Medicina (Kaunas) 2005; 41 (1): 30-38
Shoulder function in patients with frozen shoulder before and after 4-week rehabilitation
Jelena Jürgel1, 3, Lauri Rannama2, Helena Gapeyeva1, Jaan Ereline1, Ivo Kolts2, Mati Pääsuke1
1Institute of Exercise Biology and Physiotherapy, 2Department of Anatomy, 3Department of Sports Medicine and Rehabilitation, University of Tartu, Estonia
Key words: shoulder joint, range of motion, isometric strength, frozen shoulder.
Summary. This study evaluated changes in shoulder function in patients with frozen shoulder after 4-week rehabilitation combining exercise with electrical therapy and massage. Material and methods. Ten patients with frozen shoulder (mean ± standard error (SE) age 50.2±4.6 years) and 10 control subjects (49.8±4.6 years) participated in the study. Standard goniometric measurements were used to assess shoulder flexion, extension, abduction, adduction, internal and external rotation active range of motion. Isometric maximal force of the shoulder flexors, abductors, adductors, internal and external rotators was measured by hand-held dynamometer. Shoulder muscle isometric endurance was characterized by net impulse assessed during weight (30% of maximal force) holding in hand till exhaustion. Shoulder pain was assessed by visual analogue scale.
Results. Before rehabilitation, patients with frozen shoulder had less (p<0.05) active range of motion and shoulder muscle maximal force for all measured directions, and less (p<0.05) net impulse during shoulder muscle isometric endurance test for involved extremity compared to controls. In patients with frozen shoulder, shoulder flexion, abduction, adduction and adduction active range of motion, maximal force of shoulder muscles in all measured force directions and net impulse during shoulder muscle isometric endurance test for involved extremity increased (p<0.05) after rehabilitation. No significant changes in shoulder internal and external rotation active range of motion for involved extremity in patients with frozen shoulder were observed with rehabilitation. Conclusion. A 4-week rehabilitation program improved shoulder flexion, extension, abduction and adduction active range of motion in patients with frozen shoulder coupled with non-significant changes in external and internal rotation range of motion. A significant increase in shoulder muscle isometric strength and endurance and decrease in shoulder pain in patients with frozen shoulder was observed after treatment.
Correspondence to J. Jürgel, Institute of Exercise Biology and Physiotherapy, University of Tartu, Jakobi 5, 51014, Tartu, Estonia. E-mail: Jelena.Jyrgel@kliinikum.ee
Received 21 September 2004, accepted 20 October 2004