Abstract
BACKGROUND: Adhesive capsulitis (AC) is a progressive inflammatory condition of the shoulder that causes functional limitations and leads to long-term disability. The study aimed to elicit the effectiveness of proprioceptive neuromuscular facilitation (PNF) compared to standard physiotherapy approaches on AC. METHODS: An assessor-blinded single-centre randomised control trial (RCT) was carried out on 80 AC patients between May 2022 and December 2023 in Bangladesh. Random assigned and concealed allocated patients were recruited equally (n = 40) to each PNF and conventional capsular stretching group. The experimental group received a PNF approach, and the control group received capsular stretching to the affected shoulder for 24 sessions in 6 weeks. Both groups received electrical modalities as standard treatment. The primary outcome was pain measured by the numeric pain rating scale (NPRS) and range of motion in a universal goniometer. The secondary outcome was functional limitation measured by the shoulder pain and disability index (SPADI). As per the distribution of data, non-parametric tests were employed to analyse the superiority between and within groups with intention-to-treat analysis. RESULTS: Baseline compatibility was noted in all the key variables (p > 0.05). Both PNF and capsular stretching had a decrease in pain compared to baseline in all capsular pattern positions (p < 0.001), and PNF had more significant improvement compared to control (p < 0.001). Both groups had equal improvement in shoulder ROM (p < 0.001) except abduction (p < 0.05). Both groups had improvements in disability (p < 0.05), and PNF had statistical superiority of improvement (p < 0.001). CONCLUSIONS: The findings of this study support the potential of PNF intervention for 6 weeks as a treatment for shoulder adhesive capsulitis, showing improvements in pain, ROM and functional disability. However, further multicentre trials with a follow-up design are needed to fully understand the superiority of PNF on shoulder AC, encouraging continued engagement in this area of research. TRIAL REGISTRATION: The Australian New Zealand Clinical Trial Registry (ACTRN12621001299897). Registered on 27 September 2021, prospectively registered.