Frozen Shoulder Clinical Trial
Official title:
The Study of Different Treatment Programs for Patients With Frozen Shoulder
The purpose of this study is to investigate and compare different treatment programs for
frozen shoulder by evaluating changes in pain scale and shoulder range of motion(ROM) before
and after treatment.
The investigators define frozen shoulder as shoulder pain with ROM limitation,shoulder
arthrography demonstration of at least two of the following criteria:(1)reduced joint volume
under 10ml; (2)irregular capsular margin;(3)diminished or absent axillary recess.
Afer define diagnosis of frozen shoulder ,patients are randomly assigned to different
Subgroups for different treatment programs.Each subgroup consists of ten patients.
Each treatment program performed for 6 consecutive courses with each course consists of 6
days.Total 36 treatment days.
The treatment programs and grouping as follow:
Group 1:Physical modalities + therapeutic exercise Group 2:Physical modalities + therapeutic
exercise+ intra-articular injection of steroid Gouup 3:Therapeutic exercise Before
treatment,after each consecutive course (6days) of treatment,and at the end of treatment
program, the investigators evaluate the range of motion and muscle strength of shoulder
flexion,external rotation,abduction and internal rotation. Severity of shoulder pain also
evaluated by pain scale before and after treatment program.
The ROM before and after treatment program is compared by paired t-test.The ROM change
before and after treatment in different groups compared by analysis of variance(ANOVA). The
ROM change after consecutive treatment courses(6 days) are compared by multivariate
ANOVA.Pain scale before and after treatment is compared by paired t-test.
(A) Diagnosis: Patients with shoulder pain onset within 6 months are included in our study
to evaluate shoulder range of motion (ROM) in flexion, external rotation,abduction and
internal rotation by goniometer(9).Restriction in ROM is noted.Cases with possible diagnosis
of frozen shoulder is arranged to receive shoulder arthrography(10,11,12)which is performed
by the administration of contrast media(2ml) into joint space,followed by injection of
air.Injection is discontinued when resistance is felt.The joint space capacity is defined as
the total volume of contrast media and air that could be injected without resistance.All
procedures are conducted by the same well experienced radiologist to keep measurement
reproducible.The arthrographic findings should met at least two of the following criteria
for final diagnosis of frozen shoulder:(1)joint space capacity less than
10ml;(2)irregularity of capsular margin; (3)diminished or absent axillary recess.Once frozen
shoulder is confirmed,the patient is randomly arranged to receive a specific treatment
program.
(B) Treatment program:
The treatment program and grouping arranged as follow:
Group 1:Physical modalities + therapeutic exercise Group 2:Physical modalities + therapeutic
exercise+ intra-articular injection of steroid Gouup 3:Therapeutic exercise
(C) Sample size estimation: We assume α=0.05,power=1-α=0.95,from previous
literature(10),change of ROM in flexion, abduction, external rotation, internal rotation
before and after treatment was estimated as 40,40,40,20 degrees respectively,,standard
deviation was 10,15,10,10 degrees respectively.Therefore,standard effective size was
4,2.6,4,2 respectively.From applied linear statistical models(13)fourth edition,1996,if
α=0.05 sample size estimated as 5,7,5,10 Respectively.Therefore,sample size in each group is
estimated as 10.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind, Primary Purpose: Treatment
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