Dutch Frozen Shoulder Study

SUMMARY


Rationale: Adhesive capsulitis (frozen shoulder) is a common cause of shoulder pain and affects approximately 2-4% of the general population. Corticosteroid injections and physiotherapy are among the most widely used treatment modalities in adhesive capsulitis, in both primary and secondary healthcare settings. According to the current literature, there is no consensus on the role of physiotherapy in the treatment of frozen shoulder. In other words, it is uncertain whether physiotherapy is of clinical relevant additional value above an intra-articular corticosteroid injection alone.

Objective: To evaluate the difference in functional outcome, measured by a patient self-reported outcome measure, the SPADI, after treatment of adhesive capsulitis with or without physiotherapy.

Study design: (multicenter) Prospective randomised trial

Study population: Adult patients with clinical signs and symptoms of a frozen shoulder presenting to the outpatient clinic of the department of orthopaedic surgery of the participating hospitals. Conservative treatment has failed in the previous three months. As part of the standard current practice, all patients with a frozen shoulder in both groups receive an ultrasound guided corticosteroid injection in the glenohumeral joint.

Intervention: A standardised physiotherapy program.

Main study parameters/endpoints: Primary outcome: Function, measured by the SPADI
Secondary outcomes: Pain (Numeric Pain Rating Scale). General health (RAND 36), ROM, patient perceived satisfaction (PPSI)

Nature and extent of the burden and risks associated with participation, benefit and group relatedness: Subjective scores to fill out, and an increased number of (non-invasive) measurements of the function of the shoulder. Follow up consists of three moments at 6 weeks, 3 months and 6 months. Participating physiotherapists will be provided with a written treatment protocol containing detailed guidelines for these frozen shoulder patients. The benefit of the study is to provide an answer to the question if we have to treat a patient with a frozen shoulder with a physiotherapy program after a corticosteroid injection. This trial can also aid in the development of a guideline for physiotherapist in the treatment of frozen shoulders. If physiotherapy appears to be of no additional value, this can save a lot of time, effort and money for patients and the healthcare system

A benificial effect of physiotherapy in the treatment of a frozen shoulder

6 weeks, 3 months, 6 months

Physiotherapy