Exploration of the clinical course of frozen shoulder: A longitudinal multicenter prospective study of functional impairments |
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| Institution: | 1. Research Group MOVANT, Department of Rehabilitation Sciences and Physical Therapy (REVAKI), University of Antwerp, Wilrijk, Belgium;2. Pain in Motion International Research Group, Belgium;3. Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium;4. Department of Orthopedic Surgery and Traumatology, AZ Monica, Antwerp, Belgium;5. Department of Orthopaedic Surgery, University Hospital (UZA), Edegem, Belgium;6. Physiotherapy in Motion, Multi-Specialty Research Group (PTinMOTION), Department of Physical Therapy, University of Valencia, Valencia, Spain;7. Department of Physical Therapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium;8. Department of Physical Therapy, University of Valencia, Valencia, Spain;9. Department of Physical Therapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Melilla, Spain;10. Department of Nursing, Physical Therapy and Medicine, University of Almeria, Spain;11. Universidad de Malaga, Department of Physical Therapy, Malaga, Spain;1. Research Group MOVANT, Department of Rehabilitation Sciences and Physical Therapy (REVAKI), University of Antwerp, Wilrijk, Belgium;2. Pain in Motion International Research Group, Belgium;3. Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium;4. Department of Orthopedic Surgery and Traumatology, AZ Monica, Antwerp, Belgium;5. Department of Orthopaedic Surgery, University Hospital (UZA), Edegem, Belgium;6. Physiotherapy in Motion, Multi-Specialty Research Group (PTinMOTION), Department of Physical Therapy, University of Valencia, Valencia, Spain;7. Department of Physical Therapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium;8. Department of Physical Therapy, University of Valencia, Valencia, Spain;9. Department of Physical Therapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Melilla, Spain;10. Department of Nursing, Physical Therapy and Medicine, University of Almeria, Spain;11. Universidad de Malaga, Department of Physical Therapy, Malaga, Spain |
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| Abstract: | BackgroundContradictory evidence exists regarding the clinical course of frozen shoulder (FS).ObjectivesTo explore the clinical course of FS regarding disabilities, pain, range of motion (ROM), muscle strength, scapular upward rotation, and proprioception and to establish longitudinal correlations between these variables.MethodsPatients with FS were prospectively followed for 9 months at 3-month intervals. Assessment included the Disabilities of the Arm, Shoulder and Hand questionnaire; visual analogue scale for pain; an inclinometer for shoulder external rotation (ER), internal rotation (IR), flexion, and abduction ROM, and scapular upward rotation and proprioception, as well as handheld dynamometry for muscle strength in shoulder abduction, ER, and IR.ResultsInitially, 149 patients (98 females; mean (SD) age 53 (9) years) were included, with 88 completing all follow-up assessments. Most variables showed early improvement in the clinical course of FS, particularly ER and IR at 90° abduction, which continued to improve from 6 to 9 months of follow-up. Associations were observed between disabilities and pain (r = 0.61), disabilities/pain and ROM (r=-0.62 to -0.59 and r=-0.47 to -0.39, respectively), disabilities/pain and muscle strength (r=-0.24 to -0.35 and r=-0.36 to -0.17, respectively), and between disabilities/pain and scapular upward rotation below shoulder level (r = 0.23 to 0.38 and r = 0.24 to 0.30, respectively). ROM correlated with muscle strength (r = 0.14 to 0.44), while both ROM and ER muscle strength correlated with scapular upward rotation below shoulder level (r=-0.37 to -0.23 and r=-0.17 to -0.12, respectively). Muscle strength correlated with scapular upward rotation above shoulder level (r = 0.28 to 0.38) and lift-off muscle strength correlated with joint repositioning (r=-0.17 to -0.15).ConclusionAlmost all factors improved in the early phase (3–6 months) after baseline assessment, while ER and IR ROM at shoulder level continued to improve long term. |
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