Functional Outcomes after Manipulation under Anaesthesia in Patients with Adhesive Capsulitis with and Without Diabetes Mellitus: A 48-Week Prospective Cohort Study

Polisetty Sravan Akhil, Prakash Jha, Abhishek Verma

Abstract: Background: Diabetes mellitus is frequently associated with adhesive capsulitis and may influence symptom severity and recovery. Manipulation under anaesthesia (MUA) is used for patients with persistent symptoms and restricted shoulder movement despite conservative treatment. This study evaluated pain, disability and shoulder movement outcomes following MUA in patients with adhesive capsulitis with and without diabetes mellitus. Methods: This prospective cohort study included 62 patients with unilateral adhesive capsulitis who had failed at least one month of conservative treatment. Patients were classified according to diabetes status, with 31 diabetic and 31 non-diabetic patients. All patients underwent posterior intra-articular triamcinolone 40 mg and lignocaine 2% injection followed by controlled MUA and structured shoulder physiotherapy. Outcomes were assessed before MUA and at 1, 3, 6, 12, 24 and 48 weeks using the Shoulder Pain and Disability Index (SPADI), Oxford Shoulder Score and the recorded range-of-motion (ROM) component of the Constant Score. Welch's unpaired t-test was used for between-group comparisons at 48 weeks and Friedman testing for longitudinal change. Results: At 48 weeks, mean SPADI pain was 7.61 ± 2.69 in diabetic patients and 5.42 ± 2.81 in non-diabetic patients (p = 0.0027). SPADI disability was 17.52 ± 1.34 versus 16.68 ± 0.91 (p = 0.0056), and the recorded ROM component was 33.48 ± 1.36 versus 32.58 ± 1.95 (p = 0.0389). The 48-week Oxford Shoulder Score was 16.19 ± 1.66 versus 15.48 ± 1.09 (p = 0.0522). Both groups showed significant longitudinal changes in pain, disability and recorded ROM. Conclusion: Patients with adhesive capsulitis demonstrated improvement in pain, disability and recorded shoulder movement following MUA combined with intra-articular corticosteroid/local anaesthetic injection and structured physiotherapy. Differences in several recorded outcomes remained between diabetic and non-diabetic patients at 48 weeks. Because diabetes was not randomized and no multivariable adjustment was performed, these findings represent subgroup associations rather than an independent causal effect.

Keywords: adhesive capsulitis; frozen shoulder; diabetes mellitus; manipulation under anaesthesia; SPADI; shoulder function; range of motion

How to Cite?: Polisetty Sravan Akhil, Prakash Jha, Abhishek Verma, "Functional Outcomes after Manipulation under Anaesthesia in Patients with Adhesive Capsulitis with and Without Diabetes Mellitus: A 48-Week Prospective Cohort Study", Volume 15 Issue 9, September 2026, International Journal of Science and Research (IJSR), Pages: 1989-1993, https://www.ijsr.net/getabstract.php?paperid=MR26929123348, DOI: https://dx.doi.org/10.21275/MR26929123348

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