Intra-articular distension preceded by physical therapy versus intra-articular distension followed by physical therapy for treating adhesive capsulitis of the shoulder
| Autor: | Zohra Ben Salah Frih, Anis Jellad, Wafa May, Amine Kalai, Mondher Golli, Mahbouba Jguirim, Ahmed Zrig |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male 030506 rehabilitation medicine.medical_specialty Shoulder Bursitis Visual analogue scale Pain relief Pain Physical Therapy Sports Therapy and Rehabilitation Distension Injections Intra-Articular 03 medical and health sciences 0302 clinical medicine Intra articular medicine Humans Orthopedics and Sports Medicine Range of Motion Articular Physical Therapy Modalities Aged Pain Measurement business.industry Shoulder Joint Rehabilitation Frozen shoulder 030229 sport sciences Middle Aged medicine.disease Combined Modality Therapy Capsulitis Treatment Outcome Physical therapy Upper extremity pain Female 0305 other medical science business |
| Zdroj: | Journal of back and musculoskeletal rehabilitation. 33(3) |
| ISSN: | 1878-6324 |
| Popis: | Background Intra-articular distension is a validated treatment in adhesive capsulitis of the shoulder and is commonly followed by intensive in-patient physical therapy. A recent meta-analysis found that physical therapy is as effective as intra-articular distension (IAD) and that an early distension could be the primary choice for treating frozen shoulder. The question of the additional contribution of physical therapy prior to IAD compared with IAD followed by physical therapy has not been raised. Objectives We compared IAD preceded by physical therapy to that followed by physical therapy in terms of pain relief and functional outcome. Methods We enrolled patients with primitive adhesive capsulitis of the shoulder. The eligible patients were randomized into three groups: A, B and C. Group A received intra-articular distension followed by physical therapy, group B received intra-articular distension in the middle of physical therapy and group C received physical therapy alone. Patients were assessed at the beginning of the protocol (T0), after 6 weeks (T1) and after 12 weeks (T2). The main outcome measures were pain using a Visual Analog Scale and the Disabilities of Arm, Shoulder and Hand Questionnaire. Results Out of the 179 enrolled patients, only 122 completed the follow up: group A (n= 34), group B (n= 46) and group C (n= 42). Compared to intra-articular distension preceded by physical therapy, IAD followed by physical therapy did not improve significantly the outcome in terms of pain relief (p= 0.123) but it enhanced the upper extremity function (p= 0.002). Upper extremity pain and function were found to improve with time regardless of the protocol (p Conclusions IAD followed by physical therapy is more beneficial than IAD preceded by physical therapy in terms of upper extremity function. IAD, whether or not preceded by physical therapy, does not significantly improve pain compared to physical therapy alone. Time is a crucial factor to take into consideration while treating adhesive capsulitis of the shoulder. |
| Databáze: | OpenAIRE |
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