title: Changes in biomechanical properties of glenohumeral joint capsules with adhesive capsulitis by repeated capsule-preserving hydraulic distensions with saline solution and corticosteroid.
abstract: OBJECTIVE
  To investigate whether capsule-preserving hydraulic distension with saline solution and corticosteroid for adhesive capsulitis induces biomechanical alterations in glenohumeral joint capsules along with clinical improvements.
  
  
  METHODS
  A case series.
  
  
  METHODS
  University outpatient clinic of physical medicine and rehabilitation.
  
  
  METHODS
  Eighteen patients with unilateral adhesive capsulitis. INTERVENTION AND MAIN OUTCOME MEASUREMENTS: Three hydraulic distensions with saline solution and corticosteroid were performed with 1-month intervals. To avoid rupturing capsules, all distensions were monitored by using real-time pressure-volume curves. Stiffness, maximal volume capacity, and pressure at the maximal volume capacity of the capsule were measured at each intervention. Clinical parameters, such as pain and range of motion, were recorded before, 3 days after, and 1 month after each distension.
  
  
  RESULTS
  Stiffness decreased (47.6 ± 27.1 mm Hg/mL to 31.7 ± 18.4 mm Hg/mL to 24.2 ± 14.0 mm Hg/mL, mean SD) and maximal volume capacity increased (18.8 ± 7.3 mL to 20.5 ± 7.5 mL to 24.2 ± 7.0 mL, mean SD) significantly (P = .001 for both) at each repeated hydraulic distension. Pressure at the maximal volume capacity tended to decrease, but the decrements were not statistically significant (P = .662). The clinical parameters were significantly improved throughout and 1 month after the 3 repeat procedures (P < .05 for all).
  
  
  CONCLUSIONS
  Capsule-preserving hydraulic distension changed the biomechanical properties of the glenohumeral joint capsule, lessening the stiffness and enlarging the volume capacity. These alterations were accompanied by improved range of motion and relief of pain. Repeated capsule-preserving hydraulic distension with saline solution and corticosteroid would be useful to treat adhesive capsulitis and to evaluate the treatment results.
authors.affiliation: Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Eun S
authors.initials: ES
authors.lastname: Koh
authors.forename: Sun G
authors.initials: SG
authors.lastname: Chung
authors.forename: Tae Uk
authors.initials: TU
authors.lastname: Kim
authors.forename: Hee Chan
authors.initials: HC
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D002062:Bursitis / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007270:Injections, Intra-Articular; D017746:Joint Capsule; D008297:Male; D008875:Middle Aged; D011312:Pressure; D016059:Range of Motion, Articular / Q000502:physiology*; D012785:Shoulder Joint / Q000503:physiopathology*; D012965:Sodium Chloride / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D012965:Sodium Chloride