Background and aim. Frozen shoulder (FS) is defined as a condition characterized by daily and nightly pain associated with functional restriction of both active and passive shoulder motion for which radiographs of the glenohumeral joint are essentially unremarkable [1]. The relevant role of psychological factors in shoulder pathologies is recognized; it’s already been investigated in FS at baseline, however only few studies reported on its prognostic value[2,3]. The aim of this systematic review is to investigate, in patients with FS, the prognostic power of psychological factors on pain, function, disability, health-related quality of life, return to work and time to recovery.

Materials and methods. The Preferred Reporting Items for Systematic reviews and Meta-Analysis - PRISMA 2020 guideline[4] was used to direct the study, while the Cochrane Handbook for Systematic review of Intervention was used as methodological guidance[5]. For the evaluation of the Risk of Bias was used the Quality in Prognostic Studies – QUIPS tool.

Results. The results of the included studies reported that pain-related fear is strongly related with shoulder function, disability, and pain, while pain catastrophizing is only significant related with disability. Moreover, it seems that depression is related with function, disability and pain, while anxiety would appear to only impact disability and pain.

Discussion and conclusions. This study suggest that could exist, as widely reported in numerous musculoskeletal conditions, in subjects with FS, a relationship between psychological factors such as pain-related fear, pain catastrophizing, depression and anxiety, and physical dimension such as pain, disability and function. Therefore, clinicians should be encouraged to identify these factors through a whole assessment of the bio-psychological profile of each individual with FS. For this reason, patients with FS who present psychological factors, could benefit from a comprehensive and shared approach with other dedicated professionals.

BIBLIOGRAPHY

[1]      M. J. Kelley et al., “Shoulder Pain and Mobility Deficits: Adhesive Capsulitis,” Journal of Orthopaedic & Sports Physical Therapy, vol. 43, no. 5, 2013, doi: 10.2519/jospt.2013.0302.

[2]      P. Debeer et al., “The outcome of hydrodilation in frozen shoulder patients and the relationship with kinesiophobia, depression, and anxiety,” J Exp Orthop, vol. 8, no. 1, 2021, doi: 10.1186/s40634-021-00394-3.

[3]      L. de Baets, T. Matheve, C. Dierickx, E. Bijnens, D. Jans, and A. Timmermans, “Are clinical outcomes of frozen shoulder linked to pain, structural factors or pain-related cognitions? An explorative cohort study,” Musculoskelet Sci Pract, vol. 50, 2020, doi: 10.1016/j.msksp.2020.102270.

[4]      M. J. Page et al., “The PRISMA 2020 statement: An updated guideline for reporting systematic reviews,” The BMJ, vol. 372. 2021. doi: 10.1136/bmj.n71.

[5]      Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA. “Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Cochrane. Published online 2022. www.training.cochrane.org/handbook.”.