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Abstract
Objective: To investigate whether passive joint mobilisation is beneficial if added to a home-care programme when managing patients with adhesive capsulitis of the shoulder who have received corticosteroid injection.
Design: Quantitative, single-blinded, experimental, pilot study. Subjects were incidentally sampled and randomised into two groups: the control group (home-care programme), and an experimental group (which in addition received passive mobilisation of the shoulder, weekly, for 6 weeks). All subjects were assessed over a 10-week period.
Setting: The physiotherapy department at Stockport Primary Care Trust.
Participants: Fourteen subjects, mean age of 54.8 years. All subjects presented with shoulder capsulitis associated with trauma. The mean duration of symptoms was 2.4 months.
Main outcome measures: Pain as evaluated by a Visual Analogue Scale (VAS). Secondary measures were shoulder function as evaluated by the Shoulder Pain And Disability Index (SPADI) and active range of motion (ROM).
Results: By week 10, both groups showed improvement in pain, shoulder function and shoulder range of movements, with the control group showing a trend towards better improvement than the experimental group. However, no statistical tests were applicable because of the small sample size. The mean pain score of the control group reduced by 6.2 points (81.6% improvement) and the experimental group by 5.7 points (68.7% improvement). The control group average SPADI score reduced by 58.4% (72.6% improvement) and the experimental group reduced by 49% (62.3% improvement). By week 10, the overall range of movement in the control group increased by 58.6º (228% improvement) and the experimental group by 30º (84% improvement). The mean abduction in control group increased by 80º (82.4% improvement) and the experimental group by 40.7º (40% improvement). With medial rotation, the control group increased by 38.9 cm (81.2%) and the experimental group by 28.4 cm (60.3%). The mean lateral rotation in control group increased by 58.6º (228% improvement) and the experimental group by 30º (84% improvement).
Conclusions: No conclusions on efficacy can be drawn from this pilot study. The data obtained in this pilot study allow an informed sample size calculation to be made so that any statistically significant difference between the two treatment approaches can be shown.