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