title: Activity- vs. structural-oriented treatment approach for frozen shoulder: a randomized controlled trial.
abstract: OBJECTIVE
  To compare the short- and long-term effects of a structural-oriented (convential) with an activity-oriented physiotherapeutic treatment in patients with frozen shoulder.
  
  
  METHODS
  Double-blinded, randomized, experimental study.
  
  
  METHODS
  Outpatient clinic.
  
  
  METHODS
  We included patients diagnosed with a limited range of motion and pain in the shoulder region, who had received a prescription for physiotherapy treatment, without additional symptoms of dizziness, a case history of headaches, pain and/or limited range of motion in the cervical spine and/or temporomandibular joint.
  
  
  METHODS
  The study group received treatment during the performance of activities. The comparison group was treated with manual therapy and proprioceptive neuromuscular facilitation (conventional therapy). Both groups received 10 days of therapy, 30 minutes each day.
  
  
  METHODS
  Range of motion, muscle function tests, McGill pain questionnaire and modified Upper Extremity Motor Activity Log were measured at baseline, after two weeks of intervention and after a three-month follow-up period without therapy.
  
  
  RESULTS
  A total of 66 patients were randomized into two groups: The activity-oriented group ( n = 33, mean = 44 years, SD = 16 years) including 20 male (61%) and the structural-oriented group ( n = 33, mean = 47 years, SD = 17 years) including 21 male (64%). The activity-oriented group revealed significantly greater improvements in the performance of daily life activities and functional and structural tests compared with the group treated with conventional therapy after 10 days of therapy and at the three-month follow-up ( p < 0.05).
  
  
  CONCLUSIONS
  Therapy based on performing activities seems to be more effective for pain reduction and the ability to perform daily life activities than conventional treatment methods.
authors.affiliation: 1 Private Practice and Institute for Further Education for Medical Professions, Ingelheim, Germany.
authors.forename: Renata
authors.initials: R
authors.lastname: Horst
authors.affiliation: 2 Clinic of Rehabilitation, Jagiellonian University, Cracow, Poland.|3 Cracow Rehabilitation Center, Cracow, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Maicki
authors.affiliation: 2 Clinic of Rehabilitation, Jagiellonian University, Cracow, Poland.|3 Cracow Rehabilitation Center, Cracow, Poland.
authors.forename: Rafał
authors.initials: R
authors.lastname: Trąbka
authors.affiliation: 4 Leuphana University, Lüneburg, Germany.
authors.forename: Sindy
authors.initials: S
authors.lastname: Albrecht
authors.affiliation: 5 Department of Sports Medicine, Goethe-University, Frankfurt am Main, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Schmidt
authors.affiliation: 6 Department of Physical Medicine and Biomedical Renewal, University of Physical Education in Krakow, Cracow, Poland.
authors.forename: Sylwia
authors.initials: S
authors.lastname: Mętel
authors.affiliation: 7 University of Applied Science, Hochschule Osnabruck Fakultat Wirtschafts- und Sozialwissenschaften, Osnabrueck, Germany.
authors.forename: Harry
authors.initials: H
authors.lastname: von Piekartz
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000554:Ambulatory Care Facilities; D002062:Bursitis / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D052580:Muscle Stretching Exercises / Q000379:methods; D026201:Musculoskeletal Manipulations / Q000379:methods*; D010043:Outcome and Process Assessment, Health Care; D059408:Pain Management / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology*; D020069:Shoulder Pain / Q000209:etiology / Q000628:therapy*; D018709:Statistics, Nonparametric
keywords: Shoulder; manual therapy; motor learning; neuro-orthopaedic activity-dependent plasticity; pain; proprioceptive neuromuscular facilitation