title: Manipulation under anesthesia with home exercises versus home exercises alone in the treatment of frozen shoulder: a randomized, controlled trial with 125 patients.
abstract: We aimed to determine the effect of manipulation under anesthesia in frozen shoulder patients. A blinded randomized trial with a 1-year follow-up was performed at 3 referral hospitals in Southern Finland. We randomly assigned 125 patients with clinically verified frozen shoulder to the manipulation group (n = 65) or control group (n = 60). Both the intervention group and the control group were instructed in specific therapeutic exercises by physiotherapists. Clinical data were gathered at baseline and at 6 weeks and 3, 6, and 12 months after randomization. The 2 groups did not differ at any time of the follow-up in terms of shoulder pain or working ability. Small differences in the range of movement were detected in favor of the manipulation group. Perceived shoulder pain decreased during follow-up equally in the 2 groups, and at 1 year after randomization, only slight pain remained. Manipulation under anesthesia does not add effectiveness to an exercise program carried out by the patient after instruction.
authors.affiliation: Jorvi Hospital (Helsinki University Central Hospital), Espoo, Finland. jorma.kivimaki@elisanet.fi
authors.forename: Jorma
authors.initials: J
authors.lastname: Kivimäki
authors.forename: Timo
authors.initials: T
authors.lastname: Pohjolainen
authors.forename: Antti
authors.initials: A
authors.lastname: Malmivaara
authors.forename: Mikko
authors.initials: M
authors.lastname: Kannisto
authors.forename: Jacques
authors.initials: J
authors.lastname: Guillaume
authors.forename: Seppo
authors.initials: S
authors.lastname: Seitsalo
authors.forename: Maunu
authors.initials: M
authors.lastname: Nissinen
mesh_terms: D000368:Aged; D000768:Anesthesia, General; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000628:therapy*; D008297:Male; D008349:Manipulation, Orthopedic / Q000379:methods*; D008875:Middle Aged; D010349:Patient Compliance; D016059:Range of Motion, Articular; D012785:Shoulder Joint / Q000473:pathology*; D016896:Treatment Outcome