title: Adhesive capsulitis: a new management protocol to improve passive range of motion.
abstract: OBJECTIVE
  To examine the short-term efficacy of a nonoperative shoulder protocol for the treatment of adhesive capsulitis.
  
  
  METHODS
  A retrospective chart review was used to collect data for a 3-year period.
  
  
  METHODS
  Academic tertiary medical center.
  
  
  METHODS
  28 consecutive patients diagnosed as having adhesive capsulitis were identified and managed with a new protocol.
  
  
  METHODS
  The protocol consisted of the administration of a suprascapular nerve block, the subsequent injection of an intra-articular steroid, and then the injection of an anesthetic agent with brisement normal saline volume dilation. The final step was manipulation of the shoulder.
  
  
  RESULTS
  A paired t test was used to examine the difference in the preprocedure and postprocedure passive range of motion (flexion and abduction). The average shoulder abduction before the procedure was 89.5 degrees ; this improved by an average of 51.7 degrees (P<.0001). The average shoulder flexion improved from 117.3 degrees by an average of 37.7 degrees (P<.0001). There was no significant difference in either abduction or flexion based on age, gender, or chronicity of symptoms. White patients experienced significantly more improvement in abduction than did nonwhite patients.
  
  
  CONCLUSIONS
  This study suggests that this adhesive capsulitis management protocol is effective and produces a significant improvement in the passive range of motion immediately after the procedure.
authors.affiliation: Stanford University School of Medicine, 450 Broadway St, Mailcode: 6342, Redwood City, CA 94063, USA. rmitra@stanford.edu
authors.forename: Raj
authors.initials: R
authors.lastname: Mitra
authors.forename: Alex
authors.initials: A
authors.lastname: Harris
authors.forename: Chainey
authors.initials: C
authors.lastname: Umphrey
authors.forename: Matthew
authors.initials: M
authors.lastname: Smuck
authors.forename: Michael
authors.initials: M
authors.lastname: Fredericson
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D002062:Bursitis / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008349:Manipulation, Orthopedic; D008875:Middle Aged; D009407:Nerve Block; D012189:Retrospective Studies; D012785:Shoulder Joint; D014221:Triamcinolone / Q000008:administration & dosage*
chemical_list: D000893:Anti-Inflammatory Agents; D014221:Triamcinolone