A blinded, randomized, controlled trial assessing conservative management strategies for frozen shoulder

Sarah Russell, Arpit Jariwala, Robert Conlon, James Selfe, Jim Richards, Michael Walton (Lead / Corresponding author)

    Research output: Contribution to journalArticle

    43 Citations (Scopus)

    Abstract

    Background

    There is little evidence for the optimal form of nonoperative treatment in the management of frozen shoulder. This study assesses the efficacy of current physiotherapy strategies.
    Methods

    All primary care referrals of frozen shoulder to our physiotherapy department were included during a 12-month period. Of these referrals, 17% met the inclusion criteria for primary idiopathic frozen shoulder. The 75 patients were randomly assigned to 1 of 3 groups: group exercise class, individual physiotherapy, and home exercises alone. A single independent physiotherapist, who was blinded to the treatment groups, made all assessments. Range of motion, Constant score, Oxford Shoulder Score, Short Form 36, and Hospital Anxiety and Disability Scale (HADS) outcome measures were performed at baseline, 6 weeks, 6 months, and 1 year.
    Results

    The exercise class group improved from a mean Constant score of 39.8 at baseline to 71.4 at 6 weeks and 88.1 at 1 year. There was a significant improvement in shoulder symptoms on Oxford and Constant scores (P < .001). This improvement was greater than with individual physiotherapy or home exercises alone (P < .001). The improvement in range of motion was significantly greater in both physiotherapy groups over home exercises (P < .001). HADS scores significantly improved during the course of treatment (P < .001). The improvement in HADS anxiety score was significantly greater in both physiotherapy intervention groups than in home exercises alone.
    Conclusions

    A hospital-based exercise class can produce a rapid recovery from a frozen shoulder with a minimum number of visits to the hospital and is more effective than individual physiotherapy or a home exercise program.
    Original languageEnglish
    Pages (from-to)500-507
    Number of pages8
    JournalJournal of shoulder and elbow surgery
    Volume23
    Issue number4
    DOIs
    Publication statusPublished - Apr 2014

    Fingerprint

    Bursitis
    Randomized Controlled Trials
    Exercise
    Anxiety
    Group Homes
    Articular Range of Motion
    Referral and Consultation
    Conservative Treatment
    Physical Therapists
    Primary Health Care
    Therapeutics
    Outcome Assessment (Health Care)

    Cite this

    Russell, Sarah ; Jariwala, Arpit ; Conlon, Robert ; Selfe, James ; Richards, Jim ; Walton, Michael. / A blinded, randomized, controlled trial assessing conservative management strategies for frozen shoulder. In: Journal of shoulder and elbow surgery. 2014 ; Vol. 23, No. 4. pp. 500-507.
    @article{26c1b0ace47f442ea1bc917efbeb81b5,
    title = "A blinded, randomized, controlled trial assessing conservative management strategies for frozen shoulder",
    abstract = "BackgroundThere is little evidence for the optimal form of nonoperative treatment in the management of frozen shoulder. This study assesses the efficacy of current physiotherapy strategies.MethodsAll primary care referrals of frozen shoulder to our physiotherapy department were included during a 12-month period. Of these referrals, 17{\%} met the inclusion criteria for primary idiopathic frozen shoulder. The 75 patients were randomly assigned to 1 of 3 groups: group exercise class, individual physiotherapy, and home exercises alone. A single independent physiotherapist, who was blinded to the treatment groups, made all assessments. Range of motion, Constant score, Oxford Shoulder Score, Short Form 36, and Hospital Anxiety and Disability Scale (HADS) outcome measures were performed at baseline, 6 weeks, 6 months, and 1 year.ResultsThe exercise class group improved from a mean Constant score of 39.8 at baseline to 71.4 at 6 weeks and 88.1 at 1 year. There was a significant improvement in shoulder symptoms on Oxford and Constant scores (P < .001). This improvement was greater than with individual physiotherapy or home exercises alone (P < .001). The improvement in range of motion was significantly greater in both physiotherapy groups over home exercises (P < .001). HADS scores significantly improved during the course of treatment (P < .001). The improvement in HADS anxiety score was significantly greater in both physiotherapy intervention groups than in home exercises alone.ConclusionsA hospital-based exercise class can produce a rapid recovery from a frozen shoulder with a minimum number of visits to the hospital and is more effective than individual physiotherapy or a home exercise program.",
    author = "Sarah Russell and Arpit Jariwala and Robert Conlon and James Selfe and Jim Richards and Michael Walton",
    note = "Copyright {\circledC} 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.",
    year = "2014",
    month = "4",
    doi = "10.1016/j.jse.2013.12.026",
    language = "English",
    volume = "23",
    pages = "500--507",
    journal = "Journal of shoulder and elbow surgery",
    issn = "1058-2746",
    publisher = "Elsevier",
    number = "4",

    }

    A blinded, randomized, controlled trial assessing conservative management strategies for frozen shoulder. / Russell, Sarah; Jariwala, Arpit; Conlon, Robert; Selfe, James; Richards, Jim; Walton, Michael (Lead / Corresponding author).

