Prognostic factors and therapeutic options for treatment of frozen shoulder: a systematic review
- 2k Downloads
To evaluate the current status of scientific research on the natural history of frozen shoulder as published in the literature.
Materials and methods
This systematic review was carried out on PubMed data and was guided by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Articles had to meet inclusion criteria. The quality of the papers was assessed using a newly developed tool, AMQPP (Assessing the Methodological Quality of Published Papers). The AMQPP score was correlated with the level of evidence rating according to the Oxford Centre for Evidence-Based Medicine. Suitable papers were divided into groups according to the shoulder condition on which they reported. This article focuses on the frozen shoulder.
Seven articles on frozen shoulder met the inclusion criteria. One article was considered to have level 1 of evidence. Three articles had level 3 and the remaining 3 had level 4. Three papers assessed the natural history and the natural course of different forms of stiff shoulder. The others indirectly assessed the natural history by evaluating therapy trends. None of the articles clearly referred to the role of regression to the mean of frozen shoulder specifically.
Spontaneous recovery to normal levels of function is possible and standardised non-operative treatment programmes are an effective alternative to surgery in most cases. However, patients with high risk factors such as diabetes mellitus, and those who suffer chronic symptoms or bilaterally affected, would benefit from early surgery. We also concluded that AMQPP score is simple and straight forward. It works as a quick quality-checking tool which helps researchers to identify the key points in each paper and reach a decision regarding the eligibility of the paper more easily. The AMQPP score is still open for further development.
KeywordsNatural history Frozen shoulder Stiff shoulder Adhesive capsulitis Non-operative therapy Regression to the mean AMQPP assessment tool
Compliance with ethical standards
Conflict of interest
There are no competing interests (financial/potential influence the contents/other relationships or activities) involved in this work.
- 3.Neviaser JS (1945) Adhesive capsulitis of the shoulder: study of pathological findings in periarthritis of the shoulder. J Bone Joint Surg Am 27:211Google Scholar
- 18.Coleman BD, Khan KM, Maffulli N, Cook JL, Wark JD (2000) Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies. Victorian institute of sport tendon study group. Scand J Med Sci Sports 10(1):2–11PubMedCrossRefGoogle Scholar