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

Background and purpose Frozen shoulder (FS), or adhesive capsulitis, is a disabling shoulder disorder characterized by progressive pain and a marked restriction in glenohumeral joint mobility. Conservative management remains the first-line approach, with reported success rates of up to 90%. Physiotherapy is considered a cornerstone of nonoperative care, employing various manual and exercise-based strategies to reduce pain and restore function. Among the therapeutic options, Mulligan’s mobilization techniques and proprioceptive neuromuscular facilitation (PNF) have received increasing attention for their potential to accelerate recovery and improve clinical outcomes. This study aimed to compare the clinical efficacy of Mulligan Mobilization with movement (MWM) versus PNF techniques in reducing pain and improving range of motion (ROM) in individuals with frozen shoulder. Material 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. ROM was quantified using standardized goniometric instrumentation, while pain intensity was assessed via the validated numeric pain rating scale (NPRS). Participants engaged in a structured treatment regimen over a six-week period, receiving 2–3 sessions per week to ensure consistent exposure to the therapeutic interventions. Specifically, Group A underwent a treatment protocol combining MWM with passive modalities, including transcutaneous electrical nerve stimulation (TENS) and thermotherapy, whereas Group B received PNF techniques along with the same passive treatments. Results Intra-group analyses demonstrated a highly significant reduction in NPRS scores over time for both groups (P < 0.0001). Furthermore, at the six-week follow-up, the group A showed significantly greater gains in shoulder mobility compared to the PNF group, with improvements observed 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 reduced pain and improved shoulder mobility, with MWM showing greater gains in range of motion than PNF.