RecruitingNot ApplicableNCT07588087

Effect of Adding Latissimus Dorsi Myofascial Release to Scapular Proprioceptive Neuromuscular Facilitation on Pain, Disability, and Range of Motion in Adhesive Capsulitis

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

Sponsor

Ibadat International University, Islamabad

Enrollment

58 participants

Start Date

Apr 5, 2026

Study Type

INTERVENTIONAL

Conditions

Adhesive Capsulitis

Summary

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.

Eligibility

Min Age: 35 YearsMax Age: 70 Years

Inclusion Criteria9

\. 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 Criteria7

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.

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Interventions

OTHERMyofascial 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 the muscle fibers toward the thoracolumbar fascia. The technique will include sustained pressure, longitudinal gliding, and passive shoulder elevation until a tissue resistance barrier is reached. Each stretch will be maintained for 90-120 seconds, with a total MFR duration of approximately 10-15 minutes per session. Following MFR, scapular PNF will be performed using the posterior elevation to anterior depression pattern. The hold-relax technique will involve isometric contractions of 5-7 seco

OTHERScapular 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 of approximately 20 minutes. In addition, a hot pack will be applied to the affected area for 10-15 minutes prior to the exercise session to promote muscle relaxation. Treatment sessions will be conducted three times per week for a duration of 6 weeks.