Article

Tightening and contracture of the joint capsule are hallmarks of
adhesive capsulitis of the shoulder (ACS). However, quantification of capsular
stiffness and its relation to clinical features have not been investigated
thoroughly. OBJECTIVES: To quantify capsular stiffness during intra-articular
hydraulic distension (IHD) and to investigate its relationships with pain
severity, symptom duration, range of motion (ROM), gender, and diabetes status.
DESIGN: Case series. SETTING: University outpatient clinic of physical medicine and rehabilitation. PARTICIPANTS:
A total of 107 consecutive patients with ACS
who underwent IHD. METHODS: Pressure-volume monitoring data during IHD, pain
severity, symptom duration, shoulder ROM, and diabetes status were obtained by
retrospective chart review. Capsular stiffness (Kcap) was measured by calculating
the slope of the elastic phase in pressure-volume curves. ROM was evaluated in 3
directions (flexion, abduction, and external rotation) with a goniometer, and the
sum of the 3 ROMs was calculated. MAIN OUTCOME MEASUREMENTS: Pearson correlation
coefficients and comparisons of averages were used to analyze the relationships
between Kcap and clinical features. RESULTS: The mean Kcap of the total group of
participants was 26.0 +/- 14.2 mmHg/mL. Shoulder pain in motion or rest did not
correlate with Kcap. Patients with stiffer capsules had smaller sums of ROMs (r = -.298, P = .002), with distinct limitations in external rotation and abduction (r
= -.278, P = .004 and r = -.313, P = .001, respectively). Women had significantly
stiffer capsules than men (29.5 +/- 14.3 versus 20.2 +/- 12.1 mmHg/mL, P = .001).
Diabetes status had no significant effect on capsular stiffness. CONCLUSIONS:
Capsular stiffness of the glenohumeral joint significantly correlated with
limitation in shoulder ROM, especially in the abduction and external rotation
directions, whereas there were no meaningful relationships with shoulder pain
during motion or rest.
This is the first study to reveal the relationships
between in vivo quantified capsular stiffness and shoulder ROM limitations.
CI - Copyright (c) 2015 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc.
All rights reserved.

Langue : ANGLAIS