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@#Introduction: Various non-operative treatment modalities have been advocated for a frozen shoulder. In the present study we compared the efficacy of single intra-articular steroid injection vs hydrodilatation with intra-articular steroids for frozen shoulder (FS) in the frozen phase. Materials and methods: This was a prospective, randomised control trial (RCT) done at a tertiary care centre. A total of 108 participants were randomised into two groupsone group received intra-articular steroid with hydrodilatation (HDS) and other group received intraarticular steroid injection only (S). Shoulder Pain and Disability Index (SPADI) scores were taken, and statistical analysis was done to measure the outcome at two weeks, six weeks and three-month intervals after the injection. Result: There was significant improvement in symptoms at each interval for both the groups (p=0.0). There was no statistically significant difference in the SPADI score between the two groups at two weeks post injection, however at six weeks (p=0.04) and 3 months (p=0.001) significant difference in the SPADI score was demonstrated with better scores in group S. The mean duration of analgesia required in group HDS was 5.17 days (S.D.=1.73) and for group S was 4.28 days (S.D.=1.01), with a statistical significance (p=0.002). Conclusion: Better clinical results were obtained at six weeks and three months with the group receiving corticosteroid only and also had a lesser requirement of analgesia post-intervention. Thus, intra-articular steroid injection only seems to be a more desirable method of management during the frozen phase of FS than that of hydrodilatation with intra-articular steroid injection.
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Ayurveda is boon for mankind. Panchakarma is the most important part of Ayurveda to uproot the disease as well as achieving the perfect balance of vitiated Doshas, Dhatus and Agni. Avabahuka is a disease that affects the day to day activities like cooking, dressing, bathing, eating etc. Shoulder pain is a common clinical symptom of Avabahuka. The symptom of Avabahuka may be correlated with frozen shoulder because symptoms as well as pathogenesis are more or less similar to Avabahuka. Acharya Vangasena had mentioned Swedana Karma for Avabahuka. Aim: To evaluate the effectiveness of Jambira Pinda Sweda in the management of Avabahuka. Method: In our Panchakarma OPD 56 years old female patient came with complain of pain in the right shoulder joint and unable to perform her normal daily activities. Patient was admitted to the Panchakrma IPD of R.A.M&H and she had been treated with Jambira Pinda Sweda for 15 days. Result: After taking Panchakarma therapy, patient showed marked improvement of the symptoms like Shula (Pain), Sthambha (Stiffness) etc. Conclusion: It was found that Jambira Pinda Sweda had significant role in the management of Avabahuka.
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ObjectiveTo investigate the effect of neuromuscular control training on frozen shoulder. MethodsFrom February to August, 2021, 34 patients with first idiopathic frozen shoulder from the outpatients department of Rehabilitation, Beijing Tongren Hospital were randomly assigned into control group (n = 17) and experimental group (n = 17). Both groups received routine rehabilitation training, and the experimental group received neuromuscular control training in addition, one time a day, five days a week, for six weeks. The shoulder joint function was evaluated by Japanese Orthopaedic Association (JOA) score before and after training. ResultsAfter training, all the sub-item scores and total score of JOA improved in both groups (|t| > 14.835, |Z| > 2.070, P < 0.05), and the JOA sub-item scores of pain, ADL, ROM and total score were higher in the experimental group than in the control group (Z = -2.191, t > 2.060, P < 0.05). ConclusionNeuromuscular control training could improve the shoulder function of patients with frozen shoulder more effectively.
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The clinical evidences on acupuncture and moxibustion for the treatment of frozen shoulder were sorted and summarized systematically. The relevant articles of frozen shoulder treated with acupuncture and moxibustion were searched from PubMed, EMbase, Cochrane database of systematic review (CDSR), Cochrane database of controlled trials register (CENTRAL), China national knowledge infrastructure (CNKI), Wanfang, VIP, and Chinese biomedical literature databases (SinoMed), from database inception to May 31, 2021. Using AMSTAR-2, the methodological quality of the included systematic reviews was evaluated. With evidence map, the current status of clinical evidence was summarized on acupuncture and moxibustion in treatment of frozen shoulder. A total of 266 original studies and 6 systematic reviews were included finally. At present, many randomized controlled trials are designed with small sample size and the simple acupuncture and moxibustion therapy is dominant as the intervention, e.g. warm acupuncture, acupuncture with filiform needle, acupotomy and electroacupuncture. The outcomes considered in the current trials focus on clinical effective rate, the score of shoulder pain, the score of shoulder function and the score of quality of life. Most of the studies have shown that acupuncture and moxibustion is advantageous as an adjunctive therapy for frozen shoulder, but its clinical evidence is few in terms of the recurrence rate and safety. Moreover, it needs to improve the evidence quality of the relevant studies on acupuncture and moxibustion for frozen shoulder.
