Functional Consequences and Musculoskeletal Complications of Diabetic patients with Frozen Shoulder
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Keywords

Diabetes
Frozen shoulder
musculoskeletal disorder
SPADI
Physiotherapy

Abstract

Objective: This study aimed to evaluate the functional consequences and associated MSK complications in diabetic ‎patients with frozen shoulder in relation to age, demographic characteristics, and ‎physiotherapy interventions

Study Design: A cross-sectional study was conducted.

Place and duration of study: This cross-sectional study was conducted in hospitals of Abbottabad, from June to ‎November, 2024.

Material and Methods:This cross-sectional study was conducted in hospitals of Abbottabad, from June to ‎November, 2024. Participant was selected using Raosoft, with an estimated of 377 patient, ‎including adults over 20 years old diagnosed with diabetes and frozen shoulder complain, ‎however patients with paralysis or other health complications were excluded. Data was ‎collected through a structured questionnaire (demographic characteristics, SPADI, MSK and ‎physiotherapy sessions). Chi-square test and spearman’s correlation were used to determine ‎the association between categorical variables at P value<0.05 statistically significant.‎

Results: Demographic data reveals that the majority of participants were over 40 years old, with a ‎higher proportion of females, married and housewives. Most participants had 6 to 10 years ‎since diabetic diagnosed. Only 14.25% participants reported a family history of diabetes. ‎More, single/divorce, housewives and type 2 diabetes significantly (P<0.05) increase pain and ‎disability. Co-occurrence of lower back, knee, hips, ankle and wrist increased pain and ‎disability in the studied participants. Patients with severe pain were more likely receiving ‎combined therapies (electro-, manual and exercise).‎

Conclusion: ‎ This study found that frozen shoulder with other MSK disorders significantly impact daily ‎activities and functional independence. The study emphasizes early screening, comprehensive ‎physiotherapy and tailored rehabilitation for diabetic patients with frozen shoulder.‎

Keywords: Diabetes, Frozen shoulder, musculoskeletal disorder, SPADI, Physiotherapy

https://doi.org/10.37939/jnah.v4i01.202
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References

‎1.‎ Mukhtar Y, Galalain A, Yunusa U. A modern overview on diabetes mellitus: a chronic ‎endocrine disorder. European Journal of Biology. ‎‎2020;5(2):1-14.‎

‎2.‎ ‎Kalra S, Unnikrishnan AG, Baruah MP, Sahay R, Bantwal G. Metabolic and energy ‎imbalance in dysglycemia-based chronic disease. ‎Diabetes, Metabolic Syndrome and Obesity. ‎‎2021:165-84.https://doi.org/10.2147/DMSO.S286888‎

‎3.‎ ‎Struyf F. Frozen shoulder: present and future. Elsevier; 2024.‎

‎4.‎ ‎Dyer BP, Rathod-Mistry T, Burton C, Van Der Windt D, Bucknall M. Diabetes as a ‎risk factor for the onset of frozen shoulder: a systematic ‎review and meta-analysis. BMJ open. ‎‎2023;13(1):e062377.https://doi.org/10.1136/bmjopen-2022-062377‎

‎5.‎ ‎Navarro-Ledesma S, Hamed-Hamed D, Pruimboom L. A new perspective of frozen ‎shoulder pathology; the interplay between the brain and ‎the immune system. Frontiers in ‎physiology. 2024;15:1248612.DOI: 10.3389/fphys.2024.1248612‎

‎6.‎ ‎Li K, Bichoupan K, Gilchriest JA, Moosazadeh K. Real-world experience of treating ‎frozen shoulder using active manipulation under local ‎anesthetic: a retrospective study. ‎Medicine. 2021;100(47):e27839.DOI: 10.1097/MD.0000000000027839‎

‎7.‎ ‎Wang A, Lv G, Cheng X, Ma X, Wang W, Gui J, et al. Guidelines on multidisciplinary ‎approaches for the prevention and management of ‎diabetic foot disease (2020 edition). Burns ‎& trauma. 2020;8:tkaa017.‎

