High-intensity stretch treatment for severe postoperative adhesive capsulitis of the shoulder

详细信息    查看全文

• 作者：Preston M. Wolin^b ; Amy Ingraffia-Welp^b ; Carlos E. Moreyra^c ; William C. Hutton^a ; ^{whutton@emory.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Adhesive capsulitis ; Shoulder ; Stretching ; High intensity stretching ; Physical therapy
• 刊名：Annals of Physical and Rehabilitation Medicine
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：59
• 期：4
• 页码：242-247
• 全文大小：784 K

文摘

Some patients with postoperative adhesive capsulitis reach a plateau in their recovery with a standard protocol of physical therapy (PT), which puts them at risk for further surgical intervention.

Objectives

We aimed to evaluate therapy for postoperative adhesive capsulitis of the shoulder in 2 groups of patients: (1) those who used a high-intensity stretch (HIS) device after reaching a plateau in their recovery with a standard protocol of traditional PT (PT + HIS) and (2) those who showed no plateau in their recovery with a standard protocol of traditional PT alone (PT only).

Methods

We retrospectively reviewed the records for 60 patients (51 males; mean age 46.7 ± 12.6 years) with postoperative adhesive capsulitis who received treatment between March 2007 and May 2010. Forward elevation and combined internal/external rotation at the initial postoperative visit and final visit were measured. The measurements from group 2 patients were used as an observational benchmark.

Results

The PT + HIS (n = 42) and PT-only (n = 18) patients did not differ in total follow-up time. Initial elevation was worse for PT + HIS than PT-only patients (22.1° lower, P = 0.02), but the final elevation was equivalent. Initial rotation was worse for PT + HIS than PT-only patients (16.6° lower, P = 0.04), but the final rotation was higher for PT + HIS patients (10.6° higher, P = 0.04). Gains in elevation and rotation were greater for the PT + HIS than PT-only patients (P = 0.04 and P = 0.01).

Conclusions

Patients with postoperative adhesive capsulitis of the shoulder who are unable to reach their PT treatment goals with a standard protocol of PT may benefit from the addition of HIS to their treatment regimen. HIS could be a valuable adjunct to PT for treating postoperative adhesive capsulitis in appropriate patients.