Wirksamkeitsvergleich einer kaudalen Gleitmobilisationstechnik in endgradiger und mittelgradiger Schulterabduktion bei Capsulitis adhaesiva (Schultersteife)

Zusammenfassung

Hintergrund: Die Capsulitis adhaesiva (Schultersteife) zeichnet sich durch quälende und zunehmende Schmerzen aus, die mit einem Mobilitätsverlust des Schultergelenks einhergehen.

Ziel: Wirksamkeitsvergleich zwischen einer kaudalen Gleitmobilisationstechnik in endgradiger und mittelgradiger Schulterabduktion bei Patienten mit Capsulitis adhaesiva.

Methode: In der randomisierten Doppelblindstudie mit 20 Probanden mit einseitiger Capsulitis adhaesiva wurden vor Beginn der Behandlungen und nach 6 Wochen die Schmerzintensität mithilfe einer visuellen Analogskala (VAS) und das aktive Bewegungsausmaß der Abduktion mit einem Standardgoniometer gemessen. Die Probanden wurden in 2 Gruppen zu jeweils 10 Patienten mit endgradiger (ERM) bzw. mittelgradiger Schulterabduktion (MRM) eingeteilt. Die Behandlung erstreckte sich für beide Gruppen über 6 Wochen mit wöchentlich 3 Behandlungen (insgesamt 18 Behandlungen).

Ergebnisse: Der Durchschnittswert des aktiven Bewegungsausmaßes der Abduktion nahm in der ERM-Gruppe von 56,4° (± 11,62) auf 86,3° (± 11,21) zu. In der MRM-Gruppe stieg er von 56,3° (± 11,62) auf 71,4° ± (12,77). Die Schmerzintensität verringerte sich in der ERM-Gruppe von 5,3 (± 0,67) auf 2,4 (± 0,69) und in der MRM-Gruppe von 5,4 (± 0,51) auf 3,5 (± 0,52). Diese Veränderungen der Durchschnittswerte waren statistisch signifikant (p = 0,001).

Schlussfolgerungen: In Bezug auf die Verbesserung des Bewegungsausmaßes und der Schmerzintensität war bei Patienten mit Capsulitis adhaesiva die Anwendung des Kaudalgleitens in der endgradigen Gelenkstellung wirksamer als in der mittelgradigen. Allerdings verbesserten sich die Patienten unter beiden Behandlungsansätzen. Die Ergebnisse müssen auch vor dem Hintergrund der Schwächen dieser Studie beurteilt werden.

Abstract

Background: Adhesive shoulder capsulitis (frozen shoulder) is characterised by insidious and progressive pain and glenohumeral joint’s loss of mobility.

Objective: Comparison of the effectiveness of a caudal glide mobilisation technique in end-range versus mid-range shoulder abduction in subjects with adhesive shoulder capsulitis.

Method: In this randomised double-blinded study of 20 persons with unilateral adhesive shoulder capsulitis pain intensity was measured using a visual analogue scale (VAS) and active range of motion of abduction using a standard goniometer before the onset of the treatment and after 6 weeks. The subjects were divided into two groups of 10 each with end-range (ERM) and mid-range mobilisation (MRM). For both groups treatment covered 6 weeks with 3 sessions per week (a total of 18 sessions).

Results: The Mean range of motion of abduction increased from 56.4° (± 11.62) to 86.3° (± 11.21) in the ERM group and from 56.30° (± 11.62) to 71.40° (± 12.77) in the MRM group. Pain response reduced from 5.3 (± 0.67) to 2.4 (± 0.69) in the ERM group and from 5.4 (± 0.51) to 3.5 (± 0.52) in the MRM group. The mean value changes over time were statistical significant (p = 0.001).

Conclusions: In patients with adhesive shoulder capsulitis the application of caudal glide in end range shoulder abduction proved to be more effective than in mid range with view towards improvement of range of motion and pain intensity. However, patients improved under both treatment modalities. The results must be interpreted in consideration of the study’s limitations.

Schlüsselwörter

Kaudalgleiten - AROM - Capsulitis adhaesiva - Schulterabduktion

Key words

caudal glide - AROM - adhesive capsulitis - shoulder abduction

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