scholarly journals Effectiveness of Shock Wave Therapy versus Intra-Articular Corticosteroid Injection in Diabetic Frozen Shoulder Patients’ Management: Randomized Controlled Trial

2021 ◽  
Vol 11 (8) ◽  
pp. 3721
Author(s):  
Ahmed Ebrahim Elerian ◽  
David Rodriguez-Sanz ◽  
Abdelaziz Abdelaziz Elsherif ◽  
Hend Adel Dorgham ◽  
Dina Mohamed Ali Al-Hamaky ◽  
...  
Keyword(s):  
Shock Wave ◽  
Range Of Motion ◽  
Shoulder Pain ◽  
Corticosteroid Injection ◽  
Frozen Shoulder ◽  
Diabetic Patients ◽  
Shock Wave Therapy ◽  
Injection Group ◽  
Shoulder Flexion ◽  
Group B

Frozen shoulder is a major musculoskeletal illness in diabetic patients. This study aimed to compare the effectiveness of shock wave and corticosteroid injection in the management of diabetic frozen shoulder patients. Fifty subjects with diabetic frozen shoulder were divided randomly into group A (the intra-articular corticosteroid injection group) and group B that received 12 sessions of shock wave therapy, while each patient in both groups received the traditional physiotherapy program. The level of pain and disability, the range of motion, as well as the glucose triad were evaluated before patient assignment to each group, during the study and at the end of the study. Compared to the pretreatment evaluations there were significant improvements of shoulder pain and disability and in shoulder flexion and abduction range of motion in both groups (p < 0.05). The shock wave group revealed a more significant improvement the intra-articular corticosteroid injection group, where p was 0.001 for shoulder pain and disability and shoulder flexion and abduction. Regarding the effect of both interventions on the glucose triad, there were significant improvements in glucose control with group B, where p was 0.001. Shock waves provide a more effective and safer treatment modality for diabetic frozen shoulder treatment than corticosteroid intra-articular injection.

scholarly journals A Central Nervous System Focused Treatment Program for People with Frozen Shoulder: A Feasibility Study.

2020 ◽  
Author(s):  
Silvia Mena-del Horno ◽  
Lirios Dueñas Moscardó ◽  
Enrique Lluch ◽  
Adriaan Louw ◽  
Alejandro Luque-Suárez ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Shoulder Pain ◽  
Treatment Program ◽  
Washout Period ◽  
Pain Catastrophizing ◽  
Frozen Shoulder ◽  
Fear Avoidance ◽  
Shoulder Flexion ◽  
Pain Sensitization

Abstract Background: Frozen shoulder (FS) is a highly disabling pathology of poorly understood etiology, which is characterized by the presence of intense pain and progressive loss of range of motion (ROM). The aim of this study was to evaluate the feasibility and clinical impact of a CNS-focused treatment program for people with frozen shoulder (FS).Methods: 10 subjects with primary FS received a 10 weeks CNS-focused intervention including sensory discrimination training and graded motor imagery techniques delivered as clinic sessions (60 minutes) and home therapy (30 minutes five times per week). Measurements were taken at baseline, after a 2-weeks washout period, after treatment and at three months follow-up. The Shoulder Pain and Disability Index (SPADI) was the primary outcome. Secondary measures were: feasibility-related outcomes, self-reported shoulder pain, active and passive range of motion, two-point discrimination threshold (TPDT), left/right judgement task (LRJT), fear-avoidance (Tampa Scale for Kinesiophobia), pain catastrophization (Pain Catastrophizing Scale) and pain sensitization (Central Sensitization Inventory).Results: 70% of participants completed the treatment. No significant changes were found after washout period except for TPDT (p=0.02) and SPADI (p=0.025). Improvements in self-reported shoulder pain (p=0.028) and active shoulder flexion (p=0.016) were shown after treatment (p=0.028) and follow-up (p=0.001) and in SPADI at follow-up (p=0.008). No significant changes were observed in TPDT, LRJT, fear-avoidance, pain catastrophization and pain sensitization. Conclusions: a CNS-focused treatment program might be a suitable approach to improve pain and disability in FS but further research is needed to draw firm conclusions.Trial registration: Clinical Trials. NCT03320200. Registered 25 October 25 2017, https://clinicaltrials.gov/ct2/show/NCT03320200?term=NCT03320200&draw=2&rank=1

Comparative Study of effectiveness of mobilization with movement (MWM) and End range mobilization (ERM) techniques in frozen shoulder

2018 ◽  
Vol 4 (4) ◽  
pp. 519-522
Author(s):  
Jeyakumar S ◽  
Jagatheesan Alagesan ◽  
T.S. Muthukumar
Keyword(s):  
Range Of Motion ◽  
Frozen Shoulder ◽  
Type I ◽  
Mean Values ◽  
Functional Activities ◽  
Group A ◽  
The Mean ◽  
Group B

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.

scholarly journals Immediate Effect of Muscle Energy Technique and Kalternborn Mobilisation Technique on Pain in Diabetic Patients with Periarthritis of Shoulder

2021 ◽  
pp. 220-228
Author(s):  
Kamya Somaiya ◽  
G. D. Vishnu Vardhan ◽  
Ashish Bele
Keyword(s):  
Quality Of Life ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Diabetic Patients ◽  
Tissue Degeneration ◽  
Muscle Energy Technique ◽  
Group A ◽  
Muscle Energy ◽  
Group B

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.

scholarly journals A Comparative Study of Steroid Injection With or Without Lignocaine in Treating Frozen Shoulder

