Efficacy of Three Directional Capsular Stretching Versus Angular Joint Mobilization in Patients with Frozen Shoulder: A Randomized Controlled Trial


  • Rabia Noureen
  • Hajra Ameer Shaikh
  • Muhammad Amir
  • Nida Waheed
  • Sumaira Nawaz




Adhesive capsulitis, angular joint mobilization, capsular stretching, frozen shoulder


Background: The evidence regarding efficacy of the new concept of Angular Joint Mobilization technique
(AJM) is scare hence this study aimed to compare the effectiveness of AJM versus three dimensional
Capsular Stretching exercises (CS) in reducing shoulder pain, functional limitations, shoulder disability and
in improving ROM of FS survivors.
Methodology: A randomized controlled, parallel group design study was conducted on FS patients.
Participants with the history of FS and aged 35 to 60 years were included however subjects with glenohumeral
arthritis, trauma, infection or congenital abnormality of shoulder were excluded. Four outcome measures
were assessed including Numeric pain rating scale (NPRS), Simple Shoulder Test (SST), Shoulder Pain and
Disability Index (SPADI) and goniometer. 50 volunteers were equally divided into AJM and CS group.
Result: The mean comparison of post NPRS in AJM group was 3.4 and in CS group was 4.4, SST score in
AJM was 10.4 and CS was 9.4, SPDAI and ROM in all the direction showed significant improvement in
AJM as compared to CS group at p-value <0.05.
Conclusion: AJM is significantly more effective in reducing shoulder pain, functional limitations and
shoulder disability, also in improving ROM of FS patients as compared to CS.

Author Biographies

Rabia Noureen

Physiotherapist, Department of Physical Therapy, Almurtaza Hosital, Pakistan

Hajra Ameer Shaikh

Lecturer, Department of Physical Therapy and Rehabilitation Sciences, Indus University, Pakistan

Muhammad Amir

Incharge, Orthopedic Workshop, JPMC,Pakistan

Nida Waheed

Lecturer, Institute of Physical Therapy and Rehabilitation, JSMU, Pakistan

Sumaira Nawaz

Physiotherapist, Medical Center Fauji Fertilizer Company, Mirpur Mathelo, Pakistan