Therapy and rehabilitation of women with diabetic adhesive capsulitis

Iryna Zharova; Yevhen Orlenko

doi:10.15391/prrht.2025-10(2).05

Authors

Iryna Zharova Department of Therapy and Rehabilitation, National University of Physical Education and Sports of Ukraine, Kyiv, Ukraine https://orcid.org/0000-0002-8904-9446
Yevhen Orlenko Department of Therapy and Rehabilitation, National University of Physical Education and Sports of Ukraine, Kyiv, Ukraine https://orcid.org/0000-0002-0800-6744

DOI:

https://doi.org/10.15391/prrht.2025-10(2).05

Keywords:

physical therapy, rehabilitation, diabetes mellitus, adhesive capsulitis, ICF, women, motor activity, functions, activity and participation

Abstract

Purpose. The purpose of the work is to scientifically and methodologically substantiate and develop a program of therapy and rehabilitation for mature women with type 2 diabetes mellitus and adhesive capsulitis, in order to improve their functional state, activity and participation.

Material & Methods. The study of the effectiveness of the developed therapy and rehabilitation program (TtaR) was conducted based on the results of the observation of 97 women with type 2 diabetes mellitus (DM) complicated by adhesive capsulitis (AC), who was subject to a step-by-step examination at the scientific and advisory department of outpatient and preventive care for patients with endocrine pathology of the State Institution "Institute of Endocrinology and Metabolism named after V. P. Komissarenko of the National Academy of Medical Sciences of Ukraine", Kyiv. Observations were carried out using specific clinical (content analysis of medical records, review, clinical laboratory research), instrumental methods (bioimpedance diagnostics of body composition, goniometry, radiography) and sociological (visual analogue pain scale VAS, international questionnaire for assessing the quality of life MOS SF-36 (Medical Outcomes Study)) research methods.

Results. We developed and evaluated the effectiveness of a program of therapy and rehabilitation of women with diabetic adhesive capsulitis, implemented in three stages: preparatory (at a clinical institution and/or outpatient), main and final (outpatient and home training programs). To achieve a more pronounced rehabilitation effect, the development of a therapy and rehabilitation program was carried out according to the following algorithm for providing rehabilitation services: assessment of the initial morphofunctional state, activity and participation; determination of the principles and objectives of the program; development and implementation of the program; evaluation of effectiveness. The objectives of the developed program were: normalization of blood glucose levels, normalization of the functions of damaged limbs, reduction of pain syndrome, restoration of joint mobility, improvement of quality of life. The developed program is based on the following principles of providing rehabilitation services: application of the International Classification of Functioning, Disability and Health (ICF); adherence to a multidisciplinary approach; client-centric (personalized) approach; formation of goals in the SMART format; integrated approach; staged interventions; systematicity and duration. The foundation of the developed program was a combination of elements of the most effective means and methods (integrated approach) used in patients with type 2 diabetes and adhesive capsulitis: therapeutic exercises, diet therapy and nutritional correction, hardware physiotherapy, patient education within the framework of diabetes, occupational therapy measures.

Conclusions. The proposed and implemented TtaR program for women with type 2 diabetes and adhesive capsulitis allowed to reduce pain syndrome, restore functional capabilities, and improve the quality of life.

References

American Diabetes Association (2021). Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2021. Diabetes Care. 44(Suppl 1), 15-s33. https://doi.org/10.2337/dc21-S002

Colberg, S.R., Sigal, R.J., Yardley, J.E., Riddell, M.C., Dunstan, D.W., Dempsey, P.C., et al. (2016). Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care, 39(11), 2065-79. https://doi.org/10.2337/dc16-1728

Czelusniak, P., Walczak, T.G.R., & Skare, T.L. (2012). Shoulder pain and dysfunction in 150 type 2 diabetes mellitus patients. Arq Bras Endocrinol Metab, 56(4), 233-237. https://doi.org/10.1590/S0004-27302012000400003

Espeland, M.A., Lipska, K., Miller, M.E., Rushing, J., Cohen, R.A., Verghese, J., et al. (2017). Effects of Physical Activity Intervention on Physical and Cognitive Function in Sedentary Adults With and Without Diabetes. The Journals of Gerontology: Series A, 72(6), 861-6. https://doi.org/10.1093/gerona/glw179

Fasika, S., Abebe1, S.M., & Kebede, A.G. (2013). The prevalence of shoulder and hand complications and associated factors among diabetic patients at University of Gondar Teaching Referral Hospital in Northwest Ethiopia. Journal of Diabetes Research and Clinical Metabolism, 10–7243. https://doi.org/10.7243/2050-0866-2-8

