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Medicine Aug 2019Previous clinical trials have reported that physical therapy (PT) can be used for the treatment of frozen shoulder (FS). However, its effectiveness is still...
BACKGROUND
Previous clinical trials have reported that physical therapy (PT) can be used for the treatment of frozen shoulder (FS). However, its effectiveness is still inconclusive. In this systematic review study, we will aim to evaluate the effectiveness and safety of PT alone for the treatment of FS.
METHODS
The following electronic databases will be searched from the inception to the present to identify any eligible studies focusing on PT for the treatment of FS. These databases comprise of Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, the Allied and Complementary Medicine Database, and 4 Chinese databases of Chinese Biomedical Literature Database, China National Knowledge Infrastructure (which includes the database China Academic Journals), VIP Information, and Wanfang Data. All randomized controlled trials (RCTs) of PT for FS will be considered for inclusion without language restrictions. Cochrane risk of bias tool will be used to assess the methodological quality for all included RCTs.
RESULTS
The effectiveness and safety of this study will be assessed by shoulder pain intensity, shoulder function, quality of life, and any adverse events.
CONCLUSION
The findings of this study may provide most recent evidence on the effectiveness and safety of PT for patients with FS.
Topics: Bursitis; Humans; Physical Therapy Modalities; Randomized Controlled Trials as Topic; Research Design
PubMed: 31393406
DOI: 10.1097/MD.0000000000016784 -
American Family Physician Feb 2017Superficial bursitis most often occurs in the olecranon and prepatellar bursae. Less common locations are the superficial infrapatellar and subcutaneous (superficial)...
Superficial bursitis most often occurs in the olecranon and prepatellar bursae. Less common locations are the superficial infrapatellar and subcutaneous (superficial) calcaneal bursae. Chronic microtrauma (e.g., kneeling on the prepatellar bursa) is the most common cause of superficial bursitis. Other causes include acute trauma/hemorrhage, inflammatory disorders such as gout or rheumatoid arthritis, and infection (septic bursitis). Diagnosis is usually based on clinical presentation, with a particular focus on signs of septic bursitis. Ultrasonography can help distinguish bursitis from cellulitis. Blood testing (white blood cell count, inflammatory markers) and magnetic resonance imaging can help distinguish infectious from noninfectious causes. If infection is suspected, bursal aspiration should be performed and fluid examined using Gram stain, crystal analysis, glucose measurement, blood cell count, and culture. Management depends on the type of bursitis. Acute traumatic/hemorrhagic bursitis is treated conservatively with ice, elevation, rest, and analgesics; aspiration may shorten the duration of symptoms. Chronic microtraumatic bursitis should be treated conservatively, and the underlying cause addressed. Bursal aspiration of microtraumatic bursitis is generally not recommended because of the risk of iatrogenic septic bursitis. Although intrabursal corticosteroid injections are sometimes used to treat microtraumatic bursitis, high-quality evidence demonstrating any benefit is unavailable. Chronic inflammatory bursitis (e.g., gout, rheumatoid arthritis) is treated by addressing the underlying condition, and intrabursal corticosteroid injections are often used. For septic bursitis, antibiotics effective against Staphylococcus aureus are generally the initial treatment, with surgery reserved for bursitis not responsive to antibiotics or for recurrent cases. Outpatient antibiotics may be considered in those who are not acutely ill; patients who are acutely ill should be hospitalized and treated with intravenous antibiotics.
Topics: Anti-Bacterial Agents; Bursitis; Education, Medical, Continuing; Female; Humans; Male; Sepsis; Staphylococcal Infections; Staphylococcus aureus
PubMed: 28290630
DOI: No ID Found -
Medicine Jul 2020Till date only a few studies have reported the efficacy and clinical improvements obtained by extracorporeal shock-wave therapy (ESWT) on frozen shoulder. Limited by... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Till date only a few studies have reported the efficacy and clinical improvements obtained by extracorporeal shock-wave therapy (ESWT) on frozen shoulder. Limited by small number of studies and insufficient outcomes, it is important and necessary to conduct a new randomized controlled trial. The purpose of the present study is to determine whether ESWT could be more effective than oral steroid in treatment of frozen shoulder.