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Humans , Acupuncture Therapy , Bursitis/therapy , Electroacupuncture , Moxibustion , Quality of LifeABSTRACT
Objective: To observe the clinical efficacy of Tuina (Chinese therapeutic massage) plus needling the distal acupoints along the pathway of meridians for shoulder periarthritis (SP). Methods: A total of 70 patients with SP were divided into an observation group and a control group using the random number table method, with 35 cases in each group. The patients in the observation group were treated by Tuina combined with needling distal acupoints along the pathway of meridians, while those in the control group only received the same Tuina treatment as in the observation group. The visual analog scale (VAS) and shoulder joint function were scored before and after treatment, and the efficacy after treatment was evaluated. Results: After three courses of treatment, the total effective rate of the observation group was 94.3％, while the total effective rate of the control group was 80.0％, showing a statistical difference (P<0.05). After treatment, the VAS scores of the two groups were significantly lower than the baseline scores (P<0.01), and the VAS score of the observation group was lower than that of the control group (P<0.01). After treatment, the total scores of internal rotation, external rotation, back touching, ear touching and motion function in the two groups were significantly higher than those before treatment (P<0.01), and the above five scores in the observation group were significantly higher than those in the control group (P<0.01). Conclusion: Tuina combined with needling the distal acupoints along the pathway of meridians is more effective than Tuina alone in treating SP. The combined therapy can relieve the pain and improve joint function more effectively.
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Abstract Objective To clarify the association of thyroid disorders and primary frozen shoulder by comparing this group with controls without shoulder disease and with patients with rotator cuff tears. Methods We evaluated 166 patients who presented frozen shoulder with treatment in progress or already treated, which were compared with 129 patients with diagnosis of rotator cuff tears and 251 control subjects. All of the participants answered the questionnaire on the following variables: age, gender, body mass index (BMI), occupation, physical activity, presence of thyroid disorders and other comorbidities, smoking and use of alcohol. Results When comparing the frozen shoulder group with the control and rotator cuff groups, there is a specific association between the presence of thyroid disorders and frozen shoulder. By calculating relative risk, it is possible to state that an individual with thyropathy has 2.69 more chance of developing frozen shoulder. Also, there was an association with gender, since women with frozen shoulder exceeded significantly the risk. Conclusions Thyroid disorders, especially hypothyroidism and the presence of benign thyroid nodules, are risk factors significantly associated with frozen shoulder, rising the chances to 2.69 times of developing frozen shoulder. This is the first study that uses, in addition to the control group, a second group with rotator cuff tears, so it was shown that there is a specific association of thyroid disorders and frozen shoulder, but not with shoulder disorders in general.
Resumo Objetivo Verificar a asssociação entre tireopatias e ombro congelado primário, comparando com grupo controle e com grupo de pacientes com lesão no manguito rotador. Métodos Foram avaliados 166 pacientes com diagnóstico de ombro congelado primário com tratamento em andamento ou já tratados. Este grupo foi comparado com 129 pacientes com diagnóstico de lesão de manguito rotador e com um terceiro grupo controle formado por 251 indivíduos sem acometimento dos ombros. Todos os participantes responderam questionário sobre as seguintes variáveis: idade, gênero, índice de massa corpórea (IMC), profissão, atividade física, presença de tireopatia e de outras comorbidades, hábito tabagista e etilismo. Resultados Quando comparamos o grupo de ombro congelado com os grupos controle e lesão de manguito rotador, percebemos que existe uma associação específica entre presença de doenças da tireoide (tireoidite, hipotireoidismo, hipertireoidismo, nódulos e câncer) e ombro congelado. Através do cálculo do risco relativo, é possível afirmar que um indivíduo com tireopatia tem probabilidade 2.69 maior de desenvolver ombro congelado. Também houve associação com gênero, já que as mulheres com ombro congelado elevam significativamente esse risco. Conclusão Os distúrbios da tireoide, especialmente o hipotireoidismo e a presença de nódulos tireoidianos benignos, são fatores de risco significativamente associados ao ombro congelado, aumentando as chances em 2,69 vezes de desenvolver a doença. Este é o primeiro estudo que utiliza, além do grupo controle, um segundo grupo com lesões do manguito rotador, de modo que foi demonstrada uma associação específica de distúrbios da tireoide e ombro congelado.
