Effectiveness of Kaltenborn Posterior Glide and Coracohumeral Ligament Positional Stretching on External Rotation Range of Motion in Patients with Adhesive Capsulitis

2021 ◽  
Keyword(s):  
Range Of Motion ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Coracohumeral Ligament

scholarly journals Restriction of Passive Glenohumeral Abduction Combined With Normal Passive External Rotation Is a Diagnostic Feature of Calcific Tendinitis

2018 ◽  
Vol 6 (2) ◽  
pp. 232596711775290 ◽  
Author(s):  
Anna Jungwirth-Weinberger ◽  
Christian Gerber ◽  
Glenn Boyce ◽  
Thorsten Jentzsch ◽  
Simon Roner ◽  
...  
Keyword(s):  
Range Of Motion ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Salient Feature ◽  
Supraspinatus Tendon ◽  
Calcific Tendinitis ◽  
Diagnostic Feature ◽  
Inclusion Criteria ◽  
Level Of Evidence ◽  
Standardized Protocol

Background: Passive glenohumeral range of motion may be characteristically limited to specific shoulder pathologies. While pain associated with loss of range of passive external glenohumeral rotation is recognized as a salient feature in adhesive capsulitis, restriction of glenohumeral range of motion in calcific tendinitis of the supraspinatus tendon has never been studied. Hypothesis: On the basis of clinical observation, we hypothesized that calcific tendinitis of the supraspinatus tendon is associated with loss of passive glenohumeral abduction without loss of external rotation. Study Design: Cohort study; Level of evidence, 3. Methods: Ranges of passive glenohumeral rotation and abduction, which are measured with a standardized protocol in our institution, were retrospectively reviewed and compared for patients diagnosed with either adhesive capsulitis or calcific tendinitis of the supraspinatus tendon. A total of 57 patients met the inclusion criteria for the calcific tendinitis, and 77 met the inclusion criteria for the adhesive capsulitis group. Results: When compared with the contralateral, unaffected shoulder, glenohumeral abduction in the calcific tendinitis group was restricted by a median of 10° (interquartile range [IQR], –20° to –5°) as opposed to glenohumeral external rotation, which was not restricted at all (median, 0°; IQR, 0° to 0°). The adhesive capsulitis group showed a median restriction of glenohumeral abduction of 40° (IQR, –50° to –30°) and a median restriction of passive glenohumeral external rotation of 40° (IQR, –60° to –30°). Conclusion: Calcific tendinitis of the supraspinatus does not typically cause loss of external rotation but is frequently associated with mild isolated restriction of abduction. This finding can be used to clinically differentiate adhesive capsulitis from calcific tendinitis.

scholarly journals COMPARISON OF INTRA-ARTICULAR METHYLPREDNISOLONE AND KETOROLAC INJECTIONS IN IMPROVING RANGE OF MOTION FOR DIFFERENT SHOULDER JOINT DISORDERS

2021 ◽  
Vol 71 (3) ◽  
pp. 819-22
Author(s):  
Sumeera Matee ◽  
Wasif Anwar ◽  
Sami Wahid ◽  
Saeed Bin Ayaz ◽  
Rana Shahid ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Shoulder Joint ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Military Hospital ◽  
Prednisolone Acetate ◽  
Methyl Prednisolone ◽  
Shoulder Range Of Motion ◽  
Significant Difference ◽  
Flexion Extension

