Slider Versus Tensioner Median Nerve Mobilization in Patients With Frozen Shoulder Randomized Controlled Comparative Study

BACKGROUND AND PURPOSE: Pain and a progressive loss of glenohumeral (GH) joint mobility are the hallmarks of frozen shoulder (FS), which can seriously hinder daily activities. Limited GH mobility may be linked to increased neural mechanosensitivity, which could contribute to pain and functional limitations, though the precise mechanisms are still unclear. This study was established to compare the effectiveness of slider median nerve neural mobilization techniques (NMTs) versus the tensioner technique on pain intensity, functional disability and passive ROM of the GH joint in patients with FS. METHODS: Sixty-two patients with FS from both genders were randomly assigned to two equal groups. Group (A) received the slider technique of median nerve mobilization, whereas group (B) received the tensioner technique. All patients in both groups received GH joint mobilization and traditional physical therapy (three sessions per week for 6 weeks). Patients were evaluated for pain intensity by Visual Analog Scale (VAS), functional disability by Shoulder Pain and Disability Index (SPADI) and passive ROM of the GH joint by conventional goniometer at baseline and after the sixth week. RESULTS: Intergroup comparison revealed that there were statistically significant differences in the post-treatment measured outcomes: VAS (p = 0.003), SPADI (p < 0.001), passive abduction ROM (p < 0.001), passive external rotation ROM (p < 0.001), passive internal rotation ROM (p < 0.001). DISCUSSION: Both slider and tensioner median NMTs produce better improvements in pain alleviation, functional ability, and GH mobility in patients with FS, with slider approaches providing slightly greater, although incremental, benefits. TRIAL REGISTRATION: NCT06664437.