Reviewed by Tyler Tice, PT, DPT, OCS, ATC
Introduction
Adhesive Capsulitis or Frozen Shoulder Syndrome is characterized by pain and stiffness of the glenohumeral joint. However, knowledge on its disease progression, and optimal therapy timing is currently limited. Additionally, most research addresses the direct limitations of the glenohumeral joint. This randomized control trial seeks to address the abnormal rhythm of the scapula through functional scapular stabilization training. Researchers hypothesized that those participating in functional scapular stabilization training would show more improvement in pain and function compared to standard physical therapy, focusing on GH mobilization and increasing range of motion.
Methods
The study includes 86 patients (between the age of 40 and 65) who were diagnosed with non traumatic frozen shoulder syndrome and demonstrated more than 50% loss in external rotation range of motion and limitations in other directions. Each participant was randomized and allocated into two groups: intervention (functional stabilization training) and control (standard physical therapy: mobilizations, stretching). Exercise compliance and pain levels were monitored throughout the study. The main difference in exercises was activating scapular stabilizers vs rotator cuff muscles. The primary measures used were the SPADI and Numeric Pain Scale.
Results
Seventy-six out of 86 participants completed the treatment/study (38 in each group). By the end of 12 weeks, there was a significant difference in SPADI score, the NPRS, and external rotation between the intervention vs control group.
Discussion
Those within the scapular stabilization group showed greater improvement in self-reported function, pain and external rotation when compared to those who received standard physiotherapy over 12 weeks. This is one of the first studies comparing functional scapular stabilization treatment protocol to standard physical therapy for those with adhesive capsulitis of the shoulder. The thought is that focusing on retraining scapulohumeral rhythm will result in improvements in function due to reducing the stress on the GH joint.
Conclusion
The study suggests that a combination of standard physical therapy and functional scapular stabilization training is effective in reducing pain and improving function and external rotation ROM of the shoulder for those with frozen shoulder syndrome.
References
Karnawat, S., Harikesavan, K., & Venkatesan, P. (2023). Effect of Functional Scapular Stabilization Training on Function and Pain in Frozen Shoulder Syndrome: A Randomized Controlled Trial. Journal of Manipulative and Physiological Therapeutics, 46(2), 86-97. https://doi.org/10.1016/j.jmpt.2023.05.008