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FOTO Rehab Outcomes Blog

Which Approach is Better for Frozen Shoulder?

No, frozen shoulders are not cold.... 'tis getting close to the winter season and I have snow on the brain.

Of all the types of problems patients may have, I have the most difficult time treating a patient who has adhesive capsulitis. I can see the pain they are experiencing when I look into their eyes as they perform various activities in the clinic. I found this abstract interesting because it focused on patients being active. The downside: it only looked at 10 days of therapy and then 3 months later. I'm not quite sure if the improvement between the two groups was clinically relevant.

Below you will find a quick view of the abstract. 


Activity- vs. structural-oriented treatment approach for frozen shoulder: a randomized controlled trial.




To compare the short- and long-term effects of a structural-oriented (conventional) with an activity-oriented physiotherapeutic treatment in patients with frozen shoulder.


Double-blinded, randomized, experimental study.


Outpatient clinic.


We included patients diagnosed with a limited range of motion and pain in the shoulder region, who had received a prescription for physiotherapy treatment, without additional symptoms of dizziness, a case history of headaches, pain and/or limited range of motion in the cervical spine and/or temporomandibular joint.


The study group received treatment during the performance of activities. The comparison group was treated with manual therapy and proprioceptive neuromuscular facilitation (conventional therapy). Both groups received 10 days of therapy, 30 minutes each day.


Range of motion, muscle function tests, McGill pain questionnaire and modified Upper Extremity Motor Activity Log were measured at baseline, after two weeks of intervention and after a three-month follow-up period without therapy.


A total of 66 patients were randomized into two groups: The activity-oriented group ( n = 33, mean = 44 years, SD = 16 years) including 20 male (61%) and the structural-oriented group ( n = 33, mean = 47 years, SD = 17 years) including 21 male (64%). The activity-oriented group revealed significantly greater improvements in the performance of daily life activities and functional and structural tests compared with the group treated with conventional therapy after 10 days of therapy and at the three-month follow-up ( p < 0.05).


Therapy based on performing activities seems to be more effective for pain reduction and the ability to perform daily life activities than conventional treatment methods.

 2017 May;31(5):686-695. doi: 10.1177/0269215516687613. Epub 2017 Jan 13.

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