title: [Capsular distension and physical therapy in treatment of adhesive capsulitis].
abstract: OBJECTIVE
  to evaluate the efficacy of capsular distension combined with intraarticular glucocorticoid injections and immediate physical therapy in the treatment of adhesive capsulitis.
  
  
  METHODS
  a prospective open study of patients with adhesive capsulitis. Clinical and radiological criteria was used for diagnosis. Clinical evaluation was realized before treatment, at the end of the treatment, after 1 month, 3 months and 6 months. It carried on: the measure of pain and handicap intensity by an Visual Analogue Scale, the algo-functional score of Constant, the measure of passive articular mobilities. We ended in a success of the treatment when the visual analogue scale of handicap < 30, the score of Constant >70, the passive abduction >90 and the external rotation (RE) >45 degrees.
  
  
  RESULTS
  19 patients were included, mean aged 56 years with capsular retraction evolving on average for 8.5 months. The parameters of evaluation of pain function and handicap improved significantly since the end of treatment. This improvement continued until 6 months after the treatment. Earning in articular amplitudes was significant since the end of treatment for forward extension and internal rotation. However, the improvement in abduction and internal rotation was significant only at 3 months. In spite of this early significant improvement in external rotation, 6 patients had an important limitation of the RE (<20 degrees). A subacromial bursography with steroid injection was proposed to them because subacromial bursa is almost consistently involved by retraction. Only, 4 patients among them accepted it. Out come was favorable in every case with a external rotation >45 degrees at I month of the treatment. The rate of success which was only 47.3% at the end of the treatment, is crossed in 73.6% at 1 month and reaches 89.4% at 6 months.
  
  
  CONCLUSIONS
  The therapeutic association capsular distension, intraarticular steroid injections and physical therapy allows to shorten the course of adhesive capsulitis. Burso-infiltration seems to be effective as therapeutic complement in case of persistence of an articular limitation.
authors.affiliation: Service de Médecine Physique et Réadaptation Fonctionnelle, Institut National d'Orlthopédie Ksar Said, La Mannouba, Tunisie.
authors.forename: Sonia
authors.initials: S
authors.lastname: Koubâa
authors.forename: Fatma Z
authors.initials: FZ
authors.lastname: Ben Salah
authors.forename: Sonia
authors.initials: S
authors.lastname: Lebib
authors.forename: Imen
authors.initials: I
authors.lastname: Miri
authors.forename: Cathrine
authors.initials: C
authors.lastname: Dziri
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ben Hammouda
authors.forename: Mohamed F
authors.initials: MF
authors.lastname: Ladeb
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002062:Bursitis / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D012785:Shoulder Joint / Q000502:physiology / Q000503:physiopathology; D020069:Shoulder Pain / Q000175:diagnosis / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids