Evaluation of shoulder kinesthesia in patients with unilateral frozen shoulder

ABSTRACT

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.