Indian Journal of Physical Medicine and Rehabilitation

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VOLUME 24 , ISSUE 4 ( December, 2013 ) > List of Articles

RESEARCH ARTICLE

Intra-articular Steroid in the Management of Adhesive Capsulitis of Shoulder: A Comparison of the Anterior and Posterior Approaches

Sonachand Sharma G, Y Nandabir Singh, N Bimol Singh, T Touthang Alex, KH Tamphaleima

Citation Information : Sharma G S, Nandabir Singh Y, Bimol Singh N, Touthang Alex T, Tamphaleima K. Intra-articular Steroid in the Management of Adhesive Capsulitis of Shoulder: A Comparison of the Anterior and Posterior Approaches. Indian J Phy Med Rehab 2013; 24 (4):99-103.

DOI: 10.5005/ijopmr-24-4-99

Published Online: 00-12-2013

Copyright Statement:  Copyright © 2013; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objective

To compare the anterior and posterior blind intra-articular steroid injections approaches in the management of adhesive capsulitis of shoulder

Design

Randomised control trial

Setting

Department of PMR, Regional Institute of Medical Sciences (RIMS), Imphal, Manipur.

Participants

The patients having adhesive capsulitis of shoulder (n=60) attending PMR department, RIMS during the study period.

Duration

One year (August 2011 to July 2012).

Intervention

After randomisation, 60 patients were allocated in three groups (A, B and C). Group C (n=20) received physical therapy practice in the department of PMR, RIMS, Imphal. Group A (n=18) and B (n=22) received intraarticular steroid (methylprednisolone 80mg each) by anterior and posterior approaches without imaging guidance respectively in addition to physical therapy. Outcome measures: 1) Visual analogue scale (VAS) for pain, 2) Shoulder pain and disability index (SPADI) and 3) Passive range of motion of affected shoulder using goniometer.

Results

All the three groups showed improvement with statistically significant (p<0.005) findings in all the outcome variables except in shoulder flexion range (p=0.085). Improvement in outcomes namely VAS, SPADI, shoulder rotation and abduction range were more marked in group A when compared with group B which was found statistically significant (p<0.05).

Conclusion

The intra-articular steroid injection when combined with physical therapy is effective in the management of adhesive capsulitis of shoulder. The blind anterior approach intra-articular steroid injection is more effective than posterior approach in improving shoulder rotation and abduction range of movements, reducing shoulder pain and disability in patient having less than 3 months duration adhesive capsulitis of shoulder.


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