METHODS
This randomized, single-blind, superiority clinical trial was approved by the institutional review board in The Third People's Hospital of Linyi. The inclusion criteria were patients aged >18 years with shoulder pain and restriction in range of motion. A symptom duration >3 months was required, with no radiographic findings on anteroposterior shoulder plain radiographs except for osteoporosis. Group 1 patients were given 30 mg of oral prednisolone daily for 2 weeks as a single morning dose and then 15 mg daily for another 2 weeks. Group 2 patients received 3 sessions of ESWT on the first, 14th, and 28th days. The primary outcome measure was shoulder pain score. The secondary outcomes included Disabilities of the Arm, Shoulder, and Hand score, range of motion, satisfaction rate, and complications.
RESULTS
It was hypothesized that there would be a significant difference between ESWT and control groups in improving shoulder pain and functions in frozen shoulder.
TRIAL REGISTRATION
This study protocol was registered in Research Registry (researchregistry5736).
Topics: Adult; Aged; Bursitis; Extracorporeal Shockwave Therapy; Female; Humans; Male; Middle Aged; Pain Measurement; Range of Motion, Articular; Single-Blind Method; Treatment Outcome; Young Adult
PubMed: 32756135
DOI: 10.1097/MD.0000000000021399 -
Clinics in Orthopedic Surgery Mar 2020The objective of this study was to identify a consensus on definition, diagnosis, treatment, and prognosis of frozen shoulder (FS) among shoulder specialists.
BACKGROUND
The objective of this study was to identify a consensus on definition, diagnosis, treatment, and prognosis of frozen shoulder (FS) among shoulder specialists.
METHODS
A questionnaire composed of 18 questions about FS-definition, classification, utilization of diagnostic modalities, the propriety of treatment at each stage, and prognosis-was sent to 95 shoulder specialists in Korea. Most questions (15 questions) required an answer on a 5-point analog scale (1, strongly disagree; 5, strongly agree); three questions about the propriety of treatment were binary.
RESULTS
We received 71 responses (74.7%). Of the 71 respondents, 84.5% agreed with the proposed definition of FS, and 88.8% agreed that FS should be divided into primary and secondary types according to the proposed definition. Only 43.7% of the respondents agreed that FS in patients with systemic disease should be classified as secondary FS. For the diagnosis of FS, 71.9% agreed that plain radiography should be used and 64.8% agreed ultrasonography should be used. There was a high consensus on proper treatment of FS: 97.2% agreed on education, 94.4%, on the use of nonsteroidal anti-inflammatory drugs; 76.1%, on intra-articular steroid injections; and 97.2%, on stretching exercise. Among all respondents, 22.5% answered that more than 10% of the patients with FS do not respond to conservative treatment.
CONCLUSIONS
The survey revealed a general consensus among shoulder specialists on the definition and treatment of FS. However, classification of FS was found controversial.
Topics: Bursitis; Consensus; Humans; Medicine; Prognosis; Republic of Korea; Surveys and Questionnaires
PubMed: 32117540
DOI: 10.4055/cios.2020.12.1.60 -
Acta Orthopaedica Et Traumatologica... 2010The aim of the study was to compare the effects of two different exercise programs on pain, range of motion (ROM), and functional results in frozen shoulder. (Comparative Study)
Comparative Study Randomized Controlled Trial
OBJECTIVES
The aim of the study was to compare the effects of two different exercise programs on pain, range of motion (ROM), and functional results in frozen shoulder.
METHODS
Twenty-two female and 7 male patients [mean age 52.1 years (range 38-65 years)] were randomly allocated into two groups: 14 in the first group and 15 in the second group. The patients were treated for 6 weeks (30 sessions) at hospital under the supervision of physical therapist. Both groups were treated with transcutaneous electrical nerve stimulation, cold pack, and nonsteroidal antiinflammatory drugs; and were given glenohumeral ROM exercises. The scapulothoracic exercises were performed only by the second group. Functional results were assessed using the modified Constant score, pain was assessed using visual analog scale (VAS), and ROM was measured with a goniometer. Assessments were performed before treatment and repeated at 6 and 12 weeks of treatment.
