- Title
- Clinical identifiers for early-stage primary/idiopathic adhesive capsulitis: are we seeing the real picture?
- Creator
- Walmsley, Sarah; Osmotherly, Peter G.; Rivett, Darren A.
- Relation
- Physical Therapy Vol. 94, Issue 7, p. 968-976
- Publisher Link
- http://dx.doi.org/10.2522/ptj.20130398
- Publisher
- American Physical Therapy Association
- Resource Type
- journal article
- Date
- 2014
- Description
- Background: Adhesive capsulitis is often difficult to diagnose in its early stage and to differentiate from other common shoulder disorders. Objective: The aim of this study was to validate any or all of the 8 clinical identifiers of early-stage primary/idiopathic adhesive capsulitis established in an earlier Delphi study. Design: This was a cross-sectional study. Methods: Sixty-four patients diagnosed with early-stage adhesive capsulitis by a physical therapist or medical practitioner were included in the study. Eight active and 8 passive shoulder movements and visual analog scale pain scores for each movement were recorded prior to and immediately following an intra-articular injection of corticosteroid and local anesthetic. Using the local anesthetic as the reference standard, pain relief of ≥70% for passive external rotation was deemed a positive anesthetic response (PAR). Results: Sixteen participants (25%) demonstrated a PAR. Univariate logistic regression identified that of the proposed identifiers, global loss of passive range of movement (odds ratio [OR] =0.26, P=.03), pain at the end of range of all measured active movements (OR=0.06, P=.02), and global loss of passive glenohumeral movements (OR=0.23, P=.02) were associated with a PAR. Following stepwise removal of the variables, pain at the end of range of all measured active movements remained the only identifier but was associated with reduced odds of a PAR. Limitations. The lack of a recognized reference standard for diagnosing early-stage adhesive capsulitis remains problematic in all related research. Conclusions. None of the clinical identifiers for early-stage adhesive capsulitis previously proposed by expert consensus have been validated in this study. Clinicians should be aware that commonly used clinical identifiers may not be applicable to this stage.
- Subject
- adhesive capsulitis; shoulder movement; clinical identifiers; positive anaesthetic response
- Identifier
- http://hdl.handle.net/1959.13/1306781
- Identifier
- uon:21253
- Identifier
- ISSN:0031-9023
- Rights
- This is a pre-copyedited, author-produced version of an article accepted for publication in Physical Therapy following peer review. The version of record Walmsley, Sarah; Osmotherly, Peter G.; Rivett, Darren A. "Clinical identifiers for early-stage primary/idiopathic adhesive capsulitis: are we seeing the real picture?" Published in Physical Therapy, Vol. 94, Issue 7, Pages 968-976, (2014) is available online at: http://dx.doi.org/10.2522/ptj.20130398.
- Language
- eng
- Full Text
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