an 8-item disability subscale. Each item is scored on a 0-10 scale, with higher scores indicating greater pain and disability.

    Measured: Baseline and at 4 weeks post-intervention

  3. Change in Scapulohumeral Rhythm

    Scapulohumeral rhythm will be evaluated using a tape measurement method during shoulder elevation to assess the coordination between scapular and humeral motion.

    Measured: Baseline and at 4 weeks post-intervention

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Jan 2026
  2. Study start15 Feb 2026
  3. Primary completion15 Jul 2026
  4. Study completion15 Aug 2026

Resources

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
Model description
Participants will be randomly assigned into two groups receiving different therapeutic interventions (Mulligan technique with scapular mobilization versus conventional physiotherapy).
Masking
Single blind
Who is masked
Participant
Enrolment
38 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07356947
Sponsor's protocol ID
Shoulder Adhesive Capsulitis
Status last verified
Aug 2026
First submitted
13 Jan 2026
Last updated
27 Aug 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Norkin C. C., White D. J. Measurement of Joint Motion: A Guide to Goniometry. 5th Edition. F.A. Davis Company; 2016.

  • Kisner C., Colby L. A. Therapeutic Exercise: Foundations and Techniques. 7th Edition. F.A. Davis Company; 2022.

  • Rahbar M, Ranjbar Kiyakalayeh S, Mirzajani R, Eftekharsadat B, Dolatkhah N. Effectiveness of acromioclavicular joint mobilization and physical therapy vs physical therapy alone in patients with frozen shoulder: A randomized clinical trial. Clin Rehabil. 2022 May;36(5):669-682. doi: 10.1177/02692155211070451. Epub 2021 Dec 29.

    PubMed 34964679
  • Brumitt J. Scapula stabilization and rehabilitation exercise prescription. Strength and Conditioning Journal. 2006; 28(3):62-65.

  • McQuade KJ, Smidt GL. Dynamic scapulohumeral rhythm: the effects of external resistance during elevation of the arm in the scapular plane. J Orthop Sports Phys Ther. 1998 Feb;27(2):125-33. doi: 10.2519/jospt.1998.27.2.125.

    PubMed 9475136
  • Mathieu Vanderroost, Venus Pagare, Kai A. Sigel, Naomi O'Reilly, Claire Knott. Scapulohumeral rhythm. Physiopedia. Available online at: https://www.physio-pedia.com/Scapulohumeral_rhythm

  • Ludewig PM, Reynolds JF. The association of scapular kinematics and glenohumeral joint pathologies. J Orthop Sports Phys Ther. 2009 Feb;39(2):90-104. doi: 10.2519/jospt.2009.2808.

    PubMed 19194022
  • Scibek JS, Carcia CR. Assessment of scapulohumeral rhythm for scapular plane shoulder elevation using a modified digital inclinometer. World J Orthop. 2012 Jun 18;3(6):87-94. doi: 10.5312/wjo.v3.i6.87.

    PubMed 22720268
  • Kibler WB. The role of the scapula in athletic shoulder function. Am J Sports Med. 1998 Mar-Apr;26(2):325-37. doi: 10.1177/03635465980260022801.

    PubMed 9548131
  • Sami S. Almureef, et al. Effectiveness of mobilization with conventional physiotherapy in frozen shoulder patients: a systematic review. Journal of Musculoskeletal Research. 2020.

Questions about this trial

What is this clinical trial studying?

A study testing Mulligan Technique with Scapular Mobilization and Conventional Physiotherapy in people with Adhesive Capsulitis of Shoulder and Frozen Shoulder, run by Deraya University at 1 site in Egypt.

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 5 inclusion and 6 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: finished, as of the sponsor's last update on 27 Aug 2026. 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 Egypt. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Shoulder Range of Motion (Flexion, Internal Rotation, External Rotation, and Abduction) (time frame: Baseline and at 4 weeks post-intervention). 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?

On the ClinicalTrials.gov record for NCT07356947, which also lists 10 linked publications.

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 27 Aug 2026.

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