RESULTS
In both groups, the Constant score and ROM were increased, and VAS was decreased at the end of 6 and 12 weeks. The modified Constant score was not significantly different between the groups before and after treatment. VAS score was better in the second group at 6 weeks (p<0.01). Improvement in ROM was significantly better in the second group at 12 weeks (p=0.005).
CONCLUSION
In addition to glenohumeral ROM exercises, scapulothoracic exercises contribute to decreasing pain and increasing ROM in patients with frozen shoulder.
Topics: Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Arthrometry, Articular; Bursitis; Cryotherapy; Exercise Therapy; Female; Humans; Male; Middle Aged; Pain; Pain Management; Pain Measurement; Physical Therapy Department, Hospital; Program Evaluation; Recovery of Function; Shoulder Joint; Transcutaneous Electric Nerve Stimulation; Treatment Outcome
PubMed: 21252605
DOI: 10.3944/AOTT.2010.2367 -
Skeletal Radiology May 2023The native bursa is a structure lined by synovium located adjacent to a joint which may serve to decrease friction between the tendons and overlying bone or skin. This... (Review)
Review
The native bursa is a structure lined by synovium located adjacent to a joint which may serve to decrease friction between the tendons and overlying bone or skin. This extra-articular structure can become inflamed resulting in bursitis. Steroid injections have proven to be an effective method of treating bursal pathology in various anatomic locations. Performing these procedures requires a thorough understanding of relevant anatomy, proper technique, and expected outcomes. Ultrasound is a useful tool for pre procedure diagnostic evaluation and optimizing needle position during these procedures while avoiding adjacent structures. The purpose of this article is to review core principles of ultrasound-guided musculoskeletal procedures involving bursae throughout the upper and lower extremities.
Topics: Humans; Bursa, Synovial; Bursitis; Ultrasonography; Injections; Ultrasonography, Interventional; Injections, Intra-Articular
PubMed: 36008730
DOI: 10.1007/s00256-022-04153-y -
Journal of Shoulder and Elbow Surgery Apr 2014There is little evidence for the optimal form of nonoperative treatment in the management of frozen shoulder. This study assesses the efficacy of current physiotherapy... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
There is little evidence for the optimal form of nonoperative treatment in the management of frozen shoulder. This study assesses the efficacy of current physiotherapy strategies.
METHODS
All primary care referrals of frozen shoulder to our physiotherapy department were included during a 12-month period. Of these referrals, 17% met the inclusion criteria for primary idiopathic frozen shoulder. The 75 patients were randomly assigned to 1 of 3 groups: group exercise class, individual physiotherapy, and home exercises alone. A single independent physiotherapist, who was blinded to the treatment groups, made all assessments. Range of motion, Constant score, Oxford Shoulder Score, Short Form 36, and Hospital Anxiety and Disability Scale (HADS) outcome measures were performed at baseline, 6 weeks, 6 months, and 1 year.
RESULTS
The exercise class group improved from a mean Constant score of 39.8 at baseline to 71.4 at 6 weeks and 88.1 at 1 year. There was a significant improvement in shoulder symptoms on Oxford and Constant scores (P < .001). This improvement was greater than with individual physiotherapy or home exercises alone (P < .001). The improvement in range of motion was significantly greater in both physiotherapy groups over home exercises (P < .001). HADS scores significantly improved during the course of treatment (P < .001). The improvement in HADS anxiety score was significantly greater in both physiotherapy intervention groups than in home exercises alone.
CONCLUSIONS
A hospital-based exercise class can produce a rapid recovery from a frozen shoulder with a minimum number of visits to the hospital and is more effective than individual physiotherapy or a home exercise program.
Topics: Adult; Aged; Bursitis; Exercise Therapy; Female; Humans; Male; Middle Aged; Physical Therapy Modalities; Range of Motion, Articular; Single-Blind Method; Treatment Outcome
PubMed: 24630545
DOI: 10.1016/j.jse.2013.12.026 -
The Journal of International Medical... Dec 2020We evaluated the effect of ultrasound (US)-guided injection of platelet-rich plasma (PRP) into the shoulder joint in patients with adhesive capsulitis (AC) and compared... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
We evaluated the effect of ultrasound (US)-guided injection of platelet-rich plasma (PRP) into the shoulder joint in patients with adhesive capsulitis (AC) and compared its effect with that of conventional physiotherapy (CPT).