Objective: To compare the efficacy of intra-articular injection of methyl prednisolone with ketorolac for improvement in range of motion in various shoulder joint disorders. Study Design: Quasi-experimental study. Place and Duration of Study: Departments of Internal and Rehabilitation Medicine, Combined Military Hospital Mangla, from Nov 2018 to May 2019. Methodology: Through non-probability consecutive sampling, patients with shoulder disorders were enrolled in the study and divided into two groups. Group A received intra articular corticosteroid injection and group B received intra-articular Ketorolac injection. Outcome was measured in terms of improvement in shoulder range of motion. Results: A total of 60 patients were selected, 40 (66.7%) male and 20 (33.3%) female. 30 (50%) patients had adhesive capsulitis, 24 (40%) had rotator cuff syndrome and 6 (10%) had impingement syndrome. 24 patients received methyl prednisolone acetate injection while 36 received ketorolac injection. There was no significant difference in the mean gain in flexion, extension, abduction, internal or external rotation between both groups (p=0.224, p=0.261, p=0.884, p=0.238, and p=0.584 respectively). Conclusion: There was no significant difference in efficacy of corticosteroid and ketorolac when injected intra-articularly in shoulder joint disorders.

scholarly journals Factors Affecting the Outcomes of Arthroscopic Capsular Release for Idiopathic Adhesive Capsulitis

2019 ◽  
Vol 7 (9) ◽  
pp. 232596711986762 ◽  
Author(s):  
Syed M. Rizvi ◽  
Ahmed J. Harisha ◽  
Patrick H. Lam ◽  
George A.C. Murrell
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Linear Regression Analysis ◽  
Frozen Shoulder ◽  
Level Of Evidence ◽  
Duration Of Symptoms ◽  
Capsular Release ◽  
Arthroscopic Capsular Release

Background: Arthroscopic capsular release has been shown to provide excellent short- and long-term outcomes in patients with idiopathic frozen shoulder. Some surgeons delay surgery in the belief that operating in the early stages of adhesive capsulitis results in a poorer prognosis. However, it is unclear which factors, particularly the stage of the disorder, affect the surgical outcome of this procedure. Hypothesis: Patients who undergo capsular release during the early symptomatic stage of idiopathic adhesive capsulitis would have less improvement in range of motion compared with those who undergo surgery at a later stage. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 189 shoulders with idiopathic adhesive capsulitis that underwent arthroscopic capsular release were evaluated. All patients completed a L’Insalata questionnaire and had their range of motion and strength tested prior to surgery and at 1, 6, and 12 weeks and 6 months post–capsular release. Post hoc, patients were grouped by whether they had symptoms lasting <10 months (shorter symptoms group; n = 131) or ≥10 months (longer symptoms group; n = 38). Multiple linear regression analysis was performed to determine which preoperative factors were independently associated with a favorable outcome. Results: Patients in the shorter symptoms group were more restricted prior to surgery than were those in the longer symptoms group (mean ± SEM: external rotation, 17° ± 2° vs 27° ± 4° [ P = .04]; abduction, 78° ± 3° vs 92° ± 6° [ P = .04]; internal rotation, S3 ± 1 vs S1 ± 1 [ P = .03]). The shorter symptoms group had greater postoperative improvement in internal rotation (from S3 ± 1 preoperatively to T12 ± 1 vertebral levels) compared with the longer symptoms cohort (from S1 ± 1 to L2 ± 1) ( P = .02). Conclusion: Patients with a frozen shoulder and a duration of symptoms <10 months made greater improvements in internal rotation and had similar final results for flexion, abduction, and external rotation following arthroscopic capsular release when compared with patients who had a longer duration of symptoms, so there is no reason to delay surgery.

Shoulder hydrodilatation for primary, post-traumatic and post-operative adhesive capsulitis

2020 ◽  
pp. 175857322097717
Author(s):  
Daoud Makki ◽  
Mustafa Al-Yaseen ◽  
Fayaz Almari ◽  
Puneet Monga ◽  
Lennard Funk ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Outcome Measures ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Capsular Release ◽  
Arthroscopic Capsular Release ◽  
Number Of Patients ◽  
Post Traumatic

