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What is the optimum rehabilitation for patients who have undergone release procedures for frozen shoulder? A UK survey

What is the optimum rehabilitation for patients who have undergone release procedures for frozen shoulder? A UK survey
What is the optimum rehabilitation for patients who have undergone release procedures for frozen shoulder? A UK survey

Objective: despite usually being considered necessary, the rehabilitation regime that optimises outcomes for patients following release procedures for frozen shoulder has not been established and no accepted best practice guidelines currently exist. The purpose of this study was to gain insight into what physiotherapists considered best practice and factors they considered likely to affect patient outcome. 

Methods: a cross-sectional, self-administered online questionnaire was developed and distributed to UK based Physiotherapists, undergraduate students and support workers via email, social media and professional networks. 

Results: 260 eligible and fully completed surveys were received. Clear preference for early (within 72 h), frequent (2–3 times per week or weekly) and prolonged (greater than 6 weeks) treatment delivered in a 1:1 setting was expressed. 99% were highly likely/likely to advocate education and advice, range of movement exercises (99.6%), stretching (73.5%) and strengthening (61.9%). More passive modalities (manual therapy, massage, electrotherapy, acupuncture) were highly unlikely/unlikely to be used and lack of manual therapy and insufficient contact with a physiotherapist were the reasons deemed least likely to affect outcome. Most clinicians (89.2%) were likely to prescribe exercises that patients reported as painful but persistent pain and poor adherence by patients to exercises were the top reasons given for poor outcome along with psychological and psychosocial patient characteristics. 

Conclusion: physiotherapists consistently advocate early, frequent, prolonged, 1:1 treatment following release procedures for frozen shoulder. Most patients are discharged whilst still experiencing symptoms, particularly pain. Further work is needed to establish high value pathways for this patient group.

Frozen shoulder, Physiotherapy, Post-operative physiotherapy, Post-surgical rehabilitation, Rehabilitation
2468-8630
Willmore, Elaine
e76cad36-3ae1-445b-a0e9-5e3b38b158b0
McRobert, Cliona
930a484a-56d9-4a55-9f52-a9a24d67e72d
Foy, Chris
f01516ad-5692-41d8-b8f4-b5261ca33fee
Stratton, Irene
772f25b9-23c0-4240-a3f6-1e76b03b172f
van der Windt, Danielle
a51e943b-e0ed-4aba-9d2d-5e0c7a3e7aee
Willmore, Elaine
e76cad36-3ae1-445b-a0e9-5e3b38b158b0
McRobert, Cliona
930a484a-56d9-4a55-9f52-a9a24d67e72d
Foy, Chris
f01516ad-5692-41d8-b8f4-b5261ca33fee
Stratton, Irene
772f25b9-23c0-4240-a3f6-1e76b03b172f
van der Windt, Danielle
a51e943b-e0ed-4aba-9d2d-5e0c7a3e7aee

Willmore, Elaine, McRobert, Cliona, Foy, Chris, Stratton, Irene and van der Windt, Danielle (2021) What is the optimum rehabilitation for patients who have undergone release procedures for frozen shoulder? A UK survey. Musculoskeletal Science and Practice, 52, [102319]. (doi:10.1016/j.msksp.2021.102319).

Record type: Article

Abstract

Objective: despite usually being considered necessary, the rehabilitation regime that optimises outcomes for patients following release procedures for frozen shoulder has not been established and no accepted best practice guidelines currently exist. The purpose of this study was to gain insight into what physiotherapists considered best practice and factors they considered likely to affect patient outcome. 

Methods: a cross-sectional, self-administered online questionnaire was developed and distributed to UK based Physiotherapists, undergraduate students and support workers via email, social media and professional networks. 

Results: 260 eligible and fully completed surveys were received. Clear preference for early (within 72 h), frequent (2–3 times per week or weekly) and prolonged (greater than 6 weeks) treatment delivered in a 1:1 setting was expressed. 99% were highly likely/likely to advocate education and advice, range of movement exercises (99.6%), stretching (73.5%) and strengthening (61.9%). More passive modalities (manual therapy, massage, electrotherapy, acupuncture) were highly unlikely/unlikely to be used and lack of manual therapy and insufficient contact with a physiotherapist were the reasons deemed least likely to affect outcome. Most clinicians (89.2%) were likely to prescribe exercises that patients reported as painful but persistent pain and poor adherence by patients to exercises were the top reasons given for poor outcome along with psychological and psychosocial patient characteristics. 

Conclusion: physiotherapists consistently advocate early, frequent, prolonged, 1:1 treatment following release procedures for frozen shoulder. Most patients are discharged whilst still experiencing symptoms, particularly pain. Further work is needed to establish high value pathways for this patient group.

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More information

Accepted/In Press date: 4 January 2021
e-pub ahead of print date: 13 January 2021
Published date: 12 February 2021
Additional Information: Funding Information: No direct funding was received for this study but was supported by HEE/NIHR Masters to Doctorate Bridging Programme in association with Birmingham Health Partners and a British Elbow and Shoulder Society (BESS) AHP Fellowship.
Keywords: Frozen shoulder, Physiotherapy, Post-operative physiotherapy, Post-surgical rehabilitation, Rehabilitation

Identifiers

Local EPrints ID: 487236
URI: http://eprints.soton.ac.uk/id/eprint/487236
ISSN: 2468-8630
PURE UUID: 841ba4b7-7ee1-4a23-a3a7-e41af6a81dc9
ORCID for Irene Stratton: ORCID iD orcid.org/0000-0003-1172-7865

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Date deposited: 16 Feb 2024 13:42
Last modified: 18 Mar 2024 04:01

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Contributors

Author: Elaine Willmore
Author: Cliona McRobert
Author: Chris Foy
Author: Irene Stratton ORCID iD
Author: Danielle van der Windt

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