scholarly journals PREVALENCE AND MANAGEMENT OF THE DIABETIC FROZEN SHOULDER

2020 ◽  
Vol 8 (10) ◽  
pp. 944-954
Author(s):  
Niraj Kumar ◽  

The term frozen shoulder was first introduced by Codman in 1934. He described a painful shoulder condition of insidious onset that was associated with stiffness and difficulty sleeping on the affected side. Codman also identified the marked reduction in forward elevation and external rotation that are the hallmarks of the disease. Long before Codman, in 1872, the same condition had already been labelled periarthritis by Duplay. In 1945, Naviesar coined the term adhesive capsulitis. [2] The pathophysiology of idiopathic adhesive capsulitis (frozen shoulder) is poorly understood. Most authors have reported various degrees of inflammatory changes in the synovial membrane. Adhesions between the shoulder capsule and the humeral head have been noted by some, but not all, authors. [4] The aetiology of periarthritis of the shoulder, however, is not clearly understood. Amongst the factors suggested are trauma myocardial infarction hemiplegia, pulmonary tuberculosis, thyrotoxicosis, cerebral tumour, and epilepsy. [7] Subjects with Frozen Shoulder Syndrome group A treated with ERM and MWM and group B treated with MRM. The duration of each treatment was 3 weeks. There was an improvement in mobility and functional ability at 12 weeks in subjects treated with the 3 mobilization techniques. Comparing the effectiveness of the 3 treatment strategies in subjects with unilateral Frozen Shoulder Syndrome, ERM and MWM were more effective than MRM in increasing mobility and functional ability. [22].

2014 ◽  
Vol 13 (2) ◽  
pp. 21-27
Author(s):  
Sunam Kumar Barua ◽  
Sohely Rahman ◽  
Prashanta Kumar Chakrabarti ◽  
Zahangir Alam

This prospective study was performed in the department of Physical Medicine, Dhaka Medical College Hospital (DMCH), Dhaka for a period of 6 months to see the effect of phonophoresis (Ultrasound therapy with Naproxen gel) on adhesive capsulitis. During this period 240 (4% of total patients) patients were diagnosed as adhesive capsulitis of shoulder in outpatient department, Physical Medicine, Dhaka Medical College Hospital. Sixty patients were selected for the study and divided them into two groups. In group A, patients were treated with phonophoresis and exercises in contrast with group B patients who were treated with same exercises without phonophoresis for same duration. Patients in both groups were followed up weekly for consecutive six weeks. The mean age of the patients in this study was 51.73 ± 10.01 year, with a range of 35 to 70 years. Out of sixty patients 31 (51.7%) were male and 29 (48.3%) were female. The male: female ratio was 1.07: 1. Among 60 patients, 27 (45%) were housewives, 20 (33.3%) service holders (official job), 4 (6.7%) businessmen, 1 (1.7%) teacher and 8 (13.3%) retired persons. In this study 53.3% patients had right shoulder involvement and rest of them (46.7%) had left sided involvement. Pain was improved just after initiation of treatment and it was completely alleviated in group A patients after 6th week, on the contrary although pain was increased after 1st week of treatment thereafter it was gradually decreased but it was not completely alleviated in group B patients at the end of the study. All sorts of range of motions (abduction, internal rotation on abduction, external rotation on abduction) of affected shoulder were improved more rapidly in group A compared to group B patients. Shoulder pain and disability index (SPADI) were significantly reduced in group A compared to group B patients.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21057


2019 ◽  
Vol 29 (3) ◽  
pp. 225-230 ◽  
Author(s):  
Rashid Anjum ◽  
Jatin Aggarwal ◽  
Rakesh Gautam ◽  
Subodh Pathak ◽  
Aryan Sharma

Objective: Adhesive capsulitis or frozen shoulder is a painful condition affecting up to 5% of the general population. We conducted this study with the aim of evaluating the results of physiotherapy plus intra-articular methylprednisolone injection versus physiotherapy alone in idiopathic frozen shoulder. Methods: This prospective clinical study was conducted in a tertiary care center between August 2016 and August 2018. Patients who were diagnosed with idiopathic frozen shoulder were included in the study, and each patient was randomly allocated to one of two groups: physiotherapy alone (group A) and physiotherapy plus intra-articular steroid injection (group B). Results: A total of 52 cases diagnosed with idiopathic frozen shoulder were included and treated with the two modalities. There was a significant improvement in group B compared to group A at 6 weeks and 3 months in the range of flexion, abduction, and external rotation. The Shoulder Pain and Disability Index showed improvement in both pain and disability score in group B ­compared to group A, and improvement was significant at 6 weeks and 3 months. Conclusion: The results demonstrate the advantages of physiotherapy plus intra-articular steroid injection in idiopathic frozen shoulder. The predictability of results with physiotherapy plus intra-articular steroid injection in selected patients is excellent, and it is a better modality of treatment compared to physiotherapy alone.


