Elsevier

Journal of Shoulder and Elbow Surgery

Volume 16, Issue 6, November–December 2007, Pages 722-726
Journal of Shoulder and Elbow Surgery

Original article
Manipulation under anesthesia with home exercises versus home exercises alone in the treatment of frozen shoulder: A randomized, controlled trial with 125 patients

https://doi.org/10.1016/j.jse.2007.02.125Get rights and content

We aimed to determine the effect of manipulation under anesthesia in frozen shoulder patients. A blinded randomized trial with a 1-year follow-up was performed at 3 referral hospitals in Southern Finland. We randomly assigned 125 patients with clinically verified frozen shoulder to the manipulation group (n = 65) or control group (n = 60). Both the intervention group and the control group were instructed in specific therapeutic exercises by physiotherapists. Clinical data were gathered at baseline and at 6 weeks and 3, 6, and 12 months after randomization. The 2 groups did not differ at any time of the follow-up in terms of shoulder pain or working ability. Small differences in the range of movement were detected in favor of the manipulation group. Perceived shoulder pain decreased during follow-up equally in the 2 groups, and at 1 year after randomization, only slight pain remained. Manipulation under anesthesia does not add effectiveness to an exercise program carried out by the patient after instruction.

Section snippets

Materials and methods

Three regional hospitals in Southern Finland recruited patients who had a stiff and painful shoulder between June 1999 and September 2002. All underwent radiography of the shoulder joint. Specialists in physical medicine and rehabilitation ensured that the history and physical findings fit the diagnosis of frozen shoulder, and they also controlled the list of exclusion and inclusion criteria and executed the manipulations.

Adult patients with gradually increasing shoulder pain and stiffness were

Results

The demographic and clinical characteristics of the patients at baseline are presented in Table I. The 2 groups were similar. Chronic disorders were noted in the groups equally, with the most frequently reported being hypertonia (21 patients), diabetes mellitus (18 patients), and asthma (5 patients).

Follow-up information was obtained for 88% of the subjects at the 6-week follow-up examinations, with 10 being absent from the manipulation group and 5 from the control group. At 3 months,

Discussion

Only a few follow-up studies have thus far recorded the time of recovery from frozen shoulder. In our study, shoulder pain subsided essentially and glenohumeral mobility was restored nearly to normal approximately 1 year after the onset of shoulder symptoms (half a year after randomization). This finding is in contrast to the findings in the medical literature, according to which the course of the illness is notably longer-lasting.17, 19 We assume that there is selection bias in case series, in

References (21)

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