Efficacy and Cost-Effectiveness of Physiotherapy Following Glenohumeral Joint Distension for Adhesive Capsulitis: RCT

21-06-2018
This study investigated whether an active physiotherapy program at the time of joint swelling during adhesive capsulitis provides additional benefits compared to a placebo and active treatment group. A randomized, placebo-controlled study was conducted among the two above-mentioned groups consisting of random participants performed by a single evaluator.
 
A total of 156 participants, of whom 144 completed it, participated in the two movement rooms. They experienced pain and stiffness mainly in 1 shoulder for 3 months and a limitation of passive movement (30) °. After randomization, participants were randomly assigned to either manual therapy and targeted exercise or placebo (sham ultrasound), both administered twice weekly for 2 weeks and then once weekly for 4 weeks. Outcomes were pain, function, active and shoulder movements assessed by participants, as well as perceived success and quality of life, at baseline, 6, 12 and 26 weeks. The costs were also collected.
 
Both groups improved over time with no significant differences in group improvement on outcome pain, function or quality of life at any time. Significant differences favored the physical therapy group for all active shoulder movements (eg, the pooled difference in mean change between groups over all time points for total shoulder abduction was 10.6 °, 95% confidence interval [95% CI] 3.1, 18.1 ) and observed by the participant's success (pooled relative risk 1.95% CI1.1.1.65, number needed 5). The net cost of physical therapy was $ 136.8 Australian dollars (95% CI 177.5,223.1) over a 6 month period.
 
Physiotherapy after joint swelling due to adhesive sapsulitis did not yield any additional benefits in terms of pain, function or quality of life, but resulted in a persistently higher active range of shoulder movements and improvements observed by participants up to 6 months.

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