Understanding the clinical profile of patients with frozen shoulder: a longitudinal multicentre observational study
Metadatos
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BMJ
Date
2022-11-21Referencia bibliográfica
Mertens MG... [et al.]. Understanding the clinical profile of patients with frozen shoulder: a longitudinal multicentre observational studyBMJ Open 2022;12:e056563. doi: [10.1136/bmjopen-2021-056563]
Résumé
Introduction There is a large diversity in the clinical
presentation of frozen shoulder (FS) and the clinical
outcome is not always satisfactory. The aim of the current
study was to examine to what extent range of motion
(ROM) limitation, metabolic factors (diabetes mellitus
and thyroid disorders), autonomic symptoms and pain
sensitivity may contribute to the prognosis in terms of
shoulder pain and disability and quality of life in patients
with FS.
Methods Patients with stage 1 or 2 FS were longitudinally
followed-up
during 9 months after baseline assessment.
They completed six questionnaires and underwent
quantitative sensory testing (pressure pain thresholds,
temporal summation and conditioned pain modulation) and
ROM assessment.
Results One hundred and forty-nine
patients with FS
were initially recruited and 121 completed at least one
follow-up
measurement. Shoulder pain and disability
improved over time and diabetes mellitus was found to be
a prognostic factor for final outcome. Several domains of
quality of life also improved over time and external rotation
ROM, diabetes mellitus, thyroid disorder and autonomic
symptoms were found to be prognostic factors for final
outcome. These prognostic factors explained 2.5%–6.3%
of the final outcome of shoulder pain and disability and
quality of life.
Discussion and conclusion In patients with FS,
prognostic variables were able to predict different
outcomes, indicating that outcomes in this population can
be variable-dependent.
Other variables not explored in this
study might contribute to the prognosis of patients with
FS, which should be investigated in future research. In
clinical practice, baseline assessment of prognostic factors
and focusing on a more holistic approach might be useful
to inform healthcare practitioners about progression of
patients with FS during a 9-month
period.