Document Type : Research Article

Authors

Department of Exercise Physiology and Corrective exercise, Faculty of Sport Sciences, Urmia University, Urmia, Iran

Abstract

Background: Incorrect posture contributes to a frozen shoulder; this study explored the effects of eight weeks of corrective exercises on postural parameters, range of motion, and shoulder joint pain in women with frozen shoulder and upper cross syndrome.
Methods: A quasi-experimental study with a pre-test-post-test design was conducted. Thirty women aged 40 to 60 years with frozen shoulder and upper cross syndrome were purposefully selected and allocated into control and experimental groups. Pretest assessments included forward head angle (FHA) and forward shoulder angle (FSA) measured using Kinovea software, thoracic curvature assessed with a flexible ruler, range of motion of the shoulder joint (external rotation, abduction, and flexion) measured with a goniometer, and shoulder joint pain evaluated using the visual analog scale (VAS). The experimental group performed corrective exercises for eight weeks, while the control group continued their daily activities. Post-test assessments were conducted, and covariance tests and paired-sample t-test analysis were employed for between-group and within-group comparisons.
Results: The experimental group demonstrated significant improvements in shoulder joint range of motion (P=0.001), FHA (P=0.001), FSA (P=0.008), thoracic curvature (P=0.001), and shoulder joint pain (P=0.001) following corrective exercises.
Conclusions: It is recommended that trainers and therapists utilize the corrective exercises outlined in this study to enhance shoulder joint range of motion posture and alleviate pain in women with frozen shoulders and upper cross syndrome.

Highlights

Ebrahim Mohammad Ali Nasab Firouzjah: (Google Scholar)

 

 

How to Cite: Jamali Kohneh Shahri G, Mohammad Ali Nasab Firouzjah E. The Impact of Eight Weeks of Corrective Exercises on Postural Parameters, Range of Motion, and Shoulder Joint Pain in Women with Frozen Shoulder and Upper Cross Syndrome. Women. Health. Bull. 2024;11(1):47-56. doi: 10.30476/WHB.2024.101123.1262.