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Humans , Thyroid Diseases , Bursitis , Control Groups , HypothyroidismABSTRACT
Background: The available treatments for frozen shoulder yield variable results. Physical therapy andanalgesics are considered as the first-line treatment for this disorder, but the effects are not uniform.There is some evidence to support that alternative medicine may have a role in its management.Objective(s): This study was designed to examine the short-term effects of yoga therapy in patients withfrozen shoulder of mild to moderate severity.Materials and methods: A prospective randomized controlled trial was conducted on patients with frozenshoulder between 30 and 60 years of age. They were divided into two groups: yoga (Y) and control (NY).A set of Asana exercises called “Standing Group of Asana” was practiced by the yoga group in addition tothe conventional therapy as received by the control group. The patients were reviewed at 1, 2 and 4weeks. The pain and functional assessment were done at baseline and at each review using the ShoulderPain and Disability Index (SPADI).Results: There were 16 male and 20 female participants in the Y group, and 15 males and 21 females inthe NY group. There was no statistically significant difference in age, sex, and pre-treatment SPADI scorebetween the groups. At the end of the four weeks, the SPADI pain scores in the Y and NY group were20.47 and 20.14, respectively (p ¼ 0.666). The SPADI disability scores in the Y and NY group were 20.4 and19.7, respectively (p ¼ 0.599). Overall SPADI scores were 40.67 and 40.03 in the Y and NY group,respectively (p ¼ 0.736). Both groups had a significant reduction in SPADI pain and disability scores.However, there was no significant difference between the groups in terms of SPADI scores.Conclusion: The effect of the Standing Group of Asana has no added advantage relative to standard frozenshoulder treatment when practiced for one month.© 2019 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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Background: Frozen shoulder is defined as the painful and disabling condition with unknown etiology. It has a limited shoulder range of motion due to decreased capsular flexibility and altered muscle function. Assessment on the frozen shoulder is needed, and it is vital to know the alteration in scapular muscles in the shoulder range of motion during arm elevation. The intention of conducting this study is to reach conclusions of tightness of a muscle in the upper trapezius, pectoralis minor muscle, and frozen shoulder levator scapulae showing limited ranges. Methods: In this cross-sectional observational study, 50 subjects of age 30 and above were assessed for muscle length in the frozen shoulder and unaffected shoulder. Subjects with shoulder pain with frozen shoulder stage 2 and above are allotted into the affected shoulder, and unaffected shoulder; both groups were assessed. The following parameters were measured: ROM of the shoulder, SPADI ratings, short pectoral thickness, levator scapulae length, and upper trapezium muscle length. Results: Decreased shoulder flexion, extension, abduction, and limited rotations were the problems associated with frozen shoulder. Pearson correlation coefficient for PMI and LSI shows Positive Correlation r = 40.6% on the affected side. Pearson correlation for PMI and UTI shows Positive Correlation r = 13.4%. Pearson Correlation for LSI and UTI shows Positive Correlation r= 28.1% on the affected side. Conclusion: There was a correlation between upper trapezius, levator scapulae, and pectoralis minor muscle length. Most of the affected side shoulder showed the tightness in the pectoralis minor muscle.
