[Adhesive capsulitis: evaluation of a treatment coupling capsular distension and intensive rehabilitation].
BACKGROUND
Adhesive capsulitis is a clinical entity characterized by a loss of motion and a decrease of the joint volume capacity. Results of clinical trials have shown that distensions can help to decrease pain and increase the range of motion.


OBJECTIVE
The purpose of the study was to measure the effect of repeated distension arthrography combined with an intensive program of rehabilitation on pain, range of motion, and occupational outcome in patients with adhesive capsulitis.


METHODS
39 cases of idiopathic capsulitis (7 cases) or secondary capsulitis (19 post-traumatic, 13 post-surgery of the rotator cuff) were included in the study. Intervention consisted of an intensive program of passive and active physiotherapy during one? Week and then distension arthrography, performed 3 times at 1- week intervals, with steroid injections in the glenohumeral joint and 1 in the subacromial space.


RESULTS
Lateral elevation improved substantially after the first week of physiotherapy and medial rotation after the first distension. Pain intensity decreased after the first distension. After the third distension, very small changes were noted. Results did not differ by etiology of capsulitis. At the end of the program, 9 of 17 patients could return to their previous job.


CONCLUSIONS
Two repeated arthrographic distensions with steroid injection and an intensive program of physiotherapy improves the range of motion and the painful condition associated with capsulitis and allows for a rapid return to employment. A third distension does not seem to provide a further benefit, as has been found by other studies.
Fouquet
B
B
Université François-Rabelais, Fédération de Médecine Physique et de Réadaptation, CHU de Tours-CH Château-Renault, 37044 Tours cedex, France. fouquet@med.univ-tours.Fr
Griffoul
I
I
Borie
M J
MJ
Roger
R
R
Bonnin
B
B
Metivier
J C
JC
Pellieux
S
S
D002062:Bursitis / Q000534:rehabilitation / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations; D012785:Shoulder Joint; D013997:Time Factors