Abstract：
BACKGROUND: Frozen shoulder (FS) is characterized by restricted active and passive shoulder mobility and pain.
OBJECTIVE: Compare the effect of muscle-biased manual therapy (MM) and regular physical therapy (RPT) in patients with FS.
METHODS: Pretest-post-test control group study design.
METHODS: We recruited 34 patients with FS and compared the effect of 12-session MM and RPT. The outcome measures were scapular kinematics and muscle activation, scapular alignment, shoulder range of motion, and pain intensity. Two-way analysis of variance was used to examine the intervention effect with α = 0.05.
RESULTS: Both programs resulted in similar improvements in pain and shoulder function. Compared to the RPT, MM resulted in increased posterior tilt (MM: 7.04°-16.09°, RPT: -2.50° to -4.37°; p = 0.002; ES = 0.261) and lower trapezius activation (MM: 260.61%-470.90%, RPT: 322.64%-313.33%; p = 0.033; ES = 0.134) during scaption, and increased posterior tilt (MM: 0.70°-15.16°, RPT: -9.66° to -6.44°; p = 0.007; ES = 0.205) during the hand-to-neck task. The MM group also showed increased GH backward elevation (MM: 37.18°-42.79°, RPT: 43.64°-40.83°; p = 0.004, ES = 0.237) and scapular downward rotation (MM: -2.48° to 6.80°, RPT: 1.93°-1.44°; p < 0.001; ES = 0.404) during the thumb-to-waist task, enhanced shoulder abduction (MM: 84.6°-102.3°, RPT: 85.1°-92.9°; p = 0.02; ES = 0.153), and improved scapular alignment (MM: 10.4-9.65 cm, RPT: 9.41-9.56 cm; p = 0.02; ES = 0.114).
CONCLUSIONS: MM was superior to the RPT regarding scapular neuromuscular performance. Clinicians should consider adding muscle-biased treatment when treating FS.
OBJECTIVE: Compare the effect of muscle-biased manual therapy (MM) and regular physical therapy (RPT) in patients with FS.
METHODS: Pretest-post-test control group study design.
METHODS: We recruited 34 patients with FS and compared the effect of 12-session MM and RPT. The outcome measures were scapular kinematics and muscle activation, scapular alignment, shoulder range of motion, and pain intensity. Two-way analysis of variance was used to examine the intervention effect with α = 0.05.
RESULTS: Both programs resulted in similar improvements in pain and shoulder function. Compared to the RPT, MM resulted in increased posterior tilt (MM: 7.04°-16.09°, RPT: -2.50° to -4.37°; p = 0.002; ES = 0.261) and lower trapezius activation (MM: 260.61%-470.90%, RPT: 322.64%-313.33%; p = 0.033; ES = 0.134) during scaption, and increased posterior tilt (MM: 0.70°-15.16°, RPT: -9.66° to -6.44°; p = 0.007; ES = 0.205) during the hand-to-neck task. The MM group also showed increased GH backward elevation (MM: 37.18°-42.79°, RPT: 43.64°-40.83°; p = 0.004, ES = 0.237) and scapular downward rotation (MM: -2.48° to 6.80°, RPT: 1.93°-1.44°; p < 0.001; ES = 0.404) during the thumb-to-waist task, enhanced shoulder abduction (MM: 84.6°-102.3°, RPT: 85.1°-92.9°; p = 0.02; ES = 0.153), and improved scapular alignment (MM: 10.4-9.65 cm, RPT: 9.41-9.56 cm; p = 0.02; ES = 0.114).
CONCLUSIONS: MM was superior to the RPT regarding scapular neuromuscular performance. Clinicians should consider adding muscle-biased treatment when treating FS.
摘要：
背景：冻结的肩关节（FS）的特征是活动和被动的肩关节活动和疼痛受限。
目的：比较肌肉偏倚手法治疗（MM）和常规物理疗法（RPT）在FS患者中的效果。
方法：测试前-测试后对照组研究设计。
方法：我们招募了34例FS患者，比较了12个疗程MM和RPT的效果。结果测量为肩胛骨运动学和肌肉激活，肩胛骨对齐，肩部运动范围,和疼痛强度。采用双向方差分析检验干预效果,α=0.05。
结果：这两个方案在疼痛和肩关节功能方面都有相似的改善。与RPT相比，MM导致后倾角增加(MM:7.04°-16.09°,RPT：-2.50°至-4.37°；p=0.002；ES=0.261）和下斜方肌激活（MM：260.61％-470.90％，RPT:322.64%-313.33%;p=0.033;ES=0.134)并增加后倾角(MM:0.70°-15.16°,RPT：-9.66°至-6.44°；p=0.007；ES=0.205）在手颈任务期间。MM组也表现为GH向后升高增加（MM：37.18°-42.79°，RPT：43.64°-40.83°；p=0.004，ES=0.237）和肩胛骨向下旋转（MM：-2.48°至6.80°，RPT:1.93°-1.44°;p<0.001;ES=0.404)在拇指到腰部任务期间,增强肩关节外展(MM:84.6°-102.3°,RPT:85.1°-92.9°;p=0.02;ES=0.153),和改善肩胛骨对齐（MM：10.4-9.65厘米，RPT：9.41-9.56厘米；p=0.02；ES=0.114）。
结论：MM在肩胛骨神经肌肉表现方面优于RPT。临床医生在治疗FS时应考虑增加肌肉偏倚治疗。
目的：比较肌肉偏倚手法治疗（MM）和常规物理疗法（RPT）在FS患者中的效果。
方法：测试前-测试后对照组研究设计。
方法：我们招募了34例FS患者，比较了12个疗程MM和RPT的效果。结果测量为肩胛骨运动学和肌肉激活，肩胛骨对齐，肩部运动范围,和疼痛强度。采用双向方差分析检验干预效果,α=0.05。
结果：这两个方案在疼痛和肩关节功能方面都有相似的改善。与RPT相比，MM导致后倾角增加(MM:7.04°-16.09°,RPT：-2.50°至-4.37°；p=0.002；ES=0.261）和下斜方肌激活（MM：260.61％-470.90％，RPT:322.64%-313.33%;p=0.033;ES=0.134)并增加后倾角(MM:0.70°-15.16°,RPT：-9.66°至-6.44°；p=0.007；ES=0.205）在手颈任务期间。MM组也表现为GH向后升高增加（MM：37.18°-42.79°，RPT：43.64°-40.83°；p=0.004，ES=0.237）和肩胛骨向下旋转（MM：-2.48°至6.80°，RPT:1.93°-1.44°;p<0.001;ES=0.404)在拇指到腰部任务期间,增强肩关节外展(MM:84.6°-102.3°,RPT:85.1°-92.9°;p=0.02;ES=0.153),和改善肩胛骨对齐（MM：10.4-9.65厘米，RPT：9.41-9.56厘米；p=0.02；ES=0.114）。
结论：MM在肩胛骨神经肌肉表现方面优于RPT。临床医生在治疗FS时应考虑增加肌肉偏倚治疗。
