Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Wilrijk, Belgium.
Pain in Motion International Research Group.
Rheumatol Int. 2022 Jun;42(6):925-936. doi: 10.1007/s00296-021-04979-0. Epub 2021 Sep 6.
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.
冻结肩（FS）是一种难以理解且难以治疗的疾病。在过去的十年中，关于恢复及其自然病程的证据存在矛盾和新的证据。本叙述性综述提供了有关 FS 患者的诊断和保守治疗的新信息，以及正在进行的研究假设，这些假设可能为病理学和治疗选择提供新的见解。FS 具有特征性的病程。患有糖尿病和甲状腺疾病的人患 FS 的风险更高。FS 的诊断基于模式识别和体格检查。此外，可以使用“纳入”和“排除”标准来提高冻结肩诊断的可能性。推荐和最常见的物理治疗干预措施是动员技术和运动，其中组织刺激性可以指导其强度。此外，物理疗法通常与患者教育和药物治疗相结合。与 FS 相关的最新循证实践是本体感觉神经肌肉促进法和镜像疗法。此外，疼痛神经科学教育、高强度间歇训练和生活方式改变等干预措施仍处于假设阶段。最后，更好地了解生化过程、肌成纤维细胞和基质金属蛋白酶的功能可以更好地理解病理生理学，并将在本次综述中进行讨论。
