Effects of Nonthrust Joint Mobilization on Clinical Outcomes of Patients With Adhesive Capsulitis of the Shoulder: A Meta-Analysis Publisher



Halabchi F ; Mahdaviani B ; Bagheri N ; Rahimi S ; Shabbidar S ; Selkghaffari M
Source: Journal of Manipulative and Physiological Therapeutics Published:2025

Abstract

Objective: This study aimed to evaluate the effects of nonthrust joint mobilization on pain, functional disability, and range of motion in patients with adhesive capsulitis (AC) of the shoulder. Methods: This meta-analysis included all English-language randomized controlled trials and prospective quasi-experimental studies evaluating the effects of joint mobilization on pain, disability, and range of motion in adult patients with any type of AC. PubMed and SCOPUS were searched for studies published before November 2021. Further studies were identified through manual screening of the reference lists. Cochrane Collaboration tool for risk of bias (RoB 2.0) was used for risk of bias assessment. Results were pooled using random effects meta-analysis. Results: Nineteen articles involving 812 patients were included in the synthesis. Regarding the effect on pain, the overall weighted mean difference was –1.19 with significant heterogeneity. For functional disability, overall weighted mean differences were –8.69 with significant heterogeneity, 10.11 with significant heterogeneity, and –7.18 with heterogeneity for studies using SPADI, Constant Murley, and DASH scores, respectively. Regarding the effect of shoulder mobilization on flexion, abduction, external, and internal rotations, overall weighted mean differences of 17.71, 13.89, 9.68, and 11.75 degrees, all with significant heterogeneity, were reported. Conclusions: This meta-analysis found statistically significant improvements in the reduction of pain, improvement in function, and restoring of range of motion among patients with adhesive capsulitis, regardless of the mobilization technique used. However, the results should be interpreted with some caution, because of high levels of heterogeneity and lack of high-quality studies in this field. © 2025 Elsevier B.V., All rights reserved.