Author(s):  
Kamya Somaiya ◽  
G. D. Vishnu Vardhan ◽  
Ashish Bele

Background: Periarthritis Shoulder, also known as adhesive capsulitis, is a condition that results in tissue degeneration, thickening of the joint capsule, and a narrowing of the glenoid cavity. Diabetes mellitus is linked to many debilitating musculoskeletal disorders of the hand and shoulder. Prevalence of adhesive capsulitis or frozen shoulder is estimated to be 11-30 percent in people with diabetes. Various interventions have already been used to prevent pain and improve quality of life. Both Muscle Energy Technique and Kalternborn Mobilization Technique are thought to have a pain-relieving effect. Aim & Objective: The study's aim is to compare the effects of both techniques on pain in diabetic patients. Methods/Design: In this study experimental study, the participants will be divided into two groups: Kalternborn Mobilization Technique Group (A) and Muscle Energy Technique Group (B) based on inclusion and exclusion criteria. Both interventions include 30-45 min session which will be carried out for duration of four days. Outcome will be Pain and Quality of Life and outcome measures will be evaluated at beginning and at the end of intervention period. Result: Successful Completion of trial of Muscle Energy Technique and Kalternborn Mobilisation Technique will provide evidence for best strategy targeting Pain and quality of life in diabetic patients with Periarthritis of Shoulder. Conclusion: The study will be concluded with the significant effect of Muscle Energy Technique and Kalternborn Mobilisation Technique on Periarthritis shoulder of diabetic patients.


2020 ◽  
Vol 5 (04) ◽  
pp. 31-36
Author(s):  
Conception Costa ◽  
Sudarshan A. ◽  
Jeejo Chandran O

Background: Apabahuka is a Vataja Nanatmaja Vyadhi, in which locomotive functions of Amsa Sandhi are affected mainly due to Vata Dosha Prakopa causing pain, stiffness and restricted movement of the shoulder. Apabahuka can be correlated to Frozen shoulder or Adhesive Capsulitis in modern medicine because of similar symptomatology. Nasya is indicated in Urdhwajatrugata Vikaras. Pinyaka Taila and Swalpa Masha Taila are Vatahara Taila used for Nasya. Method: A single blind randomised clinical study in which 40 clinically diagnosed patients of Apabahuka, fulfilling the inclusion criteria were selected and divided into two groups - Group A treated with Pinyaka / Panchamula Taila Nasya and Group B treated with Swalpa Masha Taila Nasya, comprising of 20 patients each. Result: Statistically Nasya with Pinyaka Taila showed better results in Pain (51.2%), Stiffness (48%), Tenderness (58.33%), with improvement in goniometric readings of shoulder ROM than Nasya with Swalpa Masha Taila in Pain (39.4%), stiffness (40.9%), Tenderness (58%). Discussion: Rukshadi Gunas of Vata are increased in Apabahuka hence Viparita Gunas like Snigdhadi in the form of Brumhana Nasya with Pinyaka Taila was found to be effective in Apabahuka. In the present study Group A Nasya with Pinyaka Taila showed better effect than Group B Nasya with Swalpa Masha Taila.


2021 ◽  
Vol 71 (5) ◽  
pp. 1824-27
Author(s):  
Muhammad Umair Hashmi ◽  
Babar Bakht Chughtai ◽  
Muhammad Nadeem Ahsan

