Phys Ther 2000 Dec;80(12):1204-13
End-range mobilization techniques in adhesive capsulitis of the shoulder joint: A multiple-subject case report.
Vermeulen HM, Obermann WR, Burger BJ, Kok GJ, Rozing PM, van Den Ende CH.
Department of Physical Therapy, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands. email@example.com
BACKGROUND AND PURPOSE: The purpose of this case report is to describe the use of end-range mobilization techniques in the management of patients with adhesive capsulitis. CASE DESCRIPTION: Four men and 3 women (mean age=50.2 years, SD=6.0, range=41-65) with adhesive capsulitis of the glenohumeral joint (mean disease duration=8.4 months, SD=3.3, range=3-12) were treated with end-range mobilization techniques, twice a week for 3 months. Indexes of pain, joint mobility, and function were measured by the same observer before treatment, after 3 months of treatment, and at the time of a 9-month follow-up. In addition, arthrographic assessment of joint capacity (ie, the amount of fluid the joint can contain) and measurement of range of motion of glenohumeral abduction on a plain radiograph were conducted initially and after 3 months of treatment. OUTCOMES: After 3 months of treatment, there were increases in active range of motion. Mean abduction increased from 91 degrees (SD=16, range=70-120) to 151 degrees (SD=22, range=110-170), mean flexion in the sagittal plane increased from 113 degrees (SD=17, range=90-145) to 147 degrees (SD=18, range=115-175), and mean lateral rotation increased from 13 degrees (SD=13, range=0-40) to 31 degrees (SD=11, range=15-50). There were also increases in passive range of motion: Mean abduction increased from 96 degrees (SD=18, range=70-125) to 159 degrees (SD=24, range 110-180), mean flexion in the sagittal plane increased from 120 degrees (SD=16, range=95-145) to 154 degrees (SD=19, range=120-180), and mean lateral rotation increased from 21 degrees (SD=11, range=10-45) to 41 degrees (SD=8, range=35-55). The mean capacity of the glenohumeral joint capsule (its ability to contain fluid) increased from 10 cc (SD=3, range=6-15) to 15 cc (SD=3, range=10-20). Four patients rated their improvement in shoulder function as excellent, 2 patients rated it as good, and 1 patient rated it as moderate. All patients maintained their gain in joint mobility at the 9-month follow-up. DISCUSSION: There seems to be a role for intensive mobilization techniques in the treatment of adhesive capsulitis. Controlled studies regarding the effectiveness of end-range mobilization techniques in the treatment of adhesive capsulitis are warranted.