Exploration of the clinical course of frozen shoulder: A longitudinal multicenter prospective study of functional impairments,Brazilian Journal of Physical Therapy

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Exploration of the clinical course of frozen shoulder: A longitudinal multicenter prospective study of functional impairments
Brazilian Journal of Physical Therapy ( IF 3.4 ) Pub Date : 2023-08-23 , DOI: 10.1016/j.bjpt.2023.100539
Michel Gcam Mertens ₁ , Mira Meeus ₂ , Olivier Verborgt ₃ , Enrique Lluch Girbes ₄ , Silvia Mena-Del Horno ₅ , Marta Aguilar-Rodriguez ₆ , Lirios Dueñas ₆ , Santiago Navarro-Ledesma ₇ , Manuel Fernandez-Sanchez ₈ , Alejandro Luque-Suarez ₉ , Filip Struyf ₁₀

Affiliation

Research Group MOVANT, Department of Rehabilitation Sciences and Physical Therapy (REVAKI), University of Antwerp, Wilrijk, Belgium; Pain in Motion International Research Group, Belgium.
Research Group MOVANT, Department of Rehabilitation Sciences and Physical Therapy (REVAKI), University of Antwerp, Wilrijk, Belgium; Pain in Motion International Research Group, Belgium; Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
Research Group MOVANT, Department of Rehabilitation Sciences and Physical Therapy (REVAKI), University of Antwerp, Wilrijk, Belgium; Department of Orthopedic Surgery and Traumatology, AZ Monica, Antwerp, Belgium; Department of Orthopaedic Surgery, University Hospital (UZA), Edegem, Belgium.
Pain in Motion International Research Group, Belgium; Physiotherapy in Motion, Multi-Specialty Research Group (PTinMOTION), Department of Physical Therapy, University of Valencia, Valencia, Spain; Department of Physical Therapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium.
Department of Physical Therapy, University of Valencia, Valencia, Spain.
Physiotherapy in Motion, Multi-Specialty Research Group (PTinMOTION), Department of Physical Therapy, University of Valencia, Valencia, Spain.
Department of Physical Therapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Melilla, Spain.
Department of Nursing, Physical Therapy and Medicine, University of Almeria, Spain.
Universidad de Malaga, Department of Physical Therapy, Malaga, Spain.
Research Group MOVANT, Department of Rehabilitation Sciences and Physical Therapy (REVAKI), University of Antwerp, Wilrijk, Belgium.

Background

Contradictory evidence exists regarding the clinical course of frozen shoulder (FS).

Objectives

To 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.

Methods

Patients 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.

Results

Initially, 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).

Conclusion

Almost 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.

中文翻译：

肩周炎临床病程探索：功能障碍的纵向多中心前瞻性研究

背景

关于肩周炎（FS）的临床病程存在矛盾的证据。

目标

探讨 FS 的临床病程，包括残疾、疼痛、活动范围 (ROM)、肌肉力量、肩胛骨上旋和本体感觉，并建立这些变量之间的纵向相关性。

方法

FS 患者每隔 3 个月进行一次为期 9 个月的前瞻性随访。评估包括手臂、肩部和手部残疾问卷；疼痛视觉模拟量表；用于肩部外旋 (ER)、内旋 (IR)、屈曲和外展 ROM、肩胛骨上旋和本体感觉的倾斜仪，以及用于肩部外展、ER 和 IR 肌肉力量的手持式测力计。

结果

最初，纳入了 149 名患者（98 名女性；平均 (SD) 年龄 53 (9) 岁），其中 88 名完成了所有随访评估。大多数变量显示 FS 临床病程的早期改善，特别是 90° 外展时的 ER 和 IR，在 6 至 9 个月的随访中持续改善。观察到残疾与疼痛（ r = 0.61）、残疾/疼痛和 ROM（分别为r =-0.62 至 -0.59 和r =-0.47 至 -0.39）、残疾/疼痛和肌肉力量（ r =-0.24 至 -0.39 ）之间的关联。分别为-0.35 和r =-0.36 至 -0.17），以及残疾/疼痛和肩胛骨在肩部水平以下向上旋转之间（分别为r = 0.23 至 0.38 和r = 0.24 至 0.30）。ROM 与肌肉力量相关（r = 0.14 至 0.44），而 ROM 和 ER 肌肉力量均与肩部水平以下的肩胛骨向上旋转相关（分别为r =-0.37 至 -0.23 和r =-0.17 至 -0.12）。肌肉力量与肩胛骨向上旋转至肩部水平相关（r = 0.28 至 0.38），抬离肌肉力量与关节重新定位相关（r =-0.17 至 -0.15）。