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A blinded , randomized , controlled trial assessing conservative management strategies for frozen shoulder . BACKGROUND There is little evidence for the optimal form of nonoperative treatment in the management of frozen shoulder . This study assesses the efficacy of current physiotherapy strategies . METHODS All primary care referrals of frozen shoulder to our physiotherapy department were included during a 12-month period . Of these referrals , 17 % met the inclusion criteria for primary idiopathic frozen shoulder . The 75 patients were randomly assigned to 1 of 3 groups : group exercise class , individual physiotherapy , and home exercises alone . A single independent physiotherapist , who was blinded to the treatment groups , made all assessments . Range of motion , Constant score , Oxford Shoulder Score , Short Form 36 , and Hospital Anxiety and Disability Scale ( HADS ) outcome measures were performed at baseline , 6 weeks , 6 months , and 1 year . RESULTS The exercise class group improved from a mean Constant score of 39.8 at baseline to 71.4 at 6 weeks and 88.1 at 1 year . There was a significant improvement in shoulder symptoms on Oxford and Constant scores ( P < .001 ) . This improvement was greater than with individual physiotherapy or home exercises alone ( P < .001 ) . The improvement in range of motion was significantly greater in both physiotherapy groups over home exercises ( P < .001 ) . HADS scores significantly improved during the course of treatment ( P < .001 ) . The improvement in HADS anxiety score was significantly greater in both physiotherapy intervention groups than in home exercises alone . CONCLUSIONS A hospital-based exercise class can produce a rapid recovery from a frozen shoulder with a minimum number of visits to the hospital and is more effective than individual physiotherapy or a home exercise program .
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Intervention_Physical
group exercise class
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Intervention_Physical
individual physiotherapy
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Intervention_Physical
home exercises alone
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Intervention_Physical
hospital-based exercise class
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Outcome_Physical
Range of motion
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Outcome_Physical
Constant score
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Outcome_Physical
Oxford Shoulder Score
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Outcome_Physical
Short Form 36
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Outcome_Mental
Hospital Anxiety
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Outcome_Physical
and Disability Scale ( HADS )
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Outcome_Physical
mean Constant score
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Outcome_Physical
shoulder symptoms on Oxford and Constant scores
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Outcome_Other
individual physiotherapy or home exercises alone
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Outcome_Physical
physiotherapy groups over home exercises
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Outcome_Physical
HADS scores
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Outcome_Physical
HADS anxiety score
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Participant_Condition
frozen shoulder
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Participant_Condition
frozen shoulder
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Participant_Condition
frozen shoulder
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Participant_Condition
primary idiopathic frozen shoulder
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Participant_Sample-size
75
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Participant_Condition
frozen shoulder