Changes in Range of Motion after Intra-Articular Corticosteroid Injection in Frozen Shoulder: A Retrospective 3-Month Follow-Up Study

OBJECTIVE: To examine (1) the degree of reduction of passive range of motion (PROM) on the affected side compared to that on the unaffected side and (2) the degree of increase in PROM following intra-articular corticosteroid injection (IACI) in patients with frozen shoulder.METHOD: The medical records of 120 patients with frozen shoulder were retrospectively reviewed. PROM of the unaffected and affected shoulder (flexion, extension, abduction, internal rotation, external rotation) was compared, and changes in PROM of the affected shoulder after a single IACI (triamcinolone 20 mg) were evaluated after 12 weeks.RESULTS: At the time of diagnosis, PROM of the affected shoulder was most limited in external rotation, followed by internal rotation, abduction, extension, and flexion, compared to that of the unaffected shoulder. Compared to before IACI, PROM of external rotation demonstrated the greatest increase compared to all the other movements after IACI.CONCLUSION: Limitation in PROM of the frozen shoulder at the time of diagnosis was greatest for external rotation. Moreover, external rotation experienced the greatest improvement after IACI. Our findings should help to further clarify the clinical characteristics of frozen shoulder, aid in its diagnosis, and allow the prediction of the effects of IACI.

Arthroscopic capsular release for refractory shoulder stiffness / Liberação capsular artroscópica para a rigidez refratária do ombro

OBJECTIVE: To evaluate the results of the arthroscopic treatment of refractory adhesive capsulitis of the shoulder with two to nine years of follow-up, comparing the pre-and postoperative range of motion. METHODS: This was an observational study (case series) of 18 patients who underwent arthroscopic capsular release for refractory shoulder stiffness. The mean age was of 53.6 years (range: 39 to 68), with female predominance (77.77%) and nine cases left shoulders. There were 6 primary (33.33%) and 12 secondary cases (66.67%). Arthroscopic capsular release was performed in all patients after a mean of 9.33 months of physical therapy (range: 6 to 20 months) with a minimum follow-up of two years (range: 26 to 110 months). RESULTS: The mean active and passive forward flexion, external rotation and internal rotation increased from 94.4º/103.3º, 11.9º/21.9º, and S1/L5 vertebral level, respectively, to 151.1º/153.8º, 57.2º/64.4º, and T12/T10 vertebral level, respectively. There was a significant difference between the pre-and postoperative range of motion (p < 0.001). according to the constant-murley functional score (rom), the value increased from 14 (preoperative mean) to 30 points (postoperative mean). postoperatively, all patients showed diminished shoulder pain (none or mild/15 or 10 points in the constant-murley score). CONCLUSION: arthroscopic treatment is an effective treatment for refractory shoulder stiffness.

OBJETIVO: Avaliar os resultados do tratamento artroscópico da capsulite adesiva refratária do ombro com dois a nove anos de seguimento, comparando o arco de movimentos pré e pós-operatório. MÉTODOS: Foi realizado um estudo observacional (série de casos) em 18 pacientes com ombros rígidos resistentes a tratamento conservador submetidos à capsulotomia artroscópica. A idade média foi de 53,6 anos (39 a 68), com predomínio do sexo feminino (77,77%) e nove ombros esquerdos. Houve seis primários (33,33%) e 12 secundários (66,67%). A liberação capsular artroscópica foi realizada em todos os pacientes, após uma média de 9,33 meses de fisioterapia (6 a 20 meses), com seguimento mínimo de dois anos (26 a 110 meses). RESULTADOS: A média da elevação anterior, rotação lateral e rotação medial ativa e passiva aumentaram de 94,4º/103,3º, 11,9º/21,9ºe S1/L5 níveis vertebrais para 151,1º/153,8º, 57,2º/64,4ºe T12/T10 níveis vertebrais, respectivamente. Houve uma significativa diferença entre a amplitude de movimentos pré-e pós-operatório (p < 0,001). de acordo com o escore funcional de constant-murley, o valor aumentou de 14 (média pré-operatória) para 30 pontos (média pós-operatória). no pós-operatório, todos os pacientes demonstraram uma diminuição da dor no ombro (nenhuma ou leve/15 ou 10 pontos no escore de constant-murley). CONCLUSÃO: O tratamento artroscópico é eficaz para a rigidez refratária do ombro.