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Background. Frozen shoulder, also known as adhesive capsulitis limits shoulder range of motion (ROM) among Breast Cancer Related Lymphedema (BCRL) patients. Although several therapeutic interventions exist to treat BCRL symptoms, no consensus has been reached thus far. Case Report: This case study examined the use of Matrix Rhythm Therapy (MRT) for Frozen Shoulder in BCRL patient along with Complete Decongestive Therapy (CDT). The patient presented with chief complaints of pain and restricted shoulder movements secondary to mastectomy. MRT was administered for 60-75 minutes in 10 sessions over a period of three weeks. Results. Notable changes were observed post-intervention in ROM (from 100 to 180 degrees), pain (from 7 to 2), quality of life (QOL) (from 53 to 17) and limb volume (from 43.54% to 27.35%). Conclusion. MRT was found to be beneficial in this case in a short period of time, however, large-scale studies are required to affirm the impact of MRT as it is cost effective.
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OBJECTIVE@#To observe clinical efficacy of back arm flexion and extension combined with manipulation in treating adhesive scapulohumeral periarthritis.@*METHODS@#From March 2016 to April 2018, 53 patients with adhesive scapulohumeral periarthritis were treated with back arm flexion and extension combined with manipulation, the main symptoms were shoulder pain and limited activity. There were 22 males and 31 females aged from 45 to 71 years old with an average of (51.63±5.79) years;the courses of disease ranged from 3 to 24 months with an average of (8.62±3.73) months. Manipulation treatment was carried out once a week, and back arm flexion and extension were performed for 3 times a day with15 movements each time, totally 4 weeks for a single course. Visual analogue scale (VAS) and Constant-Murley shoulder function score were observed and compared before treatment and one week, one and three months after treatment.@*RESULTS@#All patients were followed up from 3 to 12 months, with an average of (5.91±3.55) months. VAS score before treatment was 4.02±1.46, and was improved to 3.15±1.54, 1.98±1.37, 1.12±0.86 respectively at one week, one and three months after treatment. Constant-Murley score before treatment was 42.70 ±5.72, and improved to 54.25 ±6.34, 67.45 ±6.84, 82.40 ±6.63 at one week, one and three months after treatment respectively;19 patients got excellent result, 22 good, 9 fair and 3 poor.@*CONCLUSION@#Back arm flexion combined with manipulation for the treatment of adhesive scapulohumeral periarthritis could effectively relieve pain, improve shoulder function, which is a simple effective treatment strategy.
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Aged , Female , Humans , Male , Middle Aged , Arm , Periarthritis , Therapeutics , Physical Therapy Modalities , Treatment OutcomeABSTRACT
Objective: To objectively evaluate the short-term and long-term efficacies of arthrolysis under brachial plexus anesthesia in treating adhesive capsulitis of the shoulder (ACS). Methods: One hundred patients diagnosed with ACS were divided into two groups using the random number method. The two groups both received same active rehabilitation exercises. Besides, 55 cases in the treatment group were given one session of arthrolysis under brachial plexus anesthesia, and 45 cases in the control group were given tuina treatment. Changes in the visual analog scale (VAS) score, Melle score and pressure pain index were observed 1 month and 3 months after treatment. The therapeutic efficacies were also compared. Results: The total effective rate was 96.4％ at the 1-month follow-up and 96.4％ at the 3-month follow-up in the treatment group. The total effective rate was 33.3％ at the 1-month follow-up and 28.9％ at the 3-month follow-up in the control group. There were significant differences between the two groups comparing the total effective rate at the two time points (both P<0.05). The scores of VAS, Melle and pressure pain were significantly different at the 1-month and 3-month follow-ups from those before treatment in the treatment group (all P<0.05); the three scores did not show significant differences at the 1-month and 3-month follow-ups compared with those before treatment in the control group (all P>0.05). Conclusion: Based on the active rehabilitation exercises, one session of arthrolysis under brachial plexus anesthesia can release the adhesion and restore the range of motion and function of shoulder joint in ACS patients. It is superior to rehabilitation exercises plus tuina treatment comparing both short-term and long-term efficacies.
