Gong Mobilization Versus Spencer Technique for Diabetic Frozen Shoulder

NCT ID: NCT07258368

Last Updated: 2025-12-02

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 36 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-10-01
• Study Completion Date: 2026-02-28

Brief Summary

The aim of this randomized controlled trial is to find the comparative effect of spencer technique and gong mobilization on pain, range of motion and functional disability among diabetic frozen shoulder patients.

Detailed Description

Frozen shoulder, also known as adhesive capsulitis, is a common musculoskeletal condition characterized by progressive pain, stiffness, and significant restriction of both active and passive range of motion in the shoulder joint. The condition typically progresses through three stages: the painful or freezing stage, marked by increasing pain and stiffness; the frozen or adhesive stage, where pain may subside but stiffness persists; and the thawing stage, during which mobility gradually improves. Risk factors include age, gender (more common in women), trauma, prolonged immobilization, and systemic conditions such as diabetes mellitus. Studies suggest Gong mobilization may offer superior ROM gains, while the Spencer technique provides significant long-term benefits, especially when combined with conventional therapy. Treatment effectiveness can vary, indicating a need for approaches tailored to individual patient factors and condition stage. This is particularly relevant for diabetic patients, who often experience slower, more complex recoveries.

Conditions

Frozen Shoulder

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Spencer Technique + Conventional Treatment

The Spencer Technique is an osteopathic shoulder mobilization performed with the patient lying on the unaffected side and the therapist stabilizing the scapula while moving the humerus. It consists of a sequence of seven articulatory steps: shoulder extension, flexion, circumduction with compression, circumduction with traction, abduction with internal rotation, internal rotation (hand behind back), and abduction with external rotation. Each movement is performed rhythmically at the end range to stretch the joint capsule, improve mobility, and reduce pain (Frequency: Over the course of 3 days, the exercise was repeated 3 times per session). Conventional PT: Hot pack = 15 mins, Home Plan: Pendulum Stretch, Cross-Body Arm Reach, Towel Stretch, Finger Walk (Wall Climb), External Rotation Stretch, Shoulder Blade Squeeze, Overhead Shoulder Stretch.

Group Type: EXPERIMENTAL

Spencer Technique + Conventional Treatment

Intervention Type: OTHER

The Spencer Technique is an osteopathic shoulder mobilization performed with the patient lying on the unaffected side and the therapist stabilizing the scapula while moving the humerus. It consists of a sequence of seven articulatory steps: shoulder extension, flexion, circumduction with compression, circumduction with traction, abduction with internal rotation, internal rotation (hand behind back), and abduction with external rotation. Each movement is performed rhythmically at the end range to stretch the joint capsule, improve mobility, and reduce pain (Frequency: Over the course of 3 days, the exercise was repeated 3 times per session). Conventional PT: Hot pack = 15 mins, Home Plan: Pendulum Stretch, Cross-Body Arm Reach, Towel Stretch, Finger Walk (Wall Climb), External Rotation Stretch, Shoulder Blade Squeeze, Overhead Shoulder Stretch.

Gong Mobilization + Conventional Treatment

The shoulder joint was turned upward as the patient was positioned in a side-lying posture. The patient had a 90-degree abduction of the shoulder to keep the humerus upright, and the elbow was 90 degrees flexed. Now the therapist held one hand of the patient to apply pressure to the humeral head from anterior to posterior while maintaining the position of the elbow at 90 degrees. The therapist then raised their own body while softly pushing on the shoulder joint's articular capsule. To retain the humerus' vertical axis, they achieved this while keeping shoulder abduction and elbow flexion at 90 degrees. The procedure was finished in about two to three minutes, and the articular capsule was gently squeezed for 10-15 seconds, and then relaxed for five seconds. After slightly stretching the capsule, the therapist applied gentle pressure with one hand on the shoulder joint from anterior to posterior. Maitland grades 3,4 then performed and then grade 4 approach for stretching for secs.

Group Type: EXPERIMENTAL

Gong Mobilization + Conventional Treatment

Intervention Type: OTHER

The shoulder joint was turned upward as the patient was positioned in a side-lying posture. The patient had a 90-degree abduction of the shoulder to keep the humerus upright, and the elbow was 90 degrees flexed. Now the therapist held one hand of the patient to apply pressure to the humeral head from anterior to posterior while maintaining the position of the elbow at 90 degrees. The therapist then raised their own body while softly pushing on the shoulder joint's articular capsule. To retain the humerus' vertical axis, they achieved this while keeping shoulder abduction and elbow flexion at 90 degrees. The procedure was finished in about two to three minutes, and the articular capsule was gently squeezed for 10-15 seconds, and then relaxed for five seconds. After slightly stretching the capsule, the therapist applied gentle pressure with one hand on the shoulder joint from anterior to posterior. Maitland grades 3,4 then performed and then grade 4 approach for stretching for secs.

Interventions

Spencer Technique + Conventional Treatment

The Spencer Technique is an osteopathic shoulder mobilization performed with the patient lying on the unaffected side and the therapist stabilizing the scapula while moving the humerus. It consists of a sequence of seven articulatory steps: shoulder extension, flexion, circumduction with compression, circumduction with traction, abduction with internal rotation, internal rotation (hand behind back), and abduction with external rotation. Each movement is performed rhythmically at the end range to stretch the joint capsule, improve mobility, and reduce pain (Frequency: Over the course of 3 days, the exercise was repeated 3 times per session). Conventional PT: Hot pack = 15 mins, Home Plan: Pendulum Stretch, Cross-Body Arm Reach, Towel Stretch, Finger Walk (Wall Climb), External Rotation Stretch, Shoulder Blade Squeeze, Overhead Shoulder Stretch.

Intervention Type: OTHER

Gong Mobilization + Conventional Treatment

The shoulder joint was turned upward as the patient was positioned in a side-lying posture. The patient had a 90-degree abduction of the shoulder to keep the humerus upright, and the elbow was 90 degrees flexed. Now the therapist held one hand of the patient to apply pressure to the humeral head from anterior to posterior while maintaining the position of the elbow at 90 degrees. The therapist then raised their own body while softly pushing on the shoulder joint's articular capsule. To retain the humerus' vertical axis, they achieved this while keeping shoulder abduction and elbow flexion at 90 degrees. The procedure was finished in about two to three minutes, and the articular capsule was gently squeezed for 10-15 seconds, and then relaxed for five seconds. After slightly stretching the capsule, the therapist applied gentle pressure with one hand on the shoulder joint from anterior to posterior. Maitland grades 3,4 then performed and then grade 4 approach for stretching for secs.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Patients with HbA1c ≥6.5% will be included.
• Patients diagnosed with frozen shoulder stage II, will be included.

Exclusion Criteria

• Receiving other clinical trials that could interfere with the outcomes of this study.
• Subject with recent history of surgery on affected shoulder
• Subject with history of any trauma/fracture around shoulder complex
• Subject with rotator cuff lesion and tendon calcification.
• Patients contraindicated to joint mobilization

• Minimum Eligible Age: 40 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Maria khalid, MSOMPT

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

HBS General Hospital

Islamabad, Punjab Province, Pakistan

Site Status: RECRUITING

Countries

Pakistan

Central Contacts

maria Khalid, MSOMPT

Role: CONTACT

maria.khalid@riphah.edu.pk

03315369768

Facility Contacts

maria khalid, MSOMPT

Role: primary

maria.khalid@riphah.edu.pk

03315369768

Afshan Batool, MSOMPT*

Role: backup

Other Identifiers

REC/ Afshan Batool 02212

Identifier Type: -

Identifier Source: org_study_id