Effects of Pectoralis Minor Exercises on Shoulder Pain, Scapular Dyskinesis and Thoracic Expansion in Adhesive Capsulitis Patients

NCT ID: NCT07283016

Last Updated: 2025-12-15

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 70 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-12-31
• Study Completion Date: 2026-03-31

Brief Summary

The goal of the current study is to evaluate the effects of pectoralis minor stretching and strengthening with mobility and stability exercises in patients aged 40-70 years with adhesive capsulitis. The main questions it aims to answer are:

Does the combination of pectoralis minor stretching and strengthening with mobility and stability exercises significantly reduce shoulder pain compared to mobility and stability exercises only? Does the combination of pectoralis minor stretching and strengthening with mobility and stability exercises improve scapular dyskinesis (scapular movement patterns) and thoracic expansion more effectively than mobility and stability exercises? Participants will be assigned to either an experimental group receiving pectoralis minor stretching and strengthening exercises with mobility and stability exercises or a control group receiving mobility and stability exercises only, and will complete standardized assessments of shoulder pain, scapular dyskinesis (scapular movement patterns) and thoracic expansion before and after the intervention.

Detailed Description

This clinical trial is designed to evaluate the combined effects of pectoralis minor stretching and strengthening with mobility and stability exercises on shoulder pain, scapular dyskinesis (scapular movement patterns) and thoracic expansion in individuals with adhesive capsulitis. It is commonly linked to reduce pectoralis minor tightness and improve pectoralis minor strength and interventions that target both mobility and stability as well as pectoralis minor correction may offer improved clinical outcomes of shoulder pain, scapular dyskinesis (scapular movement patterns) and thoracic expansion. All participants will undergo baseline assessment, including shoulder pain measured with the Numeric Pain Rating Scale, scapular dyskinesis assessed using the modified scapular assistance test, and thoracic expansion measured using a cloth measuring tape.

Participants will be randomized into two groups (Control Group and Experimental Group). Participants in the control group will perform mobility and stability exercises. Mobility Exercises are passive range-of-motion exercises combined with joint mobilization techniques such as pendulum exercises, wall crawls, and towel stretches. Stability Exercises are isometric rotator cuff exercises. Participants in the experimental group will perform mobility and stability exercises as described in the control group, plus pectoralis minor exercises. Pectoralis minor stretching exercises are unilateral corner and foam roller stretches. Pectoralis minor strengthening exercises are scapular push-ups (protraction-focused), scapular protraction with resistance bands, and wall slides with scapular protraction.

The interventions will occur 4 times per week for 6 weeks, with each session lasting approximately 30-40 minutes. Participants will be advised to avoid any external treatments during the study period. Post-intervention assessments will be conducted immediately after six weeks post intervention. This study aims to clarify whether the integration of pectoralis minor exercises results in superior clinical outcomes compared to mobility and stability exercises alone in the management of adhesive capsulitis.

Conditions

Adhesive Capsulitis

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

Experimental Group

Pectoralis Minor Stretching and Strengthening with Mobility and Stability Exercises

Group Type: EXPERIMENTAL

Pectoralis Minor Stretching and Strengthening with Mobility and Stability exercises

Intervention Type: OTHER

Participants in this group will follow a 6 week program targeting the Pectoralis Minor exercises in addition to mobility and stability exercises as explained in the control group used for adhesive capsulitis management. Pectoralis minor exercises include pectoralis minor stretching and strengthening. Pectoralis minor stretching exercises are unilateral corner and foam roller stretches (4 repetitions × 30 seconds hold, with a 30-second rest, performed 4 days a week for 6 weeks) to improve chest mobility. Pectoralis minor strengthening exercises are scapular push-ups (protraction-focused), scapular protraction with resistance bands, and wall slides with scapular protraction (3 sets × 10 repetitions, performed 4 days a week for 6 weeks) to boost muscle strength and support proper scapular movement. These interventions aim to reduce shoulder pain, improve scapular function, and enhance chest compliance in patients with adhesive capsulitis.

Control group

Mobility and Stability Exercises

Group Type: ACTIVE_COMPARATOR

Mobility and Stability exercises

Intervention Type: OTHER

Participants in the control group will receive a standardized physical therapy protocol commonly used for adhesive capsulitis management over a period of 6 weeks. This will include mobility and stability exercises. Mobility Exercises are passive range-of-motion exercises combined with joint mobilization techniques such as pendulum exercises, wall crawls, and towel stretches (3 sets of 10 repetitions of each exercise, performed 4 days a week for 6 weeks). Stability Exercises are isometric rotator cuff exercises performed (3 sets of 10 repetitions of each exercise, performed 4 days a week for 6 weeks). This basic treatment approach aims to reduce pain, improve joint mobility, and support gradual recovery in adhesive capsulitis without specifically targeting the pectoralis minor.

Interventions

Pectoralis Minor Stretching and Strengthening with Mobility and Stability exercises

Participants in this group will follow a 6 week program targeting the Pectoralis Minor exercises in addition to mobility and stability exercises as explained in the control group used for adhesive capsulitis management. Pectoralis minor exercises include pectoralis minor stretching and strengthening. Pectoralis minor stretching exercises are unilateral corner and foam roller stretches (4 repetitions × 30 seconds hold, with a 30-second rest, performed 4 days a week for 6 weeks) to improve chest mobility. Pectoralis minor strengthening exercises are scapular push-ups (protraction-focused), scapular protraction with resistance bands, and wall slides with scapular protraction (3 sets × 10 repetitions, performed 4 days a week for 6 weeks) to boost muscle strength and support proper scapular movement. These interventions aim to reduce shoulder pain, improve scapular function, and enhance chest compliance in patients with adhesive capsulitis.

Intervention Type: OTHER

Mobility and Stability exercises

Participants in the control group will receive a standardized physical therapy protocol commonly used for adhesive capsulitis management over a period of 6 weeks. This will include mobility and stability exercises. Mobility Exercises are passive range-of-motion exercises combined with joint mobilization techniques such as pendulum exercises, wall crawls, and towel stretches (3 sets of 10 repetitions of each exercise, performed 4 days a week for 6 weeks). Stability Exercises are isometric rotator cuff exercises performed (3 sets of 10 repetitions of each exercise, performed 4 days a week for 6 weeks). This basic treatment approach aims to reduce pain, improve joint mobility, and support gradual recovery in adhesive capsulitis without specifically targeting the pectoralis minor.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Age: 40 - 70 years
• Gender: Both Male & Female
• Clinical diagnosis of adhesive capsulitis (Thawing stage).
• Reduced thoracic expansion.
• Scapular dyskinesis

Exclusion Criteria

• Presence of rotator cuff tear, labral tears, or glenohumeral arthritis confirmed through imaging
• Post-stroke hemiparesis,
• Winged scapula due to lesions of long thoracic nerve or spinal accessory nerve.
• Rotator cuff repair
• Capsular release
• Arthroplasty

• Minimum Eligible Age: 40 Years
• Maximum Eligible Age: 70 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Lahore University of Biological and Applied Sciences

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

MUHAMMAD TARIQ RAFIQ

Role: PRINCIPAL_INVESTIGATOR

Lahore University of Biological & Applied Sciences

Central Contacts

Muhammad Hamza Mushtaq, DPT

Role: CONTACT

ubs24lmspt026@ubas.edu.pk

+923078161298

MUHAMMAD TARIQ RAFIQ, PhD

Role: CONTACT

tariq.rafiq@ubas.edu.pk

Other Identifiers

UBAS/ERB/FoRS/25/030

Identifier Type: -

Identifier Source: org_study_id