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Seminar paper from the year 2012 in the subject Physical Therapy / Occupational Therapy, printed single-sided, grade: 1,9, Teesside Business School - University of Teesside (Physiotherapy Master of Science in Advanced Clinical Practice (ACP) of Manipulative Therapy (ManipTh)), course: Evidence Based Practice (EBP), language: English, abstract: Up to five percent of the general population is affected by frozen shoulder and adhesive capsulitis, respectively. Its duration can possibly last three years and physiotherapy is a substantial part of conservative treatment. In particular, mobilisation treatment seems to play a major part, especially in the stiffness dominant stage. There is uncertainty about which mobilisation treatment works best in frozen shoulder. Whereas a stiff joint is commonly treated with success by so called end range mobilisation techniques, there is a widespread belief that this mobilisation referring to the frozen shoulder has negative effects on the condition and its healing. Therefore, it is inappropriate and ought to be substituted by so called low grade techniques. This report undertakes an evidence based approach in evaluating these mobilisation techniques in terms of their clinical effectiveness concerning joint mobility and possible adverse effects. In addition, economic issues are regarded. These evaluations consist of formulating a clearly focused research question, employing a structured search for an answer and critically appraising the findings. As a result, there is strong internal and external evidence to recommend high grade mobilisation techniques in stiffness dominant adhesive capsulitis of the shoulder in comparison to the low grade technique with a difference in the outcomes being small. Particularly, passive abduction after three and twelve months as well as active and passive external rotation after twelve months had a better outcome in comparison to low grade technique treatment. No adverse effects are reported. In addition, economic efficiency demonstrates also slight advantages for high grade treatment. The report finally develops a hypothetical plan of implementing the results into current practice. National policy yet lacks information and advice in this field. Therefore, this result should be utilised within.
