Physiotherapy Management of Adhesive Capsulitis in an Elderly Patient with Diabetes: A Case Report

Abstrak

Background: Adhesive capsulitis, commonly known as frozen shoulder, is characterized by progressive shoulder pain and restricted range of motion, leading to functional limitations, particularly in older adults with comorbidities such as diabetes mellitus.
Objective: This study aimed to evaluate the clinical outcomes of a multimodal physiotherapy intervention combining electro-physical agents and structured exercise therapy in an elderly patient with adhesive capsulitis.
Methods: This case report presents a 75-year-old male with diabetes mellitus and chronic left shoulder pain (Numeric Rating Scale [NRS] 8/10) for eight months. The intervention was administered twice weekly for three weeks and included infrared therapy and transcutaneous electrical nerve stimulation (TENS), combined with muscle activation and stretching exercises performed in 2 sets of 6–8 repetitions per session. Outcomes included NRS, range of motion (ROM), Manual Muscle Testing (MMT), Shoulder Pain and Disability Index (SPADI), and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH).
Results: Pain during movement decreased from 8 to 6 (25.0% reduction). Shoulder flexion improved from 90° to 110° (+22.2%) and abduction from 90° to 94° (+4.4%). SPADI improved from 59.2% to 42.0% (−29.1%), and QuickDASH from 59.1% to 40.0% (−32.3%). These changes exceeded commonly reported minimal clinically important difference thresholds. No adverse events were reported.
Conclusion: This case highlights that multimodal physiotherapy may provide clinically meaningful improvements in pain and functional outcomes in elderly patients with adhesive capsulitis. However, findings should be interpreted cautiously due to the single-case design.