Ann Rehabil Med.  2015 Oct;39(5):745-751. 10.5535/arm.2015.39.5.745.

Shoulder Manipulation After Distention Arthrography: Does Audible Cracking Affect Improvement in Adhesive Capsulitis? A Preliminary Study

Affiliations
  • 1Department of Physical Medicine and Rehabilitation, Korea University Guro Hospital, Seoul, Korea. rehab46@korea.ac.kr

Abstract


OBJECTIVE
To investigate whether an audible cracking sound during shoulder manipulation following distention arthrography is clinically significant in patients with adhesive capsulitis of the shoulder.
METHODS
A total of 48 patients (31 women, 17 men) with primary adhesive capsulitis of the shoulder completed the study. All participants underwent C-arm-guided arthrographic distention of the glenohumeral joint with injections of a corticosteroid and normal saline. After distention, we performed flexion and abduction manipulation of the shoulder. The patients were grouped into sound and non-sound groups based on the presence or absence, respectively, of an audible cracking sound during manipulation. We assessed shoulder pain and disability based on a Numeric Rating Scale (NRS), the Shoulder Pain and Disability Index (SPADI), and passive range of motion (ROM) measurements (flexion, abduction, internal and external rotation) before the procedure and again at 3 weeks and at 6 weeks after the intervention.
RESULTS
The patients were divided into two groups: 21 were included in the sound group and 27 in the non-sound group. In both groups, the results of the NRS, SPADI, and ROM assessments showed statistically significant improvements at both 3 and 6 weeks after the procedure. However, there were no significant differences between the two groups except with respect to external rotation at 6 weeks, at which time the sound group showed a significant improvement in external rotation when compared with the non-sound group (p<0.05).
CONCLUSION
These findings showed that manipulation following distention arthrography was effective in decreasing pain and increasing shoulder range of motion. In addition, the presence of an audible cracking sound during manipulation, especially on external rotation, was associated with better shoulder range of motion.

Keyword

Adhesive capsulitis; Distention arthrography; Manipulation; Cracking sound; Shoulder range of motion

MeSH Terms

Adhesives*
Arthrography*
Bursitis*
Female
Humans
Range of Motion, Articular
Shoulder Joint
Shoulder Pain
Shoulder*
Adhesives

Figure

  • Fig. 1 Comparison of changes in the Numeric Rating Scale (NRS) in the sound group and the non-sound group. The NRS significantly improved at 3 and 6 weeks in both groups. However, no significant differences are observed between the groups in the NRS at baseline and at 3 and 6 weeks.

  • Fig. 2 Comparison of changes in the Shoulder Pain and Disability Index (SPADI) in the sound group and the nonsound group. The SPADI significantly improved at 3 and 6 weeks in both groups. However, no significant differences are observed between the groups in the SPADI at baseline and at 3 and 6 weeks.

  • Fig. 3 Comparison of changes in total range of motion (ROM) in the sound group and the non-sound group. The total ROM significantly improved at 3 and 6 weeks in both groups. However, no significant differences are observed between the groups in the total ROM at baseline and at 3 and 6 weeks.

  • Fig. 4 Comparison of changes in external rotation in the sound group and the non-sound group. The external rotation significantly improved at 3 and 6 weeks in both groups. As compared with the non-sound group, the sound group shows a significant improvement from baseline in shoulder external rotation at 6 weeks (*p<0.05).


Cited by  1 articles

Comparison of Therapeutic Effectiveness Between Shoulder Distention Arthrography With Translation Mobilization and Distention Arthrography Alone in Patients With Frozen Shoulder
Gi Young Park, Dong Rak Kwon, Dae Gil Kwon, Jae Hwal Rim
Ann Rehabil Med. 2018;42(1):76-84.    doi: 10.5535/arm.2018.42.1.76.


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