• The Journal of Korean Physical Therapy
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• 제28권2호
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• pp.101-105
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• 2016

Purpose: The purpose of this study was to determine the effects of group exercise, manual therapy, and a home exercise program on VAS (visual analogue scale), ROM (range of motion) of shoulder, and functional outcome in adhesive capsulitis. Methods: The study was conducted with 45 patients. All subjects were randomly assigned to 3 groups: group exercise (n=15), manual therapy (n=15), home exercise (n=15). The subjects performed an intervention program 3 times a week for 4 weeks a total of 12 times. Outcome measurements were VAS, ROM, and Constant-Murley score outcome measures. Measurements were taken four times, at baseline, 4 weeks later, 8 weeks later, and 12 weeks later. Results: VAS, ROM of the shoulder, and functional outcomes showed improvement in all groups at the final follow-up (p<0.05). VAS and ROM showed greater improvement with group exercise and manual therapy than home exercise, however, there were no significant differences between the two groups (p>0.05). Functional outcomes showed the greatest improvement in group exercise at the final follow-up. This improvement was greater than with manual therapy or home exercise (p<0.05). Conclusion: Group exercise and manual therapy were more effective for improving pain, ROM, and function than home exercise in adhesive capsulitis. In particular, group exercise is more effective in functional recovery than other physiotherapy interventions.

• The Journal of Korean Physical Therapy
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• 제32권5호
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• pp.277-282
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• 2020

Purpose: The main purposes of this study are to identify the degree of effect size and variables related to it, on the effect of physical therapy on shoulder adhesive capsulitis. Methods: This study were collected 8 studies published between 2010.01.01. and 2020.08.01. The Analysis result confirmed 16 effect size data, the random effect model was chosen because of the heterogeneity of the data. Results: First, full case showed the largest mean effect size 3.28 (p<0.001). Second, Size of the effect according to hands on+off intervention the 5.17 (p>0.344). Third, Number of participants showed 15 or more effect size 4.19 (p<0.002). intervention period showed 8 weeks effect size 5.12 (p>0.425). Number of intervention showed 14 or less effect size 3.99 (p>0.061). Publication type showed thesis effect size 4.34 (p<0.003). Finally, 'Trim and Fill' result confirmed that the calibration effect size is 1.71 (p<0.001). Conclusion: We were able to confirm that physical therapy had great effect on shoulders adhesive capsulitis, and that the effect differed according to the methods of intervention, the methods of evaluation.

• Journal of Yeungnam Medical Science
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• 제38권1호
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• pp.19-26
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• 2021

Adhesive capsulitis of the shoulder joint is a common disease characterized by pain at the insertional area of the deltoid muscle and decreased range of motion. The pathophysiological process involves fibrous inflammation of the capsule and intraarticular adhesion of synovial folds leading to capsular thickening and contracture. Regarding the multidirectional limitation of motion, a limitation in external rotation is especially prominent, which is related to not only global fibrosis but also to a localized tightness of the anterior capsule. Ultrasound and magnetic resonance imaging studies can be applied to rule out other structural lesions in the diagnosis of adhesive capsulitis. Hydraulic distension of the shoulder joint capsule provides pain relief and an immediate improvement in range of motion by directly expanding the capsule along with the infusion of steroids. However, the optimal technique for hydraulic distension is still a matter of controversy, with regards to the infusion volume and rupture of the capsule. By monitoring the real-time pressure-volume profile during hydraulic distension, the largest possible fluid volume can be infused without rupturing the capsule. The improvement in clinical outcomes is shown to be greater in capsule-preserved hydraulic distension than in capsule-ruptured distension. Moreover, repeated distension is possible, which provides additional clinical improvement. Capsule-preserved hydraulic distension with maximal volume is suggested to be an efficacious treatment option for persistent adhesive capsulitis.

• PNF and Movement
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• 제16권2호
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• pp.169-178
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• 2018

Purpose: This study aimed to investigate the effect of angular joint mobilization (AJM) on the shoulder pain, range of motion, and functional improvement in a patient with shoulder adhesive capsulitis. Methods: The patient diagnosed with right shoulder adhesive capsulitis by an orthopedic surgeon was a 60-year-old male, right hand/arm dominant, with a height of 175 cm and weight of 75 kg. The patient received 12 sessions of AJM once or twice per week for eight weeks. AJM was applied for 5 min each of flexion, abduction, external rotation, internal rotation, for a total of 20 min per session. The visual analog scale, the goniometer, and the Oxford shoulder score were used to measure pain, range of motion, and shoulder pain & disability index, respectively. Results: After all the treatments, the pain decreased from 6 to 2 points. The range of motion increased in flexion by $54.3^{\circ}$ from $125^{\circ}$ to $179.3^{\circ}$, abduction by $38^{\circ}$ from $140^{\circ}$ to $178^{\circ}$, external rotation by $54.4^{\circ}$ from $30.3^{\circ}$ to $84.7^{\circ}$, and internal rotation by $25^{\circ}$ from $45^{\circ}$ to $70^{\circ}$. The shoulder disability index decreased from 33 points to 17 points. Conclusion: This study found that AJM has a positive effect on the improvement of shoulder pain, range of motion, and function in a patient with shoulder adhesive capsulitis. Further studies on AJM are needed in the future.

