The effectiveness of hydrodistension and physiotherapy following previously failed conservative management of frozen shoulder in a UK primary care centre (original) (raw)
Related papers
The American Journal of Sports Medicine, 2019
Background: Several pharmacological interventions are used for the management of adhesive capsulitis of the shoulder, although the optimal treatment has yet to be defined. Purpose: To conduct a network meta-analysis to compare the effects of different pharmacological interventions for adhesive capsulitis, administered either alone or after distension of the shoulder capsule. Study Design: Network meta-analysis. Methods: The authors searched Scopus, PubMed, and the Cochrane Central Register of Controlled Trials up to April 22, 2018, for completed studies. They enrolled trials that assessed the results of different pharmacological treatments for the primary management of adhesive capsulitis. The primary outcome was pain relief as measured by self-administered questionnaires. The secondary outcome included the assessment of composite instruments that evaluated, at a minimum, pain and function. The authors clinically interpreted the results after back-transforming the standardized mean ...
Shoulder & Elbow, 2017
Background Evidence for optimal non-operative treatment of frozen shoulder is lacking. The present study aimed to evaluate a treatment strategy for stage II to III frozen shoulder provided by the current primary care musculoskeletal service. Methods General practioner referrals of shoulder pain to the musculoskeletal service diagnosed with stage II to III frozen shoulder and who opted for a treatment strategy of hydrodistension and guided physiotherapy exercise programme over a 12-month period were evaluated for 6 months. Thirty-three patients were diagnosed with stage II to III frozen shoulder by specialist physiotherapists and opted for the treatment strategy. Outcome measures included Shoulder Pain Disability Index (SPADI) and Shortened Disabilities of the Arm, Shoulder and Hand (QuickDASH), pain score and range of movement. Data were collected at baseline, as well as at 6 weeks, 12 weeks and 6 months. Results All patients significantly improved in shoulder symptoms on the SPADI ...
Evaluating the Outcome of Two Different Regimes in Adhesive Capsulitis: A Prospective Clinical Study
Medical Principles and Practice, 2019
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 improv...
Asian Journal of Pharmaceutical and Clinical Research
Objective: In our study, we will compare the efficacy of intra-articular steroid injection with hydrodilatation (with steroid) with regards to Shoulder Pain and Disability Index (SPADI), visual analog scale (VAS), and range of motion (ROM) in patients of adhesive capsulitis. Methods: The study is a prospective study carried out on 36 patients in Department of Orthopaedics, Government Medical College, Jammu, from August 2021 to July 2022. The patients were evaluated in terms of SPADI, VAS, and ROM (flexion, abduction, and external rotation) at 0-, 6-, 12-, and 24-week interval. Results: Hydro-dilatation has better results in comparison to intra-articular steroid injection. The patients with hydrodilatation fared with better scores in terms of SPADI as well as VAS with significant p-value (≤0.05). In addition, the patients also had better ROM in the former group. Conclusion: Hydrodilatation with corticosteroid provides better relief in terms of pain as well as ROM for frozen shoulder ...
Journal of Bodywork and Movement Therapies, 2016
A pilot double blind randomized clinical trial was carried out on 50 patients suffering from primary adhesive capsulitis. Intervention included continuous 3 MHz, 1.5 w/cm 2 Ultrasound, applied for the first group and sham Ultrasound for the second group. In addition specific stretching and strengthening exercises as well as glenohumeral joint mobilization were delivered to both groups. Pain (VAS), functional ability (using Oxford Shoulder Score) and shoulder range of motion were assessed at the baseline, after 10 sessions of treatment, and at 3 months followup. An intention to treat Mixed ANOVA analysis was performed to explore the interaction effects of time and group on outcome measures. Results: No significant interaction effect of time and group was seen on pain, function and Range of Motion (p>.05), meaning that the amount of improvement in all outcome measures were alike in the two groups. Conclusion: Applying continuous Ultrasound along with a regimen of semi supervised exercise and mobilization in patients with primary adhesive capsulitis did not have any additional effect to the
Systematic Review of Nondrug, Nonsurgical Treatment of Shoulder Conditions
Journal of Manipulative and Physiological Therapeutics, 2017
Objective: The purpose of this review was to evaluate the effectiveness of conservative nondrug, nonsurgical interventions, either alone or in combination, for conditions of the shoulder. Methods: The review was conducted from March 2016 to November 2016 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and was registered with PROSPERO. Eligibility criteria included randomized controlled trials (RCTs), systematic reviews, or meta-analyses studying adult patients with a shoulder diagnosis. Interventions qualified if they did not involve prescription medication or surgical procedures, although these could be used in the comparison group or groups. At least 2 independent reviewers assessed the quality of each study using the Scottish Intercollegiate Guidelines Network checklists. Shoulder conditions addressed were shoulder impingement syndrome (SIS), rotator cuff-associated disorders (RCs), adhesive capsulitis (AC), and nonspecific shoulder pain. Results: Twenty-five systematic reviews and 44 RCTs met inclusion criteria. Low-to moderate-quality evidence supported the use of manual therapies for all 4 shoulder conditions. Exercise, particularly combined with physical therapy protocols, was beneficial for SIS and AC. For SIS, moderate evidence supported several passive modalities. For RC, physical therapy protocols were found beneficial but not superior to surgery in the long term. Moderate evidence supported extracorporeal shockwave therapy for calcific tendinitis RC. Low-level laser was the only modality for which there was moderate evidence supporting its use for all 4 conditions. Conclusion: The findings of this literature review may help inform practitioners who use conservative methods (eg, doctors of chiropractic, physical therapists, and other manual therapists) regarding the levels of evidence for modalities used for common shoulder conditions.
