Yang JL, Chang CW, Chen SY, Lin JJ
Physical therapy is an intervention commonly used in the treatment of subjects with frozen shoulder symptoms, with limited proven effect. The purpose of this study was to identify the kinematic features of patients with frozen shoulder who are more likely to respond to physical therapy. Thirty-four subjects presenting frozen shoulder syndrome were studied to determine altered shoulder kinematics and functional disability. Subjects received the same standardized treatment with passive mobilization/stretching techniques, physical modalities (i.e. ultrasound, shortwave diathermy and/or electrotherapy) and active exercises twice a week for 3 months. Shoulder kinematics were measured using a 3-D electromagnetic motion-capturing system whilst the subjects performed full active motion in 3 tests: abduction in the scapular plane, hand-to-neck and hand-to-scapula. A prediction method with two variables (scapular tipping >8.4 degrees during arm elevation, and external rotation >38.9 degrees during hand to neck) were identified. The presence of these two variables increased the probability of improvement with treatment from 41% to 92%. The authors conclude that it appears that shoulder kinematics may predict improvement in subjects with frozen shoulder syndrome. Prospective validation of the proposed prediction method is warranted.
Manual Therapy, Oct 2007, online article ahead of press.