The effectiveness of physiotherapy in idiopathic or primary frozen shoulder. A systematic review and meta-analysis

Objective. The objective of this work was to evaluate the effectiveness of physiotherapy in individuals affected by primary or idiopathic frozen shoulder, considering only studies that employed a randomized controlled trial. Methods. A systematic review and meta-analysis were carried out according to PRISMA guidelines. Three bibliographic databases were searched: MEDLINE, Cochrane Library and PEDro. The minimum prerequisites for papers to be included in the systematic review were that they had to (a) employ a randomized controlled trial; (b) be published in English or Italian language. The studies were evaluated according to Cochrane Collaboration’s tool for assessing risk of bias and Jadad scale. Results. Twelve studies in systematic review and nine studies in meta-analysis were included. Conclusions. Frozen shoulder is a condition whose therapeutic targets could change due to symptoms and stage. Rehabilitation program, particularly end-range mobilization techniques and therapeutic exercise are the most effective in reducing pain and increasing function in sub-acute phases.