International Journal of Scientific & Technology Research

Home About Us Scope Editorial Board Blog/Latest News Contact Us
10th percentile
Powered by  Scopus
Scopus coverage:
Nov 2018 to May 2020


IJSTR >> Volume 3- Issue 6, June 2014 Edition

International Journal of Scientific & Technology Research  
International Journal of Scientific & Technology Research

Website: http://www.ijstr.org

ISSN 2277-8616

Efficacy Of Physiotherapy On Adhesive Capsulitis Of Shoulder In Diabetic And Non-Diabetic Patients

[Full Text]



Ali Shawesh, Hesham Nashnoush



Key Words: Adhesive capsulitis, Physical therapy, diabetes mellitus, mobilization.



Abstract: Background and Purpose: Shoulder stiffness is one of the common clinical conditions which affect both diabetic and non diabetic of both genders as a primary or secondary problem. However the improvement varies between diabetic and non diabetic following physiotherapy. The purpose of this study was to compare the effectiveness physiotherapy (mobilization techniques and interferential therapy) in diabetic and non diabetic subjects with adhesive capsulitis of the shoulder. Subjects and Methods: Thirty patients (15 with diabetes mellitus, fasting blood glucose ≥127mg/dl, and 2hr blood glucose is ≥l80 mg/dl, and 15 with non-diabetes). They had unilateral adhesive capsulitis, lasting more than three months and ≥ 30% loss of passive movement of the shoulder joint compared to the non-affected side. Pain with motion with a minimum visual analogue scale (VAS) score of 5. Subjects assigned to the diabetic and non diabetic groups were treated with interferential therapy, mobilization techniques and home exercise programme. The duration of treatment was 10 days in both groups. Assessment of patients was at first and at 3, 5, 7 and 10 days by visual analogue scale (VAS), for pain intensity and goniometer for shoulder range of motion (abduction and external rotation). Results: The mean age, duration of symptoms, ratios of sex were similar in the two groups. Comparison of the initial pain scores and ROM values between the two groups revealed no statistical significance (P >0. 05). The mean changes in pain scores values and shoulder range of motion abduction and external rotation revealed highly statistical significant (P<0. 01), reduction. Improvement in pain, shoulder range of motion abduction and external rotation were, however; significantly better in the non diabetic group. Discussion and Conclusion: In subjects with adhesive capsulitis of the shoulder, physiotherapy appear to be more effective in improving shoulder joint mobility and pain in non-diabetic than diabetic during short period follow up.



[1]. Green, S., Buchbinder, R., Glazier, R. and Forbes, A.: “Interventions for shoulder pain” Cochrane Database of Systematic Reviews CD001156, 2000.

[2]. Wolf, J.M. and Green, A.: “Influence of comorbidity of self-assessment instrument scores of patients with idiopathic adhesive capsulitis” J Bone Joint Surg Am 84: 1167-72, 2002.

[3]. Mao, C.Y., Jaw, W.C. and Cheng, H.C.: “Frozen shoulder: correlation between the response to physical therapy and follow-up shoulder arthrography” Arch Phys Med Rehabil 78: 857-859, 1997.

[4]. Reeves, B.: “The natural history of the frozen shoulder syndrome” Scand J Rheuniatol 1975;4:193-196, 1975.

[5]. Sattar, M.A. and Luqman, W.A.: “Periarthritis: another duration related complication of diabetes mellitus” Diabetes Care, 8: 507-10, 1985.

[6]. Arkkila, P.E.T., Kantola, I.M., Viikaii, SA. and Ronnernaa, T.: “Shoulder capsulitis in type I and II diabetic patients: association with diabetic complications and related diseases” Ann Rheum Dis, 55: 907-914, 1996.

[7]. WHO: Expert committee on diabetes mellitus; second report, technical report series 646 Geneva, World Health organization, 1980.

[8]. Guler-Uysal, F. and Kozanoglu, E.: “Comparison of the early response to two methods of rehabilitation in adhesive capsulitis” Swiss Med wkly 134:353—358, 2004.

[9]. Van den Hout, W.B., Vermeulen, H.M., Rozing, P.M. and Vlieland, T.P.M.: “Impact of adhesive capsulitis and economic evaluation of high-grade and low-grade mobilization techniques” Australian Journal of Physiotherapy, 51: 141—149, 2005.

[10]. Maitland, GD.: “Treatment of the glenohumeral joint by passive movement” Physiotherapy, 69: 3-7, 1983.

[11]. Vermeulen, H.M., Obermann, W.R., Burger, B.J., Kok, G.J., Rozing, P.M. and van den Ende, C.H.: “End-range mobilization techniques in shoulder joint: A multiple-subject case report” Physical Therapy, 80: 1204-1213, 2000.

[12]. Erickson, R.P. and McPhee, MC.: “Clinical Evaluation” In: DeLisa JA, Gans BM, eds. Rehabilitation Medicine Principals and Practice, Philadelphia: Lippincott-Raven; 6 1 -108, 1998.

[13]. Reichmister, J.P. and Friedman, S.L.: “Long- term functional results after manipulation of the frozen shoulder” Md Med J, 48: 7—1 1, 1999.

[14]. Noel, G., Verbruggen, L.A., Barbaix, E. and Duquet, W.: “Adding compression to mobilization in a rehabilitation program after . knee surgery: a preliminary clinical observational study” Man Ther., 5: 102-107, 2000.

[15]. Vermeulen, H.M., Rozing, P.M. and Obermann, W.R.: “Comparison of high-grade and low-grade mobilization techniques in the management of adhesive capsulitis of the shoulder: randomized controlled trial” Phys Ther., 86: 355—368, 2006.

[16]. Shinabarger, N.I.: “Limited joint mobility in adults with diabetes mellitus” Phys There., 67: 215-218, 1987.