Effects of Passive Upper Arm Exercise on Range of Motion, Muscle Strength, and Muscle Spasticity in Hemiplegic Patients with Cerebral Vascular Disease

PURPOSE: The purpose of this study was to investigate the effects of passive upper arm exercise on range of motion, muscle strength, and muscle spasticity in hemiplegic patients with cerebral vascular disease. METHODS: A quasi-experimental design with nonequivalent control group was utilized. According to inclusion criteria, 25 patients were assigned to the control group with routine care, followed by 25 to the intervention group with passive exercise for 30 minutes per session, twice a day for 2 weeks. Eighteen patients in the intervention group and 17 in the control group completed the posttest measurement, including range of motion for upper arm joints, manual muscle test, and Modified Ashworth Scale for muscle spasticity. RESULTS: The intervention group had a significantly improved range of motion in the shoulder and wrist joints. No interaction effect was found for the elbow joint. No significant differences were found in muscle strength or muscle spasticity between the groups. CONCLUSION: Results of the study indicate that passive exercise safely applied for two weeks improves range of motion in joints of the upper arm in these patients. Further study with long-term follow-up is needed to verify the role of passive exercise in preventing muscle spasticity in this population.

Aspectos clínicos e concentração sérica da creatina-quinase e lactato-desidrogenase em cães submetidos à fisioterapia após atrofia muscular induzida / Clinical aspects and serum concentration creatina kinase and lactate dehydrogenase in dogs submitted to physiotherapy after induced muscle atrophy

Avaliou-se a resposta de diferentes protocolos fisioterapêuticos em cães após a indução de atrofia muscular por meio da imobilização do joelho por 30 dias. Os grupos foram denominados grupo C ou controle, grupo E (massagem, movimentação passiva e eletroterapia), grupo H (massagem, movimentação passiva e hidroterapia em esteira aquática) e grupo EH (massagem, movimentação passiva, eletroterapia e hidroterapia em esteira aquática). Foram mensurados os graus de claudicação, arco do movimento, circunferência da coxa e a variação sérica das enzimas creatina-quinase e lactato-desidrogenase. De acordo com os resultados encontrados, foi possível concluir que as modalidades terapêuticas de massagem, movimentação passiva da articulação, estimulação elétrica neuromuscular e hidroterapia por caminhada em esteira aquática aceleram a recuperação clínica em cães com atrofia muscular induzida.

The response of different physiotherapeutic treatment protocols was evaluated in dogs after muscle atrophy induced by joint immobilization for 30 days. Groups were named C group or control, E group (massage, passive range of motion and neuromuscular electrical stimulation), H group (massage, passive range of motion and aquatic therapy in underwater treadmill) and EH group (massage, passive range of motion, neuromuscular electrical stimulation and aquatic therapy in underwater treadmill). It was measured the degree of lameness, range motion, thigh circumference and range of serum creatine kinase (CK) and lactate dehydrogenase (LDH). According to the results, it was possible to conclude that associated therapeutics modalities such as massage, passive range of motion of the joint, neuromuscular electrical stimulation and aquatic therapy by walking on underwater treadmill accelerate clinical recovery in dogs with induced muscle atrophy.

Effects of Wrist Hand Orthoses on Cerebral Palsy Children with Adduction of Thumb / 中国康复理论与实践

@#ObjectiveTo observe the effects of wrist hand orthoses on cerebral palsy children with adduction of thumb. MethodsChildren with spastic hemiplegia were divided into experimental group （14 cases) and control group （15 cases）. Children in the both groups received routine rehabilitation for 3 months. Children in experimental group wore wrist hand orthoses 4～8 h/d in addition. ResultsThe passive range of motion (PROM) and scores of Fine Motor Function Measure Scale (FMFM) significantly increased in both groups after treatment. The PROM and FMFM scores in experimental groups increased more than those in the control group after treatment （P＜0.05).ConclusionWrist hand orthoses can improve the passive adduction angle of carpometacarpal joints of thumb and the fine motor function in spastic hemiplegia children after cerebral palsy.

Comparison of Ultrasonographic Findings with Clinical Findings in Hemiplegic Shoulder

OBJECTIVE: To identify the etiology of hemiplegic shoulder pain by ultrasonographic and clinical examinations and to determine the correlation between ultrasonographic findings and clinical factors in patients with hemiplegic shoulder. METHOD: Seventy hemiplegic patients with shoulder pain or without shoulder pain were enrolled. All of patients were evaluated by ultrasonography. We analyzed clinical factors including visual analogue scale (VAS) of hemiplegic shoulder pain, shoulder subluxation measured by plain X-ray, shoulder manual muscle test (MMT), passive range of motion (PROM) of the shoulder joint and complex regional pain syndrome (CRPS). RESULTS: 51.0% of patients with shoulder pain showed abnormal ultrasonographic findings, while 9.5% of patients without shoulder pain. Those with abnormal ultrasonographic findings had significantly decreased shoulder PROM in flexion, abduction, external rotation and internal rotation and more severe subluxation of hemiplegic shoulder (p<0.05). CONCLUSION: After investigating the hemiplegic shoulder through ultrasonography, painful hemiplegic shouder had high incidence of abnormal ultrasonographic characteristics. Ultrasonography is more worthwhile and useful as an primary diagnostic method, especially when there is severe shoulder subluxation and the limitation of PROM of shoulder in hemiplegic patients.