• 척추신경추나의학회지
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• 제14권2호
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• pp.1-14
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• 2019

Objectives : To evaluate the effectiveness of Chuna Manual Therapy for adhesive capsulitis by a systematic review manner. Methods : Five foreign electronic databases (Pubmed, Ovid-medline, Embase, Cochrane library, Chinese Academic Journals (CAJ)) and two Korean medical electronic databases (Oriental Medicine Advanced Searching Integrated System (OASIS) and Research Information Sharing Service (RISS)) were searched to find all randomized controlled trials (RCTs) using Chuna Manual Therapy as a treatment for adhesive capsulitis. The methodological quality of each RCT was assessed using the Cochrane risk of bias tool. Results : Twenty-one RCTs met our inclusion criteria. The meta-analysis showed positive results on the use of Chuna Manual Therapy combined with acupuncture or exercise therapy in terms of the efficacy rate and pain using the Visual Analogue Scale (VAS), compared to acupuncture or exercise alone [SMD-1.81 (95% CI & -2.54, -1.08), P<0.001, RR 1.19 (95% CI 1.14, 1.23), P<0.001)]. Positive results in terms of efficacy rate were also obtained comparing Chuna Manual Therapy to acupuncture alone [RR 1.10 (95% CI 1.02, 1.18), P=0.01]. Conclusions : Our systematic review found favorable results on the effectiveness of Chuna Manual Therapy for pain and efficacy rate of adhesive capsulitis. However, evidence was limited due to the lack of well-designed RCTs. More qualified clinical trials are needed to obtain stronger evidence.

• Clinics in Shoulder and Elbow
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• 제18권1호
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• pp.28-35
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• 2015

Background: We assessed the effectiveness of arthroscopic capsular release for the treatment of adhesive capsulitis. Further, we tried to ascertain the clinical benefits, if any, of pancapsular release over selective capsular release, where the two differ by performing or not performing a posterior capsular release, respectively. Methods: Thirty-five consecutive patients with either primary or secondary adhesive capsulitis who failed conservative treatment for more than 6 months were enrolled in the study. A total of 16 patients allocated in group 1 received a pancapsular release that comprises the release of the rotator interval, anteroinferior capsular, and the posterior capsular release, whereas 19 patients in group 2 received a selective capsular release that comprises only the release of the rotator interval release and anteroinferior capsular release. The clinical outcomes, visual analogue scale (VAS) score, Constant score, and range of motion, were assessed preoperative and postoperatively. Results: In both groups, the preoperative VAS score, Constant score, and ROM showed a significant improvement by the 6-month follow-up. We found that the immediate postoperative internal rotation was significantly higher in group 1 than group 2. Despite significant differences seen between the two groups at the initial postoperative period, there were no significant differences in Constant score, VAS score, and the ROM at all the subsequent follow-ups between the two groups. Conclusions: Arthroscopic capsular release for the treatment of adhesive capsulitis is very effective. However, pancapsular release did not show any advantage over selective capsular release in terms of overall clinical outcome.

• 대한물리의학회지
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• 제8권2호
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• pp.219-229
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• 2013

PURPOSE: The purpose of the study was to investigate a influence in Proprioceptive Neuromuscular Facilitation, and self-assisted ROM exercise of shoulder adhesive capsulitis. METHODS: The methods of the study was to investigate a change in range of motion (ROM), an increase in ROM, visual analogue scale (VAS) and disability questionnaire by Proprioceptive Neuromuscular Facilitation, and self-assisted ROM exercise on 32 patients who were diagnosed with shoulder adhesive capsulitis. RESULTS: There was no significant difference between the two groups who were treated in the Proprioceptive Neuromuscular Facilitation and self-assistive ROM exercise group for flexion, extension, internal rotation, external rotation, VAS and disability questionnaire. Both group's flexion, extension, internal ratation, and external rotation levels were significantly different before and after the treatment. And significant statistical decrease in VAS and disability was seen. The extension of the shoulder joint was closely related to external rotation (r=0.84). There was a close relationship between internal rotation and external rotation at the shoulder joint. There was no increased range of extension through the exercise method. However, flexion, extension, internal rotation, external rotation, VAS, and disability questionnaire of Proprioceptive Neuromuscular Facilitation groups were obviously higher than in the self-assisted ROM exercise group. CONCLUSION: Our study suggest that considering Proprioceptive Neuromuscular Facilitation for the patient who has shoulder adhesive capsulitis in clinic.

