Physiotherapeutic Case Studies in Frozen Shoulder Pathology

Not Applicable

Completed

• Conditions: Articular; Rigid
• Interventions: Diagnostic Test: First data analysis; Procedure: Second data analysis; Other: database

• Registration Number: NCT05175586
• Lead Sponsor: GEMA LEÓN BRAVO

Brief Summary

The stiff shoulder presents symptoms such as pain, loss of mobility and strength, being more common the idiopathic origin associated to the female gender. The definitive diagnosis presents complications due to the number of etiologies that can cause it. Epidemiologically, it presents from 2 to 5% of medical incapacities in the working population. Objective: To investigate the efficacy of percutaneous Neuromodulation together with Orthopedic Manual Therapy (Maitland and Mulligan) in comparison with Orthopedic Manual Therapy (Maitland and Mulligan) used in stiff shoulder.Design: Experimental clinical trial in 30 patients aged 21 to 76 years from a physiotherapy center divided into two groups: Group 1 (n=15) Percutaneous Neuromodulation + Orthopaedic Manual Therapy (Maitland and Mulligan) Group 2 (n=15) Orthopaedic Manual Therapy (Maitland and Mulligan).

Detailed Description

The stiff shoulder is a pathology characterized by a biomechanical restriction of the active and passive movement of the shoulder, showing clinical pictures of local inflammation with a notorious hyper vascularization that helps the clinical manifestations painful flexion, stiffness, limitation of external rotation, pain over the lower cervical area or near the insertion of the deltoid muscle and pain when supporting the affected limb with body weight.

Etiologically there are idiopathic and external factors that cause disorders such as osteoarthritis, chronic subacromial bursitis, or rotator cuff tendinopathy. Likewise, trauma is involved in a secondary way as well as diseases such as Parkinson's, diabetes, thyroid disorders among others. These clinical factors present two types of diagnosis: primary idiopathic stiff shoulder and extrinsic stiff shoulder secondary to trauma or surgery.

Among the physiotherapeutic treatments provided are joint mobilizations, therapeutic exercises, deep Cyriax massage, osteopathic techniques, cryotherapy (inflammatory phase), thermotherapy (chronic phase), electrotherapy for pain and ultrasound.

From the economic point of view, it presents from 2 to 5% of the medical incapacities in the working population, being this disease one of the first 20 sick leaves that reaches up to 12 months, generating high public hospital expenses and difficulties for the business area. Due to the above, many patients enter the operating room as a quick option to return to normality. However, this option does not seem to be the best for this disease, since the hypomobility of the movement increases gradually and chronically, caused by the fibrotic processes in the anterior face of the capsule, generating long-term inability for the external rotation of the joint.

The aim of this study is to investigate the efficacy of Percutaneous Neuromodulation together with Orthopaedic Manual Therapy (Maitland and Mulligan) compared to Orthopaedic Manual Therapy (Maitland and Mulligan) used in the stiff shoulder.

Study Timeline

• Study Start: 2021-02-03
• Primary Completion: 2021-10-01
• Study Completion: 2021-10-07
• Study First Submitted: 2021-10-21
• Study First Submitted QC: 2021-12-07
• Status Verified: 2022-01
• Study First Posted: 2022-01-04
• Last Update Submitted: 2022-01-11
• Last Update Posted: 2022-01-13

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 30

Inclusion Criteria

• Patients with difficulty in activities of daily living ABVD 35.
• Patients with positive results in some of the physical examination tests.
• Patients with a previous diagnosis by ultrasound imaging.
• Patients with surgical intervention after 3 months of age.

Exclusion Criteria

• Patients with mental disorders or deficits.
• Patients with needle phobia (belonephobia).
• Patients with recent surgery before 3 months of age.
• Patients with previous dislocation of the affected shoulder.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Group 1	database	15 patients in the experimental group of percutaneous neuromodulation together with orthopaedic manual therapy (Maitland and Mulligan)
Group 1	Second data analysis	15 patients in the experimental group of percutaneous neuromodulation together with orthopaedic manual therapy (Maitland and Mulligan)
Group 2	First data analysis	15 patients in the experimental group of orthopaedic manual therapy (Maitland and Mulligan).
Group 2	Second data analysis	15 patients in the experimental group of orthopaedic manual therapy (Maitland and Mulligan).
Group 1	First data analysis	15 patients in the experimental group of percutaneous neuromodulation together with orthopaedic manual therapy (Maitland and Mulligan)
Group 2	database	15 patients in the experimental group of orthopaedic manual therapy (Maitland and Mulligan).

Primary Outcome Measures

Name	Time	Method
Rigid shoulder type	3 months	Information on the type of stiff shoulder you have.
Joint range	3 months	The values of joint range during the examination are reflected by means of the joint range scale which emphasizes specific degrees for elevation, external rotation and internal rotation.
Pain scale (EVA)	3 months	The values of pain levels during the examination are reflected as follows: 0= No pain 1-2= Little pain 3-4= Moderate pain 5-6= Severe pain 7-8= Very severe pain 9-10= Unbearable pain
Daniels Scale	3 months	Muscle function values during the scan are reflected as follows, with 0 being a negative value and 5 a positive value: 0= Muscle does not contract.; 1. Muscle contracts, but there is no movement.; 2. Muscle contracts and moves normally, but without resistance.; 3. Muscle contracts and resists to a good degree.; 4. Muscle contracts and resists to almost its full extent.; 5. The muscle contracts and resists at full amplitude.

Secondary Outcome Measures

Name	Time	Method
Number of participants in each physical therapy application	3 months	Three reviews were carried out corresponding to the three months of treatment. During these three months, participants received two sessions per week, for a total of 24 sessions: * Group 1 (n=15) received the percutaneous neuromodulation treatment together with orthopedic manual therapy (Maitland and Mulligan).; * Group 2 (n=15) received orthopedic manual therapy treatment (Maitland and Mulligan) only.

Trial Locations

Locations (1)

Gema León Physiotherapy and Rehabilitation Clinic; 🇪🇸 Córdoba, Andalucía, Spain