Restoring Passive External Rotation to Gain Active Abduction in the Plane of the Scapula: Treatment of Mobilization and Static Progressive Stretch–Stress Relaxation Device in Non-Operative Shoulder Adhesive Capsulitis Patients: A Prospective Pilot Study

Abstract

We studied the short-term effects of manual physical therapy and a home program to improve active and passive range of motion in patients with primary adhesive capsulitis. Thirty patients were assigned randomly to one of two groups, both of which received the same outpatient physical therapy twice a week for 3 weeks, using manual therapy techniques. The experimental group underwent a home program that included use of a static progressive stretch–stress relaxation device. Measurements were taken before the initial session, after the sixth session (post treatment), and 10 days after the last session for follow-up. The improvement in passive and active shoulder range of motion was enhanced in the experimental device group with the use of manual therapy and a home program. The experimental device group demonstrated a strong trend of a greater increase ER/ADD compared to the control group. (P=.057, eta-squared=.148). There was a significantly greater increase in active abduction in the plane of the scapula (POS) compared to the control group (p-.010, eta-squared=.153). The correlations between ER/ADD and active abduction in the POS for the experimental group was strong and statistically significant while the control group correlation was weaker and at trend level. At post-treatment.88 (p=.000) and .48 (p=.072) and follow-up .82 (p=.000) and .65 (p=.009), for experimental and control groups, respectively. We found the home program using a static progressive stretch–stress relaxation device, in conjunction with manual therapy effective in improving passive external rotation in the adducted position and active abduction in the plane of the scapula in patients diagnosed with shoulder adhesive capsulitis.

Key words:

adhesive capsulitis, static progressive stretch-stress relaxation, plane of scapula.