Objective
Primary frozen shoulder causes significant pain and progressively restricts shoulder movements. Diagnosis is primarily 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 PICO (Population, Intervention, Comparator, and Outcome) 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 disabilities. Ultrasound and magnetic resonance imaging should be used as adjunctive tools alongside clinical diagnosis, and not 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 hydrodilatation with steroid injections can also be beneficial.
Conclusion
These guidelines provide evidence-based recommendations for diagnosing and treating primary frozen shoulder.

Diabetic peripheral neuropathy (DPN), a common complication of type 2 diabetes mellitus, leads to sensory and motor impairments that significantly affect fine motor skills, grip strength, and dexterity, limiting daily functioning. Understanding the impact of DPN on hand-related activities of daily living (ADLs) is crucial for improving patient care and outcomes. This review employed the International Classification of Functioning, Disability, and Health (ICF) framework to assess hand function issues. A systematic search of peer-reviewed studies was conducted across multiple databases to identify research examining the impact of DPN on hand-related ADLs. The findings were categorised using relevant ICF codes linked to hand function issues. The analysis identified four major themes: (1) the impact of DPN on daily activities and participation; (2) sensory impairments affecting hand function; (3) muscle weakness and functional limitations; and (4) unaddressed areas, such as structural changes, driving, assisting others, and preparing meals. DPN was found to significantly hinder hand function, reducing independence in ADLs and overall quality of life. This review highlights the need for comprehensive assessments that address not only impairments, but also activity limitations and participation restrictions, to capture the multifaceted challenges of DPN. Developing targeted assessments tailored to the specific needs of individuals with DPN is essential for improving intervention strategies and overall quality of care.

The effect of inspiratory muscle training (IMT) on cervical spinal cord injury (SCI) remains controversial. This study aimed to assess the efficacy of IMT in enhancing breathing muscle strength, pulmonary function, and quality of life (QoL) among patients with cervical SCI. A search was performed using the PubMed, Cochrane Library, Scopus, Embase, and Web of Science databases through December 2023. This review was conducted according to PRISMA guidelines and the Cochrane Library Handbook. The meta-analysis used mean differences (MDs) or standardized mean differences to pool the results. The Risk of Bias 2 and the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) were used to assess the methodological quality of the included studies. This systematic review included five randomized controlled trials (202 participants). The results of the meta-analysis showed that IMT significantly improved maximal inspiratory pressure (MIP) with MD 12.13 cmH2O (95% confidence interval [CI] 4.22 to 20.03), maximal expiratory pressure (MEP) with MD 8.98 cmH2O (95% CI 6.96 to 11.00), and vital capacity (VC) with MD 0.25 L (95% CI 0.21 to 0.28). There were no significant improvements in forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and QoL. The quality of the evidence ranged from very low to moderate, owing to bias and heterogeneity. Our results showed that IMT may improve MIP, MEP, and VC, but not FEV1, FVC, or QoL, in patients with cervical SCI. Further large-scale studies are required to determine this effect’s optimal dosage and duration.

Objective
To investigate the effects of a home-based rehabilitation program on physical capacity, lung function, and health-related quality of life (QOL) in patients with advanced lung cancer undergoing platinum-based chemotherapy.
Methods
Between December 2021 and December 2023, participants were randomly assigned to exercise and control groups. The exercise group engaged in a home-based exercise program, including respiratory, aerobic, and resistance training, for 60 minutes per session, three times per week, before the first tumor response evaluation. Outcome evaluations included the 6-minute walk test, spirometry to measure lung function (specifically assessing forced expiratory volume in 1 second [FEV1] and forced vital capacity, hand grip strength, and QOL assessments using the Short Form 36-Item Health Survey and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Lung Cancer Module 29. Participants were assessed at baseline, post-intervention, and followed up for 1 year.
Results
Twenty-one of the 26 participants completed the study. The control group showed a significant decrease in FEV1 (p=0.011). Delays in chemotherapy occurred in 40.0% of participants in the control group but none in the exercise group (p=0.019). Mental health showed improvement in the exercise group (p=0.041), whereas adverse effects were more common in the control group (p=0.007), according to QOL questionnaire results.
Conclusion
Home-based rehabilitation during chemotherapy may help maintain lung function, improve mental health, and reduce side effects in patients with lung cancer, warranting further research.

Objective
To examine the contribution of perceived upper limb function to participation and activity among community-dwelling people with chronic stroke.
Methods
A cross-sectional study was conducted with eighty-one people with stroke aged ≥50 years. The outcome measures included the Oxford Participation and Activities Questionnaire (Ox-PAQ), Arm Activity Measure (ArmA), Wolf Motor Function Test (WMFT), Timed Up and Go Test (TUG), and Geriatric Depression Scale (GDS).
Results
Correlation analyses revealed that perceived upper limb function, as measured using the ArmA, had the strongest and most significant correlations with the levels of participation and activity, as measured using the Ox-PAQ, among all of the tested variables (rs=0.35–0.59, p<0.01). Multiple linear regression analyses also showed that perceived upper limb function significantly associated the levels of participation and activity, accounting for 2.0% to 9.0% of the variance in the Ox-PAQ scores. The final model, which included TUG time, the GDS score, the WMFT score, and the ArmA score, could explain 54% and 28% of the variance in the routine activities and social engagement subscales of the Ox-PAQ, respectively. The model including the GDS score, the WMFT score, and the ArmA score explains 32% of the variance in the emotional well-being subscale of the Ox-PAQ.
Conclusion
Perceived upper limb function is a crucial determinant of participation and activity among community-dwelling people with chronic stroke. It could thus be a target component of stroke rehabilitation interventions to facilitate participation and activity after stroke.