Immediate Effects of A Treatment Program Specific to Shoulder Muscles for Patients with Frozen Shoulder

• Main Authors: Lee Chun-Shou, 李君碩
• Other Authors: Tzyy-Jiuan Wang
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/65538767839133232931

碩士 === 國立陽明大學 === 物理治療暨輔助科技學系 === 98 === Background and Objectives: Management of frozen shoulder today is still a challenging task for health practitioners. Physical therapy has been considered an appropriate treatment for subjects with frozen shoulder, in which joint mobilization techniques form an important part of the intervention. The rationale for treating frozen shoulder is based on the anatomical findings on surgery tables where capsular fibrosis with thickening and shortening was found. However, the role of muscle tightness as a primary limiting factor has not been fully investigated in the literature. Therefore, the effect of muscle stretching programs to frozen shoulder is unclear. The purpose of this study were to 1) determine the immediate effectiveness of a specific soft tissue stretching program on decreasing muscle stiffness and increasing shoulder mobility for patients with frozen shoulder; 2) investigate the correlations between muscle stiffness and shoulder range of motion (ROM) for patients with frozen shoulder. Design: One group pretest-posttest design. Methods: Twenty-eight patients with thirty phase-II frozen shoulders were recruited. All subjects received a soft tissue release program emphasizing on muscle stretching for one time. Outcome measures including active and passive shoulder range of motion (flexion, abduction, external rotation, internal rotation and hand behind back), muscle stiffness (pectoralis major, both the clavicular part and sternocostal part, teres major, infraspinatus and upper trapezius) were performed before and after the treatment. Statistical Analyses: Paired t-tests were used to examine the differences before and after the treatment in all outcome measures. Pearson correlation coefficients were used to examine the correlations between shoulder range of motions and stiffness of related muscles. The level of statistical significance was set at p < 0.05 for each test. Results: With one time intervention significant improvement of shoulder mobility for all directions could be achieved (p<0.001). We also found moderate positive correlations between the muscle stiffness of the clavicular part of pectoralis major and the range of the hand behind back test. Moderate positive correlation was also found between the difference of the muscle stiffness of teres major of bilateral sides and the difference of the shoulder flexion of bilateral sides. Discussion and Conclusion: One time specific muscular-stretched program could improve shoulder mobility in patients with frozen shoulder. The progression of ROM of flexion may be related to the reduction of muscle stiffness of teres major.