scholarly journals COMPARISON OF SHOULDER PAIN, DISABILITY AND RANGE OF MOTION IN DIABETIC AND NON-DIABETIC PATIENTS WITH FROZEN SHOULDER

2020 ◽  
Keyword(s):  
Range Of Motion ◽  
Shoulder Pain ◽  
Frozen Shoulder ◽  
Diabetic Patients ◽  
Pain Disability

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 Effectiveness of Soft Tissue Massage for Nonspecific Shoulder Pain: Randomized Controlled Trial

2015 ◽  
Vol 95 (11) ◽  
pp. 1467-1477 ◽  
Author(s):  
Paul A. van den Dolder ◽  
Paulo H. Ferreira ◽  
Kathryn M. Refshauge
Keyword(s):  
Randomized Controlled Trial ◽  
Soft Tissue ◽  
Range Of Motion ◽  
Shoulder Pain ◽  
Controlled Trial ◽  
Study Objective ◽  
Randomized Controlled ◽  
Pain Disability ◽  
Significant Difference ◽  
Cessation Of Treatment

Background Soft tissue massage and exercise are commonly used to treat episodes of shoulder pain. Objective The study objective was to compare the effects of soft tissue massage and exercise with those of exercise alone on pain, disability, and range of motion in people with nonspecific shoulder pain. Design This was a randomized controlled trial. Setting The study was conducted in public hospital physical therapy clinics in Sydney, New South Wales, Australia. Participants The study participants were 80 people with an average age of 62.6 years (SD=12.2) who were referred to physical therapists for treatment of nonspecific shoulder pain. Intervention Participants were randomly assigned to either a group that received soft tissue massage around the shoulder and exercises (n=40) or a group that received exercise only (n=40) for 4 weeks. Measurements The primary outcome was improvement in pain, as measured on a 100-mm visual analog scale, 1 week after the cessation of treatment. Secondary outcomes were disability and active flexion, abduction, and hand-behind-back range of motion. Measurements were obtained at baseline, 1 week after the cessation of treatment, and 12 weeks after the cessation of treatment. Results The between-group difference in pain scores from the baseline to 12 weeks after the cessation of treatment demonstrated a small significant difference in favor of the group receiving exercise only (mean difference=14.7 mm). There were no significant differences between groups in any other variable. Limitations It was not possible to mask therapists or participants to group allocation. Diagnostic tests were not used on participants to determine specific shoulder pathology. Conclusions The addition of soft tissue massage to an exercise program for the shoulder conferred no additional benefit for improving pain, disability, or range of motion in people with nonspecific shoulder pain.

scholarly journals The benefit of platelet-rich plasma injection over institution-based physical therapy program in adhesive capsulitis patients with diabetes mellitus: prospective observational cohort study

2021 ◽  
Author(s):  
Apurba Barman ◽  
Somanth Mukherjee ◽  
Mithilesh K Sinha ◽  
Jagannatha Sahoo ◽  
Amrutha Viswanath
Keyword(s):  
Diabetes Mellitus ◽  
Physical Therapy ◽  
Range Of Motion ◽  
Shoulder Pain ◽  
Glenohumeral Joint ◽  
Platelet Rich Plasma ◽  
Adhesive Capsulitis ◽  
Diabetic Patients ◽  
Single Shot ◽  
Patients With Diabetes

Background: The objective of this study was to compare the efficacy of platelet-rich plasma (PRP) injection with an institution-based physical therapy (PT) program for adhesive capsulitis (AC) of the shoulder in patients with diabetes mellitus (DM).Methods: A total of seventy diabetic patients with AC of the shoulder for <6 months were assigned to two groups: PRP group and PT group. In the PRP group, 35 patients were administered a single shot of PRP (4 mL) into the glenohumeral joint. In the PT group, 35 patients were given institution-based PT that included 10 30-minute sessions of planned PT over a 2-week period. After the interventions, all patients were prospectively followed for 12 weeks. Intensity of shoulder pain, function, and range of motion were assessed at baseline and then at 3, 6, and 12 weeks. Results: Thirty-three patients in the PRP group and 32 in the PT group completed the 12-week study. At 12 weeks, patients who received PRP injections showed greater improvement in shoulder pain (p<0.001) than those recruited to the PT group. In the range of motion and shoulder function activities, patients in the PRP group showed significant improvement compared with the institution-based PT group (p<0.001). No significant complications were reported from any groups.Conclusions: In a diabetic population, PRP injections significantly improved shoulder pain and function compared with an institution-based PT program for shoulder AC. Additionally, it is a safe and well-tolerated method for AC management for diabetic patients.

scholarly journals Effectiveness of Intra-articular Steroid Injection in Treatment of Idiopathic Frozen Shoulder Followed by Physiotherapy and Home Exercise Program.

