Friday, August 28, 2009

More on frozen shoulder & techniques of frozen shoulder mobilization (1)

Types of FS:

Idiopathic FS- When no secondary causes are attributed or no cause can be assigned to the onset.
Secondary FS: FS as a result of diabetes, cardiac problems, stroke, rheumatoid arthritis, or trauma.

Phases of FS:

Reeves documented 3 phases with which to address the progression of FSS: the pain phase, the stiffness phase, and the recovery phase.

To regain the normal extensibility of the shoulder capsule and tight soft tissues, passive stretching contrast to active stretching of the shoulder capsule and soft tissues by means of mobilization techniques has been recommended.

The in-vogue techniques encompasses
1. Midrange mobilization (MRM)- recommended by Maitland
2. End-range mobilization (ERM)- recommended by Kaltenborn
3. Mobilization with movement techniques (MWMs)- recommended by Mulligan

However these above recommended techniques for FS base are not based on research they are rather suggestions. Yang et al investigated the effect of mobilization treatment and to determine whether a difference of treatment efficacy exists among 3 mobilization techniques (MRM, ERM, and MWM) in patients with idiopathic 2nd phase FS. They found:
1. Co-intervention of MWM and ERM treatment techniques may be more beneficial.
2. Cumulative effects of mobilizations may be expected
3. Total 2 visits per week to the physiotherapist for total mobilization for 12 visits are more reasonable for application to normal clinical practice.

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