Indian Journal of Physical Medicine and Rehabilitation
Objective To compare the anterior and posterior blind intra-articular steroid injections approaches in the management of adhesive capsulitis of shoulder Design Randomised control trial Setting Department of PMR, Regional Institute of Medical Sciences (RIMS), Imphal, Manipur. Participants The patients having adhesive capsulitis of shoulder (n=60) attending PMR department, RIMS during the study period. Duration One year (August 2011 to July 2012). Intervention After randomisation, 60 patients were allocated in three groups (A, B and C). Group C (n=20) received physical therapy practice in the department of PMR, RIMS, Imphal. Group A (n=18) and B (n=22) received intraarticular steroid (methylprednisolone 80mg each) by anterior and posterior approaches without imaging guidance respectively in addition to physical therapy. Outcome measures: 1) Visual analogue scale (VAS) for pain, 2) Shoulder pain and disability index (SPADI) and 3) Passive range of motion of affected shoulder using goni...
Journal of Rehabilitation Medicine, 2019
Frozen shoulder commonly affects people aged around 50 years and is associated with substantial levels of shoulder pain and stiffness that may last for many years. Many people with frozen shoulder report that simple activities, such as dressing, and washing or drying their hair, become almost impossible. The condition may adversely affect the ability to work and frequently causes severe interruptions to sleep. The reasons why up to 5% of the population develop frozen shoulder are unknown. Many treatments, often lacking sound research evidence, have been recommended. Inappropriate treatment may not resolve the symptoms, may be associated with unnecessary expense, and may even cause harm. We have updated a review of the available literature to synthesize the findings of the available research so that we can make recommendations for the best current treatment alternatives to help people with frozen shoulder and for future research. Objective: To update an existing systematic review of randomized clinical trials evaluating the clinical effectiveness of non-surgical management interventions for people with primary frozen shoulder in terms of pain, movement, self-reported function and disability, quality of life, recovery time, return to work and recreation, and adverse events. Data sources: Cochrane CENTRAL, SCI and MEDLINE, CENTRAL between 1 January 2010 and June 2017, plus reference lists of included trials and trial registers. Abstracts were independently screened by 2 reviewers and discussed. Data extraction: Two reviewers evaluated eligibility. Data were extracted by one reviewer and checked by another. Two reviewers evaluated risk of bias. Metaanalyses were not appropriate. Narrative analyses were performed for trials evaluated as low risk of bias. Results: Thirty trials were included, with the majority of studies evaluated as being at high risk of potential bias. Only 4 trials were evaluated as being at low risk of bias and this, plus the variety of participants included/excluded in trials and the variety of methods, interventions and outcomes used across the trials provided limited new evidence to inform the non-surgical management and treatment of people with frozen shoulder. Conclusion: Substantial evidence gaps remain for the non-surgical treatment of people with frozen shoulder.
Scientific Reports, 2017
The objective was to explore the effectiveness of glenohumeral joint distension for the treatment of frozen shoulder. We searched electronic data sources including PubMed, Scopus, and Embase from the earliest records available to February 2017. Eleven randomized controlled trials including at least one pair of comparisons between capsular distension and a reference treatment were included, comprising 747 participants. Patients' characteristics, details of reference treatments, aspects of capsular distension therapy, and outcome measurement were evaluated at three points in time: baseline, early following intervention, and at the trial's end. The primary and secondary outcomes were the betweengroup standardized mean differences of changes in shoulder function and range of motion, respectively. Regarding the long-term primary outcome, the superiority of capsular distension to reference treatments was not identified. One secondary outcome (external rotation limitation) showed a probable early positive response to capsular distension when compared to intra-articular corticosteroid injection. Aspects of approaches, imaging guiding techniques and doses of distension were not found to modify treatment effectiveness. In conclusion, distension of the glenohumeral joint provides a similar long-term efficacy to all reference treatments. A single dose of a corticosteroid-contained regimen introduced through the ultrasound-guided posterior approach is a preferable practice of capsular distension for the management of frozen shoulder.