title: Identification of prognostic factors for the nonoperative treatment of stiff shoulder.
abstract: OBJECTIVE
  This study evaluated prognostic factors for the nonoperative treatment of stiff shoulder.
  
  
  METHODS
  Between June 2005 and May 2010, 497 stiff shoulders treated at our institute were included in this study. Multivariable analysis for recovery with Cox proportional hazard model was performed. The chief determining variable was pathogenesis (idiopathic, diabetic, post-traumatic) and confounding variables were age (49 or less, 50-59, 60 and above), sex, onset to visit interval (three months or less, four months or more), and external rotation (under 0°, 0° or more) or forward flexion (less than 90°, 90° or more) or internal rotation on the first visit.
  
  
  RESULTS
  There were 356 idiopathic, 61 diabetic, and 80 post-traumatic stiff shoulders. Hazard ratio (HR) and 95 % confidence interval (CI) for recovery (lower HR means poor prognosis) was 0.54 (0.36-0.96) in the diabetic group (p = 0.007), and 0.92 (0.67-1.25) in the post-traumatic group (p = 0.58) compared with the idiopathic group. A positive correlation was observed in ages of 60 or over (HR 1.46, 95 % CI 0.86-1.65, p-value 0.02) and external rotation under 0° on the first visit (0.71, 0.53-0.96, 0.03). No correlations were observed in sex (p = 0.78) or onset to visit interval (p = 0.99). Similar results were obtained when forward flexion or internal rotation was used as a confounding variable.
  
  
  CONCLUSIONS
  Diabetes mellitus and severely restricted joint motion on the first visit were poor prognostic factors and ages of 60 or over was a better prognostic factor.
authors.affiliation: Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Ando
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sugaya
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Hagiwara
authors.forename: Norimasa
authors.initials: N
authors.lastname: Takahashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Watanabe
authors.forename: Kenji
authors.initials: K
authors.lastname: Kanazawa
authors.forename: Eiji
authors.initials: E
authors.lastname: Itoi
mesh_terms: D000779:Anesthetics, Local / Q000627:therapeutic use; D048909:Diabetes Complications; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007270:Injections, Intra-Articular; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011379:Prognosis; D016016:Proportional Hazards Models; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000473:pathology*; D020069:Shoulder Pain / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D005938:Glucocorticoids