Background Adhesive capsulitis (frozen shoulder) is characterised by pain and loss of range of motion of the glenohumeral joint. It can be present as primary (idiopathic) or secondary to surgery, trauma or other conditions that restrict the use of the shoulder joint. Various treatment options have been adopted including physiotherapy, manipulation under anaesthetic, hydrodilatation and arthroscopic or open capsular release but the optimal form of management remains uncertain. Objectives The purpose of the study was to assess the clinical outcome of glenohumeral hydrodilatation in three cohorts of patients with different aetiologies with adhesive capsulitis. Study design & methods We carried out a retrospective study of patient who underwent hydrodilatation for adhesive capsulitis between 2013 and 2015. The procedure was performed by a specialist musculoskeletal radiologist under radiological guidance. The injection consisted of steroids, local anaesthetics and NaCl solution with a target volume around 35 mL. Our outcome measures were range of motion, and pre- and post-operative pain. Patients were divided into three groups based on the presumed cause of their stiffness: idiopathic, post-traumatic and post-surgical. Results Two hundred fifty patients were included, with a mean age of 59 years (range: 20–79). Of these, 180 had idiopathic primary adhesive capsulitis (27 were diabetic), 23 were post-traumatic, and 20 following surgical procedures. Thirty-four required further intervention following initial hydrodilatation with 8 undergoing repeat hydrodilatation, and 26 requiring arthroscopic capsular release. The diabetic group accounted for 16 capsular releases and 4 repeat procedures, while the idiopathic group accounted for 9 and 4, respectively. One patient required capsular release in the surgical group. An improvement was recorded in ROM in all groups with mean abduction improving from 59° to 110°, flexion from 50° to 120° and external rotation from 20° to 50°. With regards to pain, the majority showed an improvement from severe or moderate pain to no or mild pain. Conclusions Results show that hydrodilatation resulted in an improvement in all outcome measures, with only a small number of patients, especially those with diabetes, needing further procedures or showing no improvement in range of motion and pain. There was no difference between the post-traumatic and post-surgical groups.

scholarly journals A comparative study on the effectiveness of Mulligan mobilization versus Positional release therapy technique in patients with Adhesive capsulitis

2021 ◽  
Vol 12 (1) ◽  
pp. 1-5
Author(s):  
Chandrasekaran K ◽  
Sundaram M S ◽  
Senthil Selvam P ◽  
Viswanath Reddy A ◽  
Senthilkumar S ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Functional Activity ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Shoulder Range Of Motion ◽  
Release Technique ◽  
Group A ◽  
Group B ◽  
Shoulder Range

Adhesive capsulitis is a painful condition in which the movement of the shoulder becomes limited and functional activity is affected. Adhesive capsulitis occurs when the shoulder joint capsule become thick, stiff and inflamed. The aim of the study is to compare the effectiveness of Mulligan movement with mobilization versus Positional release technique on shoulder range of motion and functional activity in patients with adhesive capsulitis. 30 patients were randomly divided into two groups. Group A (N = 15) received Mulligan mobilization technique and Group B (N = 15) received positional release therapy. The shoulder range of motion (Abduction, External rotation, Internal rotation) was measured by goniometer, the functional activity by SPADI questionnaire. The results showed that significant differences in shoulder ROM Abduction (t = 14.18, p = 0.000), Internal rotation (t = 13.80, p = 0.000), External rotation (t = 15.87, p = 0.000) and SPADI questionnaire (t = 13.94, p = 0.000) were observed in group A patients when compared to group B. In conclusion the Mulligan mobilization technique was effective to improve the shoulder ROM and reduce functional disability in patients with adhesive capsulitis compared to Positional release technique.

scholarly journals Effects of Arthroscopic Coracohumeral Ligament Release on Range of Motion for Patients with Frozen Shoulder

2018 ◽  
Vol 12 (1) ◽  
pp. 373-379 ◽  
Author(s):  
Yoshihiro Hagiwara ◽  
Takuya Sekiguchi ◽  
Akira Ando ◽  
Kenji Kanazawa ◽  
Masashi Koide ◽  
...  
Keyword(s):  
Range Of Motion ◽  
External Rotation ◽  
Full Range ◽  
Frozen Shoulder ◽  
Coracohumeral Ligament ◽  
Significant Difference ◽  
Additional Release ◽  
Group 2 ◽  
Specific Manifestation ◽  
Group 1

