Chuna manual therapy combined with acupuncture and cupping for frozen shoulder (adhesive capsulitis): Multicenter, randomized, patient-assessor blind, clinical trial

Introduction: Frozen shoulder is a common disease that causes pain and limited range of motion. The aim of this study was to evaluate the effectiveness, safety, and cost effectiveness of Chuna combined with integrative treatments on frozen shoulder. Method: A multicenter, randomized, patient-assessor blind, parallel clinical trial was carried out. Eligible subjects were randomly allocated to one of two groups. The experimental group received acupuncture, cupping and real Chuna manual therapy, and control group received acupuncture, cupping and sham Chuna manual therapy. During the 8-weeks period, effectiveness and safety evaluations were carried out. Evaluation of satisfaction and cost effectiveness was performed at the end of the trial (20-week). The primary outcome was shoulder pain and disability index (SPADI). The secondary outcomes were; assessment on a 100 mm pain visual analog scale, passive range of motion of shoulder, Korean shoulder scoring system score, quality of life score, use of relief medicine, evaluation of patient satisfaction, safety, and cost effectiveness. Results: A total of 66 subjects were enrolled in the study. There were no adverse events reported as a result of any of the treatments administered. The difference of SPADI score between two groups was not statistically significant. The score of EuroQol-5 Dimension (VAS) was significantly improved in experimental group at the end of treatment and at follow up (p = 0.015, p = 0.009 respectively). With SPADI and rotator cuff and quality of life as indicators, the experimental treatment indicated that it may be cost-effective but will depend on willingness to pay. Conclusion: Further evidence is required on the effectiveness of the Chuna combined with acupuncture and cupping therapy, as well as more verification of the economic assessment.