Effect Of Manual Release Combined With Isokinetic Muscle Strength Training On The Recovery Of Frozen Shoulder Patient

objective: To evaluate the effect of manual release combined with isokinetic muscle strength training on the recovery of frozen shoulder patients by observing the changes of shoulder pain,shoulder range of motion,shoulder muscle strength and shoulder function before and after treatment.in order to provide a reasonable and effective treatment for patients with intractable frozen shoulder.Methods:Forty patients with frozen shoulder who were treated with frozen shoulder in municipal hospital from October 2017 to February 2019 were randomly divided into observation group(n=20)and control group(n=20).There was no significant difference between the two groups in terms of sex,age,pain side and other general data(p>0.05).The control group was treated with manual release under anesthesia,and the patients were treated with oral non-steroidal anti-inflammatory drugs or intramuscular injection of weak opioids for analgesia.After manual release,routine rehabilitation treatment mainly included passive exercise and active exercise.Active exercises include shoulder shrugging,fist-clenching and other isometric contraction training of periacromial muscles,pendulum exercises,flexion,external rotation,fingers climbing the wall,and so on.All patients are encouraged to take the initiative to exercise the shoulder joint on the affected side in their daily activities.On this basis,the treatment group selected the corresponding angular velocity according to the specific conditions of the patients,and carried out isokinetic centripetal training on the muscles around the shoulder joint(including the muscles in all directions of abduction,flexion and extension).Isokinetic muscle strength training is once a day,5 days / week,30 minutes/ time,a total of 4 weeks.The patients were routinely scored with VAS before isokinetic muscle strength training.If the VAS score was more than 3,the patients were given drug analgesia treatment,so that the VAS score was less than 3,and then the patients were instructed to carry out isokinetic muscle strength training.Before each isokinetic muscle strength training,the patient is told to fully preheat the affected shoulder and carry out active and passive movements of the shoulder joint with the help of the therapist,so that the shoulder joint ROM can reach the best state,and then the therapist measures the shoulder joint AROM of the patient,and then sets the joint activity value of this isokinetic training on the isokinetic muscle strength training equipment(no more than 90% of the measured shoulder joint AROM).In the first week,120 °/ s is used,the movement speed is faster,but the pressure on the articular surface is less,so it is safer.60°/s(slow speed)is selected from the 2nd week to the 3rd week,which mainly increases the muscle tension and shortens the time of muscle strength recovery;in the4 th week,180°/s(high speed)is used for functional adaptability training,which can be carried out repeatedly.By simulating daily life activities and the contraction speed of exercise,the functional requirements of patients’ daily life can be achieved and patients can return to daily exercise.Pain visual analogue scale(VAS),joint angle ruler,ISOMED2000 isokinetic test system and Constant-Murley shoulder function score were used to evaluate the VAS score,active range of motion(AROM),peak moment(PT)and Constant-Murley shoulder function score before and after treatment.Results: Before treatment,there was no significant difference in VAS score,AROM,PT and Constant-Murley shoulder function scores between the two groups.After treatment,the VAS score,AROM,PT and Constant-Murley shoulder function score of the affected side in the two groups were better than those before treatment in the two groups(p< 0.05).The VAS score after treatment in the treatment group was lower than that in the control group(p<0.05).After treatment,the active range of motion of the shoulder joint in the treatment group [abduction(115.7°±12.2°),flexion(128.1°±16.2°),extension(33.5°±6.6°)] was larger than that in the control group(AROM(99.9°±14.7°),flexion(109.9 °±13.5°),extension(24.1°±4.8°)(p<0.05,120°/s,60°/s,180°/s).After treatment,the PT of shoulder joint in abduction,flexion and extension in the treatment group was higher than that in the control group(p<0.05).The Constant-Murley shoulder function score in the treatment group was higher than that in the control group.The Constant-Murley shoulder function score in the treatment group was higher than that in the control group.Conclusion: In this study,the effect of manual release combined with isokinetic muscle strength training on the recovery of frozen shoulder patients is more significant than that of manual release alone.Manual release combined with isokinetic muscle strength training has a positive effect on shoulder pain,range of motion,shoulder joint strength and shoulder function recovery in frozen shoulder patients.