Abstract
BACKGROUND: Frozen shoulder (FS) is a common musculoskeletal condition characterized by inflammatory contracture of the glenohumeral joint capsule, leading to restricted active and passive range of motion, particularly in external rotation. Eccentric control exercises have demonstrated effectiveness in managing various upper limb disorders, including subacromial impingement, tennis elbow, and rotator cuff tendinopathy. However, there is limited evidence on their efficacy in individuals with frozen shoulder. This study aimed to evaluate the effects of eccentric control exercises on pain, functional disability, range of motion, psychosocial outcomes, and patient satisfaction in individuals with FS and mild to moderate disability. METHODS: A single-group pre-post design was used. Twenty patients with clinically diagnosed FS and mild to moderate disability participated. All underwent 20 sessions of supervised eccentric control exercises over four weeks. Outcome measures included the Shoulder Pain and Disability Index (SPADI), Numerical Pain Rating Scale (NPRS), shoulder range of motion (flexion, abduction, hand-behind-back, and external rotation), Tampa Scale of Kinesiophobia (TSK), and Pain Self-Efficacy Questionnaire (PSEQ). Assessments were conducted at baseline, post-intervention (4 weeks), and follow-ups at 3 and 6 months. A 6-point Likert scale was used to measure patient satisfaction post-intervention. Data were analyzed using Repeated Measures ANOVA. RESULTS: All outcome measures showed statistically significant improvement post-intervention (p < 0.05), with the benefits maintained at the 3- and 6-month follow-ups. Effect size indices at 4 weeks demonstrated a large treatment effect across all variables, suggesting strong clinical relevance. CONCLUSIONS: Eccentric control exercises significantly improved pain, functional disability, range of motion, kinesiophobia, pain self-efficacy, and patient satisfaction in individuals with frozen shoulder and mild to moderate disability. These findings support the incorporation of eccentric training in rehabilitation programs for frozen shoulder.