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An overview of effective and potential new conservative interventions in patients with frozen shoulder

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Abstract

Frozen shoulder (FS) is a pathology that is difficult to understand and difficult to manage. Over the last ten years, contradictory and new evidence is provided regarding the recovery and its natural course. This narrative review provides new information about the diagnosis and conservative treatment of patients with FS and ongoing research hypotheses that might provide new insights in the pathology and treatment options. FS has a characteristic course. People with Diabetes Mellitus and thyroid disorders have a higher risk of developing a FS. The diagnosis FS is based on pattern recognition and physical examination. Additionally, ‘rule-in’ and ‘rule-out’ criteria can be used to increase the likelihood of the frozen shoulder diagnosis. Recommended and most common physical therapy interventions are mobilization techniques and exercises, in which tissue irritability can guide its intensity. In addition, physical therapy is often complementary with patient education and pharmacotherapy. The latest evidence-based practice related to FS is proprioceptive neuromuscular facilitation and mirror therapy. In addition, interventions like pain neuroscience education, high-intensity interval training and lifestyle changes are still hypothetical. Finally, better insight in the involvement of biochemical processes, function of myofibroblasts and matrix metalloproteinases can provide better understanding in the pathophysiology and will be addressed in current review.

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Authors and Affiliations

  1. Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Wilrijk, Belgium

    Michel GCAM Mertens, Mira Meeus, Olivier Verborgt & Filip Struyf

  2. Pain in Motion International Research Group https://www.paininmotion.be

    Michel GCAM Mertens & Mira Meeus

  3. Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium

    Mira Meeus

  4. Department of Orthopedic Surgery and Traumatology, AZ Monica, Antwerp, Belgium

    Olivier Verborgt

  5. Department of Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands

    Eric H. M. Vermeulen

  6. Schuitemaker en Van Schaik Fysiotherapie en Manuele Therapie, Amsterdam, The Netherlands

    Ruud Schuitemaker

  7. Medisch Centrum Jan Van Goyen, Amsterdam, The Netherlands

    Karin M. C. Hekman

  8. Schoudercentrum IBC Amstelland, Amstelveen, The Netherlands

    Karin M. C. Hekman

  9. Fysiotherapie Oost Nederland (FYON), Enschede, The Netherlands

    Donald H. van der Burg

  10. Saxion Hogeschool, Enschede, The Netherlands

    Donald H. van der Burg

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  1. Michel GCAM Mertens
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  8. Filip Struyf
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Mertens, M.G., Meeus, M., Verborgt, O. et al. An overview of effective and potential new conservative interventions in patients with frozen shoulder. Rheumatol Int 42, 925–936 (2022). https://doi.org/10.1007/s00296-021-04979-0

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