Preston M Wolin1, Amy Ingraffia-Welp1, Carlos E Moreyra2, William C Hutton3. 1. Center for Athletic Medicine, Chicago, IL, USA. 2. Tenet Florida Physician Services, Boca Raton, FL, USA. 3. Emory University, Atlanta, GA, USA. Electronic address: whutton@emory.edu.
Abstract
BACKGROUND: 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±12.6years) 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.
BACKGROUND: 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±12.6years) 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+HISpatients (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.
Authors: Riki Patel; Ivan Urits; John Wolf; Anu Murthy; Elyse M Cornett; Mark R Jones; Anh L Ngo; Laxmaiah Manchikanti; Alan D Kaye; Omar Viswanath Journal: Psychopharmacol Bull Date: 2020-10-15