Dynamic Neuromuscular Stabilization for Middle-Aged Women With Frozen Shoulder: Clinical Effects on Pain and COP

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Abstract

Background: Frozen shoulder (FS) leads to pain, reduced shoulder function, and deficits in postural stability and sensorimotor control during upper-limb weight-bearing tasks. This study investigated how an eight-week Dynamic Neuromuscular Stabilization (DNS) program affected Center of Pressure (COP) control and pain in middle-aged women with FS. Methods: Twenty-two middle-aged women with FS were randomly assigned to a DNS group (DNSG, n = 11) or a control group (CG, n = 11). The DNSG performed DNS exercises twice weekly for eight weeks, while the CG performed dynamic stretching. COP variables (distance, velocity, and root mean square (RMS) in the anterior–posterior (AP) and medial–lateral (ML) directions) were measured using a force platform under affected-side single-hand support with visual input and bilateral hand support with and without visual input. Pain was assessed using the Visual Analog Scale (VAS). All variables were analyzed using a two-way mixed ANOVA. Results: Under the affected-side single-hand support condition, significant group-by-time interaction effects were found in AP distance, AP velocity, ML velocity, and ML RMS (p < 0.05). In the bilateral hand-support conditions with and without visual input, additional COP variables also showed significant interactions (p < 0.05), and VAS-measured pain decreased over time in both groups. Conclusions: The DNS intervention demonstrated positive changes in postural stability and pain during upper-limb weight-bearing tasks in middle-aged women with FS. These findings suggest that DNS has potential as an intervention strategy to support functional recovery and enhance sensorimotor control in individuals with FS.

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