Adhesive CapsulitisNCT07854288
Maitland Mobilization With and Without Stroking Release Technique of Rotator Cuff Muscle in Frozen Shoulder
A study testing Maitland mobilization combined with Stroking release technique and Maitland Mobilization, along with baseline treatment in people with Adhesive Capsulitis, run by Riphah International University at 1 site in Pakistan.
Trial summary
Frozen shoulder has been described as a painful condition associated with stiffness and difficulty in sleeping on the affected side. People with this condition have difficulty in dressing, overhead movements and sleep disturbance. It occurs in 2 - 5% of general adult population, 10 - 15% of the people with diabetes. 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?
- Maitland mobilization combined with Stroking release technique and Maitland Mobilization, along with baseline treatment
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 44 participants
- Where
- 1 sitePakistan
- Study dates
- 1 May 2026to 1 Dec 2026
- Phase
- Interventional
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 between 40 to 60 years
- Stage 2 and 3 Frozen shoulder
- Positive capsular pattern
- Positive Apley's scratch test
- Unilateral Frozen Shoulder
Who cannot join
- Rotator cuff disease
- Post CABG
- Post stroke frozen shoulder
- Fracture of shoulder
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
Riphah International University
Lahore, 54000
Danish Hassan, PhD*, 03457946009, danish.hassan@riphah.edu.pk
About this study
Official title: Effects of Maitland Mobilization With and Without Stroking Release Technique of Rotator Cuff Muscle on Pain, Range of Motion and Disability in Patients With Frozen Shoulder
Frozen shoulder has been described as a painful condition associated with stiffness and difficulty in sleeping on the affected side. People with this condition have difficulty in dressing, overhead movements and sleep disturbance. It occurs in 2 - 5% of general adult population, 10 - 15% of the people with diabetes. It mainly affects the individuals of 35 - 65 years of age with female predominance. Frozen shoulder is characterized by fibroproliferative tissue fibrosis whereby fibroblasts, producing predominantly type I and type III collagen, transform into myofibroblasts, which is accompanied by inflammation, resulting in shoulder capsular fibrotic contractures and the associated clinical stiffness.
There are two frozen shoulder syndromes, namely primary syndrome and secondary syndrome. In primary or idiopathic syndrome, frozen shoulder that occurs spontaneously or directly without knowing the causative factors. Primary syndrome occurs due to a chronic inflammatory response with fibroblast proliferation which can actually be a response from an abnormal immune system. Secondary syndromes occur due to several triggers such as trauma that can cause shoulder injuries or surgery associated with the onset of other conditions such as diabetes mellitus, autoimmune diseases and cardiovascular disorders.
Read more
The clinical presentation of frozen shoulder typically progresses through three stages: the freezing stage, where the shoulder becomes painful and progressively stiff over two to nine months; the frozen stage, characterized by significant stiffness and reduced pain over four to twelve months; and the thawing stage, where gradual improvement in shoulder mobility occurs over five to twenty-four months. The condition can be severely debilitating, impacting daily activities and overall quality of life.
Adhesive capsulitis treatment primarily consists of pain relief and physical therapy techniques. Anti-inflammatory medication is helpful in pain relief, so that mobility interventions can be initiated. Therapeutic modalities include Transcutaneous Electrical Nerve Stimulation (TENS), Interferential Therapy (IFT), Ultrasound, Short Wave Diathermy (SWD) etc, and the physical therapy exercises such as stretching, Codman exercise can be used. Exercises which may be active, passive or active assisted, play a crucial role in the early rehabilitation of these patients.
Read the detailed description
Myofascial treatment is an emerging treatment in different musculoskeletal conditions although its clinical benefits is still not clearly understood. Myofascial release therapy (MRT) aims at restoring the normal length of a tight structure with the target goal of decreasing pain and improving function. Since patients with frozen shoulder presents with tightness of rotator cuff muscles, Stroking release technique can be effective in treatment of frozen shoulder.
