Effectiveness of Proprioceptive Neuromuscular Facilitation Pattern on Upper Extremity and Scapula in Patients with Adhesive Capsulitis: A single centre assessor-blinded Randomised controlled trial (RCT)

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 Randomized control trial (RCT) was carried out on 80 AC patients between May 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 (http://www.anzctr.org.au) (ACTRN12621001299897).