• 대한물리치료과학회지
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• 제13권4호
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• pp.27-34
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• 2006

Purpose : The purpose of this study is to prove the increasing range of motion of joint to the patients of adhesive capsulitis of the shoulder applied the gliding-mobilization. Subjects and methods : The subjects are patients of adhesive capsulitis of the shoulder who have limited range of motion due to capsular pattern on the shoulder. The subjects are volunteer patients without a history of neuromuscular problems and randomly distributed into two groups. 15 experimental subjects(4 male, 11 female) received therapy with gliding-mobilization applied on limited shoulder joint and a second group with 15 control subjects(6 male 9 female) was treated by physiological passive range of motion therapy. The data were analyzed with paired t-test to determine striking differences depending on the course of treatment. Result : 1) In the group treated by gliding-mobilization the range of motion in shoulder flexion was increased in accordance to the course of treatment, and paired t-test showed striking differences(p<.05). 2) The range of motion in shoulder extension was increased in accordance to the course of treatment, and paired t-test showed striking differences(p<0.05). 3) The range of motion in shoulder abduction was increased with serise of treatment, and paired t-test showed striking differences(p<0.05). Conclusion : The gliding-mobilization increases the range of motion of the patient of adhesive capsulitis of the shoulder.

• Physical Therapy Rehabilitation Science
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• 제9권2호
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• pp.90-97
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• 2020

Objective: This study investigated the effects of combining both mobilization and hold-relax (HR) technique on the function of post-surgical patients with shoulder adhesive capsulitis. Design: Randomized controlled trial. Methods: Forty-five surgical patients with shoulder adhesive capsulitis participated in this study and were randomly divided into three groups; both mobilization with movement (MWM) and HR technique (HR-MWM) group (n=15), the MWM group (n=15), and control group (n=15). All participants received three different interventions; 1) MWM combined with HR technique in PNF stretching on the shoulder, 2) MWM on the shoulder, 3) general physical therapy and intervention with neither MWM or HR stretching. Pre- and post-intervention, each subject was randomly evaluated for shoulder flexion range of motion (ROM), shoulder flexor muscle strength, Visual Analogue Scale (VAS), and the Korean version of the Shoulder Pain And Disability Index (SPADI). Results: The MWM combined with HR technique group had significant effects on shoulder flexion ROM, shoulder flexor muscle strength, VAS and SPADI compared to the MWM and control group (p<0.05). The MWM group showed a significantly greater increase in shoulder flexion ROM compared to the control group (p<0.05). Conclusions: These findings suggest that combining both the MWM and HR technique on the shoulder may more effectively improve shoulder function than MWM alone or without MWM&HR technique. Therefore, combining both the MWM and HR technique is a suggested intervention for increasing function due to shoulder adhesive capsulitis after surgery.

• The Korean Journal of Pain
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• 제35권3호
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• pp.280-290
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• 2022

Background: This study aimed to determine the impact of complex decongestive therapy applications on upper extremity function in breast cancer patients who developed adhesive capsulitis after lymphedema. Methods: Thirty patients who developed adhesive capsulitis due to lymphedema were divided into two groups as study (n = 15) and control (n = 15) groups. Both groups received 20 minutes of exercise five days a week for three weeks using a Biodex isokinetic dynamometer, as well as a hot pack and TENS (Transcutaneous Electrical Nerve Stimulation) treatment to the shoulder joint. The study group received 45 minutes of intensive decongestive therapy along with the adhesive capsulitis treatment. The visual analogue scale was used to assess pain, circumference, and volumetric measurements were used to assess edema, and the Arm, Shoulder, and Hand Problems Questionnaire (DASH: Disabilities of the Arm, Shoulder, and Hand) was used to assess upper extremity functionality. The shoulder range of motion was evaluated. Results: Both groups had improvements in pain (P < 0.001), shoulder joint range of motion (P < 0.001), and upper extremity functionality (P < 0.001) after the treatment. There was a significant decrease in circumference and volumetric measurements in the study group (P < 0.001). However, no differences were seen in measurements in the control group. Conclusions: The results showed that complex decongestive therapy was beneficial in reducing lymphedema in breast cancer patients who acquired adhesive capsulitis due to lymphedema. Consequently, the authors believe that supplementing conventional physiotherapy with complex decongestive therapy will benefit patients.