Ivanenko, Y.O., Kalmykov, S.A., & Kalmykova, Y.S. (2020). Basic approaches to non-drug and restorative treatment of patients with type 2 diabetes. Fizicna Reabilitacia ta Rekreacijno-Ozdorovci Tehnologii, 5(1), 19-25. https://doi.org/10.15391/prrht.2020-5(1).03

Kalmykova, Y., & Kalmykov, S. (2023). The effectiveness of the physical therapy program for patients with metabolic syndrome based on the study of the dynamics of the functional state of the autonomic nervous system and hemodynamic parameters. Fizicna Reabilitacia ta Rekreacijno-Ozdorovci Tehnologii, 8(2), 117-127. https://doi.org/10.15391/prrht.2023-8(2).05

Kriska, A.M., Rockette-Wagner, B., Edelstein, S.L., Bray, G.A., Delahanty, L.M., Hoskin, M.A., et al. (2021). The Impact of Physical Activity on the Prevention of Type 2 Diabetes: Evidence and Lessons Learned From the Diabetes Prevention Program, a Long-Standing Clinical Trial Incorporating Subjective and Objective Activity Measures. Diabetes Care, 44(1), 43-9. https://doi.org/10.2337/dc20-1129

Liu, Y., Ye, W., Chen, Q., Zhang, Y., Kuo, C.H., & Korivi, M. (2019). Resistance Exercise Intensity is Correlated with Attenuation of HbA1c and Insulin in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health, 16(1) (pii), ijerph16010140. https://doi.org/10.3390/ijerph

Loh, R., Stamatakis, E., Folkerts, D., Allgrove, J.E., & Moir, H.J. (2020). Effects of Interrupting Prolonged Sitting with Physical Activity Breaks on Blood Glucose, Insulin and Triacylglycerol Measures: A Systematic Review and Meta-analysis. Sports Med., 50(2), 295-330. https://doi.org/10.1007/s40279-019-01183-w

Maund, E., Craig, D., Suekarran, S., Neilson, A., Wright, K., Brealey, S., et al. (2012). Management of frozen shoulder: a systematic review and cost-effectiveness analysis. Health Technol Assess, 16(11), 1-264. https://doi.org/10.3310/hta16110

Sergii, K., Yuliya, K., Anastasiia, Y. (2021). Alternative methods of kinesotherapy with the use of elements of yogi asans for type 2 diabetes mellitus. Fizicna Reabilitacia ta Rekreacijno-Ozdorovci Tehnologii, 6(2), 5-12. https://doi.org/10.15391/prrht.2021-6(2).01

Takahashi, P.Y., Quigg, S.M., Croghan, I.T., Schroeder, D.R., & Ebbert, J.O. (2019). SMART goals setting and biometric changes in obese adults with multimorbidity: Secondary analysis of a randomized controlled trial. SAGE Open Med., 7, 2050312119858042. https://doi.org/10.1177/2050312119858042

Tang, M.Y., Smith, D.M,, Mc Sharry, J., Hann, M., & French, D.P. (2019). Behavior change techniques associated with changes in postintervention and maintained changes in self-efficacy for physical activity: A Systematic Review With Meta-analysis. Ann Behav Med., 53(9), 801-15. https://doi.org/10.1093/abm/kay090

Turchyna, S., Nikitina, L., Varodova, O., Kalmykova, Y., & Kalmykov, S. (2022). Functional state of the GH/IGF-1 system in adolescents with type 1 diabetes mellitus. Fizicna Reabilitacia ta Rekreacijno-Ozdorovci Tehnologii, 7(4), 171-178. https://doi.org/10.15391/prrht.2022-7(4).28

Turchina, S., Kosovtsova, G., Varodova, O., Kalmykov, S., & Kalmykova, Y. (2024). Physical development of adolescents with type 1 diabetes mellitus and the impact of the war in Ukraine on its impairment. Fizicna Reabilitacia ta Rekreacijno-Ozdorovci Tehnologii, 9(4), 285-300. https://doi.org/10.15391/prrht.2024-9(4).08

World Health Organisation (2002). International Classification of Functioning, Disability and Health (ICF) – Beginners’ Guide. In Rehabilitation Resource Repository. https://bit.ly/4jf6OGj

World Health Organisation (2013). A Practical Manual for using the International Classification of Functioning, Disability and Health. In Rehabilitation Resource Repository. https://bit.ly/3RltOHF

World Health Organization (2003). ICF Checklist Version 2.1a, Clinician Form. https://bit.ly/4lB3mYj

Yian, E.H., Contreras, R., & Sodl, J.F. (2012). Effects of glycemic control on prevalence of diabetic frozen shoulder. J Bone Joint Surg Am, 94(10), 919-923. https://doi.org/10.2106/JBJS.J.01930