Background: A thickened coracohumeral ligament is a highly specific manifestation of, and primary restraint against external rotation in frozen shoulders. Objective: The purpose of this study was to evaluate the effects of complete arthroscopic coracohumeral ligament release on range of motion in frozen shoulder. Methods: Fifty-two consecutive shoulders in 52 patients were treated between April 2015 and June 2016. To evaluate solely glenohumeral range of motion, the scapula was fixed by an examiner with one hand (without palpating scapular motion), and range of motion was measured using a goniometer. For the first step, arthroscopic pancapsular release was performed in a beach-chair position with (Group 1) or without (Group 2) complete coracohumeral ligament release. For the final step, the remaining coracohumeral ligaments in Group 2 were released and the ranges of motion were compared to those in Group 1. Results: The average age of the patients was significantly higher in Group 1, but there were no significant differences between the two groups with respect to sex, affected side, preoperative range of motion, or American Shoulder and Elbow Society Score. Abduction, external rotation at adduction, and external and internal rotations at 90° of flexion in Group 1 were significantly greater than those in Group 2. After the additional release of the remaining coracohumeral ligaments in Group 2, all ranges of motion were significantly recovered and there was no significant difference between the groups. Conclusion: Complete coracohumeral ligament release is a recommended intraoperative procedure for regaining full range of motion in frozen shoulders.

scholarly journals Effects of platelet-rich plasma injection on pain, range of motion, and disability in adhesive capsulitis: A prospective, randomized-controlled study

2021 ◽  
Vol 67 (4) ◽  
pp. 462-472
Author(s):  
Çağlar Karabaş ◽  
Havva Talay Çalış ◽  
Ulaş Serkan Topaloğlu ◽  
Çiğdem Karakükçü
Keyword(s):  
Range Of Motion ◽  
External Rotation ◽  
Platelet Rich Plasma ◽  
Adhesive Capsulitis ◽  
Controlled Study ◽  
Control Group ◽  
Plasma Injection ◽  
Active Flexion ◽  
Home Based ◽  
Significant Difference

Objectives: In this study, we aimed to investigate the effectiveness of intra-articular platelet-rich plasma (PRP) injection in adhesive capsulitis. Patients and methods: Between January 2019 and December 2019, a total of 40 patients (21 males, 19 females; mean age: 57.1±6.5 years; range, 44 to 72 years) with idiopathic adhesive capsulitis were included. The patients were randomly assigned into two equal groups as the PRP and the control group. The PRP group received two doses of PRP via intra-articular route biweekly under ultrasound guidance. No injection was performed to the control group. In both groups, stretching and Codman exercises were applied as a home- based program. The Visual Analog Scale (VAS), range of motion (ROM), and Shoulder Pain and Disability Index (SPADI) scores were evaluated before the treatment and at 2, 6 and 12 weeks after the treatment. Results: There were significant differences in all VAS, SPADI, and ROM scores at all time points after treatment compared to baseline in both groups. At the end of the study, there were significant differences in the active flexion, passive flexion, active abduction, passive abduction, and active external rotation scores at 12 weeks between the groups (p=0.012, p=0.015, p=0.008, p=0.019, and p=0.040, respectively). No significant difference was observed between the groups in terms of VAS and SPADI scores and the other parameters (active and passive extension, active and passive internal rotation, passive external rotation) at 2, 6, and 12 weeks (p>0.05). Conclusion: The addition of PRP to exercise treatment can improve patients' joint mobility, but not pain and disability in patients with adhesive capsulitis.

scholarly journals Correlations Between Range of Motion and Elasticity of the Coracohumeral Ligament Evaluated With Shear-Wave Elastography

