Efficacy and cost-effectiveness of physiotherapy following glenohumeral joint distension for adhesive capsulitis: A randomized trial

Rachelle Buchbinder, Joanne M. Youd, Sally Green, Alicia Stein, Andrew Forbes, Anthony Harris, Kim Bennell, Simon Bell, Warwick J. L. Wright

The purpose of this study was to determine whether an active physiotherapy program following arthrographic joint distension for adhesive capsulitis provides additional benefits.  A total of 156 participants with pain and stiffness in predominantly 1 shoulder for 3 months and restriction of passive motion >30° in 2 planes of movement entered the study. Following joint distension, participants were randomly assigned to either manual therapy and directed exercise or placebo (sham ultrasound), both administered twice weekly for 2 weeks then once weekly for 4 weeks. Pain, function, active shoulder movements, participant-perceived success, and quality of life were assessed at baseline, 6, 12, and 26 weeks.  Both groups improved over time with no significant differences in improvement between groups for pain, function, or quality of life at any time point. Significant differences favored the physiotherapy group for all active shoulder movements and participant-perceived success. The authors concluded that physiotherapy following joint distension provided no additional benefits in terms of pain, function, or quality of life but resulted in sustained greater active range of shoulder movement and participant-perceived improvement up to 6 months.

Arthritis Care and Research, 2007, 57(6), 1027-1037

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