    In: Journal of shoulder and elbow surgery, Vol. 23, No. 4, 04.2014, p. 500-507.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - A blinded, randomized, controlled trial assessing conservative management strategies for frozen shoulder

    AU - Russell, Sarah

    AU - Jariwala, Arpit

    AU - Conlon, Robert

    AU - Selfe, James

    AU - Richards, Jim

    AU - Walton, Michael

    N1 - Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

    PY - 2014/4

    Y1 - 2014/4

    N2 - BackgroundThere is little evidence for the optimal form of nonoperative treatment in the management of frozen shoulder. This study assesses the efficacy of current physiotherapy strategies.MethodsAll primary care referrals of frozen shoulder to our physiotherapy department were included during a 12-month period. Of these referrals, 17% met the inclusion criteria for primary idiopathic frozen shoulder. The 75 patients were randomly assigned to 1 of 3 groups: group exercise class, individual physiotherapy, and home exercises alone. A single independent physiotherapist, who was blinded to the treatment groups, made all assessments. Range of motion, Constant score, Oxford Shoulder Score, Short Form 36, and Hospital Anxiety and Disability Scale (HADS) outcome measures were performed at baseline, 6 weeks, 6 months, and 1 year.ResultsThe exercise class group improved from a mean Constant score of 39.8 at baseline to 71.4 at 6 weeks and 88.1 at 1 year. There was a significant improvement in shoulder symptoms on Oxford and Constant scores (P < .001). This improvement was greater than with individual physiotherapy or home exercises alone (P < .001). The improvement in range of motion was significantly greater in both physiotherapy groups over home exercises (P < .001). HADS scores significantly improved during the course of treatment (P < .001). The improvement in HADS anxiety score was significantly greater in both physiotherapy intervention groups than in home exercises alone.ConclusionsA hospital-based exercise class can produce a rapid recovery from a frozen shoulder with a minimum number of visits to the hospital and is more effective than individual physiotherapy or a home exercise program.

    AB - BackgroundThere is little evidence for the optimal form of nonoperative treatment in the management of frozen shoulder. This study assesses the efficacy of current physiotherapy strategies.MethodsAll primary care referrals of frozen shoulder to our physiotherapy department were included during a 12-month period. Of these referrals, 17% met the inclusion criteria for primary idiopathic frozen shoulder. The 75 patients were randomly assigned to 1 of 3 groups: group exercise class, individual physiotherapy, and home exercises alone. A single independent physiotherapist, who was blinded to the treatment groups, made all assessments. Range of motion, Constant score, Oxford Shoulder Score, Short Form 36, and Hospital Anxiety and Disability Scale (HADS) outcome measures were performed at baseline, 6 weeks, 6 months, and 1 year.ResultsThe exercise class group improved from a mean Constant score of 39.8 at baseline to 71.4 at 6 weeks and 88.1 at 1 year. There was a significant improvement in shoulder symptoms on Oxford and Constant scores (P < .001). This improvement was greater than with individual physiotherapy or home exercises alone (P < .001). The improvement in range of motion was significantly greater in both physiotherapy groups over home exercises (P < .001). HADS scores significantly improved during the course of treatment (P < .001). The improvement in HADS anxiety score was significantly greater in both physiotherapy intervention groups than in home exercises alone.ConclusionsA hospital-based exercise class can produce a rapid recovery from a frozen shoulder with a minimum number of visits to the hospital and is more effective than individual physiotherapy or a home exercise program.

    U2 - 10.1016/j.jse.2013.12.026

    DO - 10.1016/j.jse.2013.12.026

    M3 - Article

    VL - 23

    SP - 500

    EP - 507

    JO - Journal of shoulder and elbow surgery

    JF - Journal of shoulder and elbow surgery

    SN - 1058-2746

    IS - 4

    ER -