Keywords

  1. 1. Itoi E. Pathophysiology and treatment of atraumatic instability of the shoulder. J Orthop Sci. 2004;9(2):208-13. doi: 10.1007/s00776-003-0748-1. PubMed PMID: 15045553. ##
  2. 2. Lo M-Y, Wu C-H, Luh J-J, Wang T-G, Fu L-C, Lin J-G, et al. The effect of electroacupuncture merged with rehabilitation for frozen shoulder syndrome: a single-blind randomized sham-acupuncture controlled study. J Formos Med Assoc. 2020;119:81-88. doi: 10.1016/j.jfma.2019.03.012. PubMed PMID: 31097283. ##
  3. 3. Wolf JM, Green A. Influence of comorbidity on self-assessment instrument scores of patients with idiopathic adhesive capsulitis. J Bone Joint Surg Am. 2002;84(7):1167-73. PubMed PMID: 12107317. ##
  4. 4. Hand G, Athanasou N, Matthews T, Carr A. The pathology of frozen shoulder. J Bone Joint Surg Br. 2007;89(7):928-32. doi: 10.1302/0301-620X.89B7.19097. PubMed PMID: 17673588. ##
  5. 5. Robinson C, Seah KM, Chee Y, Hindle P, Murray I. Frozen shoulder. J Bone Joint Surg Br. 2012;94(1):1-9. doi: 10.1302/0301-620X.94B1.27093. PubMed PMID: 22219239. ##
  6. 6. Cho N-J, Park J-W. Effect of Pain and Shoulder Joint Function on Extracorporeal Shock Wave Therapy of Patients with Frozen Shoulder. The Journal of Korean Academy of Orthopedic Manual Physical Therapy. 2007;13(2):69-78. ##
  7. 7. Hertling D, Kessler RM. Management of common musculoskeletal disorders: physical therapy principles and methods: Lippincott Williams & Wilkins; 2006. ##
  8. 8. Kashuba V, Andrieieva O, Goncharova N, Kyrychenko V, Karp I, Lopatskyi S, et al. Physical activity for prevention and correction of postural abnormalities in young women. Journal of Physical Education and Sport. 2019;19:500-506. ##
  9. 9. Ambegaonkar JP, Mettinger LM, Caswell SV, Burtt A, Cortes N. Relationships between core endurance, hip strength, and balance in collegiate female athletes. Int J Sports Phys Ther. 2014;9(5):604-16. PubMed PMID: 25328823; PubMed Central PMCID: PMC4196325. ##
  10. 10. Page P, Frank CC, Lardner R. Assessment and treatment of muscle imbalance; 2010. ##
  11. 11. Dunning JR, Butts R, Mourad F, Young I, Fernandez-de-Las Peñas C, Hagins M, et al. Upper cervical and upper thoracic manipulation versus mobilization and exercise in patients with cervicogenic headache: a multi-center randomized clinical trial. BMC Musculoskelet Disord. 2016;17:64. doi: 10.1186/s12891-016-0912-3. PubMed PMID: 26852024; PubMed Central PMCID: PMC4744384. ##
  12. Homsi C, Bordalo-Rodrigues M, Da Silva JJ, Stump XMGRG. Ultrasound in adhesive capsulitis of the shoulder: is assessment of the coracohumeral ligament a valuable diagnostic tool? Skeletal Radiol. 2006;35(9):673-8. doi: 10.1007/s00256-006-0136-y. PubMed PMID: 16724200. ##
  13. 13. Ryans I, Montgomery A, Galway R, Kernohan W, McKane R. A randomized controlled trial of intra-articular triamcinolone and/or physiotherapy in shoulder capsulitis. Rheumatology. 2005;44(4):529-35. doi: 10.1093/rheumatology/keh535. PubMed PMID: 15657070. ##
  14. Ng C, Amin A, Narborough S, McMullan L, Cook R, Brenkel I. Manipulation under anaesthesia and early physiotherapy facilitate recovery of patients with frozen shoulder syndrome. Scott Med J. 2009;54(1):29-31. doi: 10.1258/rsmsmj.54.1.29. PubMed PMID: 19291933. ##
  15. Omari A, Bunker TD. Open surgical release for frozen shoulder: surgical findings and results of the release. J Shoulder Elbow Surg. 2001;10(4):353-7. doi: 10.1067/mse.2001.115986. PubMed PMID: 11517365. ##
  16. 16. Berghs BM, Sole-Molins X, Bunker TD. Arthroscopic release of adhesive capsulitis. J Shoulder Elbow Surg. 2004;13(2):180-5. doi: 10.1016/j.jse.2003.12.004. PubMed PMID: 14997096. ##
  17. Vermeulen HM, Rozing PM, Obermann WR, Le Cessie S, Vliet Vlieland TPMV. Comparison of high-grade and low-grade mobilization techniques in the management of adhesive capsulitis of the shoulder: randomized controlled trial. Phys Ther. 2006;86(3):355-68. PubMed PMID: 16506872. ##
  18. Dini R, Ghiamirad A, Rouhani A. The Effectiveness of Training Therapy with and without Complementary Shock Wave‎ Therapy on the Pain and Range of Motion in Patients with Frozen Shoulder. Journal of Paramedical Sciences & Rehabilitation. 2022;11(2):56-67. doi: 10.22038/jpsr.2022.58058.2261. Pesian. ##
  19. 19. Sahrmann S. Movement system impairment syndromes of the extremities, cervical and thoracic spines. Elsevier Health Sciences; 2010. ##
  20. 20. El-Hamalawy FA. Forward head correction exercises for management of myogenic tempromandibular joint dysfunction; 2011. ##
  21. 21. Sali F, Ghani Zadeh Hesar N, Mohamadi M, Roshani S. Comparison of upper body posture and shoulder range of motion in women with and without frozen shoulder. Studies in Sport Medicine. 2020;12(28):149-64. doi: 10.22089/smj.2021.10567.1500. ##
  22. Celik D. Comparison of the outcomes of two different exercise programs on frozen shoulder. Acta Orthop Traumatol Turc. 2010;44(4):285-92. doi: 10.3944/AOTT.2010.2367. PubMed PMID: 21252605. ##