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BACKGROUND: The objective of this study was to identify a consensus on definition, diagnosis, treatment, and prognosis of frozen shoulder (FS) among shoulder specialists.METHODS: A questionnaire composed of 18 questions about FS—definition, classification, utilization of diagnostic modalities, the propriety of treatment at each stage, and prognosis—was sent to 95 shoulder specialists in Korea. Most questions (15 questions) required an answer on a 5-point analog scale (1, strongly disagree; 5, strongly agree); three questions about the propriety of treatment were binary.RESULTS: We received 71 responses (74.7%). Of the 71 respondents, 84.5% agreed with the proposed definition of FS, and 88.8% agreed that FS should be divided into primary and secondary types according to the proposed definition. Only 43.7% of the respondents agreed that FS in patients with systemic disease should be classified as secondary FS. For the diagnosis of FS, 71.9% agreed that plain radiography should be used and 64.8% agreed ultrasonography should be used. There was a high consensus on proper treatment of FS: 97.2% agreed on education, 94.4%, on the use of nonsteroidal anti-inflammatory drugs; 76.1%, on intra-articular steroid injections; and 97.2%, on stretching exercise. Among all respondents, 22.5% answered that more than 10% of the patients with FS do not respond to conservative treatment.CONCLUSIONS: The survey revealed a general consensus among shoulder specialists on the definition and treatment of FS. However, classification of FS was found controversial.
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Humans , Bursitis , Classification , Consensus , Diagnosis , Education , Korea , Prognosis , Radiography , Shoulder , Specialization , Surveys and Questionnaires , UltrasonographyABSTRACT
Objective: To observe the clinical efficacy of filiform fire-needling plus continuous passive motion (CPM) therapy for frozen shoulder. Methods: A total of 72 patients were randomized into an observation group and a control group by the random number table method, with 36 cases in each group. Patients in the control group received celecoxib capsule plus CPM, while those in the observation group received filiform fire-needling plus CPM. The whole course of treatment lasted for 2 weeks in both groups. The visual analog scale (VAS), Constant-Murley score (CMS) and range of motion of shoulder joint were measured for therapeutic efficacy evaluation. Results: The total effective rate was 91.7％ in the observation group, higher than 72.2％ in the control group, and the between-group comparison showed statistical significance (P<0.05). After treatment, the VAS scores in the two groups dropped significantly, the CMS as well as the range of motion including abduction, forward flexion and extension were all increased significantly, and the intra-group comparisons showed statistical significance (all P<0.05). The betweengroup comparisons showed the improvements in these items in the observation group were more significant than those in the control group (all P<0.05). Conclusion: Filiform fire-needling plus CPM can produce more significant efficacy than celecoxib capsule plus CPM for frozen shoulder; it can alleviate pain, improve shoulder function and restore joint range of motion in such patients.
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OBJECTIVE@#To compare clinical effects of inside-out technique and outside-in technique for the treatment of idiopathic frozen shoulder under arthroscopy.@*METHODS@#From April 2015 to July 2019, 65 patients with primary frozen shoulder were divided into observation group and control group according to different treatment methods. In observation group, there were 32 cases, including 14 males and 18 females, aged 48 to 64 (54.82±5.35) years old, 18 cases on the right side and 14 cases on the left side. The course of disease was 4 to 10 (7.76±1.19) months. The patients were treated with outside in technique. In control group, there were 33 cases, 16 males and 17 females, aged 45 to 62 (54.64±4.16) years old, 18 cases on the right side and 15 cases on the left side. The course of disease was 5 to 9 (7.65±1.24) months. The patients were treated with inside out technique. The operation time, hospitalization days and treatment cost were compared between the two groups. Constant-Murley function score before and after the operation andthe shoulder joint range of motion one month after operation were compared to evaluate the clinical efficacy.@*RESULTS@#All 65 patients were followed up for 9 to 17 months with an average follow up time of (11.34±2.24) months. Compared with control group, operation time in observation group was shorter[(55.53± 10.23) min vs (85.58±13.39) min], and functional scores of Constant-Murley after surgery were significantly changed in both groups compared with that before surgery(@*CONCLUSION@#The two arthroscopic release schemes have achieved satisfactory results for thetreatment of primary frozen shoulder, and the shoulder joint function and pain degree have been effectively improved. Compared with the inside-out technique, the outside in release technique is more direct, the operation is simpler and the operation time is shorter. It has certain advantages in releasing operation for primary frozen shoulder.