2019 ◽  
Vol 4 (1) ◽  
pp. 611-615
Author(s):  
Shambhu Sah ◽  
Shivam Karn ◽  
Deepak Sigdel ◽  
Mukunda Dahal ◽  
Ragin Kathet ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Shoulder Pain ◽  
Steroid Injection ◽  
Frozen Shoulder ◽  
Treatment Protocol ◽  
Exercise Program ◽  
Oral Steroid ◽  
Home Exercise ◽  
Home Exercise Program ◽  
The Mean

Introduction: Idiopathic frozen shoulder (IFS) is a common chronic and disabling condition of shoulder pain characterized by progressive loss of active and passive range of motion (ROM) with unclear pathogenesis. The ideal treatment protocol is still controversial but commonly used treatment includes single agent or combination of oral non-steroid anti- inflammatory drugs (NSAIDS), oral steroids, intra-articular steroid injection and physiotherapy. Objective: The objective of this study was to evaluate the effectiveness of intra-articular methylprednisolone injection for pain and ROM in patients suffering from idiopathic frozen shoulder who did not respond to oral NSAIDS with or without oral steroid. Methodology: A total of 70 patients suffering from IFS were enrolled in this cross sectional study from May 2017–October 2018 from outpatient department of orthopaedic and physiotherapy of Koshi Zonal Hospital. All the patients underwent treatment protocol that comprised of Intra-articular steroid injection followed by five days of oral NSAIDS along with five days regime of physical therapy at the physiotherapy centre, followed by home exercise program. Each patient was followed up at every two weeks interval from intra-articular injection till 6th week. Each patient was evaluated for range of motion (ROM), Numerical Pain Rating Scale (NPRS) and Shoulder Pain and Disability Index (SPADI) before the treatment protocol and at every follow up visit. Data was analyzed using Microsoft Excel Program. Results: All patients enrolled for the study had satisfactory response. The mean age of the patient was 51.8 years (range 40-65 years). The mean age of the 26 male patients was 54 years (range 45-65), whereas the mean age of 44 female patients was 50.5 years (range 45-60). Mean duration of illness was 26.5 weeks (range 18-32 weeks), SPADI before medication was 83.14, at 2nd week was 50.92, at 4th week was 38.63 and at 6th week was 27.22. Conclusion: Combination of intra-articular methylprednisolone injection, physiotherapy and home exercise program is effective in IFS for rapid improvement in pain and ROM.

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

scholarly journals Effect of Spencer Muscle Energy Technique Versus Maitland’s Mobilization Technique on Pain, ROM and Disability in Patients with Frozen Shoulder: A Comparative Study

2021 ◽  
Vol 9 (4) ◽  
pp. 3928-3936
Author(s):  
Raksha R. Jivani ◽  
◽  
Dharti N Hingarajia ◽  
Keyword(s):  
Range Of Motion ◽  
Shoulder Pain ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Group Comparison ◽  
Post Intervention ◽  
Muscle Energy Technique ◽  
Significant Difference ◽  
Muscle Energy ◽  
Conventional Physiotherapy

Background: Adhesive capsulitis is characterized by a painful, gradual loss of both active and passive glenohumeral motion resulting from progressive fibrosis and ultimate contracture of the glenohumeral joint capsule. Patients with Adhesive capsulitis have difficulties in everyday activities and shoulder pain also disturbs sleep at night on the affected side. Muscle energy technique helps in increasing shoulder range of motion. Maitland Mobilization is commonly used in the treatment of frozen shoulder. SPENCER Muscle Energy Technique (MET) is unique in its application as the client provides the initial effort while the practitioner facilitates the process. Objective: Objectives of the study was to compare the effect of Spencer MET Vs Maitland’s mobilization on pain, Range of Motion (ROM) and Disability in the patients with frozen shoulder. Methods: In the present experimental study, total 58 patients with frozen shoulder were included. Inclusion criteria were male and female with age of 40 to 60 year with unilateral frozen shoulder (at least 3-month duration). Patients were randomly allocated in two groups with 29 patients in each group: SPENCER MET and Conventional physiotherapy and MM and conventional physiotherapy for 5days a week with total duration of 4 weeks. Pre and post intervention assessment was carried out by using VAS, SPADI and ROM. Data was analysed by using SPSS 15 version. Results: Paired t test was applied within group comparison and result showed statistically significant difference in post intervention measurement compared to pre intervention for improving pain, reducing disability and increasing all ROM in both the groups. Independent t test was applied between group comparison and result showed statistically significant difference between groups mean pre-post differences in improving pain, reducing disability and increasing all ROM except extension and internal rotation. Conclusion: This study concludes that both the techniques used in the present study i.e., Spencer Muscle Energy Technique and Maitland Mobilization are effective for improving pain, reducing disability, and increasing ROM. However, SPENCER MET is the more effective for improving pain, reducing disability, and increasing ROM compared to Maitland Mobilization in patients with frozen shoulder. KEY WORDS: Frozen shoulder, SPENCER MET, Maitland mobilization, Shoulder Pain and Disability Index, Visual Analogue Scale.

scholarly journals Effect of Hijamah (Dry Cupping) on Frozen Shoulder: A Case Study