  23. Jürgel J, Rannama L, Gapeyeva H, Ereline J, Kolts I, Pääsuke M. Shoulder function in patients with frozen shoulder before and after 4-week rehabilitation. Medicina (Kaunas). 2005;41(1):30-8. PubMed PMID: 15687748. ##
  24. Kang H. Sample size determination and power analysis using the G* Power software. J Educ Eval Health Prof. 2021;18:17. doi: 10.3352/jeehp.2021.18.17. PubMed PMID: 34325496; PubMed Central PMCID: PMC8441096. ##
  25. Firouzjah MH, Firouzjah EMAN, Ebrahimi Z. The effect of a course of selected corrective exercises on posture, scapula-humeral rhythm and performance of adolescent volleyball players with upper cross syndrome. BMC Musculoskelet Disord. 2023;24(1):489. doi: 10.1186/s12891-023-06592-7. PubMed PMID: 37316911; PubMed Central PMCID: PMC10265808. ##
  26. Seidi F, Bayattork M, Minoonejad H, Andersen LL, Page P. Comprehensive corrective exercise program improves alignment, muscle activation and movement pattern of men with upper crossed syndrome: randomized controlled trial. Sci Rep. 2020;10(1):20688. doi: 10.1038/s41598-020-77571-4. PubMed PMID: 33244045; PubMed Central PMCID: PMC7692548. ##
  27. Challoumas D, Biddle M, McLean M, Millar NL. Comparison of treatments for frozen shoulder: a systematic review and meta-analysis. JAMA Netw Open. 2020;3(12):e2029581. doi: 10.1001/jamanetworkopen.2020.29581. PubMed PMID: 33326025; PubMed Central PMCID: PMC7745103. ##
  28. Struyf F, Meeus M. Current evidence on physical therapy in patients with adhesive capsulitis: what are we missing? Clin Rheumatol. 2014;33(5):593-600. doi: 10.1007/s10067-013-2464-3. PubMed PMID: 24374758. ##
  29. Cao D-Z, Wang C-L, Qing Z, Liu L-D. Effectiveness of extracorporeal shock-wave therapy for frozen shoulder: a protocol for a systematic review of randomized controlled trial. Medicine. 2019;98(7):e14506. doi: 10.1097/MD.0000000000014506. PubMed PMID: 30762780; PubMed Central PMCID: PMC6408004. ##
  30. Miccinilli S, Bravi M, Morrone M, Manco D, Bressi F, Campi S, et al. The effectiveness of extracorporeal shock wave therapy on adhesive capsulitis of the shoulder: a systematic review and meta-analysis. Medicina dello Sport. 2020;73(2):341-71. doi: 10.23736/S0025-7826.20.03667-4. ##
  31. Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. 2001;8(12):1153-7. doi: 10.1111/j.1553-2712.2001.tb01132.x. PubMed PMID: 11733293. ##
  32. Jensen MP, Chen C, Brugger AM. Interpretation of visual analog scale ratings and change scores: a reanalysis of two clinical trials of postoperative pain. J Pain. 2003;4(7):407-14. doi: 10.1016/s1526-5900(03)00716-8. PubMed PMID: 14622683. ##
  33. Riddle DL, Rothstein JM, Lamb RL. Goniometric reliability in a clinical setting: shoulder measurements. Phys Ther. 1987;67(5):668-73. doi: 10.1093/ptj/67.5.668. PubMed PMID: 3575423. ##
  34. Ruivo RM, Pezarat-Correia P, Carita AI. Intrarater and interrater reliability of photographic measurement of upper-body standing posture of adolescents. J Manipulative Physiol Ther. 2015;38(1):74-80. doi: 10.1016/j.jmpt.2014.10.009. PubMed PMID: 25467608. ##
  35. Thigpen CA, Padua DA, Michener LA, Guskiewicz K, Giuliani C, Keener JD, et al. Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks. J Electromyogr Kinesiol. 2010;20(4):701-9. doi: 10.1016/j.jelekin.2009.12.003. PubMed PMID: 20097090. ##
  36. Lynch SS, Thigpen CA, Mihalik JP, Prentice WE, Padua D. The effects of an exercise intervention on forward head and rounded shoulder postures in elite swimmers. Br J Sports Med. 2010;44(5):376-81. doi: 10.1136/bjsm.2009.066837. PubMed PMID: 20371564. ##
  37. Seidi F, Rajabi R, Ebrahimi I, Alizadeh MH, Minoonejad H. The efficiency of corrective exercise interventions on thoracic hyper-kyphosis angle. J Back Musculoskelet Rehabil. 2014;27(1):7-16. doi: 10.3233/BMR-130411. PubMed PMID: 23948845. ##
  38. Clark M, Lucett S. NASM essentials of corrective exercise training. Lippincott Williams & Wilkins; 2010. ##
  39. Flannery O, Mullett H, Colville J. Adhesive shoulder capsulitis: does the timing of manipulation influence outcome? Acta Orthop Belg. 2007;73(1):21-5. PubMed PMID: 17441653. ##
  40. Simpson JK, Budge R. Treatment of frozen shoulder using distension arthrography (hydrodilatation): a case series. Australas Chiropr Osteopathy. 2004;12(1):25-35. PubMed PMID: 17987207; PubMed Central PMCID: PMC2051310. ##
  41. Moore MK. Upper crossed syndrome and its relationship to cervicogenic headache. J Manipulative Physiol Ther. 2004;27(6):414-20. doi: 10.1016/j.jmpt.2004.05.007. PubMed PMID: 15319765. ##
  42. Janda V. Muscle and cervicogenic pain syndromes. In Grant R, editors. Physical Therapy of the Cervical and Thoracic Spine. New York: Churchill Livingstone; 1988. ##
  43. Sahrmann S, Azevedo DC, Van Dillen L. Diagnosis and treatment of movement system impairment syndromes. Braz J Phys Ther. 2017;21(6):391-399. doi: 10.1016/j.bjpt.2017.08.001. PubMed PMID: 29097026; PubMed Central PMCID: PMC5693453. ##