Symptoms Of Frozen Shoulder Research Articles

Developing a Motion Sensor-Based Game to Support Frozen Shoulder Rehabilitation in Older Adults through a Participatory Design Approach.

Objective: Although some serious games have been developed for physical therapy, little work has been conducted through a participatory design approach. Therefore, a game prototype was developed, which involved related stakeholders in the design process. Materials and Methods: The iterative participatory design process was adopted with the input of 18 patients with frozen shoulder symptoms, 4 health professionals, 2 game designers, and 5 researchers in an iterative process to design, test, and evaluate the game prototype. In total, 17 patients participated in the interviews to explore their needs and desires for a serious game. The health professionals participated in the interviews to understand the medical requirement and experience pertaining to frozen shoulder and were included in the workshop to give feedback on the game prototype. At the conclusion of the iterative design process, a Kinect-based prototype game with three levels was used for a case study with one patient who was diagnosed with frozen shoulder and has been receiving medical treatment in the hospital. Results: Based on the outcomes derived from data collected among diverse stakeholders, the prototype game underwent iterative development by the team and was assessed by a participant with frozen shoulder symptoms. Findings revealed that the participant demonstrated enhanced shoulder mobility and a reduction in pain intensity, despite the lack of significant improvement for health-related quality of life. Nevertheless, the participant reported a positive experience with the prototype game. Conclusion: This study underscores the importance of involving diverse stakeholders in the development process to create more effective and user-centric serious games for rehabilitation. The participatory approach, exemplified by the prototype game, demonstrates potential improvements in both user experience and overall effectiveness during the rehabilitation process.

A CLINICAL STUDY TO EVALUATE THE EFFECT OF MASHA TAILA AND PHYSIOTHERAPY IN THE MANAGEMENT OF AVABAHUKA W.S.R.TO FROZEN SHOULDER

Introduction : Paradoxically shoulder joint privileged as the most mobile joint in the body has its nemesis be-cause of this advantage i.e. it become more vulnerable to injuries. Frozen shoulder is a clinical syndrome char-acterized by painful restriction of both active and passive shoulder movements due to abnormalities within the shoulder joint or remote. Prevalence of this disease is around 2.1 - 5% and women suffer more than men be-tween age group of 40-60 years .According to Ayurvedic principles, frozen shoulder can be taken as“Avabahuka”(Frozen shoulder), as its clinical features are almost similar. Ayurvedic principles of manage-ment for these diseases are more effective than other pathies . In modern medicine the current management has many side effects and having success rate of 58% only.Even on surgical decompression recurrence is also there. Aim:- To determine the effect of Masha Taila(oil) and physiotherapy in the management of Avabahuka w.s.r.to Frozen Shoulder. Materials and method : The study was conducted on 30 patients in two groups with symp-toms of Frozen shoulder. Statistical Analysis used : Observations of the study were analyzed, and findings were evaluated by using statistical methods. Result: Group I:-Among15 patients,11patients (73%) had markedly im-proved .Group II:-Among 15 patients, 2 patients (13.33%)had markedly improved. Conclusion: In group I: -Masah Taila (Matar Vasti(Enema) and Sthanic Snehna(Oleation) along with physiotherapy gave better results ,in less duration of time then physiotherapy alone in group II.

Impacts of preoperative anxiety and depression on pain and range of motion after arthroscopic frozen shoulder release: a cohort study

PurposeWe aimed to evaluate the impact of preoperative anxiety and depression levels on baseline and postoperative pain in patients who underwent arthroscopic frozen shoulder release.MethodsThe study included 59 patients with more than three months of idiopathic frozen shoulder. All patients had arthroscopic frozen shoulder release. Two patients were excluded from statistical analysis. Therefore, the statistical analysis was performed on the remaining 57 patients. The patients were divided into two groups according to HADS scores: group 1 which included 28 patients with a healthy psychological status (anxiety ≤ 7 and depression ≤ 7), and Group 2, which included 29 patients with psychological distress ( anxiety ≥ 8 or depression ≥ 8).ResultsThe hallmark finding of this study is that patients complaining of frozen shoulder symptoms and having psychological distress (HADS ≥ 8) experienced higher pain scores preoperatively and at one-year follow-up after arthroscopic release. All patients showed significant improvement between the preoperative period and the one year follow-up regarding the abduction, forward flexion, external rotation at the side and the VAS pain score with a P value of 0.001.ConclusionsArthroscopic frozen shoulder release significantly lowers the VAS pain score over the 12-month.

The Effectiveness of Acupuncture in the Treatment of Frozen Shoulder: A Systematic Review and Meta-Analysis.

Background Frozen shoulder (FS) is associated with pain, reduced range of motion (ROM), and shoulder function. The condition occurs in 2–5% of the population, and it is especially common around the age of 50 years. FS symptoms will recover after 1–4 years. Many patients turn to acupuncture in order to alleviate the FS symptoms. Objective In this review, we will investigate the efficiency of acupuncture as a FS treatment. Methods A literature search of acupuncture and FS-related keywords was performed in the following databases: PubMed, Cochrane Library, Embase, and Web of Science. Thirteen publications were included for a systematic review, and a meta-analysis was done using the following measurements: visual analogue scale (VAS) for pain, Constant-Murley Shoulder Outcome Score (CMS) for shoulder function, and active shoulder ROM including flexion, abduction, and external rotation. The Cochrane Collaboration's risk of bias tool and quality of evidence GRADE recommendations and STRICTA 2010 were used to grade the included publications. Results A meta-analysis on VAS pain score showed significant pain reduction, restoring CMS shoulder function, and flexion ROM in favor of acupuncture versus the control. In external rotation and abduction ROM, a meta-analysis was not significant. The most used acupoints are Jian Yu (LI15) and Jian Liao (TB14). Conclusions The results indicate that acupuncture could be safe and effective for pain reduction, restoring shoulder function, and restoring flexion ROM for FS patients in the short term and midterm. However, the level of evidence was very low. More high-quality and longer studies are needed in order to robust the evidence.

Clinical trial of treatment of frozen shoulder by intensive moxibustion plus acupuncture

To compare the clinical therapeutic effect of intensive moxibustion plus acupuncture and simple acupuncture therapy in the treatment of frozen shoulder so as to provide a reference for clinical practice. A total of 60 patients with frozen shoulder were randomly divided into intensive moxibustion plus acupuncture group and simple acupuncture group (n＝30 per group). Acupoints Jianyu (LI15), Jianzhen (SI9), Jianliao (TE14), Tiaokou (ST38), Chengshan (BL57) and Ashi points (Extra) were punctured with filiform needles which were manipulated till the patients experienced feelings of soreness and distension in the local region, followed by retaining the needles for 40 min. For patients of the moxibustion plus acupuncture group, after acupuncture, an ignited moxa-stick segment was applied to the affected shoulder for 40－50 min. After the treatment, all patients were ordered to make a shoulder exercise (anteflexion, rear protraction, abduction and upthrow movements, etc.). The visual analogue scale (VAS) was used to assess the pain severity, and the Constant-Murley shoulder assessment scale (the total score is 100 points, including 15 points in pain severity and 20 points in daily living activities, 40 points in joint motion range, and 25 points in myodynamia) used to assess the functional state of the shoulder, and the "Standards for Diagnosis and Therapeutic Effect Evaluation of Diseases of Traditional Chinese Medicine"(1994) were employed to evaluate the therapeutic effect. Following the treatment, intra-group comparison showed that the VAS score was significantly reduced in both groups in comparison with their own pre-treatment (P<0.05), and the total scores of Constant-Murley scale, the scores of activities of daily living and active motion range, as well as the scores of pain integration and myodynamia, were all considerably increased in the two groups in comparison with their own pre-treatment (all P<0.05). The therapeutic effect of the moxibustion plus acupuncture was significantly superior to that of the simple acupuncture in reducing VAS score and increasing total score of Constant-Murley scale, and scores of activities of daily living and active motion range, as well as the scores of pain integration (P<0.05). Of the two 29 cases in the moxibustion plus acupuncture and simple acupuncture groups, 19 (65.52%) and 10 (34.48%) were cured, 8 (27.58%) and 12 (41.38%) experienced improvement, 2 (6.90%) and 7 (24.14%) were failed, with the effective rate being 93.10% and 75.86%, respectively. The therapeutic effective rate of the moxibustion plus acupuncture was evidently higher than that of the simple acupuncture (P<0.05)．. The therapeutic effect of intensive moxibustion plus acupuncture is superior to that of simple acupuncture in improving symptoms of frozen shoulder in patients.

Treatment of the frozen shoulder by combination of cervical adjustment, ultrasonic therapy and muscle stretching

Abstract Background: Physical therapy is an intervention commonly used in the treatment of subjects with frozen shoulder symptoms. The purpose of this study was to determine the influence and treatment efficiency of combination therapy of cervical adjustment, ultrasonic therapy and stretching on the frozen shoulder. Material/Methods: We studied 39 patients (male 22, female 17) who had frozen shoulder and divided them into test group (20, male 12, female 8) and control group (19, male 10, female 9). Results: The result of combination therapy of cervical adjustment, ultrasonic therapy and stretching was higher than control group, in study group 95.0%, in control group 78.9%.

Low-grade infections in nonarthroplasty shoulder surgery

Recent studies have identified the diagnostic challenge of low-grade infections after shoulder arthroplasty surgery. Infections after nonarthroplasty procedures have not been reported. This study assessed patient-related risk factors, outcomes, and clinical presentation of low-grade infection after open and arthroscopic nonarthroplasty shoulder surgery. The cases of 35 patients presenting with suspected low-grade infection were reviewed. Biopsy specimens taken at revision surgery were cultured in the sterile environment of a class II laminar flow cabinet and incubated for a minimum of 14 days at a specialist orthopedic microbiology laboratory. Patient-related factors (age, occupation, injection), index surgery, and infection characteristics (onset of symptoms, duration to diagnosis, treatment) were analyzed. Positive cultures were identified in 21 cases (60.0%), of which 15 were male patients (71%). Of all patients with low-grade infection, 47.6% were male patients between 16 and 35 years of age. Propionibacterium acnes and coagulase-negative staphylococcus were the most common organisms isolated (81.1% [n = 17] and 23.8% [n = 5], respectively). Of 14 negative culture cases, 9 were treated with early empirical antibiotics (64.3%); 7 patients reported symptomatic improvement (77.8%). Of 5 patients treated with late empirical antibiotics, 4 stated improvement. Patients presented with symptoms akin to resistant postoperative frozen shoulder (persistent pain and stiffness, unresponsive to usual treatments). Young male patients are at greatest risk for low-grade infections after arthroscopic and open nonarthroplasty shoulder surgery. P. acnes was the most prevalent organism. Patients presented with classic postoperative frozen shoulder symptoms, resistant to usual treatments. Interestingly, 78.6% of patients with negative cultures responded positively to empirical treatment.

A Novel Arthroscopic Mclaughlin Procedure for Rotator Cuff Repair in Patients with the Osteoporotic Major Tubercle: A Minimum of 6 Years Follow Up

0bjective: To evaluate the outcomes of rotator cuff tear repair with arthroscopic McLaughlin suture in patients with major tubercle osteoporosis. Methods: 35 patients with rotator cuff tear were treated by arthroscopic McLaughlin suture from April 2007 to January 2009. The mean age of the cases was 63.8 (48 to 78) years. All of the cases were full thickness tear ranging 15 mm to 35 mm. The AP and the supraspinatus outlet projection of the X-rays were obtained before surgery. 11 patients had undergone MR examinations and 21 cases had MRA. All the patients underwent acromioplasty. 18 cases were treated by 1, and 17 cases were treated by 2 arthroscopic McLaughlin sutures. UCLA scoring system and MRI scan was adopted to evaluate shoulder function before operation and at the final follow-up time. Results: 32 cases were followed up with a mean postoperative time of 7.8 years. The average UCLA score was improved from a preoperative rating of 13.3 to a postoperative rating of 33.1. The mean pain score was 3.2 vs. 8.7, for pre- vs. post-operation, the function score was 5.3 vs. 9.1, the mean forward flexion score was 3.5 vs. 4.9, the mean forward flexion strength was 4.0 vs. 4.8. The results were 22 excellent, 8 good, 2 fair. The complications encountered included development of major tubercle broken during operation in 1 case; retear in one case and 3 cases with frozen shoulder symptoms. Conclusion: Arthroscopic McLaughlin suture fixation can provide a micro invasive, firm fixation and a large area for rotator cuff healing, without any anchor related complications. The technique is especially valid for the patient with osteoporosis. Clinical relevance: Arthroscopic McLaughlin suture technique in the treatment of rotator cuff tear with major tubercle osteoporosis can give a fine substrate for the bone-tendon ultimate integration, it’s firm, saveable, and can be a widely used technique especially the patients with humeral head osteoporosis. Level of Evidence: Level IV, therapy.

Treatment of frozen shoulder with subcutaneous TNF-alpha blockade compared with local glucocorticoid injection: a randomised pilot study

We compared the effect of subcutaneous adalimumab injections with intraarticular glucocorticoid injections on frozen shoulder of 18 patients with unilateral joint involvement. Ten patients were randomised to subcutaneous injections with adalimumab and eight to intraarticular glucocorticoid injections administered every other week for a total of three administrations. The evaluation included validated scores. No effect of subcutaneous injections of adalimumab on frozen shoulder symptoms was demonstrated.

Shoulder kinematic features using arm elevation and rotation tests for classifying patients with frozen shoulder syndrome who respond to physical therapy

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. Initially, subjects were asked to perform full active motion in 3 tests: abduction in the scapular plane, hand-to-neck and hand-to-scapula. During the test, shoulder kinematics were measured using a 3-D electromagnetic motion-capturing system. In the initial and follow-up sessions, the self-reported Flexilevel Scale of Shoulder Function (FLEX-SF) was used to determine functional disability from symptoms. Improvement with treatment was determined using percent change in FLEX-SF scores over three months of treatment [(final score−initial score)/initial score×100, >20% improvement and <=20% nonimprovement]. Shoulder kinematics were first analysed for univariate accuracy in predicting improvement and then combined into a multivariate prediction method. A prediction method with two variables (scapular tipping >8.4° during arm elevation, and external rotation >38.9° during hand to neck) were identified. The presence of these two variables (positive likelihood ratio=15.71) increased the probability of improvement with treatment from 41% to 92%. It appears that shoulder kinematics may predict improvement in subjects with frozen shoulder syndrome. Prospective validation of the proposed prediction method is warranted.

Abnormal temperature control suggesting sympathetic dysfunction in the shoulder skin of patients with frozen shoulder.

In view of the possibility that sympathetically mediated pain could be responsible for frozen shoulder symptoms we compared shoulder skin vasomotor control in 11 patients with frozen shoulder and 17 similarly aged normal subjects without shoulder pain. Using computer-assisted thermography the shoulder skin temperature was assessed before and following a 'cold challenge' which consisted of a 15 degrees C cold pack being held against the skin for 60 sec. Both prior to and immediately following the cold challenge shoulder skin temperatures tended to be lower in the patients. During a 10-min rewarming phase, however, the between-group temperature difference increased and became significant at the 0.05 level. These abnormalities of temperature control in patients clearly suggest sympathetic dysfunction in the dermatome subserving pain sensation from the affected shoulder. Whether these abnormalities are primary or secondary remains unresolved.