[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100658582":3},{"organization":4,"outcomesModule":7,"designInfo":17,"detailedDescription":25,"studyPopulation":16,"armGroups":26,"interventions":38,"overallOfficials":16,"centralContacts":48,"locations":58,"responsibleParty":75,"collaborators":16,"id":77,"slug":78,"hasResults":79,"nctId":80,"briefTitle":81,"officialTitle":81,"acronym":16,"eligibilityCriteria":82,"healthyVolunteers":79,"sex":83,"minAge":84,"maxAge":85,"enrollmentInfo":86,"targetDuration":16,"studyType":89,"phases":90,"briefSummary":92,"conditions":93,"keywords":16,"overallStatus":61,"whyStopped":16,"lastUpdateSubmitDate":95,"lastUpdatePostDateStruct":96,"startDateStruct":99,"completionDateStruct":101,"leadSponsor":103,"locationsCount":104},{"fullName":5,"class":6},"Foundation University Islamabad","OTHER",{"primaryOutcomes":8,"secondaryOutcomes":16,"otherOutcomes":16},[9,13],{"measure":10,"description":11,"timeFrame":12},"Shoulder Range of Motion","A greater increase in shoulder range of motion of shoulder in goniometry","Baseline (before intervention) and after 4 weeks of intervention",{"measure":14,"description":15,"timeFrame":12},"Functional Disability.","Functional disability in patients with adhesive capsulitis will be assessed as a secondary outcome using the Shoulder Pain and Disability Index (SPADI). SPADI is a patient-reported outcome measure specifically designed to assess shoulder pain and functional disability. It consists of 13 items, divided into two subscales: 5 items assessing pain and 8 items assessing disability. Each item is scored on a 0-10 numerical scale, where 0 represents no pain\u002Fno difficulty and 10 represents the worst pain or inability to perform the activity. The scores are converted to a 0-100 scale, with higher scores indicating greater pain and functional disability. SPADI will be assessed at baseline (pre-intervention) and again after completion of the intervention (post-intervention). The change in SPADI score from pre- to post-intervention will be used to determine improvement in shoulder-related functional disability and will be analyzed as a secondary outcome of the study.",null,{"allocation":18,"interventionModel":19,"interventionModelDescription":16,"primaryPurpose":20,"observationalModel":16,"timePerspective":16,"maskingInfo":21},"RANDOMIZED","PARALLEL","TREATMENT",{"masking":22,"maskingDescription":16,"whoMasked":23},"SINGLE",[24],"OUTCOMES_ASSESSOR","The research synopsis entitled \"Comparative Effects of Niel-Asher Technique and Bowen Technique on Pain, Range of Motion and Functional Disability in Adhesive Capsulitis\" aims to evaluate and compare the effectiveness of two manual therapy approaches in the management of adhesive capsulitis. Adhesive capsulitis is a common musculoskeletal disorder characterized by progressive pain and stiffness of the shoulder joint, leading to marked restriction in both active and passive movements. The condition develops due to inflammation, fibrosis, and contracture of the glenohumeral joint capsule and surrounding periarticular structures. It predominantly affects individuals between the ages of 40 and 60 years and significantly limits functional independence and quality of life. Patients often experience difficulty performing routine activities such as dressing, combing hair, lifting objects, and reaching overhead. Although adhesive capsulitis generally follows a self-limiting course, recovery may take several months or even years, making effective conservative treatment essential. The synopsis explains that adhesive capsulitis progresses through four clinical stages: the painful phase, freezing phase, frozen phase, and thawing phase. The painful phase is characterized by gradually increasing pain with minimal movement restriction. During the freezing stage, pain intensifies while shoulder mobility progressively decreases. The frozen stage presents with significant stiffness and reduced pain, whereas the thawing stage involves gradual restoration of shoulder movement. The disorder may be primary (idiopathic) or secondary to underlying conditions such as diabetes mellitus, thyroid disease, rotator cuff pathology, cardiac disorders, or neurological conditions. Because the exact cause remains uncertain, treatment primarily focuses on symptom relief and restoration of function. Conservative physiotherapy remains the first-line treatment for adhesive capsulitis worldwide. Available interventions include electrotherapy, therapeutic exercises, manual therapy, stretching, joint mobilization, and rehabilitation programs. Despite the wide range of treatment options, there is still no universally accepted gold-standard intervention. This lack of consensus has encouraged researchers to investigate newer manual therapy techniques that may produce superior clinical outcomes. One intervention investigated in this study is the Niel-Asher Technique (NAT), developed by Simeon Niel-Asher in 1999. NAT is a structured five-step manual therapy protocol specifically designed to manage adhesive capsulitis. The technique combines deep stroking massage with ischemic trigger-point compression to treat muscles and periarticular tissues surrounding the shoulder, including the deltoid, biceps, rotator cuff muscles, and upper trapezius. After completing the five treatment steps, active shoulder rotations are performed. The proposed mechanism of NAT is based on Cortico-Neurosomatic Programming (CNSP), which suggests that manual stimulation activates mechanoreceptors, improves cortical body mapping, normalizes muscle tone, reduces sympathetic nervous system activity, decreases pain perception, and restores normal movement patterns. Previous studies cited in the synopsis indicate that NAT significantly improves shoulder pain, range of motion, and functional recovery in patients with adhesive capsulitis. The second intervention is the Bowen Technique (Bowtech), developed by Australian therapist Tom Bowen. This therapy involves gentle rolling movements over muscles, fascia, tendons, and ligaments, combined with therapeutic pauses between movements to allow neuromuscular adaptation. The technique targets structures around the shoulder, including the deltoid, supraspinatus, infraspinatus, subscapularis, and upper trapezius muscles. Bowen therapy is believed to work through fascial mechanotransduction, proprioceptive stimulation, and autonomic nervous system regulation. Gentle stimulation activates muscle spindles, Golgi tendon organs, and fascial mechanoreceptors, reducing muscle tension and promoting tissue relaxation. Research cited in the synopsis suggests that Bowen Technique effectively reduces pain, improves mobility, enhances functional status, and provides a safe, non-invasive complementary treatment for frozen shoulder. The primary objective of the study is to compare the effects of Niel-Asher Technique and Bowen Technique on three important clinical outcomes: pain, shoulder range of motion, and functional disability. Accordingly, three alternate hypotheses propose that significant differences will exist between the two interventions regarding pain reduction, improvement in shoulder mobility, and reduction in disability. Corresponding null hypotheses state that no statistically significant differences will exist between the interventions. Methodologically, the research is designed as a single-blind randomized clinical trial conducted at Fauji Foundation Hospital, Rawalpindi, over one year. A total sample of 54 participants will be recruited through purposive sampling, including an additional 10% to compensate for anticipated attrition. Eligible participants will be adults aged 40-60 years diagnosed with unilateral primary adhesive capsulitis in the frozen stage, experiencing moderate pain and restricted shoulder movements for more than six months. Participants with recent shoulder surgery, corticosteroid injections, neurological disorders, uncontrolled diabetes, fractures, or other serious shoulder pathologies will be excluded. Random allocation into two treatment groups will be achieved using a simple coin toss, while the outcome assessor will remain blinded to group allocation. Outcome assessment will include three validated measurement tools. Pain intensity will be measured using the Numeric Pain Rating Scale (NPRS), where participants rate pain from 0 (no pain) to 10 (worst imaginable pain). Functional disability will be evaluated using the Shoulder Pain and Disability Index (SPADI), a validated questionnaire assessing pain and daily functional limitations. Shoulder mobility will be objectively measured using a universal goniometer to assess flexion, abduction, internal rotation, and external rotation. Measurements will be recorded before treatment and again after four weeks of intervention. The synopsis also describes standardized procedures for measuring each shoulder movement and reports high reliability for the selected outcome measures. Both groups will receive a standardized conventional physiotherapy program consisting of hot packs, therapeutic ultrasound, Transcutaneous Electrical Nerve Stimulation (TENS), and supervised stretching and mobility exercises. In addition, Group A will receive the Niel-Asher Technique, while Group B will receive the Bowen Technique. Treatment sessions will occur three times per week for four weeks, with each session lasting approximately twenty minutes for the manual therapy component in addition to conventional treatment. Detailed treatment protocols are provided to ensure consistency and reproducibility of both interventions. In conclusion, this randomized clinical trial seeks to generate high-quality evidence comparing the effectiveness of the Niel-Asher Technique and Bowen Technique in managing adhesive capsulitis. By evaluating their impact on