Objective: Primary frozen shoulder causes significant pain and progressively restricts shoulder movements. Diagnosis is made clinically based on patient history and physical examination. Management is mainly non-invasive owing to its self-limiting clinical course. However, clinical practice guidelines for frozen shoulder have not yet been developed in Korea. The developed guidelines aim to provide evidence-based recommendations for the diagnosis and treatment of frozen shoulder. Methods: A guideline development committee reviewed the literature from four databases (PubMed, Embase, Cochrane Library, and KMbase). Using the Population, Intervention, Comparator, and Outcome (PICO) framework, the committee formulated two backgrounds and 16 key questions to address common clinical concerns. Recommendations were made using the Grading of Recommendations, Assessment, Development, and Evaluation framework. Results: Diabetes, thyroid disease, and dyslipidemia significantly increase the risk of developing a frozen shoulder. Although frozen shoulder is often self-limiting, some patients may experience long-term functional disabilities. Ultrasound and magnetic resonance imaging should be used as adjunctive tools alongside clinical diagnosis, and rather than as independent diagnostic methods. Noninvasive approaches, such as medications, physical modalities, exercises, electrical stimulation, and manual therapy, may reduce pain and improve shoulder function. Other noninvasive interventions have limited evidence, and their application should be based on clinical judgment. Intra-articular steroid injections are recommended for treatment, and physiotherapy or hydrodilation with steroid injections can also be beneficial. Conclusion These guidelines provide evidence-based recommendations for diagnosing and treating primary frozen shoulder.

BACKGROUND: The purpose of this study was to examine histological changes of testes induced by hindlimb unloading & position change of testis in mature adult male rats. METHOD: Eight month old (390~410g) 36 male Sprague-Dawley rats were weight-matched assigned to Ground Control (GC), Hindlimb Unloading (HU), Hindlimb Unloading & Testis Tie(HUT), Intra-abdominal Testis(IAT) for 24 days. Daily body weight was watched for status of animal. Testis weight, Seminiferous Tubule Diameter(STD), Seminiferous Tubule Perimeter(STP), Serminiferous Tubule Area(STA), Sertori Cell Height(SCH) were examined in each group. RESULTS: The 24-day hindlimb unloading of HU, HUT and IAT showed no significant change of body weight compared to GC. HUT maintained the weights, STD, STP, STA, SCH of their testes as GC while HU, IAT had significantly decreased the weights, STD, STP, STA of their testes. CONCLUSION: These results support that hindlimb unloading experiment induces serious morphological changes of testes. Therefore, on the hindlimb unloading experiment, IAT should be avoid or the effect of IAT should be correct. It will be necessary to study the pure effect of hindlimb unloading without IAT on the musculoskeltal system and so on which are associated with testosterone.
Adult ; Animals ; Body Weight ; Hindlimb Suspension* ; Hindlimb* ; Humans ; Male ; Rats* ; Rats, Sprague-Dawley ; Seminiferous Tubules ; Testis* ; Testosterone ; Weightlessness ; Weights and Measures