Observation on the application effect of early rehabilitation procedure of frozen shoulder incorporating high-frequency ultrasound technology_West China Medical Journal

Authors：

CHEN Mi ¹ , WANG Baolan ¹ , WU Hengmin ¹ , MA Quanxi ¹ , ZHANG Tiecheng ¹ , LIU Ling ¹ ,  LI Chao ²

1. Department of Rehabilitation Medicine, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, P. R. China;
2. Department of Critical Care Medicine, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, P. R. China;

Corresponding author：

LI Chao, Email: 790701592@qq.com

Keywords：

Frozen shoulder; high-frequency ultrasound; early rehabilitation; rehabilitation procedure

DOI：

10.7507/1002-0179.202203140

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Objective To explore the effect of self-designed early rehabilitation procedure of frozen shoulder incorporating high-frequency ultrasound technology in the outpatient treatment of patients with early frozen shoulder. Methods One hundred and eighty-two consecutive patients who attended the outpatient clinic of the Department of Rehabilitation Medicine of the First Affiliated Hospital of Xinjiang Medical University and were diagnosed with frozen shoulder between January 2018 and May 2021 were selected and randomly divided into the trial group and the control group, with 91 patients in each group. Patients in the trial group received early rehabilitation procedures for frozen shoulder, and patients in the control group received conventional physiotherapy. The Visual Analogue Scale (VAS) (including VAS score for resting pain and VAS score for active motion), active range of motion of the shoulder joint (external rotation, forward flexion, and abduction), Shoulder Pain and Dysfunction Index (SPADI) (including pain subscale score, dysfunction subscale score, and total score) were compared between the two groups before treatment (Week 0) and 4 and 8 weeks after the start of treatment (Week 4 and 8). Results A total of 143 patients (74 in the trial group and 69 in the control group) completed the study. There was no significant difference in any assessment index between the two groups in Week 0 (P>0.05). The results of the within-group comparison after treatment showed that the VAS score for resting pain (F=44.359, P<0.001), VAS score for active motion (F=158.458, P<0.001), anterior shoulder flexion (F=123.334, P<0.001), abduction mobility (F=117.539, P<0.001), total SPADI score (F=133.814, P<0.001), SPADI pain subscale score (F=74.093, P<0.001), and SPADI dysfunction subscale score (F=145.336, P<0.001) in Week 4 and 8 were better than those in Week 0, and the assessments in Week 8 were better than those in Week 4 in each group (P<0.05); in the control group, there was no statistically significant difference in the external rotation mobility of the shoulder in Week 4 compared with that in Week 0 (P=0.599), and the external rotation in Week 8 improved significantly compared with that in Week 0 (P<0.001), whereas the external rotation of the shoulder in Week 4 and 8 in the trial group improved significantly compared with that in Week 0 (P<0.001). The results of the between-group comparison after treatment showed that the two groups had statistically significant differences in resting shoulder pain VAS score (F=93.712, P<0.001), active motion VAS score (F=103.565, P<0.001), external shoulder rotation (F=13.388, P<0.001), anterior shoulder flexion (F=66.375, P<0.001), abduction mobility (F=110.253, P<0.001), total SPADI score (F=7.917, P=0.006), and SPADI pain subscale score (F=39.091, P<0.001); the SPADI dysfunction subscale score was lower in the trial group than that in the control group in Week 4 (P=0.002), but by Week 8 there was no statistically significant difference between the two groups (P=0.352). Conclusion The early rehabilitation program for frozen shoulder incorporating high-frequency ultrasound technology is more effective than conventional physiotherapy in the intervention of patients with early frozen shoulder, and may provide a referenceable example for the combined application of high-frequency ultrasound technology and physiotherapy.

