Effect of Niel-Asher Technique vs Spencer Technique for Pain, Range of Motion and Functional Disability in Frozen Shoulder: A Randomized Clinical Trial.

Background: Adhesive capsulitis, also known as frozen shoulder, is a painful and gradual loss of active and passive shoulder motion caused by fibrosis and contracture of the joint capsule. The Niel-Asher technique is a hands-on manual therapy used to treat adhesive capsulitis, while the Spencer technique focuses on mobilizing the glenohumeral and scapulothoracic joints. Objective: The study aims to compare the effect of the Niel-Asher and Spencer techniques on frozen shoulder. Method: A randomized clinical trial on 36 participants with frozen shoulder compared the Niel Asher technique (Group A) and the Spencer technique (Group B). Both groups underwent 10 sessions over 2 weeks, along with a hot moist pack and conventional therapy. Outcomes, including Shoulder Pain and Disability Index (SPADI), Visual Analog Scale (VAS),and Shoulder Range of Motion (ROM), were assessed at baseline and post-treatment after 2 weeks, to evaluate pain and functional abilities. Results: The results showed significant improvement within the groups across all measured variables, Shoulder Pain and Disability Index (SPADI), Visual Analogue Scale (VAS), and Range of Motion (ROM) (P < .001). Group A and Group B showed greater improvement in pain intensity, decreased shoulder disability, and increased range of motion. No significant differences were found between groups for the outcome measures. Group B had a slightly better clinical response, as evidenced by larger effect sizes (Cohen's d). Conclusion: Both the Niel-Asher and Spencer techniques are equally effective in improving pain, shoulder range, and functional disabilities, with no statistical difference between them (P ≥ .05).However, the Spencer technique is clinically more effective than the Niel-Asher technique in subjects with frozen shoulder. Keywords: frozen shoulder, Spencer technique, Niel-Asher Technique, adhesive capsulitis, glenohumeral joint.