Effects of manual therapy in patients with frozen shoulder – literature review

Uvod: Adhezivni kapsulitis ali sindrom zamrznjene rame je pogosta patologija ramenskega sklepa, katero spremljata bolečina ter zmanjšan pasivni in aktivni obseg gibljivosti v ramenskem sklepu. Najbolj je omejeno gibanje v smeri zunanje rotacije in abdukcije. Slednje otežuje posamezniku izvajanje dnevnih aktivnosti in zmanjša kakovost življenja. Sindrom zamrznjene rame prizadene 3 % do 5 % splošne populacije, bolj so k razvoju tega podvržene ženske. Fizioterapija je najpogosteje predpisana oblika zdravljenja pri pacientih s sindromom zamrznjene rame. Uporabljajo se različne oblike fizioterapevtskih postopkov, med njimi tudi manualna terapija. Namen: V diplomskem delu smo želeli prikazati učinke manualnih tehnik pri pacientih s sindromom zamrznjene rame. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo s sistematičnim pregledom literature. Literatura je bila iskana po podatkovnih zbirkah PubMed in PEDro, v časovnem okvirju od leta 2015 do 2020. Na podlagi tega je bilo izbranih sedem člankov v angleškem jeziku, v katerih so proučevali učinkovitost manualnih tehnik pri pacientih s sindromom zamrznjene rame. Rezultati: Uporaba različnih tehnik manualne terapije pri obravnavi pacientov s sindromom zamrznjene rame prinaša pozitivne učinke na zmanjšanje pojavnosti simptomov. Sklepna mobilizacija, mobilizacija lopatice, manualni razteg sklepne ovojnice in pristopi različnih avtorjev ter njihova kombinacija, pripomorejo k zmanjšanju bolečine, izboljšanju obsega gibljivosti, izboljšanju funkcije zgornjega uda ter posledično izboljšanju kakovosti pacientovega vsakdanjika. Razprava in zaključek: Pregled izbranih raziskav je pokazal, da so različne tehnike manualne terapije učinkovit del zdravljenja pacientov s sindromom zamrznjene rame. Četudi je sindrom zamrznjene rame pogosta patologija ramenskega sklepa, obstaja malo raziskav v povezavi z manualno terapijo. Nadaljnje raziskave so potrebne za razumevanje natančnega poteka in patogeneze bolezni. Ravno poznavanje pravilnega poteka bolezni prispeva k najboljši izbiri metod zdravljenja in uspešnosti. Prav tako so potrebne nadaljnje raziskave v katerih bodo avtorji primerjali različne manualne tehnike med seboj in s tem ugotovili katera izmed njih, je v primerjavi z drugimi, najučinkovitejša pri pacientih s sindromom zamrznjene rame.Introduction: Adhesive capsulitis or frozen shoulder syndrome is a common condition that affects the shoulder joint, characterized by stiffness and pain in the shoulder. Both the active and the passive range of motion are limited, especially with external rotation and abduction of the shoulder joint. All of these symptoms affect the individual’s daily activities and quality of life. Frozen shoulder affects 3 % to 5 % of the general population, women are more likely to develop it. Physiotherapy is the most common source of treatment for patients with frozen shoulder. Different forms of physiotherapy are used to treat frozen shoulder, such as manual therapy. Purpose: The purpose of this diploma work was to determine the effects of manual therapy in patients with frozen shoulder. Methods: In this diploma work we used a descriptive method with a systematic literature review. Literature was gathered using PubMed and PEDro. The search was limited to articles issued after 2015. We selected seven articles in English, published between 2015 and 2020 which analyzed the effectiveness of manual therapy in patients with frozen shoulder. Results: A variety of different techniques of manual therapy are known to have a positive effect on reducing symptoms of patients with frozen shoulder. Joint mobilization, mobilization of the scapula, manual stretch of the joint capsule, other concepts of different authors and the combination of them, contribute to reducing the pain, improving the range of motion and function of the arm and consequently improving the quality of life. Discussion and conclusion: The results of the examined articles have shown that different types of manual therapy techniques are an effective part of treating patients with frozen shoulder. Further research is required for better understanding of the etiology and pathophysiology of the frozen shoulder as this contributes to choosing the best treatment and the success of said treatment. Further research is also required to compare different techniques of manual therapy and to determine which one is the most effective in its treatment