Article

Adhesive capsulitis is often difficult to diagnose in its early stage
and to differentiate from other common shoulder disorders. The aim of
this study was to validate any or all of the 8 clinical identifiers of
early-stage primary/idiopathic adhesive capsulitis established in an earlier
Delphi study. METHODS: Sixty-four
patients diagnosed with early-stage adhesive capsulitis by a physical therapist
or medical practitioner were included in the study. Eight active and 8 passive
shoulder movements and visual analog scale pain scores for each movement were
recorded prior to and immediately following an intra-articular injection of
corticosteroid and local anesthetic. Using the local anesthetic as the reference
standard, pain relief of >/=70% for passive external rotation was deemed a
positive anesthetic response (PAR). RESULTS: Sixteen participants (25%)
demonstrated a PAR. Univariate logistic regression identified that of the
proposed identifiers, global loss of passive range of movement (odds ratio
[OR]=0.26, P=.03), pain at the end of range of all measured active movements
(OR=0.06, P=.02), and global loss of passive glenohumeral movements (OR=0.23,
P=.02) were associated with a PAR. Following stepwise removal of the variables,
pain at the end of range of all measured active movements remained the only
identifier but was associated with reduced odds of a PAR. LIMITATIONS: The lack
of a recognized reference standard for diagnosing early-stage adhesive capsulitis
remains problematic in all related research. CONCLUSIONS: None of the clinical
identifiers for early-stage adhesive capsulitis previously proposed by expert
consensus have been validated in this study. Clinicians should be aware that
commonly used clinical identifiers may not be applicable to this stage.
CI - (c) 2014 American Physical Therapy Association.

Langue : ANGLAIS