Comparative Effects of Niel Asher Technique and Bowen Technique on Pain, Range of Motion and Functional Disability in Patients With Adhesive Capsulitis.

Description

This research synopsis, titled "Comparative Effects of Niel-Asher Technique and Bowen Technique on Pain, Range of Motion, and Functional Disability in Adhesive Capsulitis," aims to compare the effectiveness of two manual therapy techniques in managing adhesive capsulitis (frozen shoulder). Adhesive capsulitis is a painful musculoskeletal condition characterized by progressive stiffness, reduced shoulder range of motion (ROM), and functional limitations that significantly affect daily activities and quality of life. Although several conservative treatment approaches exist, there is still no consensus regarding the most effective intervention. The study will be conducted as a single-blind randomized clinical trial at the Rehabilitation Department of Fauji Foundation Hospital, Rawalpindi, over one year. A total of 54 participants aged 40-60 years with stage II (frozen stage) adhesive capsulitis will be recruited using purposive sampling and randomly allocated into two groups through a coin toss method. Group A will receive the Niel-Asher Technique (NAT) combined with conventional physical therapy, while Group B will receive the Bowen Technique along with the same conventional treatment. Both groups will undergo treatment three times per week for four weeks.

Interventions

• Niel asher technique (Procedure)
  The Niel-Asher Technique (NAT) is a standardized five-step manual therapy protocol designed to treat adhesive capsulitis by targeting myofascial trigger points around the shoulder. It begins with a brief soft tissue massage to relax the neck and shoulder muscles. Step 1 involves deep stroking massage along the lateral arm. Step 2 applies sustained ischemic compression to trigger points in the posterior rotator cuff region. Step 3 consists of gentle passive circumduction of the glenohumeral joint. Step 4 combines deep stroking and trigger-point compression over the long head of the biceps tendon. Step 5 applies compression to the infraspinatus trigger point with assisted external rotation, followed by shoulder rolls to conclude treatment.
• Bowen Technique (Procedure)
  The Bowen Technique is a gentle, non-invasive manual therapy that involves a series of precise rolling movements applied over specific muscles, tendons, fascia, and connective tissues. The technique is delivered in a standardized treatment protocol with short pauses between sets of moves to allow the body's neuromuscular and autonomic responses to occur. In patients with adhesive capsulitis, the intervention targets the shoulder girdle and associated regions, including the upper trapezius, levator scapulae, deltoid, rotator cuff muscles, pectoral muscles, and thoracic region, with the aim of reducing pain, improving shoulder range of motion, decreasing muscle tension, and enhancing functional mobility. Each treatment session lasts approximately 40 minutes, with three sessions per week for four weeks (12 sessions total).

Eligibility criteria

Conditions

Locations

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