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Physiotherapy plus Steroid injection has better outcome in frozen shoulder


Physiotherapy plus Steroid injection has better outcome in frozen shoulder

A new study published in the World Journal of Orthopedics reports that additional physiotherapy after corticosteroid injection improves range of motion (ROM) and functional limitations in early-stage frozen shoulder up to the first three months.

Tim Kraal et al. conducted a two centered, randomized controlled trial to investigate the additional value of physiotherapy after a corticosteroid injection in stage one or two idiopathic frozen shoulders (FSs).

Patients with a painful early-stage idiopathic FS were eligible for inclusion. All patients received an ultrasound-guided intra-articular corticosteroid injection. One group underwent additional physiotherapy treatment (PT) and the other group did not (non-PT). The primary outcome measure was the Shoulder Pain and Disability Index (SPADI). Secondary outcomes were the pain (numeric pain rating scale), the range of motion (ROM), quality of life (RAND-36 score), and patient satisfaction. Follow-up was scheduled after 6, 12 and 26 wks. Twenty-one patients were included, 11 patients in the non-PT and ten in the PT group, with a mean age of 52 years.

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Key study findings: 

  • Both treatment groups showed a significant improvement at 26 wk for the SPADI score.
  • At the 6 wk follow-up, the median SPADI score was significantly decreased in the PT group vs the non-PT group.
  • Pain decreased significantly in both groups but no differences were observed between both treatment groups at any time point, except for night pain at 6 wk in favor of the PT group.
  • Significant differences in all three ROM directions were observed after 6 wk in favor of the PT group.
  • A significantly greater improvement in abduction and external rotation was also present in favor of the PT group after 12 wk.
  • RAND-36 scores showed no significant differences in health-related quality of life at all follow-up moments.
  • At 26 wk, both groups did not differ significantly with respect to any of the outcome parameters. No complications were reported in both groups.

Frozen shoulder (FS), a common cause of shoulder pain and disability which affects approximately 2% to 4% of the general population.

For reference log on to 10.5312/wjo.v9.i9.165

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Vinay Singh

Vinay Singh

Vinay Singh joined Medical Dialogue as Desk Editor in 2018. He covers the medical speciality news in different medical categories including Medical guidelines, updates from Medical Journals and Case Reports. He completed his graduation in Biotechnology from AAIDU and did his MBA from IILM Gurgaon. He can be contacted at editorial@medicaldialogues.in . Contact no. 011-43720751
Source: With inputs from World Journal of Orthopedics

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  1. user
    Dr. Chandrashekhar V. Shettar October 18, 2018, 7:24 pm

    Whatever the stage, I mean even in early stages do manipulation and release the adhesions & steroid injections mixed with local anaesthesia and follow up with Physio therapy and the results are superb.