Journal of Paramedical Sciences & Rehabilitation

Journal of Paramedical Sciences & Rehabilitation

Comparison of the Effect of Codman Exercises and Scapular Rhythm on Some Postural Factors in Women with Frozen Shoulder

Document Type : Original Article

Authors
Z Sokhtezari 1
N Ghani Zadeh Hesar 1
M Mohamadi Dangheralo 2
S Roshani 1
1 Department of Exercise Physiology and Corrective Exercise , Faculty of Sport Sciences , Urmia University , Urmia, Iran
2 Department of Exercise Physiology and Corrective Exercise , Faculty of Sport Sciences , Urmia University , Urmia, Iran.
10.22038/jpsr.2022.58034.2260
Abstract
Purpose:
Frozen shoulder syndrome is a condition that causes pain and limited movement in the glenohumeral joint. Various treatments such as steroid injections, anesthesia manipulation and physical therapy have been introduced to improve the symptoms of this complication. Among these methods, various types of physical therapy are important because they are non-invasive. The aim of this study was to compare the effect of Cadman exercises and scapular rhythm on some postural factors in women with frozen shoulder.
Methods:
In this quasi-experimental study, 30 women with frozen shoulder with an age range of 40 to 60 years in Ilam city, were purposefully selected and randomly divided into two equal groups, Cadman exercises (15 women) and scapular rhythm exercises (15 women) based on inclusion criteria. Both groups performed their exercises for 8 weeks, 3 sessions per week and 30 to 40 minutes per session. Before and after the training intervention, the amount of forward head and round shoulder were assessed by imaging using Kinovea software and kyphosis with flexible ruler. After checking the normality of the data by Kolmogorov-Smirnov test, ANCOVA statistical method considering the error of the type I, α = 0.05, data analysis was performed.
Results:
The results showed that there was no significant difference between the two training programs of Cadman and scapular rhythm in the variable of forward head (P=0.478) and kyphosis (P=0.215). But in the round shoulder variable, the results showed a significant difference between Cadman training program and scapular rhythm (P=0.001).
Conclusion:
The scapular rhythm training program has performed better in improving the round shoulder position of women with frozen shoulder due to its positive effect on the balance of the muscles around the scapula and the position of the scapula. Because movements of glenohumeral such as external rotation and abduction affect the position of the scapula, scapular rhythm exercises can reduce the symptoms of affected people by improving the round shoulder position and scapular position.
Keywords
frozen shoulder
scapula
kyphosis
Limited range of motion
  1. Ng CY, Amin AK, Narborough S, McMullan L, et al. Manupulation under Anesthesia and early physiotherapy facilitate recovery of patient with frozen shoulder syndrome. Scot Med J 2009; 54(1): 29-31.
  2. Flannery O, Mullett H, Colville J. Adhesive shoulder capsulitis: Does the timing of manipulation influence outcome? Acta Orthop Belg 2007; 73(1): 21-25.
  3. Codman EA. Normal motions of the shoulder joint. The Shoulder. Rupture of the Supraspinatus Tendon, Other Lesions in or About the Subacromial Bursa. Boston, MA: Thomas Todd. 1934; 3264.
  4. Struyf F, Meeus M. Current evidence on physical therapy in patients with adhesive capsulitis: what are we missing? Clin Rheumatol 2014; 33(4): 567-573.
  5. Kelley, M. J., McClure, P. W., Leggin, B. G. (2009). Frozen shoulder: Evidence and a proposed model guiding rehabilitation. J Orthop Sports Phys Ther 2009; 39(2): 135-148.
  6. Cohen C, Ejnisman B. Epidemiology of frozen shoulder. InShoulder stiffness. Springer, Berlin, Heidelberg: 2015: 21-30 
  7. Zreik NH, Malik RA, Charalambous CP. Adhesive capsulitis of the shoulder and diabetes: a meta-analysis of prevalence. Muscles Ligaments Tendons J 2016; 6(1):26-27.
  8. Simpson, J. K., Budge, R. Treatment of frozen shoulder using distension arthrography (hydrodilatation): a case series. Australas Chiropr Osteopathy 2004; 12(1), 25-38.
  9. Allander E. Prevalence, incidence, and remission rates of some common rheumatic diseases or syndromes. Scand J Rheumatol 1974; 3(3): 145-153.
  10. Hertling D, Kessler RM, Shimandle SA. Management of Common Musculoskeletal Disorders, Physical Therapy Principles and Methods. Dimens Crit Care Nurs Nursing: 1990: 261- 279.
