PM&R
Volume 1, Issue 12 , Pages 1064-1068, December 2009

Adhesive Capsulitis: A New Management Protocol to Improve Passive Range of Motion

  • Raj Mitra, MD

      Affiliations

    • Stanford University School of Medicine, 450 Broadway St, Mailcode: 6342, Redwood City, CA 94063†
    • Corresponding Author InformationAddress correspondence to: R.M.
    • ,
  • Alex Harris, PhD

      Affiliations

    • Stanford University School of Medicine, Redwood City, CA‡
    • ,
  • Chainey Umphrey, MD

      Affiliations

    • Stanford University School of Medicine, Redwood City, CA§
    • ,
  • Matthew Smuck, MD

      Affiliations

    • Stanford University School of Medicine, Redwood City, CA
    • ,
  • Michael Fredericson, MD

      Affiliations

    • Stanford University School of Medicine, Redwood City, CA∥

Received 12 July 2009; accepted 15 October 2009.

Objective

To examine the short-term efficacy of a nonoperative shoulder protocol for the treatment of adhesive capsulitis.

Design

A retrospective chart review was used to collect data for a 3-year period.

Setting

Academic tertiary medical center.

Patients

28 consecutive patients diagnosed as having adhesive capsulitis were identified and managed with a new protocol.

Methods

The protocol consisted of the administration of a suprascapular nerve block, the subsequent injection of an intra-articular steroid, and then the injection of an anesthetic agent with brisement normal saline volume dilation. The final step was manipulation of the shoulder.

Results

A paired t test was used to examine the difference in the preprocedure and postprocedure passive range of motion (flexion and abduction). The average shoulder abduction before the procedure was 89.5°; this improved by an average of 51.7° (P < .0001). The average shoulder flexion improved from 117.3° by an average of 37.7° (P < .0001). There was no significant difference in either abduction or flexion based on age, gender, or chronicity of symptoms. White patients experienced significantly more improvement in abduction than did nonwhite patients.

Conclusions

This study suggests that this adhesive capsulitis management protocol is effective and produces a significant improvement in the passive range of motion immediately after the procedure.

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  • † Disclosure: nothing to disclose
  • ‡ Disclosure: nothing to disclose
  • § Disclosure: nothing to disclose
  •  Disclosure: nothing to disclose
  • ∥ Disclosure: 2A, Cool Systems; 8A, NIH

 This CME activity is designated for 1.0 AMA PRA Category 1 Credit™ and can be completed online at me.aapmr.org. Log on to www.me.aapmr.org, go to Lifelong Learning (CME) and select Journal-based CME from the drop down menu. At $10 per activity for AAPM&R members, journal CME is a cost-effective option for obtaining Category 1 CME credit!

 Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org

PII: S1934-1482(09)01461-0

doi:10.1016/j.pmrj.2009.10.005

PM&R
Volume 1, Issue 12 , Pages 1064-1068, December 2009

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