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Management of Adhesive Capsulitis in Physical Medicine and Rehabilitation Department: A Comparative Study

Wassia Kessomtini, Mouna Sghir, Mariem Rekik, Aymen Haj Salah, Rim Ben Khaled and Imen Ksibi

Objective: This study aimed to compare the outcome of two different populations, diabetes mellitus (DM) patients with adhesive capsulitis of the shoulder (ACS) and those with idiopathic ACS undergoing rehabilitation treatment.

Methods: A retrospective study was carried out between January 2005 and December 2016 in Physical Medicine and Rehabilitation (PMR) Department including patients diagnosed with ACS divided into two groups: diabetic ACS (G1) and idiopathic ACS (G2) (N=166 patients with 177 ACS). Both groups were evaluated before and after 3 months of a conventional physical therapy program. Epidemiological characteristics were gathered. Pain was measured with a visual analog scale (VAS), abduction and external rotation (ER) range of motion (ROM) with goniometry and internal rotation with hand behind back (HBB). Functional disability was assessed by the Constant modified score and general satisfaction by a Likert verbal scale.

Results: The mean age was 56 ± 7.3 years for G1 and 57 ± 10.6 years for G2. The sex ratio was respectively 1.25 and 0.47 for G1 and G2. A statistically significant improvement was noted in pain, ROM, and the modified Constant score after 3 months of treatment (p<0.05) as well as a general satisfaction in both groups. This improvement was significantly better in G2 than G1.

Conclusion: This study suggests that rehabilitation care is beneficial among population suffering from ACS with better results for the idiopathic one. This care should be early and regular with a balance in the diabetic in order to ensure a better response of the treatment.