Mulligan Mobilization vs Shockwave Therapy in Adhesive Capsulitis

NCT ID: NCT07310810

Last Updated: 2025-12-30

Basic Information

• Recruitment Status: ACTIVE_NOT_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-05-01
• Study Completion Date: 2026-02-01

Brief Summary

To investigate and compare the effects of Mulligan mobilization versus shock wave therapy in patients with adhesive capsulitis on Pain intensity level, Range of motion, Functional disability level, Ultrasonographic changes (soft tissue thickness) and Hand grip strength.

Detailed Description

sixty patients of both genders according to sample size calculation, referred from orthopedist, diagnosed adhesive capsulitis patients. they screened according to inclusion and exclusion criteria. Their age between 40 and 60 years was randomly allocated to three treatment groups.

• Group A (study group) (n=20) will receive mulligan technique and conventional treatment.
• Group B (study group) (n=20) will receive extracorporeal shockwave therapy and conventional treatment.
• Group C (control group) (n=20) will receive conventional treatment only.

Inclusion criteria: patients that will be included in the study will be referred from orthopedic physician with:

1. Patients referred from orthopedist and diagnosed as frozen shoulder

2. The age of the participant will be from 40-60 (Agarwal S., et al.2016).

3. Body mass index from 25- 30 kg/m2.

4. having a painful stiff shoulder for at least 3 months

5. having limited ROM of a shoulder joint (ROM losses of 25% or greater compared with the noninvolved shoulder in at least 2 of the following shoulder motions: glenohumeral flexion, abduction and lateral rotation.

6. ability to complete Disabilities of the Arm, Shoulder and Hand questionnaires (DASH).

Exclusion criteria:

1. history of surgery on the particular shoulder

2. Rheumatoid arthritis

3. painful stiff shoulder after a severe trauma

4. fracture of the shoulder complex

5. rotator cuff rupture

6. tendon calcification.

Conditions

Adhesive Capsulitis

Keywords

Adhesive capsulitis; Mulligan mobilization; EXTRACORPOREAL SHOCKWAVE THERAPY; ULTRASONOGRAPHIC CHANGES

Study Design

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

Study Groups

- Group A (study group)

received mulligan technique and conventional treatment

Group Type: EXPERIMENTAL

Mulligan mobilization

Intervention Type: OTHER

Mobilization with movement (MWM) is the concurrent application of sustained accessory mobilization applied by a therapist and an active physiological movement to end range applied by the patient. Passive end-of-range overpressure, or stretching, is then delivered without pain as a barrier

Conventional treatment

Intervention Type: OTHER

Conventional treatment will be axillary ultrasound and laser ,low loading stretching exercise and home program exercises

Group B (study group)

received extracorporeal shockwave therapy and conventional treatment.

Group Type: EXPERIMENTAL

Shockwave

Intervention Type: DEVICE

From sitting with shoulder abducted at 45 degree and elbow flexed and the forearm rested on flat surface, The patients in the intervention group B received shock wave therapy once a week for 4 weeks. The focus probe sets were used and, in each session, patients received ESWT from anterior and posterior directions (on the average 1200 shocks between 0.1 and 0.3 mJ/mm2) up to the maximum threshold of pain tolerance in the shoulder

Conventional treatment

Intervention Type: OTHER

Conventional treatment will be axillary ultrasound and laser ,low loading stretching exercise and home program exercises

Group C (control group)

received conventional treatment only.

Group Type: EXPERIMENTAL

Conventional treatment

Intervention Type: OTHER

Conventional treatment will be axillary ultrasound and laser ,low loading stretching exercise and home program exercises

Interventions

Shockwave

From sitting with shoulder abducted at 45 degree and elbow flexed and the forearm rested on flat surface, The patients in the intervention group B received shock wave therapy once a week for 4 weeks. The focus probe sets were used and, in each session, patients received ESWT from anterior and posterior directions (on the average 1200 shocks between 0.1 and 0.3 mJ/mm2) up to the maximum threshold of pain tolerance in the shoulder

Intervention Type: DEVICE

Mulligan mobilization

Mobilization with movement (MWM) is the concurrent application of sustained accessory mobilization applied by a therapist and an active physiological movement to end range applied by the patient. Passive end-of-range overpressure, or stretching, is then delivered without pain as a barrier

Intervention Type: OTHER

Conventional treatment

Conventional treatment will be axillary ultrasound and laser ,low loading stretching exercise and home program exercises

Intervention Type: OTHER

Other Intervention Names

Mobilization with movement

Eligibility Criteria

Inclusion Criteria

Patients referred from orthopedist and diagnosed as frozen shoulder The age of the participant will be from 40-60 (Agarwal S., et al.2016). Body mass index from 25- 30 kg/m2. having a painful stiff shoulder for at least 3 months having limited ROM of a shoulder joint (ROM losses of 25% or greater compared with the noninvolved shoulder in at least 2 of the following shoulder motions: glenohumeral flexion, abduction and lateral rotation.

ability to complete Disabilities of the Arm, Shoulder and Hand questionnaires (DASH).

Exclusion Criteria

history of surgery on the particular shoulder Rheumatoid arthritis painful stiff shoulder after a severe trauma fracture of the shoulder complex rotator cuff rupture tendon calcification.

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

Sponsors

Cairo University

OTHER

Sponsor Role: lead

Responsible Party

Mohamed Ragab Gaber

lecturer assistant

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Mohamed R Gaber, Asst. lect.

Role: PRINCIPAL_INVESTIGATOR

Cairo University

Locations

Faculty of Physical Therapy

Giza, , Egypt

Countries

Egypt

Other Identifiers

012/005863

Identifier Type: -

Identifier Source: org_study_id