ClinicalTrials.gg
RecruitingNCT07667556Updated Aug 4, 2026

The Combined Effect of Mulligan Mobilization, Pain Neuroscience-Based Training, and Core Stabilization Exercises in Frozen Shoulder Patients

An interventional study of Pain Neuroscience Education (PNE) and Mulligan Mobilization With Movement (MWM) in Frozen Shoulder, sponsored by Yeditepe University. Recruiting at 1 site in Turkey (Türkiye). Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-08-04.

Sponsored by Yeditepe University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Apr 2026; still recruiting 6 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
36
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

The purpose of this randomized controlled study is to investigate the effects of a combined rehabilitation program consisting of Mulligan Mobilization with Movement (MWM), Pain Neuroscience Education (PNE), and core stabilization exercises in individuals with adhesive capsulitis (frozen shoulder).

The main questions this study aims to answer are:

Does the combination of Mulligan mobilization, Pain Neuroscience Education, and core stabilization exercises reduce pain in individuals with adhesive capsulitis? Does this combined intervention improve shoulder range of motion, shoulder function, quality of life, scapular dyskinesis, and pain catastrophizing compared with conventional physical therapy?

Participants diagnosed with adhesive capsulitis will be randomly assigned to one of two groups. The intervention group will receive Mulligan mobilization, Pain Neuroscience Education, and core stabilization exercises, while the control group will receive conventional physical therapy, including TENS, hot-pack application, passive joint mobilization, and stretching exercises. Both groups will participate in treatment sessions three times per week for six weeks. Outcome measures will be assessed at baseline and after completion of the 6-week intervention period.

Read the detailed description

Adhesive capsulitis, commonly known as frozen shoulder, is a musculoskeletal disorder characterized by shoulder pain, progressive restriction of active and passive range of motion, and functional disability. The condition negatively affects activities of daily living and quality of life and is most frequently observed in individuals between 40 and 65 years of age. Despite the widespread use of conventional physiotherapy interventions, optimal treatment strategies remain under investigation.

Mulligan Mobilization with Movement (MWM) is a manual therapy technique that combines sustained accessory joint glides with active pain-free movement. Previous studies have demonstrated beneficial effects of Mulligan mobilization on pain reduction and functional improvement in individuals with adhesive capsulitis. Pain Neuroscience Education (PNE) is an educational approach designed to improve patients' understanding of pain mechanisms and reduce maladaptive beliefs related to pain. Core stabilization exercises, particularly those based on Dynamic Neuromuscular Stabilization (DNS) principles, aim to improve postural control, neuromuscular coordination, and movement efficiency.

Although the effectiveness of Mulligan mobilization has been investigated in patients with adhesive capsulitis, there is limited evidence regarding the use of Pain Neuroscience Education in this population, and the effects of DNS-based core stabilization exercises have not been adequately studied. Furthermore, no previous study has examined the combined effects of Mulligan mobilization, Pain Neuroscience Education, and core stabilization exercises in individuals with adhesive capsulitis.

This randomized controlled trial aims to evaluate the short-term effects of a combined intervention consisting of Mulligan mobilization, Pain Neuroscience Education, and core stabilization exercises on pain intensity, shoulder range of motion, shoulder function, pain catastrophizing, scapular dyskinesis, core stability, and health-related quality of life in individuals with adhesive capsulitis.

Participants diagnosed with adhesive capsulitis will be randomly allocated to one of two groups. The experimental group will receive Mulligan mobilization, Pain Neuroscience Education, and DNS-based core stabilization exercises. The control group will receive conventional physical therapy consisting of transcutaneous electrical nerve stimulation (TENS), hot-pack application, passive joint mobilization, and stretching exercises. Both groups will participate in treatment sessions three times per week for six weeks. Assessments will be conducted at baseline and after completion of the intervention period.

The findings of this study may contribute to the development of a more comprehensive rehabilitation approach for individuals with adhesive capsulitis and provide evidence regarding the effectiveness of combining manual therapy, pain education, and core stabilization strategies in clinical practice.

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Conditions studied

  • Frozen Shoulder

Browse trials for

03

In context

Bursitis

383 studies on the registry are indexed under Bursitis; 111 are open to participants now.

This study's planned enrollment of 36 is below the median of 44 across 346 interventional studies indexed under Bursitis.

Browse Bursitis studies →

Lead sponsor

Yeditepe University is the lead sponsor of 131 studies on the registry; 29 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Adults aged 18 to 65 years
  • Diagnosis of adhesive capsulitis confirmed by an orthopedic surgeon or a physical medicine and rehabilitation physician
  • Presence of shoulder pain and limitation of shoulder range of motion
  • Ability to communicate verbally
  • Ability to understand study procedures and educational content
  • Willingness to participate and provide written
  • (MMSE) score of 24 or higher
  • Ability to attend treatment and assessment sessions regularly

Exclusion criteria

Exclusion Criteria:

  • score below 24
  • Severe cognitive impairment
  • Severe psychiatric disorders
  • Active infectious disease
  • Active
  • Uncontrolled cardiovascular disease
  • Presence of a cardiac pacemaker
  • to transcutaneous electrical nerve stimulation (TENS)
  • Neurological disorders that may affect participation or outcomes
  • Systemic diseases that may interfere with the safe implementation of the intervention
  • Inability to comply with the study protocol or attend scheduled sessions
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

MMSE and MoCA

Short tests of memory and thinking, each scored out of 30. Lower scores suggest more difficulty; criteria give a range, either to include people with memory problems or to leave them out.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
36 participants (estimated)

Study arms

  • Experimental
    Experimental - Combined Treatment Group

    Mulligan Mobilization + Pain Neuroscience Education + Core Stabilization Exercises

    Behavioral: Pain Neuroscience Education (PNE) · Procedure: Mulligan Mobilization With Movement (MWM) · Behavioral: Core Stabilization Exercises

  • Active comparator
    Active Comparator - Conventional Physical Therapy Group

    Conventional Physical Therapy (TENS + hot-pack + ROM Exercises + Stretching Exercises)

    Other: Conventional Physical Therapy

Interventions

  • BehavioralPain Neuroscience Education (PNE)

    Participants will receive Pain Neuroscience Education focused on the biopsychosocial nature of pain, central sensitization, the distinction between pain and tissue damage, and strategies to reduce fear of movement. The initial educational session will last approximately 15-20 minutes, followed by 5-10 minute reinforcement sessions throughout the intervention period. Education will be delivered through verbal explanations and interactive discussion.

