Prognostic factors of non-surgical intervention for Frozen Shoulder Contracture Syndrome: a retrospective study

Background and aim. Frozen Shoulder Contracture Syndrome (FSCS), also known as Frozen Shoulder (FS), is a musculoskeletal condition that typically involves substantial pain, movement restriction and considerable morbidity. FSCS management include education, non-surgical interventions, such as physiotherapy and intra-articular injections, and surgical treatment, that should be performed in case of failure of conservative treatment, as recent evidence displays. As for prognostic factors associated with treatment, evidence suggests that the outcome of interventions for FSCS may be moderated by the stage of disease, female sex and diabetes. No study has yet attempted to investigate whether psychological factors affect the outcome of conservative treatment for FSCS. In fact, what we know to have predictive value for individuals with FSCS concerns only the biological sphere. The aim of this study is to identify which patient’s characteristics, resulting from usual physiotherapy biopsychosocial assessment, are associated with better objective and subjective outcomes at 3 months after conservative treatment. Methods. Medical records from 52 patients affected by FSCS were selected. All patients met the inclusion criteria and had completed a 12-week treatment program that included intra-articular injections (corticosteroid and anesthetic) and physical therapy. Range of motion (ROM) and Pain subscale from the Shoulder Pain And Disability Index (SPADI) were extracted at baseline and after 12 weeks. Prognostic factors selected for investigation were age, gender, BMI, comorbidity, duration of symptoms, dominant limb affected, subscales from Short Form Health Survey 36 (SF-36). Multivariable linear regression was used to analyse prognostic factors associated with outcome measures. Results. All patients had significant improvement in ROM and SPADI Pain subscale. Older age (>60 years group) was associated with worse outcome in SPADI, whereas there was no significant association of gender, BMI, duration of symptoms and affected limb with ROM and SPADI outcome. Conclusion. Age appears to be a relevant prognostic factor for FSCS patients undergoing non-surgical treatment.