Physiotherapy Management of Shoulder Osteoarthritis with Functional Limitation: A Case Report

Abstract

Introduction: Shoulder osteoarthritis (OA) can significantly impair daily functional activities in older adults, leading to reduced quality of life and independence. Population-based studies report that 16.1%–20.1% of adults over 65 years show radiographic evidence of glenohumeral OA. Physiotherapy plays an important role in reducing pain and improving joint function.
Objective: This case report aimed to describe the effects of a short course of physiotherapy on pain, muscle strength, and functional ability in an elderly patient with long-standing shoulder OA.
Methods: This case report used quantitative and qualitative approaches. Quantitative assessments included Manual Muscle Testing (MMT), the Shoulder Pain and Disability Index (SPADI), the Visual Analog Scale (VAS), and the Human Rating Scale for Activities (HRS-A). Qualitative data were obtained through clinical observation and patient interviews.
Results: An 87-year-old woman with a five-year history of shoulder OA presented with chronic pain, limited range of motion, and muscle weakness (MMT 3/5). Physiotherapy interventions included Transcutaneous Electrical Nerve Stimulation (TENS) and exercise therapy consisting of strengthening exercises, roll-gliding and traction-translation mobilization, and proprioceptive neuromuscular facilitation (PNF). After intervention, VAS scores decreased from 4 to 2 for palpation pain and from 8 to 5 for movement pain. Muscle strength improved to MMT grade 4, and SPADI scores decreased from 68 to 59.
Conclusion: A short course of physiotherapy combining TENS and targeted exercise therapy effectively reduced pain and improved functional capacity in a very elderly patient with long-standing shoulder OA.