Citation： CHEN Mi, WANG Baolan, WU Hengmin, MA Quanxi, ZHANG Tiecheng, LIU Ling, LI Chao. Observation on the application effect of early rehabilitation procedure of frozen shoulder incorporating high-frequency ultrasound technology. West China Medical Journal, 2022, 37(5): 710-716. doi: 10.7507/1002-0179.202203140 Copy

1.	Tang HY, Wei W, Yu T, et al. Physical therapy for the treatment of frozen shoulder: a protocol for systematic review of randomized controlled trial. Medicine (Baltimore), 2019, 98(32): e16784.
2.	Wong CK, Levine WN, Deo K, et al. Natural history of frozen shoulder: fact or fiction? A systematic review. Physiotherapy, 2017, 103(1): 40-47.
3.	Mertens MG, Meeus M, Verborgt O, et al. An overview of effective and potential new conservative interventions in patients with frozen shoulder. Rheumatol Int, 2021, 6(9): 57-68.
4.	王艳华, 陈建海. 凝肩: ISAKOS 上肢委员会专家共识(上). 中华肩肘外科电子杂志, 2016, 4(4): 236-242.
5.	Challoumas D, Biddle M, McLean M, et al. Comparison of treatments for frozen shoulder: a systematic review and meta-analysis. JAMA Netw Open, 2020, 3(12): e2029581.
6.	Zavala-González J, Pavez-Baeza F, Gutiérrez-Espinoza H, et al. The effectiveness of joint mobilization techniques for range of motion in adult patients with primary adhesive capsulitis of the shoulder: a systematic review and meta-analysis. Medwave, 2018, 18(5): e7265.
7.	周玉兰, 袁德超, 吴超, 等. 超声引导下肩关节腔注射联合液压扩张治疗不同临床分期冻结肩. 华西医学, 2021, 36(12): 1679-1685.
8.	栗平, 王东海, 郭芳芳, 等. 超声引导液压松解盂肱关节囊联合康复训练治疗冻结肩的临床效果. 中国医学影像学杂志, 2020, 28(4): 285-289.
9.	Rex SS, Kottam L, McDaid C, et al. Effectiveness of interventions for the management of primary frozen shoulder: a systematic review of randomized trials. Bone Jt Open, 2021, 2(9): 773-784.
10.	Lädermann A, Piotton S, Abrassart S, et al. Hydrodilatation with corticosteroids is the most effective conservative management for frozen shoulder. Knee Surg Sports Traumatol Arthrosc, 2021, 29(8): 2553-2563.
11.	Hengeveld E, Banks K. Maitland’s peripheral manipulation. 4th ed. London, Britain: Elsevier Butterworth Heinman, 2014: 127-217.
12.	吴伟, 黄粉燕, 林彩娜, 等. 《肩关节疼痛与功能障碍指数中文版》在肩痛患者中的信度与效度分析. 中国康复医学杂志, 2013, 28(9): 846-848.
13.	Earls J, Myers T. 筋膜释放技术—身体结构平衡调整. 瓮长水, 张丹玥, 王娜, 等, 译. 北京: 北京科学技术出版社, 2018: 211-244.
14.	Butler D. The neurodynamic techniques. Adelaide, Australia: Noigroup Publications, 2005: 33-72.
15.	Davies C, Davies A, Simons DG. The trigger point therapy workbook. 3rd ed. California, United States: New Harbinger Publications, 2013: 6-129.
16.	Donatelli RA. 肩关节物理治疗. 5 版. 张安仁, 金荣疆, 罗绯, 译. 北京: 人民军医出版社, 2015: 133-136, 297-305.
