The outcome of hydrodilation in frozen shoulder patients and the relationship with kinesiophobia, depression, and anxiety

Abstract

Purpose The aims of this study were to (1) investigate the effect of hydrodilatation in frozen shoulder patients on objective indices of shoulder functionality and subjective outcomes of pain, mobility, kinesiophobia, depression, and anxiety, and (2) progress knowledge about the reciprocal temporal relationship between psychological parameters at baseline and objective and subjective outcomes at 3-month follow-up. Methods We evaluated the clinical and psychological status of 72 patients with a frozen shoulder before and after hydrodilatation, using the Constant Murley score, the Visual Analogue score, the Tampa Scale for Kinesiophobia, the Hospital Anxiety and Depression Scale, and the Shoulder Pain And Disability Index. Results We noted a significant improvement in functionality, pain and disability (p < .001). Depression and anxiety improved significantly (p < .001) between baseline and 3-month follow-up. Prospective analyses demonstrated that psychological factors are more likely to predict outcomes of hydrodilatation than vice versa. Conclusion Hydrodilatation followed by physiotherapy is an excellent way to treat patients with recalcitrant frozen shoulder, resulting in a continuous improvement of ROM and pain. Physiotherapists and physicians should be aware that psychological factors might have an impact on the treatment outcome.

Calcific Tendinitis of the Shoulder: A Neuro-Psychomotor Behavioral Diagnostic and Therapeutic Approach With Radioelectric Asymmetric Conveyer Neurobiological Stimulation Treatments

“…It might seem unlikely that a purely orthopedic pathology may have a psychogenic/neuropsychic origin or component that determines its onset or conditions and its severity. For some years, the scientific literature has been increasingly highlighting this correlation between psychogenic/neuropsychic components and orthopedic pathologies, such as calcific tendinitis of the shoulder, FS [ 13 ], or osteoarthritis of the knee [ 18 ]. Nevertheless, in clinical practice, this aspect is considered neither by the patient nor by the therapist who continues to use exclusively pharmacological and physiotherapy treatments.…”

“…In case of failure of the previous treatments, therapeutic ultrasound, extracorporeal shockwave therapy, radial shockwave therapy, joint washing treatment with saline solution, intra-articular infiltrations with hyaluronic acid, and surgical treatment are also used. The treatments listed above are intended to reduce pain, inflammatory processes, and mechanically or chemically break down calcification, but none of these are intended to reduce the constant state of muscle tension induced by depression, anxiety, and stress, conditions reported by various authors in the field of CST [ 4 , 5 , 10 , 13 , 16 ].…”

“…The second treatment used is called neuro-psycho-physical optimization (NPPO). This treatment, which consists of a cycle of 18 sessions lasting a few seconds, has been designed to improve mood and behavioral disorders, such as depression, anxiety, and stress [ 13 , 16 ]. The third neurobiological stimulation treatment used is called tissue optimization type B (TO-B).…”

“…The mechanism that can most easily determine this situation in an unconscious way is the postural attitude, which is a neuro-psychomotor behavior correlated to the subject's emotional state [5]. In the 70s, some studies [10] had highlighted correlations between CTS and emotional and behavioral states, such as depression and anxiety [5,[11][12][13]. On these assumptions, our behavioral neuro-psychomotor etiopathogenic and therapeutic approach was developed.…”

The Relationship between Self-Perceived Health and Clinical Symptoms in Patients with Frozen Shoulders

“…Patients with FS have perceived their health status through the activities of daily living, including experiencing shoulder pain and shoulder ROM limitations while performing certain physical activities (e.g., raising hands overhead, combing hair, or washing the back) [ 14 , 15 , 16 ]. Those physical limitations can cause psychological anxiety or depression [ 17 , 18 ], which could reduce their willingness to participate in social activities and could even result in encounters with environmental facilities that are unfavorable to them (e.g., having difficulty pulling the overhead handrail when taking public transportation) [ 14 , 15 ]. Accordingly, FS patients’ perceptions of their health status, as experienced in four dimensions (physical, psychological, social, and environmental interactions), can be expressed in terms of health-related quality of life.…”