METHODS
Sixty-four subjects with AC were included and randomly allocated into two groups, as follows: PRP (n=32; intra-articular [IA] PRP [4 mL] was injected); and CPT (n=32; short wave diathermy and exercise therapy were performed at three sessions/week for 6 weeks). Treatment outcomes evaluated therapeutic effectiveness before and at 1, 3, and 6 weeks after PRP injection and CPT initiation.
RESULTS
Subjects in both groups showed a significant decrease in the visual analogue scale score for pain and shoulder and hand scores, and they a significant increase in shoulder passive range of motion at all evaluation time points. There was no significant difference in the measured outcomes between the two groups. However, there was less acetaminophen consumption after IA PRP injection compared with that after CPT.
CONCLUSIONS
IA PRP injection is a useful option for treating patients with AC, particularly those who have low therapeutic compliance for exercise therapy or have contraindications for corticosteroid injection or oral pain reduction medication.
Topics: Bursitis; Humans; Physical Therapy Modalities; Platelet-Rich Plasma; Range of Motion, Articular; Treatment Outcome; Ultrasonography, Interventional
PubMed: 33296615
DOI: 10.1177/0300060520976032 -
JPMA. the Journal of the Pakistan... Jan 2022To compare the effect of muscle energy technique and Mulligan mobilisation with movement on pain, range of motion and disability in patients of adhesive capsulitis. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To compare the effect of muscle energy technique and Mulligan mobilisation with movement on pain, range of motion and disability in patients of adhesive capsulitis.
METHODS
The single-blind, randomised controlled study was conducted at the Physiotherapy Department of Mayo Hospital, Lahore, Pakistan, from July to December, 2018, and comprised patients of either gender aged 30-70 years with adhesive capsulitis stage 2. The subjects were randomised using the lottery method into Mulligan mobilisation with movement group A, and the muscle energy technique grouo B. Conventional treatment, including hot packs and exercises like pulley rope exercise, wall climbing, and shoulder wheel, were part of both the groups. Each technique was applied five times per set, 2 sets per session 3 days a week for three weeks. Baseline and post-intervention readings were recorded for pain, range of motion and disability Using numeric pain rating scale, goniometer, and shoulder pain and disability index. Data was analysed using SPSS 23.
RESULTS
Of the 70 individuals assessed, 64(91.4%) were included; 32(50%) in each of the two groups. The mean age in group A was 49.93±6.69 years, while in group B it was 49.17±8.92 years. Group A showed significantly better results compared to group B (p<0.05).
CONCLUSIONS
Muscle energy technique and Mulligan mobilisation with movement were both found to be effective, but the latter was significantly better compared to the former.
CLINICAL TRIAL NUMBER
IRCT20200611047734N2 (https://www.irct.ir/trial/48851).
Topics: Adult; Bursitis; Humans; Middle Aged; Muscles; Range of Motion, Articular; Shoulder Pain; Single-Blind Method
PubMed: 35099430
DOI: 10.47391/JPMA.1360 -
Ugeskrift For Laeger Feb 2019Frozen shoulder, or adhesive capsulitis, is a painful inflammatory disorder with an unknown pathogenesis characterised by progressive fibrosis of the capsule. Frozen...
Frozen shoulder, or adhesive capsulitis, is a painful inflammatory disorder with an unknown pathogenesis characterised by progressive fibrosis of the capsule. Frozen shoulder presents clinically with intense pain at rest and passive restricted motion. In general, treatment modalities seem to relieve pain and improve the range of movement, but no single treatment modality has been shown to affect the long-term outcome. Initially, a non-operative approach is traditionally recommended. Oral or intraarticular injection of cortisone relieves short-term pain. In refractory cases, arthroscopic capsular release is suggested.
Topics: Arthralgia; Arthroscopy; Bursitis; Cortisone; Glucocorticoids; Humans; Range of Motion, Articular; Shoulder Joint; Treatment Outcome
PubMed: 30777592
DOI: No ID Found