17.	Hanchard NC, Goodchild L, Thompson J, et al. Evidence-based clinical guidelines for the diagnosis, assessment and physiotherapy management of contracted (frozen) shoulder: quick reference summary. Physiotherapy, 2012, 98(2): 117-120.
18.	Kelley MJ, Shaffer M, Kuhn JE, et al. Shoulder pain and mobility deficits: adhesive capsulitis. J Orthop Sports Phys Ther, 2013, 43(5): A1-31.
19.	王艳华, 陈建海. 凝肩: ISAKOS 上肢委员会专家共识(下). 中华肩肘外科电子杂志, 2017, 5(1): 61-65.
20.	Haughton DN, Barton S, Meenan E, et al. Can we improve the outcome of hydrodilatation for adhesive capsulitis?. Shoulder Elbow, 2018, 10(2): 93-98.
21.	中国医师协会超声医师分会. 中国医师协会超声医师分会指南丛书: 中国肌骨超声检查指南. 北京: 人民卫生出版社, 2017: 5-17.
22.	Spinner DA, Kirschner JS, Herrera JE. 超声引导下肌肉骨骼注射图解. 罗文, 张云飞, 译. 北京: 世界图书出版公司, 2018: 7-30.
23.	Georgiannos D, Markopoulos G, Devetzi E, et al. Adhesive capsulitis of the shoulder. Is there consensus regarding the treatment? A comprehensive review. Open Orthop J, 2017, 11: 65-76.
24.	Schiefer M, Teixeira P, Fontenelle C, et al. Prevalence of hypothyroidism in patients with frozen shoulder. J Shoulder Elbow Surg, 2017, 26(1): 49-55.
25.	Liao W, He X, Du Z, et al. The synergistic effects of applying pulsed radiofrequency lesioning of the suprascapular nerve plus physical therapy on pain and function in patients with adhesive capsulitis: a protocol of a prospective, randomized, controlled trial. Medicine (Baltimore), 2021, 100(14): e25431.
26.	Redler LH, Dennis ER. Treatment of adhesive capsulitis of the shoulder. J Am Acad Orthop Surg, 2019, 27(12): e544-e554.
27.	Wu H, Tian H, Dong F, et al. The role of grey-scale ultrasound in the diagnosis of adhesive capsulitis of the shoulder: a systematic review and meta-analysis. Med Ultrason, 2020, 22(3): 305-312.
28.	Cho CH, Min BW, Bae KC, et al. A prospective double-blind randomized trial on ultrasound-guided versus blind intra-articular corticosteroid injections for primary frozen shoulder. Bone Joint J, 2021, 103-B(2): 353-359.
29.	Strakowski JA, Visco CJ. Diagnostic and therapeutic musculoskeletal ultrasound applications of the shoulder. Muscle Nerve, 2019, 60(1): 1-6.
30.	Cho CH, Lee YH, Kim DH, et al. Definition, diagnosis, treatment, and prognosis of frozen shoulder: a consensus survey of shoulder specialists. Clin Orthop Surg, 2020, 12(1): 60-67.
31.	Tveitå EK, Ekeberg OM, Juel NG, et al. Responsiveness of the shoulder pain and disability index in patients with adhesive capsulitis. BMC Musculoskelet Disord, 2008, 9: 161.

