Article

OBJECTIVE: To investigate whether capsule-preserving hydraulic distension with
saline solution and corticosteroid for adhesive capsulitis induces biomechanical
alterations in glenohumeral joint capsules along with clinical improvements.
DESIGN: A case series. SETTING: University outpatient clinic of physical medicine
and rehabilitation. PARTICIPANTS: Eighteen patients with unilateral adhesive
capsulitis. OUTCOME MEASUREMENTS: Three hydraulic
distensions with saline solution and corticosteroid were performed with 1-month
intervals. To avoid rupturing capsules, all distensions were monitored by using
real-time pressure-volume curves. Stiffness, maximal volume capacity, and
pressure at the maximal volume capacity of the capsule were measured at each
intervention. Clinical parameters, such as pain and range of motion, were
recorded before, 3 days after, and 1 month after each distension. RESULTS:
Stiffness decreased (47.6 +/- 27.1 mm Hg/mL to 31.7 +/- 18.4 mm Hg/mL to 24.2 +/-
14.0 mm Hg/mL, mean SD) and maximal volume capacity increased (18.8 +/- 7.3 mL to
20.5 +/- 7.5 mL to 24.2 +/- 7.0 mL, mean SD) significantly (P = .001 for both) at
each repeated hydraulic distension. Pressure at the maximal volume capacity
tended to decrease, but the decrements were not statistically significant (P =
.662). The clinical parameters were significantly improved throughout and 1 month
after the 3 repeat procedures (P < .05 for all). CONCLUSION: Capsule-preserving
hydraulic distension changed the biomechanical properties of the glenohumeral
joint capsule, lessening the stiffness and enlarging the volume capacity. These
alterations were accompanied by improved range of motion and relief of pain.
Repeated capsule-preserving hydraulic distension with saline solution and
corticosteroid would be useful to treat adhesive capsulitis and to evaluate the
treatment results.
CI - Copyright (c) 2012 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS