- My Library
- 2018 Issues
- Issue 10
- A PRAGMATIC REGIONAL INTERDEPENDENCE APPROACH TO…
A PRAGMATIC REGIONAL INTERDEPENDENCE APPROACH TO PRIMARY FROZEN SHOULDER: A RETROSPECTIVE CASE SERIES
BACKGROUND & OBJECTIVE
The current clinical practice guidelines for frozen shoulder focus on treatments specifically to the shoulder, none of which receive a strong recommendation. The goal of this case series was to evaluate a regional interdependence approach to treatment, addressing adjacent joints that influence the shoulder while also treating the shoulder itself.
This study conducted a retrospective analysis of five patients aged 40-66 years old that had been dealing with symptoms for 2-30 weeks and were referred by physician for either frozen shoulder/adhesive capsulitis. Confirmation of condition was done through clinical practice guidelines diagnostic criteria - patients presented with either gradual or insidious onset, pain at end range motion, joint hypomobility, reduction in active range of motion and passive range of motion, with external rotation being reduced by at least 50%. The patients were checked for their unaffected shoulder range of motion being within normal limits and screened for red flags and cervical pathology. Treatment focused on patient education on frozen shoulder, a home exercise program, manual treatments, stretching for the upper kinetic chain (shoulder girdle, shoulder joint, scapulothoracic and humerothoracic muscles, and the spine), strengthening, neuromuscular re-education, and functional training. Treatment success was evaluated through changes in shoulder ROM limitation and Disability of the Arm Shoulder and Hand (DASH) questionnaire.
There was an average of 14.8 visits over 7.6 weeks, with a 32.4 week average follow up. The patients saw significant improvements in ROM and DASH scores. The patients all had an increase in passive range of motion beyond the