1. Tang HY, Wei W, Yu T, et al. Physical therapy for the treatment of frozen shoulder: a protocol for systematic review of randomized controlled trial. Medicine (Baltimore), 2019, 98(32): e16784.
2. Wong CK, Levine WN, Deo K, et al. Natural history of frozen shoulder: fact or fiction? A systematic review. Physiotherapy, 2017, 103(1): 40-47.
3. Mertens MG, Meeus M, Verborgt O, et al. An overview of effective and potential new conservative interventions in patients with frozen shoulder. Rheumatol Int, 2021, 6(9): 57-68.
4. 王艳华, 陈建海. 凝肩: ISAKOS 上肢委员会专家共识(上). 中华肩肘外科电子杂志, 2016, 4(4): 236-242.
5. Challoumas D, Biddle M, McLean M, et al. Comparison of treatments for frozen shoulder: a systematic review and meta-analysis. JAMA Netw Open, 2020, 3(12): e2029581.
6. Zavala-González J, Pavez-Baeza F, Gutiérrez-Espinoza H, et al. The effectiveness of joint mobilization techniques for range of motion in adult patients with primary adhesive capsulitis of the shoulder: a systematic review and meta-analysis. Medwave, 2018, 18(5): e7265.
7. 周玉兰, 袁德超, 吴超, 等. 超声引导下肩关节腔注射联合液压扩张治疗不同临床分期冻结肩. 华西医学, 2021, 36(12): 1679-1685.
8. 栗平, 王东海, 郭芳芳, 等. 超声引导液压松解盂肱关节囊联合康复训练治疗冻结肩的临床效果. 中国医学影像学杂志, 2020, 28(4): 285-289.
9. Rex SS, Kottam L, McDaid C, et al. Effectiveness of interventions for the management of primary frozen shoulder: a systematic review of randomized trials. Bone Jt Open, 2021, 2(9): 773-784.
10. Lädermann A, Piotton S, Abrassart S, et al. Hydrodilatation with corticosteroids is the most effective conservative management for frozen shoulder. Knee Surg Sports Traumatol Arthrosc, 2021, 29(8): 2553-2563.
11. Hengeveld E, Banks K. Maitland’s peripheral manipulation. 4th ed. London, Britain: Elsevier Butterworth Heinman, 2014: 127-217.
12. 吴伟, 黄粉燕, 林彩娜, 等. 《肩关节疼痛与功能障碍指数中文版》在肩痛患者中的信度与效度分析. 中国康复医学杂志, 2013, 28(9): 846-848.
13. Earls J, Myers T. 筋膜释放技术—身体结构平衡调整. 瓮长水, 张丹玥, 王娜, 等, 译. 北京: 北京科学技术出版社, 2018: 211-244.
14. Butler D. The neurodynamic techniques. Adelaide, Australia: Noigroup Publications, 2005: 33-72.
15. Davies C, Davies A, Simons DG. The trigger point therapy workbook. 3rd ed. California, United States: New Harbinger Publications, 2013: 6-129.
16. Donatelli RA. 肩关节物理治疗. 5 版. 张安仁, 金荣疆, 罗绯, 译. 北京: 人民军医出版社, 2015: 133-136, 297-305.
17. Hanchard NC, Goodchild L, Thompson J, et al. Evidence-based clinical guidelines for the diagnosis, assessment and physiotherapy management of contracted (frozen) shoulder: quick reference summary. Physiotherapy, 2012, 98(2): 117-120.
18. Kelley MJ, Shaffer M, Kuhn JE, et al. Shoulder pain and mobility deficits: adhesive capsulitis. J Orthop Sports Phys Ther, 2013, 43(5): A1-31.
19. 王艳华, 陈建海. 凝肩: ISAKOS 上肢委员会专家共识(下). 中华肩肘外科电子杂志, 2017, 5(1): 61-65.
20. Haughton DN, Barton S, Meenan E, et al. Can we improve the outcome of hydrodilatation for adhesive capsulitis?. Shoulder Elbow, 2018, 10(2): 93-98.
21. 中国医师协会超声医师分会. 中国医师协会超声医师分会指南丛书: 中国肌骨超声检查指南. 北京: 人民卫生出版社, 2017: 5-17.
22. Spinner DA, Kirschner JS, Herrera JE. 超声引导下肌肉骨骼注射图解. 罗文, 张云飞, 译. 北京: 世界图书出版公司, 2018: 7-30.
23. Georgiannos D, Markopoulos G, Devetzi E, et al. Adhesive capsulitis of the shoulder. Is there consensus regarding the treatment? A comprehensive review. Open Orthop J, 2017, 11: 65-76.
24. Schiefer M, Teixeira P, Fontenelle C, et al. Prevalence of hypothyroidism in patients with frozen shoulder. J Shoulder Elbow Surg, 2017, 26(1): 49-55.
25. Liao W, He X, Du Z, et al. The synergistic effects of applying pulsed radiofrequency lesioning of the suprascapular nerve plus physical therapy on pain and function in patients with adhesive capsulitis: a protocol of a prospective, randomized, controlled trial. Medicine (Baltimore), 2021, 100(14): e25431.
26. Redler LH, Dennis ER. Treatment of adhesive capsulitis of the shoulder. J Am Acad Orthop Surg, 2019, 27(12): e544-e554.
27. Wu H, Tian H, Dong F, et al. The role of grey-scale ultrasound in the diagnosis of adhesive capsulitis of the shoulder: a systematic review and meta-analysis. Med Ultrason, 2020, 22(3): 305-312.
28. Cho CH, Min BW, Bae KC, et al. A prospective double-blind randomized trial on ultrasound-guided versus blind intra-articular corticosteroid injections for primary frozen shoulder. Bone Joint J, 2021, 103-B(2): 353-359.
29. Strakowski JA, Visco CJ. Diagnostic and therapeutic musculoskeletal ultrasound applications of the shoulder. Muscle Nerve, 2019, 60(1): 1-6.
30. Cho CH, Lee YH, Kim DH, et al. Definition, diagnosis, treatment, and prognosis of frozen shoulder: a consensus survey of shoulder specialists. Clin Orthop Surg, 2020, 12(1): 60-67.
31. Tveitå EK, Ekeberg OM, Juel NG, et al. Responsiveness of the shoulder pain and disability index in patients with adhesive capsulitis. BMC Musculoskelet Disord, 2008, 9: 161.

West China Medical Journal

Observation on the application effect of early rehabilitation procedure of frozen shoulder incorporating high-frequency ultrasound technology

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