Manual therapy is an effective treatment for frozen shoulder in diabetics: An observational study

Objectives: This study aims to compare the efficacy of manual therapy in the frozen shoulder patients with or without diabetes mellitus. Patients and methods: Between May 2006 and January 2008, 50 patients (10 males, 40 females; mean age 52±10 years; range 40 to 65 years) orthopedic surgeons referred to the Sports Physiotherapy Unit were included in the study. The patients were divided into two groups, including patients with primary frozen shoulder with type II diabetes mellitus (n=12) and non diabetics (n=38). All patients underwent a rehabilitation program including cold application, manual therapy and exercises twice a week. A total of 16 treatment sessions were performed. The most important part of the manual therapy included scapular mobilization and posterior capsule stretching. The range of motion was measured by goniometry. Functional activity status was assessed by Constant's score. The pain level was evaluated by visual analog scale, while muscle strength was evaluated by hand-held dynamometer. Student t-test was used to compare between the parameters of groups, while Paired sample t-test was used to compare preand post-treatment parameters of the patients. Results: The range of motion, functional activity status and muscular strength were improved and the pain level was reduced after rehabilitation in all of the patients in both groups (p<0.05). There was no difference in duration of the treatment between the groups (p>0.05). There were no differences in range of motion, functional activity status, pain level, and muscle strength before and after rehabilitation between the groups (p>0.05). Conclusion: Manual therapy approaches may be safely applied in diabetic patients with frozen shoulder.