Article

Objective: To evaluate the efficacy of manipulation followed by arthroscopic release of the glenohumeral joint in conjunction with an immediate and intensive rehabilitation program. Design: Retrospective, descriptive study. Setting: A free-standing, university-affiliated orthopedics and rehabilitation hospital. Participants: Forty patients with
a clinical diagnosis of adhesive capsulitis resistant to pharmacologic and physical therapy (PT). Interventions: Patients underwent manipulation and arthroscopic release of the capsular joint and were given an intensive PT program on the first postoperative day. Main Outcome Measures: All patients were evaluated pre- and postoperatively at follow-up at an average of 42 months by using the Simple Shoulder Test (SST), the Constant-Murley system score, and passive (PROM) and active (AROM) range of motion. Results: The SST, which showed a mean preoperative score of 2.2 +/- 0.7, was 10.8 +/- 0.7
(P < .001) after surgery. Preoperatively, the mean Constant-Murley score was 33.2% +/- 1.9%; postoperatively, the mean score was 91.7% +/- 2.9% (P < .001). PROM increased from 90degrees to 165degrees for anterior elevation, from 85degrees to 160degrees for abduction, from 20degrees to 60degrees for external rotation, and from 10degrees to 40degrees for internal rotation. AROM improved for anterior elevation from 82degrees to 155degrees ; for abduction from 77degrees to 143degrees, and for external rotation, with the arm along the patient's side, from 5degrees to 50degrees. Conclusions: Results support the efficacy of manipulation follow by arthroscopic release and rehabilitative treatment for patients with resistant adhesive capsulitis of the shoulder. (C) 2004 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.

Langue : ANGLAIS