Objective: To determine outcomes of intra-articular corticosteroids injection versus physiotherapy for the treatment of adhesive capsulitis using mean pain score on the visual analogue scale. Study Design: Comparative prospective study. Place and Duration of Study: Orthopedic outpatient department, Bahawal Victoria Hospital Bahawalpur from Jan to Jun 2021. Methodology: A total of 120 cases having adhesive capsulitis (frozen shoulder) were included in the study according to inclusion criteria. Non-probability consecutive sampling technique was used for the selection of cases. Patients were divided into two groups, group-A and group B, each containing 60 cases. Patients in group-A were given intra-articular steroid injection (2ml triamcinolone 40mg ± 2ml of bupivacaine). Patients in group B received ten sessions of physiotherapy by a welltrained physiotherapist under the supervision of an orthopaedic surgeon on alternate days. After six weeks, outcomes were measured in terms of pain score using a visual analogue pain scale. Results: Significant improvement was seen among patients in group-A with mean pain score from 7.32 ± 0.89 measured initially to 5.44 ± 1.37 measured after six weeks (p<0.001). No significant improvement was found among patients in group B with a mean pain score of 7.58 ± 0.94 measured initially to 7.12 ± 0.88 measured after six weeks (p>0.05). Conclusion: Significant improvement in pain relief can be achieved using intra-articular steroid injection administered in the shoulder as compared to supervised sessions of physiotherapy among patients with adhesive capsulitis.


2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Abhay Kumar ◽  
Suraj Kumar ◽  
Anoop Aggarwal ◽  
Ratnesh Kumar ◽  
Pooja Ghosh Das

Objective. To study the effectiveness of Maitland techniques in the treatment of idiopathic shoulder adhesive capsulitis. Methods. total of 40 patients diagnosed with idiopathic shoulder adhesive capsulitis were recruited and randomly allocated into two groups. In Group A () subjects were treated with Maitland mobilization technique and common supervised exercises, whereas subjects in Group B () only received common supervised exercises. Variables. Shoulder pain and disability index (SPADI), VAS and shoulder ROM (external rotation and abduction) were variables of the study. These were recorded before and after the session of the training. Total duration of the study was four weeks. Result. Statistical analysis of the data revealed that within-group comparison both groups showed significant improvement for all the parameters, whereas between-group comparison revealed higher improvement in Group A compared to the Group B. Conclusion. The study confirmed that addition of the Maitland mobilization technique with the combination of exercises have proved their efficacy in relieving pain and improving R.O.M. and shoulder function and hence should form a part of the treatment plan.


Author(s):  
Chandrasekaran K ◽  
Sundaram M S ◽  
Senthil Selvam P ◽  
Viswanath Reddy A ◽  
Senthilkumar S ◽  
...  

Adhesive capsulitis is a painful condition in which the movement of the shoulder becomes limited and functional activity is affected. Adhesive capsulitis occurs when the shoulder joint capsule become thick, stiff and inflamed. The aim of the study is to compare the effectiveness of Mulligan movement with mobilization versus Positional release technique on shoulder range of motion and functional activity in patients with adhesive capsulitis. 30 patients were randomly divided into two groups. Group A (N = 15) received Mulligan mobilization technique and Group B (N = 15) received positional release therapy. The shoulder range of motion (Abduction, External rotation, Internal rotation) was measured by goniometer, the functional activity by SPADI questionnaire. The results showed that significant differences in shoulder ROM Abduction (t = 14.18, p = 0.000), Internal rotation (t = 13.80, p = 0.000), External rotation (t = 15.87, p = 0.000) and SPADI questionnaire (t = 13.94, p = 0.000) were observed in group A patients when compared to group B. In conclusion the Mulligan mobilization technique was effective to improve the shoulder ROM and reduce functional disability in patients with adhesive capsulitis compared to Positional release technique.


2022 ◽  
Vol 38 (3) ◽  
Author(s):  
Senthil Kumar Balu ◽  
Subbaiah Siva ◽  
Arunachalam Ramachandran

