Effectiveness of Mulligan mobilization versus proprioceptive neuromuscular facilitation on pain reduction and shoulder mobility in patients with frozen shoulder

Aim of the study. This study compared the efficacy of Mulligan’s mobilization versus proprioceptive neuromuscular facilitation (PNF) techniques in reducing pain and enhancing the range of motion (ROM) in individuals with frozen shoulder. Materials and methods. A total of 48 subjects, fully adhering to the study protocol, were allocated into two groups: group A (n = 25) and group B (n = 23). The clinical parameters evaluated included rom and pain intensity. Range of motion was measured using standardized goniometric instrumentation, while pain intensity was assessed using the validated numeric pain rating scale (NPRS). Participants underwent a structured treatment regimen over six weeks, receiving 2–3 sessions per week to ensure consistent therapeutic exposure. Specifically, group A received Mulligan’s mobilization combined with passive modalities, including transcutaneous electrical nerve stimulation (TENS) and thermotherapy. Group B underwent PNF techniques alongside the same passive treatments. Results. Intra-group analyses showed a highly significant reduction in NPRS scores in both groups over time (P < 0.0001). At the six-week follow-up, group A demonstrated significantly greater gains in shoulder mobility than the PNF group, with improvements in flexion (P = 0.010), extension (P = 0.011), abduction (P = 0.001), internal rotation (P = 0.003), and external rotation (P < 0.0001). Conclusions. Both interventions significantly reduced pain. However, after six weeks, the group treated with Mulligan mobilization achieved substantially greater improvements in shoulder mobility, indicating enhanced functional outcomes and supporting the need for further research on its long-term efficacy.