Adhesive Capsulitis also known as “frozen shoulder” is a painful condition characterized by gradual limitation of active and passive joint movements as a result of progressive fibrosis and excessive contracture of the glenohumeral joint capsule. Most commonly, patients will notice limitations in shoulder external rotation and abduction range of motion. This pathology affects about 2-5% of the population and frequently occurs in females between the ages of 40-60 years. Adhesive capsulitis is more common among patients with diabetes mellitus, thyroid dysfunction, Dupuytren’s contracture, myocardial infarction and those who have been treated for breast cancer. Typically, treatment for this pathology includes stretching, therapeutic exercises and use of modalities like heat to help loosen the soft tissue restrictions.
Mirror therapy is an easy, inexpensive and patient centered treatment method used to provide immediate functional feedback to patients. It has been proposed that pain originates from an incoordination between the motor commands of the brain and the visual and proprioceptive feedback. The aim of the treatment is to have the patient view the unaffected shoulder in the mirror while the affected shoulder also performs the exercise to help the brain realize motor commands can be pain free. The study by Baskaya et al., investigated the effect of mirror therapy in conjunction with standard physical therapy on shoulder range of motion, pain and quality of life in patients with adhesive capsulitis.
30 total participants
-15 in the mirror group
-15 in the control group
All participants underwent a standard physical therapy program for 10 sessions consisting of transcutaneous electrical nerve stimulation (TENS), ultrasound, shoulder isometrics, range of motion exercises, stretching and home exercise program. The mirror group performed the exercises with the reflective side of the mirror and the control group performed the exercise with the non-reflective side of the mirror. Pre-treatment and post-treatment assessments were taken of range of motion using a goniometer and pain using the visual analog scale.
The post treatment visual analog scale for pain was significantly lower in the mirror therapy group. The post treatment active/passive range of motion measurements were significantly higher in the mirror group compared to the control group.
The perception of pain is very complicated and varies greatly from person to person. Adhesive capsulitis is a diagnosis characterized with significant levels of pain and loss of active/passive range of motion which can last up to 2 years. The exact mechanism with which mirror therapy reduces pain is unclear but this study revealed that in the short term when mirror therapy is applied in conjunction with standard physical therapy methods for adhesive capsulitis it can reduce pain and improve joint range of motion, shoulder function and quality of life.
Baskaya MC, Ercalık C, Karatas Kır Ö, Ercalık T, Tuncer T. The efficacy of mirror therapy in patients with adhesive capsulitis: A randomized, prospective, controlled study. J Back Musculoskelet Rehabil. 2018;31(6):1177-1182. doi: 10.3233/BMR-171050. PMID: 30056414.