Adhesive Capsulitis: A New Management Protocol to Improve Passive Range of Motion
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.
aStanford University School of Medicine, 450 Broadway St, Mailcode: 6342, Redwood City, CA 94063†
bStanford University School of Medicine, Redwood City, CA‡
cStanford University School of Medicine, Redwood City, CA§
dStanford University School of Medicine, Redwood City, CA¶
eStanford University School of Medicine, Redwood City, CA∥
Address correspondence to: R.M.
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ABSTRACT