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Female , Humans , Male , Middle Aged , Arthroscopy , Bursitis/surgery , Range of Motion, Articular , Shoulder Joint/surgery , Treatment OutcomeABSTRACT
Objective: To evaluate mid-term effectiveness of manipulation under anesthesia combined with arthroscopic capsular release and subacromial debridement for primary frozen shoulder. Methods: Between January 2013 and December 2017, 33 patients of primary frozen shoulder were treated with manipulation under anesthesia combined with 360° arthroscopic capsular release and subacromial debridement. There were 10 males and 23 females, aged from 37 to 65 years, with a mean age of 50.9 years. The affected shoulder on left side in 17 cases and on right side in 16 cases. The disease duration was 6-13 months (mean, 8.4 months). Before and after operation, the visual analogue scale (VAS) score was used to evaluate the shoulder joint pain, Constant score was used to evaluate the shoulder joint function, and the flexion, abduction, and external rotation of shoulder joint were recorded. The internal rotation function was assessed based on the vertebral plane that the thumb could reach after internal rotation of the affected shoulder joint (the rank of internal rotation vertebra). X-ray film was taken to measure the distance of the subacromial space. Results: There was no fracture or labrum tear in all patients, and all the incisions healed by first intention. All the 33 patients were followed up 20-31 months, with an average of 24.1 months. During the follow-up, there was no complication such as wound infection and nerve injury. At last follow-up, the range of motion of shoulder flexion, abduction, and external rotation, the rank of internal rotation vertebra, the VAS score, Constant score, and subacromial space were significantly improved when compared with preoperative ones ( P<0.05). Conclusion: Manipulation under anesthesia combined with arthroscopic capsular release and subacromial debridement can achieve a good mid-term effectiveness without complication for primary frozen shoulder.
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Background: Intact sensory-motor system provides kinesthesia for maintaining joint stability. Joint proprioception or joint kinesthetic sensation is often used alternately to describe a deep sensation of joint motion and joint position sense. Mechanoreceptors located in superficial layer of joint capsule, muscle spindle, golgi tendon organ complex and ligaments around joint provides joint kinesthetic sensation. Frozen shoulder or adhesive capsulitis is one of the common musculoskeletal disorders encountered in Indian population with a prevalence of almost 50% older patients with diabetes and 2-10% in non-diabetic patients. This study assessed joint kinesthetic sensation during shoulder movements in people with frozen shoulder and healthy controls which may be affected due to presence of disease process or pain. Authors hypothesized that pain and alterations in non-contractile tissues (mainly capsule) around shoulder joint due to frozen shoulder may interfere with the joint kinesthetic sensation.Methods: Case group consisted of 41 participants with frozen shoulder and 41 healthy participants without shoulder pathology. Joint kinesthesia was assessed in frozen shoulders and dominant shoulders using angle reproduction test by actively reproducing the target angle placed passively by the therapist during flexion, abduction, medial and lateral rotation movements. The angle reproduced was measured using universal goniometer by the same therapist and 3 readings were recorded.Results: Results indicate significant differences between the mean difference of angle reproduction test during shoulder movements in cases of frozen shoulder and healthy group (p value <0.05).Conclusions: Significant shoulder kinesthetic deficits were observed in patients with unilateral frozen shoulder. Therefore, clinicians should consider rehabilitation of kinesthesia in treatment of patients with frozen shoulder.
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Background: Frozen shoulder is defined as an idiopathic condition of the shoulder characterized by the spontaneous onset of pain in the shoulder with restriction of movement in every direction. Prevalence of frozen shoulder was found to be 3.06% in a regional community based study. Frozen shoulder is a discrete clinical diagnosis for painful restriction of shoulder motion that results from capsular fibrosis. It is usually present in age group between 40-60 years. Muscle Energy (MET) technique is very much beneficial in this condition. Muscle energy techniques are class of soft tissue osteopathic manipulation consisting of isometric contraction design to improve musculoskeletal function and reduce pain. MET combined along with scapular Mobilization gives much better effect. So, the aim of the study is to check the effectiveness of muscle energy technique and mobilization to improve shoulder range of motion frozen shoulder. Materials and methods: 60 patients were included in the study which was divided into two groups; Group A and Group B, 30 patients in each group. Subjects were randomly selected and assigned to each group. Pre-test measurements of the patient were done with the help of two measures VAS, Shoulder pain and disability index (SPADI) and Goniometer was used for assessing range motion of shoulder movements for each group. The Subjects in Group-A were given muscle energy technique. The Subjects in Group-B were given maitland technique. Then the Result analysis was done. Sreenivasu Kotagiri, Neeti Mathur, Vadana, Gayathri Balakavi, Anup Kumar Songa. The Effectiveness of Muscle Energy Technique and Mobilization to Improve the Shoulder Range of Motion in Frozen Shoulder. IAIM, 2019; 6(10): 64-73. Page 65 Results: On comparing Group A and Group B for post-treatment VAS and SPADI score, results showed a significant difference (p=0.001). The overall study proved that MET is beneficial in improving Pain and decreasing the disability level. Conclusion: The analysis obtained indicated that Group A (Muscle energy Technique) showed more significant improvement when compared to Group B (Mobilization).