2021 ◽  
Vol 08 (1&2) ◽  
pp. 14-17
Author(s):  
Mohammad Abid ◽  
Keyword(s):  
General Population ◽  
Range Of Motion ◽  
Shoulder Pain ◽  
Clinical Presentation ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Left Shoulder ◽  
Radiological Assessment ◽  
Common Causes

Frozen shoulder or adhesive capsulitis is one of the most common causes of shoulder pain and disability in the general population. Its prevalence is 2-5% in the general population and 10-20% among diabetics. It predominantly affects females and most commonly affects people between the ages of 40 and 60 years. The left shoulder is more likely to be affected, with both shoulders affected in 12% of cases. A case study is presented to illustrate the clinical presentation, aetiology, diagnosis, radiological assessment, and management of frozen shoulder through Hijamah bila shurt (dry cupping) in a 60-year-old diabetic male patient. The present case was studied for over 8 weeks; Hijamah (dry cupping) was done on prescribed points for the affected shoulder twice a week for 8 weeks, and assessment was done at baseline and every 2 weeks. This study concluded that regimental therapy Hijamah bila shurt (dry cupping) has a significant effect in reducing pain, stiffness of joints, and increasing range of motion in frozen shoulder.

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 POS1276 LONG TERM OUTCOME OF MULTIPLE ULTRASOUND GUIDED SUPRASCAPULAR NERVE BLOCK IN TREATMENT OF FROZEN SHOULDER IN DIABETIC PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 922.2-922
Author(s):  
M. A. Mortada ◽  
R. Hassan ◽  
Y. A. Amer
Keyword(s):  
Nerve Block ◽  
External Rotation ◽  
Frozen Shoulder ◽  
Suprascapular Nerve ◽  
Diabetic Patients ◽  
Ultrasound Guided ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Suprascapular Nerve Block

Background:Frozen shoulder is prevalent among diabetic patients, and usually has aggressive course, with more tendency to be bilateral and resistant to treatment. Suprascapular nerve block (SSNB) is used with increasing frequency by anesthetists and rheumatologists in the management of frozen shoulder. We previously introduced a protocol of nine injections for SSNB with better short term outcome than single SSNB injection (1). Long term outcome of SSNB in management of frozen shoulder is still not detected.Objectives:To evaluate the long term effect of multiple (nine) ultrasound guided supra-scapular nerve block in treatment of diabetic frozen shoulder.Methods:A retrospective cohort study followed up 40 diabetic patients who received a course of ultrasound guided multiple supra-scapular nerve block (9 injections) on 2014. In this study we retrospectively assessed the patients from previously recorded data at a mean duration of 6 years after completing the 9 injection course SSNB clinically by measuring the shoulder active range of motion (using a goniometer in three planes: abduction, internal, and external rotation). Visual analogue scale and Functional assessment by shoulder pain and disability index (SPADI).Results:Thirty four patients (85% of original cohort) completed the long term follow up.The patients were 19 (55.9%) females, 60.6 y mean age, and the mean of disease duration was 85.6 months. The majority of patients (33 patients 97.05%) continues improvement and gained within normal complete range of motions in all directions and excellent grades of shoulder function (Table 1).Table 1.Clinical ParametersAt base lineAt 4 monthsLast follow up at (72months±4)**P valueSPADI pain score (100)(68.8 ± 0.5)a(10.3 ± 7.4)b(0.9±1.9)c0.00*SPADI disability score (100)(69.2 ± 7.7)a(6.25 ± 2.25)b(0.4±0.8)c0.00*SPADI total (100)(69.1 ± 8.5)a(8.15 ± 5.4)b(1.1±0.9)c0.00*Patient global assessment (100)(90.2 ± 8.2)a(8.2 ± 4.2)b(0.4±2.1)c0.00*Night pain (100)(55.4±10.2)a(10.3 ± 4.9)b(2.3±1.1)c0.00*Abduction (180°)(77.5 ± 4.7)a(170.3 ± 10.3)b(174.2±6.2)b0.00*External rotation (100 °)(46 ± 12.6)a(80.1 ± 10.2)b(86.4±10.3)b0.00*Internal rotation (70 °)(34.5 ± 2.4)a(55.4 ± 10.1)b(60.2±9.5)b0.00** P <0.05 there was a statistical significant difference•A,b,c--- the alphabet of different symbols ---means a significant statistical difference between groupsSPADI: shoulder pain and disability indexConclusion:The multiple injection courses for supra-scapular nerve block has an excellent long term efficacy as treatment of diabetic frozen shoulder. This method should be the treatment of choice in patients of diabetic frozen shoulder who do not respond to physiotherapy.References:[1]Mortada, M. A., Ezzeldin, N., Abbas, S. F., Ammar, H. A. & Salama, N. A. Multiple versus single ultrasound guided suprascapular nerve block in treatment of frozen shoulder in diabetic patients. J. Back Musculoskelet. Rehabil. 30, 537–542 (2017).Disclosure of Interests:None declared

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