The Effectiveness of Intensive Mobilization Techniques Combined with Capsular Distension for Adhesive Capsulitis of the Shoulder

[Purpose] The aim of this study was to determine the synergistic effect of intensive mobilization techniques combined with capsular distension for patients with adhesive capsulitis (AC). [Subjects] The subjects were 53 patients with AC (mean age, 56.0 ± 7.6 years). [Methods] Patients were randomized to one of four treatment groups: intensive mobilization after one steroid injection with capsular distension (IMSID); intensive mobilization (IM); one steroid injection with capsular distension (SID); and general physical therapy only (GPT). The IMSID, IM, and SID groups also received general physical therapy for 20 minutes. All treatments were performed twice per week for 4 weeks. Patients were assessed using the Shoulder Pain and Disability Index (SPADI), Constant-Murley Shoulder Function Assessment Score (CS), Active Range of Motion (AROM), and Verbal Numeric Score (VNS). [Results] There were significant post-intervention differences in all the measured values in each of the groups, except for external rotation ROM in the SID group. The IMSID group showed the greatest differences among the groups. There were significant differences among the means of all the groups. [Conclusion] The most effective treatment for AC was the combination of the intensive mobilization and steroid injection with capsular distension, which helped to control inflammation, extend joint space, and recover ROM.