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Objective: To explore the value of ultrasound scanning of the posterior capsule thickness of shoulder (PCT) and glenohumeral distance (GHD) for clinical staging of frozen shoulder (FS). Methods: Totally 100 patients with clinically diagnosed unilateral frozen shoulder were recruited. According to clinical staging standards, 51 shoulders were divided into stageFS group (freeing stage), 35 shoulders into stage Ⅱ FS group (frozen stage), 14 shoulders into stage III FS group (thawing stage), while 100 unaffected side shoulders of FS patients were taken as control group. Ultrasonic findings of the posterior capsule of shoulder and GHD were observed, while PCT and GHD of the affected shoulders and the unaffected shoulders were all measured and compared. Results: In stageFS group, the margin of the posterior capsule of the affected shoulders were clear, there was no significant difference of PCT between stage I FS group and control group (P>0.05), while GHD of the affected side shoulders were larger than that of the control group ([3.14±0.44]mm vs [2.22±0.35]mm, P0.05). Conclusion: Ultrasound scanning of PCT and GHD can contribute to clinical staging of frozen shoulder.
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Objective@#To observe the clinical effect of massage combined with warm acupuncture and moxibustion on primary frozen shoulder.@*Methods@#From April 2018 to April 2019, 30 patients with primary frozen shoulder admitted and treated in Wenzhou Hospital of Traditional Chinese Medicine were selected in theresearch.According to different admission time, they were divided into observation group and control group, with 15 patients in each group.The control group was treated with warm acupuncture and moxibustion, while the observation group was combined with massage.The total effective rate and VAS pain score after treatment were compared and observed.@*Results@#The total effective rate in the observation group was 93.33%, which was higher than 73.33% in the control group (χ2=3.294, P<0.05). The VAS score of the observation group was (1.05±0.22)points after treatment, which was lower than (3.13±0.43)points of the control group, the difference between the two groups was statistically significant(t=2.493, P=0.000).@*Conclusion@#Massage combined with warm acupuncture and moxibustion in the treatment of primary frozen shoulder is more effective than the single treatment method, which can relieve the pain of patients and is a safe and effective treatment.
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OBJECTIVE: To examine (1) the degree of reduction of passive range of motion (PROM) on the affected side compared to that on the unaffected side and (2) the degree of increase in PROM following intra-articular corticosteroid injection (IACI) in patients with frozen shoulder.METHOD: The medical records of 120 patients with frozen shoulder were retrospectively reviewed. PROM of the unaffected and affected shoulder (flexion, extension, abduction, internal rotation, external rotation) was compared, and changes in PROM of the affected shoulder after a single IACI (triamcinolone 20 mg) were evaluated after 12 weeks.RESULTS: At the time of diagnosis, PROM of the affected shoulder was most limited in external rotation, followed by internal rotation, abduction, extension, and flexion, compared to that of the unaffected shoulder. Compared to before IACI, PROM of external rotation demonstrated the greatest increase compared to all the other movements after IACI.CONCLUSION: Limitation in PROM of the frozen shoulder at the time of diagnosis was greatest for external rotation. Moreover, external rotation experienced the greatest improvement after IACI. Our findings should help to further clarify the clinical characteristics of frozen shoulder, aid in its diagnosis, and allow the prediction of the effects of IACI.