The effect of muscle-biased manual therapy on shoulder kinematics, muscle performance, functional impairment, and pain in patients with frozen shoulder

Chun-Kai Tang; Yi-Fen Shih; Chun-Shou Lee

doi:10.1016/j.jht.2024.02.010

The effect of muscle-biased manual therapy on shoulder kinematics, muscle performance, functional impairment, and pain in patients with frozen shoulder

J Hand Ther. 2024 Jun 28:S0894-1130(24)00026-7. doi: 10.1016/j.jht.2024.02.010. Online ahead of print.

Authors

Chun-Kai Tang¹, Yi-Fen Shih², Chun-Shou Lee³

Affiliations

¹ Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan. Electronic address: cktang.be10@nycu.edu.tw.
² Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan. Electronic address: yfshih@nycu.edu.tw.
³ Division of Physical therapy, Department of Rehabilitation, Taipei City Hospital-Renai Branch, Taipei, Taiwan. Electronic address: A0019@tpech.gov.tw.

PMID: 38944638
DOI: 10.1016/j.jht.2024.02.010

Abstract

Background: Frozen shoulder (FS) is characterized by restricted active and passive shoulder mobility and pain.

Purpose: Compare the effect of muscle-biased manual therapy (MM) and regular physical therapy (RPT) in patients with FS.

Study design: Pretest-post-test control group study design.

Methods: We recruited 34 patients with FS and compared the effect of 12-session MM and RPT. The outcome measures were scapular kinematics and muscle activation, scapular alignment, shoulder range of motion, and pain intensity. Two-way analysis of variance was used to examine the intervention effect with α = 0.05.

Results: Both programs resulted in similar improvements in pain and shoulder function. Compared to the RPT, MM resulted in increased posterior tilt (MM: 7.04°-16.09°, RPT: -2.50° to -4.37°; p = 0.002; ES = 0.261) and lower trapezius activation (MM: 260.61%-470.90%, RPT: 322.64%-313.33%; p = 0.033; ES = 0.134) during scaption, and increased posterior tilt (MM: 0.70°-15.16°, RPT: -9.66° to -6.44°; p = 0.007; ES = 0.205) during the hand-to-neck task. The MM group also showed increased GH backward elevation (MM: 37.18°-42.79°, RPT: 43.64°-40.83°; p = 0.004, ES = 0.237) and scapular downward rotation (MM: -2.48° to 6.80°, RPT: 1.93°-1.44°; p < 0.001; ES = 0.404) during the thumb-to-waist task, enhanced shoulder abduction (MM: 84.6°-102.3°, RPT: 85.1°-92.9°; p = 0.02; ES = 0.153), and improved scapular alignment (MM: 10.4-9.65 cm, RPT: 9.41-9.56 cm; p = 0.02; ES = 0.114).

Conclusions: MM was superior to the RPT regarding scapular neuromuscular performance. Clinicians should consider adding muscle-biased treatment when treating FS.

Keywords: Frozen shoulder; Manual therapy; Muscle activation; Scapular kinematics.