OBJECTIVE: To systematically review the literature for efficacy of isolated articular mobilization techniques in patients with primary adhesive capsulitis (AC) of the shoulder. DATA SOURCES: PubMed and Web of Science were searched for relevant studies published before November 2014. Additional references were identified by manual screening of the reference lists. STUDY SELECTION: All English language RCTs evaluating the efficacy of mobilization techniques on range of motion (ROM) and pain in adult patients with primary AC of the shoulder were included in this systematic review. Twelve RCTs involving 810 patients were included. DATA EXTRACTION: Two reviewers independently screened the articles, scored methodological quality and extracted data for analysis. The review was conducted and reported according to the PRISMA Statement. All studies were assessed in duplicate for risk of bias using the Physiotherapy Evidence Database scale for randomized controlled trials. DATA SYNTHESIS: The efficacy of 7 different types of mobilization techniques was evaluated. Angular mobilization (n = 2), Cyriax approach (n = 1) and Maitland's technique (n = 6) showed improvement in pain score and ROM. With respect to translational mobilizations (n = 1), posterior glides are preferred to restore external rotation. Spine mobilizations combined with glenohumeral stretching and both angular and translational mobilization (n = 1) had a superior effect on active ROM compared to sham ultrasound. High intensity mobilization (n = 1) showed less improvement in Constant Murley Score compared to a neglect group. Finally, positive long-term effects of Mulligan's technique (n = 1) were found on both pain and ROM. CONCLUSION: Overall, mobilization techniques have beneficial effects in patients with primary AC of the shoulder. Due to preliminary evidence for many mobilization techniques, the Maitland's technique and the combined mobilizations seem recommended at the moment.

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