Objectives: The objective of the study was to identify the effect of Maitland mobilization with hand-eye coordination and hand function exercises in the prognosis of adhesive capsulitis. Methods: This non-randomized control trial was done with 40 patients with adhesive capsulitis referred to the OPD at UCA College of Physiotherapy, Chennai. The study was performed for 8 months duration from August 2018 to March 2019. After providing a sufficient explanation of the procedure, the patients were divided into Group-A and Group-B. Group-A were allocated to Maitland group (n=20) (MG) and Group-B, were assigned to the Maitland, Hand-eye coordination and Hand Function exercises group (n=20) (MHG), respectively. We measured Quality of life using SF36 to know whether these patients had poor QOL compared to normative. Each patient underwent testing before the experiment to evaluate the range of motion of the shoulder (Abduction and External rotation) measured using a 180º goniometer, Functional Disability assessed using SPADI index. Statistical analysis was applied using SPSS version 20.0. Before the study, data normality was tested. A parametric test was used to compare pre-and post-intervention data in each Group-And also compare the MG vs. MHG. An α < 0.05 is the level of significance in all analyses. Results: A total of 40 subjects accounted for the study results. Their quality of life was significantly lower from the normative values. Both groups were homogenous at baseline with no significant difference between the ROM and SPADI scores. Both groups showed a significant improvement in ER, abduction ROM and SPADI scores, however the between group posttest analysis revealed that the Group-B subjects progressed significantly better. Conclusions: The study concluded that the Maitland mobilization and hand-eye coordination and hand function exercises are an effective tool in improving shoulder abduction, external rotation and shoulder functions. doi: https://doi.org/10.12669/pjms.38.3.5153 How to cite this:Senthil Kumar B, Subbaiah S, Ramachandran A. Need for including Hand Eye Coordination and Hand Function Training in the Management of Adhesive Capsulitis – A non-randomized control trial. Pak J Med Sci. 2022;38(3):---------.  doi: https://doi.org/10.12669/pjms.38.3.5153 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2021 ◽  
Vol 3 (5) ◽  
pp. 50-53
Author(s):  
A. K. M. Rezwan ◽  
T. M. Shahriar ◽  
A. N. M. Rasal ◽  
M. Rahman ◽  
T. Haque ◽  
...  

Background: Frozen shoulder is the stage II of adhesive capsulitis characterized by progressive loss of shoulder movement and symptoms of pain, decrease joint range of motion. Objective: To determine the effectiveness of kaltenborn mobilization technique grade-III to the treatment of frozen stage of adhesive capsulitis of shoulder joint. Methods: This quasi-experimental study in total number of 40 respondent were diagnosed with frozen stage of adhesive capsulitis of shoulder joint and randomly allocated into 2 groups. Within both group (n=20) & experimental group were treated by kaltenborn mobilization technique grade III whereas control group were treated by routine physiotherapy treatment and apply one session per day for four weeks. Outcome measures used were Visual analog scale (VAS) and Shoulder disability questioner (SDI). Paired ‘t’-tests was used to compare the pre and posttest value of treatment within both groups. Participants were selected based on the inclusion and exclusion criteria. Statistics & Results: Data was collected on a data sheet & encoded for computerized analysis using SPSS version 19. The statistical analysis of post values of Group A (Kaltenborn mobilization technique grade III) where VAS mean of pretest (6.90 ± 1.02) and posttest (4.35 ± 1.60) value where (p < 0.0001). SDI mean of pretest (4.1±1.45) and posttest (2.9 ±1.20) value where (p < 0.0002). In group B (Routine physiotherapy treatment) where VAS mean of pretest (6.75 ± 1.07) and posttest (6.25 ± 1.06) value where (p < 0.0003). SDI mean of pretest (4.1±1.45) and posttest (3.5 ±0.49) value where (p < 0.0077). Conclusion: It was concluded that both techniques were effective but kaltenborn mobilization techniques grade III was more effective then routine physiotherapy technique.


2018 ◽  
Vol 4 (4) ◽  
pp. 519-522
Author(s):  
Jeyakumar S ◽  
Jagatheesan Alagesan ◽  
T.S. Muthukumar

Background: Frozen shoulder is disorder of the connective tissue that limits the normal Range of motion of the shoulder in diabetes, frozen shoulder is thought to be caused by changes to the collagen in the shoulder joint as a result of long term Hypoglycemia. Mobilization is a therapeutic movement of the joint. The goal is to restore normal joint motion and rhythm. The use of mobilization with movement for peripheral joints was developed by mulligan. This technique combines a sustained application of manual technique “gliding” force to the joint with concurrent physiologic motion of joint, either actively or passively. This study aims to find out the effects of mobilization with movement and end range mobilization in frozen shoulder in Type I diabetics. Materials and Methods: 30 subjects both male and female, suffering with shoulder pain and clinically diagnosed with frozen shoulder was recruited for the study and divided into two groups with 15 patients each based on convenient sampling method. Group A patients received mobilization with movement and Group B patients received end range mobilization for three weeks. The outcome measurements were SPADI, Functional hand to back scale, abduction range of motion using goniometer and VAS. Results: The mean values of all parameters showed significant differences in group A as compared to group B in terms of decreased pain, increased abduction range and other outcome measures. Conclusion: Based on the results it has been concluded that treating the type 1 diabetic patient with frozen shoulder, mobilization with movement exercise shows better results than end range mobilization in reducing pain and increase functional activities and mobility in frozen shoulder.


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