Effect of Spencer Technique Versus Mulligan Mobilization With Movement on Pain, ROM and Functional Disability in Patients With Adhesive Capsulitis

Abstract

Adhesive capsulitis (AC) is a painful and disabling shoulder disorder marked by progressive loss of active and passive glenohumeral motion. Manual therapy is central to its conservative management, yet direct comparisons between the osteopathic Spencer technique and Mulligan mobilization with movement (MWM) remain scarce.To compare the effect of the Spencer technique versus Mulligan MWM on pain, shoulder range of motion (ROM) and functional disability in patients with stage II adhesive capsulitis.A parallel-group, assessor-blinded randomized controlled trial was conducted on 60 patients aged 40–65 years, allocated to Group A (Spencer technique, n = 30) or Group B (Mulligan MWM, n = 30). Both groups also received a standardized conventional programme of moist heat and home exercises. Treatment was delivered three times per week for four weeks (12 sessions). Pain was measured with the Numeric Pain Rating Scale (NPRS), ROM with a universal goniometer and functional disability with the Shoulder Pain and Disability Index (SPADI) at baseline, week 2 and week 4. Fifty-six participants completed the study. Both groups improved significantly over time on every outcome (p < 0.001). At week 4, Group B showed significantly greater reduction in pain (mean difference −1.0; 95% CI −1.6 to −0.4; p = 0.001) and disability (SPADI mean difference −7.1%; p = 0.001), and greater gains in abduction (11.2°; p < 0.001) and external rotation (7.8°; p < 0.001). Differences in flexion and internal rotation were not significant. Both techniques are effective in the management of adhesive capsulitis; however, Mulligan MWM produced superior short-term improvements in pain, abduction, external rotation and functional disability compared with the Spencer technique.