de Sire Alessandro, Agostini Francesco, Bernetti Andrea, Mangone Massimiliano, Ruggiero Marco, Dinatale Stefano, Chiappetta Alessandro, Paoloni Marco, Ammendolia Antonio, Paolucci Teresa
Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy.
Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, Rome, Italy.
J Pain Res. 2022 Aug 19;15:2449-2464. doi: 10.2147/JPR.S371513. eCollection 2022.
Frozen shoulder (FS) is a painful condition characterized by progressive loss of shoulder function with passive and active range of motion reduction. To date, there is still no consensus regarding its rehabilitative treatment for pain management.
The aim of this umbrella review of systematic reviews was to analyze the literature, investigating the effects of non-surgical and rehabilitative interventions in patients suffering from FS.
A review of the scientific literature was carried out from 2010 until April 2020 using the following search databases: PubMed, Medline, PEDro, Scopus and Cochrane Library of Systematic Reviews. A combination of terms was used for the search: frozen shoulder OR adhesive capsulitis AND systematic review OR meta-analysis AND rehabilitation NOT surgery NOT surgical intervention. We included systematic reviews that specifically dealt with adults with FS, treated with non-surgical approaches. All the systematic reviews and meta-analyses included in the study that met the inclusion criteria were assessed using the Assessment of Multiple Systematic Reviews as a quality assessment tool.
Out of 49 studies, only 14 systematic reviews respected the eligibility criteria and were included in this study. Their results showed an important heterogeneity of the studies and all of them agree on the lack of high-quality scientific work to prove unequivocally which rehabilitative treatment is better than the other. Due to this lack of gold standard criteria, there may be also a heterogeneity in the diagnosis of the reviews analyzed.
Non-surgical and rehabilitative interventions are undoubtedly effective in treating FS, but there is no evidence that one approach is more effective than the other regarding the methods reported. Future high-quality RCTs are needed to standardize the treatment modalities of each physiotherapy intervention to provide strong recommendations in favor.
肩周炎（FS）是一种疼痛性疾病，其特征是肩部功能逐渐丧失，被动和主动活动范围减小。迄今为止，关于其疼痛管理的康复治疗仍未达成共识。
本系统评价的伞状综述旨在分析文献，调查非手术和康复干预对肩周炎患者的影响。
使用以下检索数据库对2010年至2020年4月的科学文献进行综述：PubMed、Medline、PEDro、Scopus和Cochrane系统评价图书馆。检索使用了以下组合词：肩周炎或粘连性关节囊炎以及系统评价或荟萃分析以及康复而非手术而非手术干预。我们纳入了专门针对采用非手术方法治疗的成年肩周炎患者的系统评价。使用“多个系统评价评估”作为质量评估工具，对纳入研究的所有符合纳入标准的系统评价和荟萃分析进行评估。
在49项研究中，只有14项系统评价符合纳入标准并被纳入本研究。它们的结果显示研究存在重要的异质性，并且所有研究都一致认为缺乏高质量的科学研究来明确证明哪种康复治疗比另一种更好。由于缺乏金标准标准，所分析的综述在诊断方面也可能存在异质性。
非手术和康复干预无疑对治疗肩周炎有效，但就所报道的方法而言，没有证据表明一种方法比另一种更有效。未来需要高质量的随机对照试验来规范每种物理治疗干预的治疗方式，以提供有力的支持性建议。
