The efficacy of supervised physiotherapy for the treatment of adhesive capsulitis

The aim of this study was to evaluate the efficacy of supervised physiotherapy supplemented with non-steroidal antiinflammatory drugs (NSAIDs) for treating adhesive capsulitis.

Even though adhesive capsulitis is a common disorder, literature on its treatment is still limited.

Forty-five patients with adhesive capsulitis treated between 2004 and 2007 were reviewed retrospectively and 29 patients were enrolled in the study. All patients received a supervised physiotherapy program supplemented with NSAIDs. The outcome variables were determined as passive range of motion (ROM) values and intensity of shoulder pain. The clinical assessment was performed at the initial visit and immediately after physiotherapy. One to four years after the supervised physiotherapy, the resolved patients were reevaluated.

The mean age of patients was 55.4+/-9.2 years. Fifteen patients (51.7 %) were women and 14 (48.3 %) were men. The average length of supervised physiotherapy was 3.5+/-0.5 weeks. After physiotherapy, the shoulder flexion, abduction and external rotation significantly increased (p<0.001) compared with the initial values. Additionally, shoulder pain significantly decreased (p<0.001). In the follow-up, 25 (86.2 %) of 29 patients were resolved with physiotherapy, whereas 4 (13.8 %) patients required capsular release operation because of residual functional impairment. As to long-term results of patients resolved with physiotherapy, 45.4 % of cases were cured with less than a 10 % loss in total passive ROM of the shoulder, 22.7 % of cases with a total ROM loss between 10 and 20 %, 18.1 % of cases with a total ROM loss from 20 to 30 %, and lastly, 13.6% of cases with a total ROM loss up to 40 %.

Supervised physiotherapy supplemented with NSAIDs improves the ROM values in most of patients with adhesive capsulitis. A small percentage of patients may require operative treatment (Tab. 2, Fig. 1, Ref. 23). Full Text in free PDF www.bmj.sk.