title: Efficacy of a static progressive stretch device as an adjunct to physical therapy in treating adhesive capsulitis of the shoulder: a prospective, randomised study.
abstract: BACKGROUND
  Stress relaxation and static progressive stretch are techniques used for non-surgical restoration of shoulder range of motion for patients with adhesive capsulitis.
  
  
  OBJECTIVE
  To compare a static progressive stretch device plus traditional therapy with traditional therapy alone for the treatment of adhesive capsulitis of the shoulder.
  
  
  METHODS
  Prospective, randomised controlled trial.
  
  
  METHODS
  Sixty patients with adhesive capsulitis of the shoulder were assigned at random to an experimental group or a control group.
  
  
  METHODS
  Both groups received three traditional therapy sessions per week for 4 weeks. In addition, the experimental group used a static progressive stretch device for 4 weeks.
  
  
  METHODS
  The primary outcome measure was shoulder range of motion (active and passive shoulder abduction, and passive shoulder external rotation). The secondary outcome measures were function [measured by the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire] and pain [measured using a visual analogue scale (VAS)].
  
  
  RESULTS
  At baseline, there were no differences between the two groups. However, after the intervention, there were significant (P<0.05) differences between the groups for all outcome parameters: 0.3 for mean VAS scores [95% confidence interval (CI) -0.6 to 1.1], -10.1 for DASH scores (95% CI -21.0 to 0.9), 21.2° for shoulder passive external rotation (95% CI 16.8 to 25.7), 26.4° for shoulder passive abduction (95% CI 17.4 to 35.3), and 27.7° for shoulder active abduction (95% CI 20.3 to 35.0). At 12-month follow-up, the differences between the groups were maintained and even increased for mean shoulder range of motion, VAS scores and DASH scores, with significant differences (P<0.001) between the groups: -2.0 for VAS scores (95% CI -2.9 to -1.2), -53.8 for DASH scores (95% CI -64.7 to -42.9), 47.9° for shoulder passive external rotation (95% CI 43.5 to 52.3), 44.9° for shoulder passive abduction (95% CI 36.0 to 53.8), and 94.3° for shoulder active abduction (95% CI 87.0 to 101.7).
  
  
  CONCLUSIONS
  Use of a static progressive stretch device in combination with traditional therapy appears to have beneficial long-term effects on shoulder range of motion, pain and functional outcomes in patients with adhesive capsulitis of the shoulder. At 12-month follow-up, the experimental group had continued to improve, while the control group had relapsed.
authors.affiliation: Physical Therapy Department, Health Professions Division, College of Health Care Sciences, Nova Southeastern University, Fort-Lauderdale-Davie, USA; Orthopaedic and Sports Physical Therapy Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt. Electronic address: msrt78@aol.com.
authors.forename: M
authors.initials: M
authors.lastname: Ibrahim
authors.affiliation: Physical Therapy Department, Health Professions Division, College of Health Care Sciences, Nova Southeastern University, Fort-Lauderdale-Davie, USA.
authors.forename: R
authors.initials: R
authors.lastname: Donatelli
authors.affiliation: Physical Therapy Department, Health Professions Division, College of Health Care Sciences, Nova Southeastern University, Fort-Lauderdale-Davie, USA.
authors.forename: M
authors.initials: M
authors.lastname: Hellman
authors.affiliation: Physical Therapy Department, Health Professions Division, College of Health Care Sciences, Nova Southeastern University, Fort-Lauderdale-Davie, USA.
authors.forename: J
authors.initials: J
authors.lastname: Echternach
mesh_terms: D002062:Bursitis / Q000503:physiopathology / Q000534:rehabilitation*; D004185:Disability Evaluation; D004311:Double-Blind Method; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D052580:Muscle Stretching Exercises / Q000295:instrumentation*; D010147:Pain Measurement; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D012399:Rotation; D012785:Shoulder Joint; D016896:Treatment Outcome
keywords: Frozen shoulder; Mobilisation; SPS; Shoulder adhesive capsulitis; Static progressive stretch orthosis; Stiff shoulder