  • ProcedureMulligan Mobilization With Movement (MWM)

    Participants will receive Mulligan Mobilization with Movement techniques applied to the glenohumeral joint, including posterolateral glide with active abduction, inferior glide with shoulder flexion, and posterior glide with internal rotation. Mobilizations will be performed within a pain-free range of motion. Each technique will be administered in 3 sets of 10 repetitions with 30 seconds of rest between sets. Treatment will be provided three times per week for six weeks

  • BehavioralCore Stabilization Exercises

    Participants will perform Dynamic Neuromuscular Stabilization (DNS)-based core stabilization exercises. The program will include diaphragmatic breathing, supine 90/90 positioning, abdominal bracing, and progression to dead bug, bird-dog, and modified plank exercises as tolerated. Exercises will be performed in 2-3 sets of 8-12 repetitions with 10-20 second isometric holds. Progression will occur from stable to unstable surfaces and from static to dynamic activities

  • OtherConventional Physical Therapy

    Participants in the control group will receive conventional physical therapy consisting of transcutaneous electrical nerve stimulation (TENS) applied at a sensory level for 20 minutes, hot-pack application for 20 minutes, passive shoulder joint mobilization exercises, pendulum exercises, and wand exercises. Treatment sessions will be conducted three times per week for six weeks.

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What researchers measure

Primary outcomes

  1. Pain Intensity

    Pain intensity during movement will be assessed using the Visual Analog Scale (VAS). Higher scores indicate greater pain intensity.

    Time frame: Baseline and week 6

  2. Shoulder Function

    Shoulder pain, function, and patient satisfaction will be evaluated using the Penn Shoulder Score (PSS). Higher scores indicate better shoulder function.

    Time frame: Baseline and week 6

  3. Shoulder Range of Motion

    Active shoulder flexion, abduction, internal rotation, and external rotation range of motion will be measured using a goniometer.

    Time frame: Baseline and week 6

Secondary outcomes

  1. Pain Catastrophizing

    Pain-related catastrophic thinking will be assessed using the Pain Catastrophizing Scale (PCS). Higher scores indicate greater pain catastrophizing.

    Time frame: Baseline and week 6

  2. Core Stability

    Core stability and neuromuscular control will be assessed using the Sahrmann Core Stability Test.

    Time frame: Baseline and week 6

  3. Change in Scapular Dyskinesis

    Scapular movement patterns and dyskinesis will be evaluated using the Scapular Dyskinesis Test.

    Time frame: Baseline and week 6

  4. Change in Health-Related Quality of Life

    Health-related quality of life will be assessed using the 12-Item Short Form Health Survey (SF-12).

    Time frame: Baseline and week 6

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Study locations

1 of 1 sites recruiting
  • Life Med Tıp Merkezi
    Istanbul, Turkey (Türkiye)
    Recruiting
08

References and documents

Publications

  • Sullivan MJL, Bishop SR, Pivik J. The Pain Catastrophizing Scale: Development and validation. Psychological Assessment. 1995;7(4):524-532.
  • Leggin BG, Michener LA, Shaffer MA, Brenneman SK, Iannotti JP, Williams GR Jr. The Penn shoulder score: reliability and validity. J Orthop Sports Phys Ther. 2006 Mar;36(3):138-51. doi: 10.2519/jospt.2006.36.3.138. PubMed 16596890 ↗
  • Razzaq A, Nadeem RD, Akhtar M, Ghazanfar M, Aslam N, Nawaz S. Comparing the effects of muscle energy technique and mulligan mobilization with movements on pain, range of motion, and disability in adhesive capsulitis. J Pak Med Assoc. 2022 Jan;72(1):13-16. doi: 10.47391/JPMA.1360. PubMed 35099430 ↗
  • Doner G, Guven Z, Atalay A, Celiker R. Evalution of Mulligan's technique for adhesive capsulitis of the shoulder. J Rehabil Med. 2013 Jan;45(1):87-91. doi: 10.2340/16501977-1064. PubMed 23037929 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Apr 2026 (actual). Primary completion is estimated for Jan 2027, 9 months after the start.

Of 217 non-industry interventional studies with no phase under Bursitis, half reached primary completion within 10 months of starting (the median), counting those still running; a quarter within 5 and three quarters within 17. This study's planned 9 months is close to that.

Counting every sponsor, half of 217 studies reached it within 10 months; a quarter within 5 and three quarters within 17.

How these figures are worked out, and which studies are left out of them.

Registered
Jun 19, 2026
First posted
Jun 25, 2026
StartActual
Apr 21, 2026
Primary completionEst.
Jan 2027
CompletionEst.
Jan 2027
Last update
Aug 4, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 4, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07667556
Responsible party
Sponsor
First posted
Jun 25, 2026
Start date
Apr 21, 2026
Primary completion
Jan 2027 (estimated)
Completion
Jan 2027 (estimated)
Last update
Aug 4, 2026

Study contacts

Dilay Döner
Contact
dilay.doner@std.yeditepe.edu.tr
+90 0535 019 58 83

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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