Range of motion at baseline predict patient reported outcome measures in frozen shoulder patients treated with injections and rehabilitation
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Abstract
Frozen shoulder is a common shoulder concern with a prevalence of 2-5 per cent in the general population that affects the shoulder joint between the ages of 40 and 60, mostly in female subjects, manifesting in progressive loss of glenohumeral movements associated with intense pain.
The pathological process consists of a fibroproliferative tissue fibrosis and an inflammation of the synovial membrane. Although the pathophysiology of this condition has been deeply studied, the mechanisms underpinning remain poorly understood.
Frozen shoulder manifests clinically as shoulder pain with progressive restricted movement, both active and passive, in the absence of trauma, along with normal radiographic scans of the glenohumeral joint.
It classically progresses through 3 overlapping stages of pain (stage 1, lasting 2-9 months), stiffness (stage 2, lasting 4-12 months) and recovery (stage 3, lasting 5-24 months); however, up to day seems that pain-predominant and stiff-predominant phases could be more usefull in treatment modality choice and managing.
The medical management has not been defined with a wide spectrum of operative and nonoperative treatments available. The most widely used treatments are local steroid and/or anesthetic injections, stretching, active and passive mobilization, physiotherapy, hydrodistension, capsular release; hoverver, he goals of the treatment are pain management, shoulder function restoration and improvement in quality of life. Based on the best available evidence it appears that the use of corticosteroid injections plus physiotherapy has been associated with better outcomes above all in terms of early benefit in ER ROM with clinical significance as long as 6 weeks of treatments.
Nevertheless, it remains unclear which parameters influence the prognosis of the pathology.
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This Zenodo record is a permanently preserved version of a PREreview. You can view the complete PREreview at https://prereview.org/reviews/19198730.
Short Summary of Main Findings In this 2022 medRxiv preprint, baseline shoulder range of motion (particularly external rotation and abduction) significantly predicted patient-reported outcome measures (PROMs, such as pain and disability scores) in patients with frozen shoulder treated with corticosteroid injections plus rehabilitation. Patients with less severe ROM restrictions at baseline showed greater improvements and better final PROM scores after treatment. The work supports using initial ROM assessment as a simple, objective prognostic tool.
How This Work Has Moved the Field Forward It adds evidence that baseline impairment level can help forecast treatment response in a common …
This Zenodo record is a permanently preserved version of a PREreview. You can view the complete PREreview at https://prereview.org/reviews/19198730.
Short Summary of Main Findings In this 2022 medRxiv preprint, baseline shoulder range of motion (particularly external rotation and abduction) significantly predicted patient-reported outcome measures (PROMs, such as pain and disability scores) in patients with frozen shoulder treated with corticosteroid injections plus rehabilitation. Patients with less severe ROM restrictions at baseline showed greater improvements and better final PROM scores after treatment. The work supports using initial ROM assessment as a simple, objective prognostic tool.
How This Work Has Moved the Field Forward It adds evidence that baseline impairment level can help forecast treatment response in a common conservative protocol (injection + physio), aiding clinicians in setting realistic expectations, triaging patients, and personalizing rehab plans. It reinforces the prognostic value of ROM over other factors in non-operative frozen shoulder management.
Major Issues
Remains an unreviewed preprint (no peer-reviewed journal version identified as of 2026).
Small sample size and lack of control group limit generalizability and causal inference.
Potential selection bias and short or unclear follow-up duration.
Minor Issues
Title has grammatical error ("predict" should be "predicts").
Limited detail on exact statistical models or effect sizes in available summaries.
Unclear reporting of confounders (e.g., diabetes, symptom duration).
Competing interests
The author declares that they have no competing interests.
Use of Artificial Intelligence (AI)
The author declares that they did not use generative AI to come up with new ideas for their review.
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