Prognostic Factors Affecting Duration of the Adhesive Capsulitis Rehabilitation

Main Article Content

Jantira Hongrapipat


Background: Adhesive capsulitisis a common painful multidirectional restriction of shoulder motion. Of 2-5% general population has the adhesive capsulitis. From other reports, it was found that 20-50% of patients suffer long term range of motion deficits. Non-operative treatment according to stage of disease can help most patients recovered much better.
Objective: To identify the prognostic factors affecting duration of the adhesive capsulitis rehabilitation more than 6 months.
Methods: A retrospective study was conducted with outpatients, in the Department of Rehabilitation in Surin hospital, whom had been diagnosed with adhesive capsulitis and rehabilitation, during October 1st 2016 to September 30th 2018. The Fisher’s exacttest, Univariable logistic regression and Multivariable logistic regression was used in the analysis.
Results: The results showed that 49 patients (41.2%) out of the total 119 adhesive capsulitis required rehabilitation more than 6 months.In the univariable logistic regression, it was found that(1) diabetes mellitus (OR 2.80, 95%CI 1.19 – 6.57, p-value=0.017) (2) history of shoulder trauma (OR 2.76, 95%CI 1.22 - 6.24, p-value=0.015) (3)moderate pain score (OR 0.35, 95%CI 0.17 - 0.75, p-value=0.035) (4)severe pain score(OR 3.52, 95%CI 1.64 – 7.57, p-value=0.001) (5)shoulder forward flexion range of motion less than 120 degree(OR 3.71, 95%CI 1.71 – 8.03, p-value=0.001) and (6)shoulder abduction range of motion less than 120 degree(OR 5.59, 95%CI 2.36 – 13.26, p-value=<0.001). In the multivariable logistic analysis, it was found that (1) diabetes mellitus (aOR 3.44, 95%CI 1.25 – 9.48, p-value=0.017), (2) severe pain score ( aOR 3.26, 95%CI 1.35 - 7.79, p-value=0.008) and (3) shoulder abduction range of motion less than 120 degree(aOR 3.51, 95%CI1.03 –11.98, p-value=0.045) are the main factors causing the adhesive capsulitis rehabilitation for more than 6 months.
Conclusions: Prognostic factors affecting the adhesive capsulitis rehabilitation of more than 6 months are diabetes, severe pain score, and range of motion of shoulder abduction less than 120 degree. The results from this research can be used for prognosis and treatment.
Keywords: Adhesive capsulitis, Frozen shoulder, Prognostic factors


Article Details

Original Articles


1. ชยาภรณ์ โชติญาณวงษ์. ข้อไหล่ติด (Frozen shoulder). กรุงเทพฯ : ภาควิชาเวชศาสตร์ฟื้นฟู คณะแพทยศาสตร์ ศิริราชพยาบาล; มปป. [สืบค้นเมื่อ 15 กพ.62]. เข้าได้ถึงจาก URL:

2. Ewald A. Adhesive capsulitis: a review. Am Fam Physician 2011;83(4):417-22.

3. Binder A, Hazleman BL, Parr G, Roberts S. A controlled study of oral prednisolone in frozen shoulder. Br J Rheumatol 1986;25(3):288-92.

4. Manske RC, Prohaska D. Diagnosis and management of adhesive capsulitis. Curr Rev Musculoskelet Med 2008;1(3-4):180-9.

5. Milgrom C, Novack V, Weil Y, Jaber S, Radeva-Petrova DR, Finestone A. Risk factors for idiopathic frozen shoulder. Isr Med Assoc J 2008;10(5):361-4.

6. Hand C, Clipsham K, Rees JL, Carr AJ. Long-term outcome of frozen shoulder. J Shoulder Elbow Surg 2008;17(2):231-6.

7. Wang K, Ho V, Hunter-Smith DJ, Beh PS, Smith KM, Weber AB. Risk factors in idiopathic adhesive capsulitis: a case control study. J Shoulder Elbow Surg 2013;22(7):e24-9.

8. Vastamäki H, Kettunen J, Vastamäki M. The natural history of idiopathic frozen shoulder: a 2- to 27-year followup study. Clin Orthop Relat Res. 2012;470(4):1133-43.

9. Reeves B. The natural history of the frozen shoulder syndrome. Scand J Rheumatol 1975;4(4):193-6.

10. Shaffer B, Tibone JE, Kerlan RK. Frozen shoulder. A long-term follow-up. J Bone Joint Surg Am 1992;74(5):738-46.

11. Ogilvie-Harris DJ, Biggs DJ, Fitsialos DP, MacKay M. The resistant frozen shoulder. Manipulation versus arthroscopic release. Clin Orthop Relat Res 1995;(319):238-48.

12. Vastamäki H, Varjonen L, Vastamäki M. Optimal time for manipulation of frozen shoulder may be between 6 and 9 months. Scand J Surg 2015;104(4):260-6.

13. ณัฏฐิยา ตันติศิริวัฒน์. อาการปวดและความผิดปกติของข้อไหล่ ที่พบบ่อยในเวชศาสตร์ฟื้นฟู. Chula Med J 2017;16:206-21.

14. Griggs SM, Ahn A, Green A. Idiopathic adhesive capsulitis. A prospective functional outcome study of nonoperative treatment. J Bone Joint Surg Am 2000;82-A(10):1398-407.

15. Ando A, Sugaya H, Hagiwara Y, Takahashi N, Watanabe T, Kanazawa K, et al. Identification of prognostic factors for the nonoperative treatment of stiff shoulder. Int Orthop 2013;37(5):859-64.