Defrost Training | The Niel-Asher Technique

Links to Frozen Shoulder

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Unique Therapy | Current Treatment (Evidence Base) | Our Evidence

A Randomized Placebo Controlled Trial

this trial was undertaken in association with the Rheumatology Research Unit, Addenbrokes Hospital (the teaching hospital for Cambridge - UK). It involved 3 groups of patients each treated with a different approach; the Niel-Asher Technique®, standard physiotherapy and a specially designed hands-on placebo treatment.

The results were extremely encouraging and have been published in the British Journal of Rheumatology Volume 42, Supplement 1, 2003, Article 418 BHPR p.146. The results were also presented to The 1st international Anglo-French society of Rheumatologists 2003 and the International Conference for advancing Osteopathic research 2003. You can read the article for this trial here: http://rheumatology.oupjournals.org/cgi/reprint/42/suppl_1/145.pdf

Conclusions

The Niel-Asher Technique® demonstrated a significant improvement in active range of movement (p=0.0002), and strength and power (p=0.047)over and above traditional physiotherapy treatment, in an outpatient hospital setting. Patients treated with the Niel-Asher Technique® also showed the largest clinical improvement in shoulder pain and disability (p=0.057). A larger clinical trail is now under development with a major UK orthopaedic hospital.

Results explained

In this clinical trial the Niel-Asher Technique® was compared to standard physiotherapy (with exercise) and a placebo (or dummy) treatment.

6 treatments were performed over 9 weeks
All patients were fully assessed by a consultant rheumatologist
Patients were then randomized into one of three groups; Niel-Asher Technique®, Physiotherapy and Placebo
Patients were independently measured and assessed by a research physiotherapist
The physiotherapists were experienced hospital outpatient therapists
The average duration of symptoms for the group having the Niel-Asher Technique® was 33.6 weeks (8.4 months)
The total group was 60% female/40% male
The average age of the patients was 51 years
All treatments were carried out in the Addenbrookes Hospital physiotherapy outpatient department

The two main outcome measures were improvement in active range of motion (i.e. lifting the arm higher without help) and pain (measured on various pain scales especially the well used and reliable Shoulder Pain and Disability Index - SPADI questionnaire) - since these are the most common components of Frozen Shoulder Syndrome.

Significantly increased range of motion

Range of motion improved by 52.6° degrees for the Niel-Asher Technique® compared to 24° degrees for physiotherapy and 0.8° degrees for placebo. This was a statistically significant result (p=0.0002)

80% Reduction in Pain

Pain improved by 38.7 points for the Niel-Asher Technique® compared to 19.9 points for physiotherapy and 22.8 points for placebo. In fact those patients treated with the the Niel-Asher Technique® reported an 80% decrease in pain over 9 weeks! This result approached statistical significance (p=0.07).

80% Reduction in Pain

Significantly Increased Strength and Power

Interestingly, treatment with the Niel-Asher Technique® demonstrated a significant increase in strength and power (Newton metres per second as measured by a cybex dynamometer), even though no exercises were given. In this study the physiotherapy group did not improve at all and the placebo group decreased in strength and power! This makes sense only when you understand that the Niel-Asher Technique® works directly on the brain to improve shoulder muscle co-ordination. (p=0.043)

Significantly Increased Strength and Power

IMPORTANT

This was a pilot study; a study with a higher statistical power is warranted.