Review article (meta-analysis)Effectiveness of Nonsurgical Interventions for Managing Adhesive Capsulitis in Patients With Diabetes: A Systematic Review
Section snippets
Description of the therapeutic interventions
The diagnostic criteria of AC such as the global loss of shoulder ROM and night pain have been common proposed previously by several experts.10 However, these clinical criteria were not found to be valid diagnostic signs of AC due to the lack of information about the first 3-6 months of this disorder.9, 10 Thus, there is uncertainty about AC diagnosis and natural history.9 The lack of understanding of early AC suggests that appropriate early treatment might be needed to avoid long-term
Study design
RCTs published in English or any other language were eligible for inclusion in this review.
Participants
Trials that included adult participants aged 18 years or older with a stated diagnosis of AC and diabetes (both types) were eligible to be included in this review. Because of the lack of a criterion standard for the diagnosis of AC, trials were included if it was stated that participants had pain and restriction in shoulder joint ROM in 1 or more planes.23 Studies that included participants with other
Characteristics of included studies
Our search strategy generated 165 articles on MEDLINE and 650 articles in total (fig 1). After applying the inclusion and exclusion criteria, 10 studies were eligible to be included. Of these 10 studies, 2 studies were excluded because the full study was not published (conference abstracts). Eight studies were evaluated, and data from these studies were extracted and summarized in table 1. Among these 8 studies, 2 studies were translated from Chinese33 and Persian34 languages into English
Discussion
This review revealed very low-quality RCTs (all at high risk of bias) that demonstrated benefits of a variety of nonsurgical treatments in managing shoulder pain, ROM, and function in diabetic patients with AC. Therefore, we have very little confidence in the effect estimates of these individual RCTs, or which treatments might be more beneficial.
In this systematic review, joint mobilization plus exercises,29 continuous passive motion with electrotherapy,28 and low-level laser therapy30
Conclusion
Very low-quality evidence indicated that a combination of physiotherapeutic interventions (exercises, modalities, mobilization), NSAIDs, and/or corticosteroid injections can have trivial to large effects in improving shoulder function or disability, ROM, and pain levels in managing AC in patients with diabetes. Future high-quality RCTs are needed to determine the best intervention for managing AC in patients with diabetes and to improve the confidence and precision of estimated effects.
Acknowledgments
We would like to thank Shirin Modarresi, PhDc, for translating 1 article from Persian language to English and Steve Lu for translating 1 article from Chinese language to English.
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Efficacy of Platelet-Rich Plasma Injection on Range of Motion, Pain, and Disability in Patients With Adhesive Capsulitis: A Systematic Review and Meta-analysis
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2022, Archives of Physical Medicine and RehabilitationCitation Excerpt :Although diagnosing disease stage is difficult, comparability of patients could be done with tissue irritability levels. Second, there is conflicting evidence whether patients with FS and diabetes mellitus have a worse prognosis for recovery,34,92-95 and therefore it is uncertain whether these studies can be compared to each other. There is a large heterogeneity in type of exercise (eg, supervised, home, strength training, ROM exercises) and dose between studies that provided exercise programs solely or as part of a treatment program.
Effectiveness of radial extracorporeal shock-wave therapy versus ultrasound-guided low-dose intra-articular steroid injection in improving shoulder pain, function, and range of motion in diabetic patients with shoulder adhesive capsulitis
2020, Journal of Shoulder and Elbow SurgeryCitation Excerpt :AC of the shoulder is a common comorbidity in diabetic patients with a significant impact on patients’ quality of life and worse outcomes than nondiabetic patients.25,37,41 A recent systematic review found a very low quality of evidence on nonsurgical interventions for managing shoulder AC in diabetic patients, including physiotherapeutic interventions (exercise, modalities, mobilization), nonsteroidal anti-inflammatory drugs, and/or corticosteroid injections.29 Radial ESWT has been applied successfully for the treatment of several musculoskeletal complaints.3,13,16,19,38
Recurrence of the frozen shoulder after hydrodilatation, what is the true incidence?
2023, Shoulder and Elbow
Joy C. MacDermid was supported by a Canadian Institutes of Health Research Chair in Gender, Work and Health and the James Roth Chair in Musculoskeletal Measurement and Knowledge Translation.
Systematic Review Registration No.:CRD42018084090.
Disclosures: none.