{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:03:56Z","timestamp":1789621436461,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100019725","name":"Deanship of Scientific Research, Prince Sattam bin Abdulaziz University","doi-asserted-by":"publisher","award":["PSAU\/2024\/03\/29095"],"award-info":[{"award-number":["PSAU\/2024\/03\/29095"]}],"id":[{"id":"10.13039\/100019725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiotherapy Res Intl"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>Although neural mobilization techniques (NMTs) and proprioceptive neuromuscular facilitation (PNF) are well\u2010known therapeutic techniques among physical therapists, evidence regarding the additional benefit of combining these approaches in the management of adhesive capsulitis (AC) remains limited. This study was established to determine the effectiveness of combined NMTs and PNF techniques on pain intensity, functional disability and passive ROM of the shoulder joint in patients with AC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty\u2010six patients with AC of both genders were randomly assigned to two groups of equal size. The experimental group received combined slider median nerve NMTs, PNF and conventional physical therapy, while the control group received PNF and the same conventional physical therapy, three sessions per week for 6\u00a0weeks. Patients were evaluated for pain intensity, functional disability and passive ROM of the shoulder joint at baseline and after the 6th week.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After adjusting for baseline values using ANCOVA, the experimental group demonstrated significantly greater improvements across all outcomes. The adjusted between\u2010group differences (95% CI) were: VAS (0\u201310 scale) \u2212 0.88 (\u22121.24, \u22120.52;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001,\n                      <jats:italic>\u03b7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a00.313); SPADI \u22125.69 (\u22129.83, \u22121.55;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.008,\n                      <jats:italic>\u03b7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a00.125); abduction 14.08\u00b0 (11.22, 16.94;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001,\n                      <jats:italic>\u03b7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a00.647); external rotation 6.71\u00b0 (5.26, 8.16;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001,\n                      <jats:italic>\u03b7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a00.619); and internal rotation 1.83\u00b0 (0.94, 2.72;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001,\n                      <jats:italic>\u03b7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a00.244). When evaluated against established MCID thresholds, the 14.08\u00b0 improvement in shoulder abduction was the only outcome that approached the established MCID and exceeded measurement error, indicating a possible clinically meaningful benefit. Conversely, changes in pain and disability did not reach their respective MCID thresholds and should therefore be interpreted cautiously, with confirmation in larger studies warranted.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The combination of NMTs with PNF and conventional physical therapy resulted in statistically significant short\u2010term improvements in pain, disability, and passive shoulder ROM. However, the between\u2010group difference in pain and disability did not reach the reported MCID limits, and shoulder abduction had the most potential therapeutic value. Consequently, the results indicate that NMTs may provide additional advantages, especially for shoulder mobility, but do not show a clinically significant effect on other outcomes. Larger trials with longer follow\u2010up are necessary to corroborate these findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>NCT06664437<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pri.70350","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T04:33:13Z","timestamp":1789619593000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Added Value of Neural Mobilization Techniques to Proprioceptive Neuromuscular Facilitation in Patients With Adhesive Capsulitis: Randomized Controlled Trial"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5725-3135","authenticated-orcid":false,"given":"Mohammed Moustafa Aldosouki","family":"Hegazy","sequence":"first","affiliation":[{"name":"Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences Prince Sattam bin Abdulaziz University  Al\u2010Kharj Saudi Arabia"},{"name":"Department of Physical Therapy for Musculoskeletal Disorders and Its Surgery, Faculty of Physical Therapy Cairo University  Giza Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saud M.","family":"Alrawaili","sequence":"additional","affiliation":[{"name":"Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences Prince Sattam bin Abdulaziz University  Al\u2010Kharj Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5011-8619","authenticated-orcid":false,"given":"Tamer Emam","family":"El Negamy","sequence":"additional","affiliation":[{"name":"Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences Prince Sattam bin Abdulaziz University  Al\u2010Kharj Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatema M.","family":"Rizk","sequence":"additional","affiliation":[{"name":"Physical Therapist at Ministry of Health Hospitals  Giza Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"\u2018PNF in Practice\u2019: An Illustrated Guide","author":"Adler S. S.","year":"2008"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1589\/jpts.28.3342"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1589\/jpts.26.1803"},{"issue":"7","key":"e_1_2_12_5_1","article-title":"Frozen Shoulder","volume":"181","author":"Bak K.","year":"2019","journal-title":"Ugeskr Laeger"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11010154"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2017.7117"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269215515597294"},{"key":"e_1_2_12_9_1","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen J.","year":"1988"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.20310"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.331.7530.1453"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2012.3854"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1179\/2042618614Y.0000000092"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pri.70164"},{"key":"e_1_2_12_15_1","volume-title":"Maitland's Peripheral Manipulation: Management of Neuromusculoskeletal Disorders\u2014Volume 2","author":"Hengeveld E.","year":"2013"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.21608\/mjcu.2022.272091"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1179\/108331905X55776"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2013.0302"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063\u2010025\u201008848\u20100"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0129398"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010022\u201005327\u20104"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063\u2010019\u20103585\u2010z"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010022\u201005251\u20107"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.50858\/acompt.1.037"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2023.02.134"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000001070"},{"key":"e_1_2_12_27_1","volume-title":"Measurement of Joint Motion: A Guide to Goniometry","author":"Norkin C. C.","year":"2016"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbmt.2022.03.002"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S03043959(02)000489"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2009.04.008"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40634\u2010021\u201000352\u2010z"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010016\u20101190\u20109"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2018.7716"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010015\u20100495\u20104"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JSE.2009.03.021"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1515\/jmni\u20102019\u20100053"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891023062682"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010025\u201008303\u2010w"}],"container-title":["Physiotherapy Research International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pri.70350","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pri.70350","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pri.70350","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T04:33:41Z","timestamp":1789619621000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pri.70350"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,16]]},"references-count":37,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/pri.70350"],"URL":"https:\/\/doi.org\/10.1002\/pri.70350","archive":["Portico"],"relation":{},"ISSN":["1358-2267","1471-2865"],"issn-type":[{"value":"1358-2267","type":"print"},{"value":"1471-2865","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,16]]},"assertion":[{"value":"2026-06-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70350"}}