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Additional Effects of Thoracic Mobilization Versus Manipulation Along With Standard Physical Therapy in Adhesive Capsulitis

Sponsor: Foundation University Islamabad • ClinicalTrials.gov ID: NCT07838610

Registry updated: 2026-09-24

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Description

Participants will be divided into two groups, with both receiving conventional physical therapy along with their respective thoracic intervention. One group will receive thoracic manipulation at the identified T1-T7 segment using a controlled High-Velocity, Low-Amplitude thrust in the prone position at the end of full exhalation, while the other group will receive central PosterioAnterior thoracic mobilization in the prone position for 30 repetitions with a 1-minute rest between two sets. The most painful or stiffest segment will be identified using the Passive Accessory Intervertebral Movement (PAIVM) test; if no joint sign is present, mobilization will be performed at T6-T7.

Interventions

Thoracic Manipulation (Procedure)
Group A will receive thoracic thrust manipulation in addition to the conventional treatment program. The target thoracic segment (T1-T7) will be identified through posterior-to-anterior (PA) assessment. With the patient in a prone position, the therapist will position and preload the tissues at the identified segment and deliver a quick, controlled, high-velocity, low-amplitude (HVLA) thrust at the end of the patient's full expiration.
Thoracic mobilization (Procedure)
Thoracic mobilization will be performed as an adjunct to the conventional physical therapy program. Central posterior-to-anterior oscillatory mobilization will be performed in the prone position. The treatment segment will be identified using the Passive Accessory Intervertebral Motion (PAIVM) test, with the most painful or stiffest segment selected; if no joint sign is present, mobilization will be applied at T6-T7.

Eligibility criteria

Inclusion Criteria * Age range between 40 and 60 years. * Both male and female patients with unilateral or bilateral shoulder pain. * Pain persisting for at least 3 months. * Decreased shoulder ROM, including external rotation, abduction, internal rotation, and flexion, with both active and passive ROM reduced by more than 50%. * Clinically diagnosed with Stage 2 or Stage 3 adhesive capsulitis. Exclusion Criteria * History of fracture, surgery, or dislocation in the affected shoulder. * Shoulder pain resulting from systemic diseases such as rheumatoid arthritis, infection, or tumors, or conditions such as myelopathy (positive Hoffman's sign). * Neurological conditions such as stroke or cervical radiculopathy (positive Spurling's test). * Thoracic Outlet Syndrome (positive Roos test). * Uncontrolled hypertension or cardiac instability, including unstable angina, recent myocardial infarction, or other cardiovascular conditions.

Conditions

Adhesive Capsulitis

Locations

Foundation University College of Physical Therapy — Islamabad, Punjab Province, Pakistan

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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