‎8.‎ ‎ Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sørensen F, Andersson G, et al. ‎Standardised Nordic questionnaires for the ‎analysis of musculoskeletal symptoms. Applied ‎ergonomics. 1987;18(3):233-7‎

‎9.‎ ‎Roach KE, Budiman‐Mak E, Songsiridej N, Lertratanakul Y. Development of a shoulder ‎pain and disability index. Arthritis & Rheumatism: ‎Official Journal of the American College ‎of Rheumatology. 1991;4(4):143-9‎

‎10.‎ ‎Zhang M, Zhang Y. Motivation and barriers to postoperative rehabilitation exercise in ‎type 2 diabetic patients with rotator cuff injuries: a ‎qualitative study. Patient preference and ‎adherence. 2024:1483-92.https://doi.org/10.2147/PPA.S467952‎

‎11.‎ ‎Sana’a AA, MacDermid JC, Overend TJ, Faber KJ, Furtado R. Physiotherapy Exercise ‎Program for Managing Adhesive Capsulitis in ‎Patients with and without Diabetes: A Pilot ‎Randomized Trial. Archives of Orthopaedics. 2020;1(2):27-‎‎‎39.https://doi.org/10.33696/Orthopaedics.1.006‎

‎12.‎ ‎Al Mamun MA. The Status of Work Life Balance of Women's Employment in Primary ‎Education Sector and Its Impact on Their Perception ‎of Work in Bangladesh: A Study on ‎Khulna City. International Journal of Science and Business. 2020.‎

‎13.‎ ‎Suleman S, Tariq H, Asif T, Khan AQ, Sehar H, Akhtar M, et al. Frequency of ‎Shoulder Pain in Type 2 Diabetes Mellitus Patients. Journal ‎Riphah College of Rehabilitation ‎Sciences. 2023;11(04).DOI:https://dxdoi.org/10.53389/JRCRS.2023110408‎

‎14.‎ ‎Dyer BP, Burton C, Rathod‐Mistry T, Blagojevic‐Bucknall M, van Der Windt DA. Are ‎patients with newly diagnosed frozen shoulder more ‎likely to be diagnosed with type 2 ‎diabetes? A cohort study in UK electronic health records. Diabetes, Obesity and Metabolism. ‎‎‎2024;26(12):5915-21.https://doi.org/10.1111/dom.15965‎

‎15.‎ ‎Shariat A, Cardoso JR, Cleland JA, Danaee M, Ansari NN, Kargarfard M, et al. ‎Prevalence rate of neck, shoulder and lower back pain in ‎association with age, body mass ‎index and gender among Malaysian office workers. Work. 2018;60(2):191-‎‎9.https://doi.org/10.3233/WOR-‎‎182738‎

‎16.‎ ‎Dighriri YH, Akkur MA, Alharbi SA, Madkhali NA, Matabi KI, Mahfouz MS. ‎Prevalence and associated factors of neck, shoulder, and ‎low-back pains among medical ‎students at Jazan University, Saudi Arabia: A cross-sectional study. Journal of family ‎medicine and primary ‎care. 2019;8(12):3826-31.doi: 10.24911/IJMDC.51-1659545872‎

‎17.‎ ‎Khosravi, Z., E. Mohammad Ali Nasab Firouzjah, et al. (2024). "Comparison of balance ‎and proprioception of the shoulder joint in girls with ‎and without upper cross syndrome." ‎BMC Musculoskeletal Disorders 25(1): 618.‎

‎18.‎ ‎Intolo P, Shalokhon B, Wongwech G, Wisiasut P, Nanthavanij S, Baxter DG. Analysis ‎of neck and shoulder postures, and muscle activities ‎relative to perceived pain during laptop ‎computer use at a low-height table, sofa and bed. Work. 2019;63(3):361-‎‎‎7.https://doi.org/10.3233/WOR-192942‎

‎19.‎ ‎Nazish N, Charles MJ, Kumar V. Prevalence of musculoskeletal disorder among house ‎wives and working women. IJHSR. 2020;10(2):215-‎‎22.‎ ‎

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