pain, shoulder range of motion, and functional disability, the study intends to identify the more effective manual therapy approach.",[27,33],{"label":28,"type":29,"description":30,"interventionNames":31},"Group A: Niel asher technique","EXPERIMENTAL","Participants in Group A will receive the Niel-Asher Technique (NAT) in addition to a conventional physiotherapy program. Conventional treatment includes a hot pack (10 minutes), therapeutic ultrasound (1 MHz, 1.25-1.5 W\u002Fcm² for 7 minutes), TENS (10 minutes), and supervised shoulder stretching and mobility exercises performed three times weekly for four weeks. The NAT protocol consists of a standardized five-step manual therapy sequence targeting myofascial trigger points in the deltoid, biceps, rotator cuff muscles, upper trapezius, subscapularis, and surrounding periarticular tissues. Techniques include deep stroking massage, ischemic trigger-point compression, passive circumduction, and guided shoulder movements, ending with anterior and posterior shoulder rolls. Treatment sessions will be conducted three times per week for four weeks, with each NAT session lasting approximately 20 minutes.",[32],"Procedure: Niel asher technique",{"label":34,"type":29,"description":35,"interventionNames":36},"Group B: Bowen technique","Participants in Group B will receive the Bowen Technique along with the same conventional physiotherapy program consisting of a hot pack, therapeutic ultrasound, TENS, and supervised shoulder stretching and mobility exercises. The Bowen Technique is a gentle manual therapy that targets the deltoid, upper trapezius, supraspinatus, infraspinatus, and subscapularis muscles through three specific rolling movements separated by therapeutic pauses of 2-5 minutes. The intervention begins with relaxation moves over the neck, shoulders, and upper back, followed by the cup move, passive shoulder adduction with tapping, and anterior deltoid release. Each Bowen session lasts approximately 40 minutes and is administered three times per week for four weeks",[37],"Procedure: Bowen Technique",[39,44],{"type":40,"name":41,"description":42,"armGroupLabels":43,"otherNames":16},"PROCEDURE","Niel asher technique","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.",[28],{"type":40,"name":45,"description":46,"armGroupLabels":47,"otherNames":16},"Bowen Technique","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).",[34],[49,54],{"name":50,"role":51,"phone":52,"phoneExt":16,"email":53},"Adeeba Ali, DPT","CONTACT","03310000956","muneebaalipt@gmail.com",{"name":55,"role":51,"phone":56,"phoneExt":16,"email":57},"Ateeqa Younis, MS-OMPT","03459559471","ateeqa.younis@fui.edu.pk",[59],{"facility":60,"status":61,"city":62,"state":63,"zip":64,"country":65,"countryCode":66,"cosmosGeoPoint":67,"geoPoint":72,"contacts":73},"Foundation University College of Physical Therapy","RECRUITING","Islamabad","Punjab Province","44000","Pakistan","PK",{"type":68,"coordinates":69},"Point",[70,71],74.4039,31.6047,{"lat":71,"lon":70},[74],{"name":55,"role":51,"phone":56,"phoneExt":16,"email":57},{"type":76,"investigatorFullName":16,"investigatorTitle":16,"investigatorAffiliation":16,"oldNameTitle":16,"oldOrganization":16},"SPONSOR","100658582","comparative-effects-of-niel-asher-technique-and-bowen-technique-on-pain-range-of-motion-and-functional-disability-in-patients-with-adhesive-capsulitis-100658582",false,"NCT07856173","Comparative Effects of Niel Asher Technique and Bowen Technique on Pain, Range of Motion and Functional Disability in Patients With Adhesive Capsulitis.","Inclusion criteria:\n\nThe participants with following criteria will be included in the study:\n\n* Diagnosed case of unilateral primary or idiopathic Adhesive Capsulitis.\n* Age ranging from 40-60 years.\n* Frozen stage (Stage II).\n* Having pain and restricted active and passive range of motion \\>6 months.\n* Capsular pattern of motion restriction (external rotation, abduction, internal rotation and flexion).\n* Moderate (4-6) pain intensity on NPRS\n* Both genders will be included.\n\nExclusion criteria:\n\nThe participants with following criteria will be excluded in the study:\n\n* Local corticosteroid injection to the affected shoulder within the last three months or who were on current corticosteroid therapy.\n* Any recent shoulder surgery.\n* Patients with neurological disorders, such as stroke, as well as those with uncontrolled diabetes, rheumatic disease in the shoulder, malignant tumors.\n* A history of the fracture or subluxation in the affected shoulder, history of surgery to the injured shoulder.","ALL","40 Years","60 Years",{"count":87,"type":88},54,"ESTIMATED","INTERVENTIONAL",[91],"NA","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.",[94],"Adhesive Capsulitis","2026-09-28",{"date":97,"type":98},"2026-10-02","ACTUAL",{"date":100,"type":98},"2026-02-12",{"date":102,"type":88},"2027-12-18",{"name":5,"class":6},1]