Rotator cuff is the dynamic stabilizer of the glenohumeral joint (GHJ). It depresses and compresses the humeral head on the glenoid cavity and prevents superior translation of the humerus. Therefore, Rotator Cuff dysfunction, weakness, or rupture may reduce GHJ stability. Rotator cuff rupture also causes shoulder pain, muscle weakness, decrease of shoulder range of motion (ROM), and function. Additionally, fear of movement develops due to shoulder pain and affects ROM and function.
The scapulothoracic joint is not a true joint but functions as an integral part of the shoulder complex. Scapulothoracic movements that include rotation, elevation, depression, protraction, retraction, and circumduction are important for the normal functioning of the shoulder. Scapular mobilization is a widely used manual therapy technique for the management of musculoskeletal disorder of the shoulder, it involves the manual application of a sustained mobilization (in 4 directions) to the scapulothoracic joint.
Codman pendulum is a technique, in the form of arm swing movements with a bent body position and the self-mobilization technique. Scapular mobilization is a treatment technique used for the management of shoulder musculoskeletal disorders. Scapular mobilization aims to mobilize joints or distractions, thus providing scapulothoracic distance and muscles will be extended. By controlling movement from the position of the scapula can help the glenoid in its normal position.
Maitland mobilization (MM) is a manual technique commonly used in the physiotherapy management of FS. It applies passive oscillations, classified from Grade I-IV with respect to amplitude and intensity, to the shoulder in order to treat pain and stiffness. Grades I and II of Maitland mobilization techniques are primarily used for treating joints limited by pain. Whereas Grades III and IV are primarily used as stretching maneuver. There are few previous studies which prove the effect of MM on pain and ROM among FS patients .
Frozen shoulder is a condition with pain and limited range of motion. It is often managed with maitland mobilization. Rotator cuff muscle can contribute to persistent pain and limited function. Very few studies have examined the role of Stroking release technique of rotator cuff muscle in frozen shoulder treatment. This study aims to evaluate the added benefit of Stroking Release technique of Rotator cuff muscle in improving pain, ROM, and disability. The findings could guide clinicians toward more comprehensive and effective treatment protocols. In the future, this approach may lead to faster recovery and improved quality of life for patients.
- Conditions
- Adhesive Capsulitis
- Being tested
- Maitland mobilization combined with Stroking release technique, Maitland Mobilization, along with baseline treatment
- Keywords
- Pian, Disability, Adhesive Capsulitis, Mobilization
- Medical subject headings
- Bursitis, Yaws
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Maitland mobilization combined with Stroking release techniqueOther
Maitland mobilization combined with Stroking release technique of Rotator cuff muscles, along with baseline treatment
- Maitland mobilization:
- Perform using Grades III and IV glides (anterior, posterior, inferior) targeting the glenohumeral joint.
- Aimed at reducing stiffness and improving range of motion.
- 3 sets for 30 sec.
- Rotator cuff muscle release: (Stroking release technique)
- Manual muscle release of supraspinatus, Infraspinatus, Subscapularis and Teres minor for 15 minutes. (2-3 reps per muscle and 1 set per muscle per session)
- It will help to reduce muscle tightness and improve mobility
- Supraspinatus release: The patient will be in sitting or side-lying. Palpate just above the spine of the scapula. Use thumb pressure along muscle fibres. Move from distal end to proximal.
- Infraspinatus release: The patient will be in a sitting position. Locate the muscle below the spine of the scapula. Apply thumb pressure along muscle fibres or cross friction.
Maitland Mobilization, along with baseline treatmentOther
Maitland Mobilization, along with baseline treatment No additional soft tissue work was performed on the rotator cuff muscles.
Baseline treatment will be:
Hot pack and TENS for 10 minutes
Scapular mobilization:
Scapular mobilization is performed in a side-lying with the patient relaxed. The therapist passively mobilizes the scapula in different directions to improve scapulothoracic rhythm and reduce stiffness. Techniques used will be:
- Scapular elevation, depression
- Scapular protraction, retraction 3 sets of 6-8 mobilizations in each direction. 1 session per day and 3 sessions per week (26).