2021 ◽  
Vol 30 (1) ◽  
pp. 9-15 ◽  
Author(s):  
Kenji Kanazawa ◽  
Yoshihiro Hagiwara ◽  
Takuya Sekiguchi ◽  
Ryo Fujita ◽  
Kazuaki Suzuki ◽  
...  
Keyword(s):  
Elastic Modulus ◽  
Range Of Motion ◽  
Shear Wave ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Age Groups ◽  
Shear Wave Elastography ◽  
Underlying Mechanism ◽  
Older Individuals ◽  
Coracohumeral Ligament

Context: Range of motion (ROM) in the glenohumeral joint decreases with age in healthy subjects; however, the underlying mechanism remains unclear. The process of aging of the joint capsule, including the coracohumeral ligament (CHL), could affect ROM limitation. Objective: This study investigated correlations between elasticity of the CHL, evaluated by means of shear-wave elastography, and age, side dominance, and ROM in healthy individuals. Design: Experimental study. Setting: Laboratory. Subjects: Eighty-four healthy volunteers (39 men and 45 women, mean age: 42.6 y) were included. Main Outcome Measures: Subjects were divided into 3 age groups: younger (20–39 y), middle (40–59 y), and older (≥60 y) age groups. With participants in the supine position, CHL elasticity in both shoulders was evaluated in both neutral and 30° external rotation, with arms at the sides. ROM, including forward flexion, lateral elevation, external rotation, 90° abduction with external rotation, and hand behind the back were measured with participants in the standing position. Results: The CHL elastic modulus was higher in the older group than in the younger group in the neutral (78.4 kPa [SD: 37.1] and 56.6 kPa [SD: 31.7], respectively) and 30° external rotation positions (135.5 kPa [SD: 63.5] and 71.4 kPa [SD: 32.2], respectively). Negative correlations were found between the CHL elastic modulus and ROM in terms of 30° external rotation and both external rotation (R = −.59, P = .02) and 90° abduction with external rotation (R = −.71, P = .003) in the older group, with correlation coefficients increasing with age. Conclusions: Significant correlations were identified between CHL elasticity and ROM in both external rotation and 90° abduction with external rotation with increasing age. Decreased CHL elasticity was strongly associated with decreased shoulder ROM in middle-aged and older individuals.

scholarly journals A Thickened Coracohumeral Ligament and Superomedial Capsule Limit Internal Rotation of the Shoulder Joint: Report of Three Cases

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Masashi Koide ◽  
Junichiro Hamada ◽  
Yoshihiro Hagiwara ◽  
Kenji Kanazawa ◽  
Kazuaki Suzuki
Keyword(s):  
Internal Rotation ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Arthroscopic Surgery ◽  
Frozen Shoulder ◽  
Severe Restriction ◽  
Manipulation Under Anesthesia ◽  
Coracohumeral Ligament ◽  
Joint Report

Adhesive capsulitis of the shoulder (also known as frozen shoulder) is a painful and disabling disorder with an estimated prevalence ranging from 2% to 5% in the general population. Although the precise pathogenesis of frozen shoulder is unclear, thickened capsule and coracohumeral ligament (CHL) have been documented to be one of the most specific manifestations. The thickened CHL has been understood to limit external rotation of the shoulder, and restriction of internal rotation of the shoulder has been believed to be related to posterior capsular tightness. In this paper, three cases of refractory frozen shoulder treated through arthroscopic release of a contracted capsule including CHL were reported. Two cases in which there is recalcitrant severe restriction of internal rotation after manipulation under anesthesia (MUA) were finally treated with arthroscopic surgery. Although MUA could release the posterior capsule, internal rotation did not improve in our cases. After release of the thickened CHL, range of motion of internal rotation was significantly improved. This report demonstrates the role of the thickened CHL in limiting the internal rotation of the shoulder. We highlight the importance of release of thickened CHL in addition to the pancapsular release, in case of severe limitation of internal rotation of shoulder.

Sign in / Sign up

Export Citation Format

Share Document