  11. Esmaeelnezhad M, Ahmadi A, Maroufi N, Sarrafzadeh J, Fouladi M. Comparison of Scapular Posture between Individuals with and without Forward Head Posture Using a Clinical Test, J Rehab Med 2018; 7(1): 208-215. [Persian]
  12. Kibler, W.B. The role of the scapula in athletic shoulder function. Am J Sports Med 1998; 26(2):325-37.
  13. Sahrmann S, Azevedo DC, Van Dillen L. Diagnosis and treatment of movement system impairment syndromes. Braz J Phys Ther. 2017; 21(6): 391-399.
  14. Ludewig P M, Reynolds J E. The association of scapular kinematics and glenohumeral joint pathologies." J Orthop Sports Phys Ther 2009; 39(2): 90-104.
  15. Savadatti, R.Gaude, G.S. Effect of forward shoulder posture on forced vital capacity - ACo - relational study. Indian J Physiother Occup Ther 2011; 5(2): 119-123.
  16. Wang CH, McClure P, Pratt NE, Nobilini R. Stretching and strengthening exercises: Their effect on tree-dimensional Scapular kinematics. J Phys Med Rehabil 1999; 80(8): 923-929.
  17. Page P, Frank C, Lardner R. Assessment and treatment of muscle imbalance: The Janda approach. J Orthop Sports Phys Ther. 2011; 41(10): 799-800.
  18. Suárez-Sanabria N, Osorio-Patiño AM. Biomecánica del hombro y bases fisiológicas de los ejercicios de Codman. Ces medicina 2013; 27(2): 205-217.
  19. Sahrmann S. Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines. Elsevier Health Sciences 2010; 4(4): 26-37.
  20. Roshani S, Mahdavinejad R, Ghanizadehesar N. The effect of a NASM-based training protocol on upper cross syndrome in paraplegia spinalcord injury patients. Sjimu 2018; 25(6): 73-85. [Persian]
  21. Rostamizalani F, Ahanjan S, Rowshani S, BagherianDehkordi S, Fallah A. Comparison of the effects of three corrective exercise methods on the quality of life and forward head of men with upper cross syndrome. JPSR 2019; 8(1): 26-36. [Persian]
  22. Rowshani S, Moghaddasi A, Abbasi M, Abdol-Mohammadi A, Ahanjan S. The Effect of 4-weeks Rehabilitation Program on Range of Motion and. SALMAND 2010; 5(3): 7-15. [Persian]
  23. Fayad F, Roby-Brami A, Yazbeck C, Hanneton S, et al. Three-dimensional scapular kinematics and scapulohumeral rhythm in patients with glenohumeral osteoartritis or frozen shoulder. J Biomech 2008; 41: 326-332.
  24. Rundquist PJ, Anderson DD, Guanche CA, Ludewig PM. Shoulder kinematics in subjects with frozen shoulder. Arch Phys Med Rehabil 2003; 84: 1473-1479.
  25. Celik D. Comparison of the outcomes of two different exercise programs on frozen shoulder. Acta Orthop Traumatol Turc 2010; 44(4): 285-292.
  26. Raine S, Twomey L. Posture of the head, shoulders and thoracic spine in comfortable erect standing. Aust J Physiother 1994; 40(1): 25-32.
  27. Thigpen CA, Padua DA, Michener LA, Guskiewicz K, et al. Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks. J Electromyogr Kinesiol 2010; 20(4): 701-709.
  28. Khalil Khodaparast M, GhaniZadeh Hesar N. Effect of corrective exercises on the shoulder and cervical spine position and the performance of boxers. J Rehab Med 2020; 9(2): 210-218. [Persian]
  29. Janda, V., Muscles and cervicogenic pain syndromes. Grant R, editor. Physical therapy of the cervical and thoracic spine. New York: Churchill Livingstone 1988; 9(3): 113-134.
  30. Greenfield B, Catlin PA, Coats PW. Posture in Patients with Shoulder Overuse Injuries and Healthy Individuals, J Orthop Sports Phys Ther 1995; 21(5): 287-295.
  31. Yang JL, Chang CW, Chen SY, Lin JJ. Shoulder kinematic features in the predictin of response to physical therapy in patients with frozen shoulder syndrome. J Biomech 2007; 40(2): 12-23.
  32. Kotteeswaran, K, Rekha K, Anandh V. Effect of Stretching and Strengthening Shoulder Muscles in Protracted Shoulder in Healthy Individuals. Int J Comput Appl; 2012; 2(2): 111-118.
  33. Boruah L, Dutta A, Deka P, Roy J. To study the effect of scapular mobilization versus mobilization with movement to reduce pain and improve glenohumeral range of motion in adhesive capsulitis of shoulder: a comparative study. Int J Physiother. 2015; 1;2(5): 811-818.
  34. Pandey V, Madi S. Clinical Guidelines in the Management of Frozen Shoulder: An Update! Indian J Orthop 2021; 1(3): 1-12.
  35. Chan HB, Pua PY, How CH. Physical therapy in the management of frozen shoulder. Singapore Med J 2017; 58(12): 685-693.
Journal of Paramedical Sciences & Rehabilitation
Volume 11, Issue 2
Summer 2022
Pages 18-28