Patient experiences of hydrodistension as a treatment for frozen shoulder: A longitudinal qualitative study

Whelan, Gareth; Yeowell, Gillian; Littlewood, Chris

Abstract

BackgroundFrozen shoulder is a condition associated with severe shoulder pain and loss of function impacting on a persons{\textquoteright} physical and mental health. Hydrodistension treatment that has been widely adopted within the UK National Health Service for the condition. However, evidence of clinical effectiveness and understanding of the patient experiences of this treatment are lacking. This study explored the experiences of people with a frozen shoulder who received hydrodistension treatment.MethodsA qualitative design with repeat semi-structured interviews was used to explore participants{\textquoteright} experiences of hydrodistension treatment. Participants were interviewed 2-4 weeks and again at 8-10 weeks after treatment. Interviews were audio-recorded and transcribed verbatim. Findings were analysed using an inductive thematic analysis framework. The study is reported in accordance with the consolidated criteria for reporting qualitative (COREQ) research.Results15 participants were interviewed online or over the phone. Three themes were identified: {\textquoteleft}Preparing for and having a hydrodistension{\textquoteright}, {\textquoteleft}Physiotherapy after hydrodistension{\textquoteright}, and {\textquoteleft}Outcome of hydrodistension {\textquoteleft}. Participants believed hydrodistension would benefit them, was well tolerated by many, and the effects were apparent to most within the first week. Physiotherapy still seemed to be valued to support recovery beyond this timepoint, despite these early effects. Some participant{\textquoteright}s experienced harms including severe procedural pain and blood sugar dysregulation.ConclusionThis is the first study to investigate the experiences of people who undergo hydrodistension for frozen shoulder. Hydrodistension appears an acceptable treatment to participants with a frozen shoulder, acceptability is enhanced through adequate shared decision making. Further high-quality research is required to understand the comparative effectiveness of hydrodistension as a treatment for frozen shoulder, including adverse events, and the benefit of treatment by a physiotherapist after hydrodistension.

Citation

Whelan, G., Yeowell, G., & Littlewood, C. (2024). Patient experiences of hydrodistension as a treatment for frozen shoulder: A longitudinal qualitative study. PLoS ONE, https://doi.org/10.1371/journal.pone.0304236

• Journal Article Type: Article
• Acceptance Date: May 8, 2024
• Online Publication Date: Jun 14, 2024
• Publication Date: Jun 14, 2024
• Deposit Date: Nov 11, 2024
• Publicly Available Date: Nov 12, 2024
• Journal: PLOS ONE
• Electronic ISSN: 1932-6203
• Publisher: Public Library of Science
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1371/journal.pone.0304236
• Keywords: Patient experiences, hydrodistension, treatment, frozen shoulder, longitudinal qualitative study, physical health, mental health