The Combined Effect of Mulligan Mobilization, Pain Neuroscience-Based Training, and Core Stabilization Exercises in Frozen Shoulder Patients

The purpose of this randomized controlled study is to investigate the effects of a combined rehabilitation program consisting of Mulligan Mobilization with Movement (MWM), Pain Neuroscience Education (PNE), and core stabilization exercises in individuals with adhesive capsulitis (frozen shoulder). The main questions this study aims to answer are: Does the combination of Mulligan mobilization, Pain Neuroscience Education, and core stabilization exercises reduce pain in individuals with adhesive capsulitis? Does this combined intervention improve shoulder range of motion, shoulder function, quality of life, scapular dyskinesis, and pain catastrophizing compared with conventional physical therapy? Participants diagnosed with adhesive capsulitis will be randomly assigned to one of two groups. The intervention group will receive Mulligan mobilization, Pain Neuroscience Education, and core stabilization exercises, while the control group will receive conventional physical therapy, including TENS, hot-pack application, passive joint mobilization, and stretching exercises. Both groups will participate in treatment sessions three times per week for six weeks. Outcome measures will be assessed at baseline and after completion of the 6-week intervention period.

Inclusion Criteria: * Adults aged 18 to 65 years * Diagnosis of adhesive capsulitis confirmed by an orthopedic surgeon or a physical medicine and rehabilitation physician * Presence of shoulder pain and limitation of shoulder range of motion * Ability to communicate verbally * Ability to understand study procedures and educational content * Willingness to participate and provide written informed consent * Mini-Mental State Examination (MMSE) score of 24 or higher * Ability to attend treatment and assessment sessions regularly Exclusion Criteria: * MMSE score below 24 * Severe cognitive impairment * Severe psychiatric disorders * Active infectious disease * Active malignancy * Uncontrolled cardiovascular disease * Presence of a cardiac pacemaker * Contraindications to transcutaneous electrical nerve stimulation (TENS) * Neurological disorders that may affect participation or outcomes * Systemic diseases that may interfere with the safe implementation of the intervention * Inability to comply with the study protocol or attend scheduled sessions