Codman exercises:
Codman exercises help promote passive motion of the shoulder joint without activating the shoulder musculature, reducing pain and improving mobility. Patient leans forward, hanging the affected arm freely. Small pendulum-like motions are performed in:
- Circular motion
- Forward back swing
- Side-to-side swing 4 sets of 6-8 reps in each direction
| Study group | Role | What they receive |
|---|---|---|
| Group A | Experimental | Maitland mobilization combined with Stroking release technique of rotator cuff muscle Receives: Other: Maitland mobilization combined with Stroking release technique |
| Group B | Active comparator | Maitland mobilization Receives: Other: Maitland Mobilization, along with baseline treatment |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numeric pain rating scale (NPRS)
The Numeric Pain Rating Scale (NPRS) is a widely used tool designed to assess pain intensity in both clinical and research settings. It consists of an 11-point scale ranging from 0 to 10, where 0 represents "no pain" and 10 indicates the "worst imaginable pain." NPRS is a quick and straightforward method, commonly used to track changes in pain over time, particularly in musculoskeletal and postoperative populations
Measured: Baseline; Week 3; Week 6
Universal Goniometer
The goniometer is a widely used instrument in clinical and rehabilitation settings to measure joint angles and assess the range of motion (ROM). It helps clinicians monitor progress and identify movement limitations in patients with musculoskeletal conditions.
Measured: Baseline; Week 3; Week 6
Shoulder pain and disability index
It is a self-administered questionnaire designed to evaluate pain and functional impairment related to shoulder disorders. It consists of 13 items, divided into pain and disability subscales, and is often used in both clinical practice and research.
Measured: Baseline; Week 3; Week 6
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Oct 2026
- Study start1 May 2026
- Primary completion1 Nov 2026 (estimated)
- Study completion1 Dec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Adhesive CapsulitisStudies of the same condition, open and under way.
- 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
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 44 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Muhammad Umar Hasnain, MS, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07854288
- Sponsor's protocol ID
- Umar Hassnain
- Status last verified
- Sep 2026
- First submitted
- 27 Sep 2026
- Last updated
- 2 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Eybye MN, Madsen SD, Schultz ANO, Nim CG. Database coverage and their use in systematic reviews regarding spinal manipulative therapy: an exploratory study. Chiropr Man Therap. 2022 Dec 19;30(1):57. doi: 10.1186/s12998-022-00468-8.
PubMed 36536437Deodato M, Martini M, Buoite Stella A, Citroni G, Ajcevic M, Accardo A, Murena L. Inertial Sensors and Pressure Pain Threshold to Evaluate People with Primary Adhesive Capsulitis: Comparison with Healthy Controls and Effects of a Physiotherapy Protocol. J Funct Morphol Kinesiol. 2023 Oct 6;8(4):142. doi: 10.3390/jfmk8040142.
PubMed 37873901Satpute K, Reid S, Mitchell T, Mackay G, Hall T. Efficacy of mobilization with movement (MWM) for shoulder conditions: a systematic review and meta-analysis. J Man Manip Ther. 2022 Feb;30(1):13-32. doi: 10.1080/10669817.2021.1955181. Epub 2021 Aug 1.
PubMed 34334099Phansopkar P, Qureshi MI. Impact of Spencer Technique on Pain, Range of Motion, and Functional Disability in Patients With Frozen Shoulder: A Pilot Study. Cureus. 2024 Jan 30;16(1):e53263. doi: 10.7759/cureus.53263. eCollection 2024 Jan.
PubMed 38435910Phansopkar P, Qureshi MI. An Integrated Physical Therapy Using Spencer's Technique in the Rehabilitation of a Patient With a Frozen Shoulder: A Case Report. Cureus. 2023 Jun 30;15(6):e41233. doi: 10.7759/cureus.41233. eCollection 2023 Jun.
PubMed 37529524