2018 ◽  
Vol 5 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Alok Pandey ◽  
B Shrestha ◽  
K M Shrestha
Keyword(s):  
Range Of Motion ◽  
Steroid Injection ◽  
Frozen Shoulder ◽  
Equal Frequency ◽  
Steroid Injections ◽  
Shoulder Range Of Motion ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Dominant Side

BACKGROUND: Treatment of Frozen shoulder (Adhesive Capsulitis) is mainly nonoperative. Intra-articular steroid injections and physiotherapy are one of the most effective and useful treatment. Even though intra-articular steroid injections are very effective in inflammatory phase of the disease; patients are reluctant to move their affected shoulder for fear of pain. Thus, they do not follow exercise program properly resulting in poor outcomes.OBJECTIVE: If pain could be reduced, outcome of treatment can improve. Lignocaine, when combined with steroid injection, plays an important role in immediate improvement of pain and active range of motion thereby increasing the overall result. MATERIALS & METHODS: 100 patients with frozen shoulder were selected according to predetermined inclusion and exclusion criteria. After randomization by sealed envelope technique, patients were divided into Group A and Group B. Group A patients were injected with 2 ml (80 mg) of methylprednisolone and 3 ml of 1% Lignocaine, and Group B patients were injected with 2 ml (80 mg) of methylprednisolone and 3 ml of Distilled water in the affected shoulder via standard posterior approach. Then half an hour of standard shoulder range of motion (ROM) exercise regimen was performed under supervision. Pre injection and post injection pain level was scored by Visual Analogue Score (VAS) and Subjective satisfaction score (SSS). Shoulder exercises were taught and home based physiotherapy was carried out by patients themselves. They were also prescribed oral analgesics for 5 days and were followed at 1, 3, and 6 weeks. At every follow up visit, they were assessed for improvement via Constant-Murley Score (CMS).RESULTS: The mean age of this study in group A and group B was 56.46 years (SD 10.05) and 57.18 years (SD 8.87) respectively (P0.70). There were 31 male and 19 female in group A as compared to group B where there was 26 males and 24 females (P0.41). In both the groups, maximum number of patients presented at around 10 weeks. In both the groups left side dominated right side with equal frequency (33 left sides and 17 right sides) (P 1.00) and non dominant side outnumbered dominant side with near equal frequency (P 1.00). After the intervention, excellent result in SSS was observed only in group A whereas maximum patients of Group B had only fair result (42 patients). There was statistically significant difference between two groups in terms of pain; Activity of daily living (ADL) and Range of motion (ROM). Patients in group A were able to carry more weight than group B.   In CMS 1 and 6 week total, there was statistically highly significant difference between two groups. CONCLUSION: Even though steroid and physical exercises play important role in managing frozen shoulder, addition of lignocaine to steroid injection seems to be helpful. It relieves immediate pain on movement and improves exercise compliance thereby improving early outcomes. Evaluation of long term benefits of lignocaine injection needs further studies. Journal of Universal College of Medical Sciences (2017) Vol.05 No.01 Issue 15, Page: 22-28 

Effectiveness of Radial Extracorporeal Shock Wave Therapy (rESWT) When Combined With Supervised Exercises in Patients With Subacromial Shoulder Pain: A Double-Masked, Randomized, Sham-Controlled Trial

2017 ◽  
Vol 45 (11) ◽  
pp. 2547-2554 ◽  
Author(s):  
Elisabeth Kvalvaag ◽  
Jens Ivar Brox ◽  
Kaia Beck Engebretsen ◽  
Helene Lundgaard Soberg ◽  
Niels Gunnar Juel ◽  
...  
Keyword(s):  
Shock Wave ◽  
Rotator Cuff ◽  
Shoulder Pain ◽  
Controlled Trial ◽  
Extracorporeal Shock Wave Therapy ◽  
Mean Difference ◽  
Shock Wave Therapy ◽  
Level Of Evidence ◽  
Group Assignment ◽  
Extracorporeal Shock Wave

Background: Subacromial shoulder pain is a common complaint, and radial extracorporeal shock wave therapy (rESWT) is increasingly used to treat this condition. Although many therapists use rESWT in combination with supervised exercises, no studies have evaluated the additional effect of rESWT with supervised exercises for subacromial shoulder pain. Purpose: To assess whether rESWT is more effective than sham rESWT when combined with supervised exercises for improving pain and function in patients with subacromial shoulder pain. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Patients between 25 and 70 years of age with subacromial shoulder pain with and without calcification in the rotator cuff lasting at least 3 months were assessed for eligibility; 143 patients were recruited. Participants were allocated (1:1) by computer-generated randomization in blocks of 20 to receive either rESWT or sham rESWT in addition to supervised exercises. The rESWT and sham rESWT were performed once a week with additional supervised exercises once a week for the first 4 weeks. The following 8 weeks, the patients received supervised exercises twice a week. The primary outcome was change in the Shoulder Pain and Disability Index (SPADI) after 24 weeks. Patients and outcome assessors were masked to group assignment. Results: At 24 weeks, participants in both the sham group and the rESWT group had improved ( P < .001) in SPADI score compared with baseline (−23.9 points [SD, 23.8 points] and −23.3 points [SD, 25.0 points], respectively), but there were no differences between the groups (mean difference 0.7; 95% CI, −6.9 to 8.3; P = .76). Prespecified subgroup analysis of patients with calcification in rotator cuff showed that the rESWT group had a greater improvement in SPADI score after 24 weeks (mean difference −12.8; 95% CI, −24.8 to −0.8; P = .018). Conclusion: Radial ESWT offered no additional benefit to supervised exercises in the treatment of subacromial shoulder pain after 24 weeks, except in the subgroup of patients with calcification in the rotator cuff. Registration: NCT01441830 ( ClinicalTrials.gov identifier).

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