Turkish Journal of Physical Medicine and Rehabilitation 2021 , Vol 67 , Num 2

Prognostic value of magnetic resonance imaging in the evaluation of physical therapy outcomes in patients with adhesive capsulitis

Sacide Nur Saraçgil Coşar 1 ,Selin Ozen 1 ,Ali Niyazi Kurtcebe 2 ,Mehmet Coşkun 3 ,Oya Ümit Yemişci 1
1 Department of Physical Medicine and Rehabilitation, Başkent University Faculty of Medicine, Ankara, Turkey
2 Department of Physical Medicine and Rehabilitation, Gölbaşı Şehit Ahmet Özsoy State Hospital, Ankara, Turkey
3 Department of Radiology, Başkent University Faculty of Medicine, Ankara, Turkey
DOI : 10.5606/tftrd.2021.5139 Objectives: This study aims to investigate whether the treatment outcomes of patients with a clinical diagnosis of adhesive capsulitis (AC) and magnetic resonance imaging (MRI) findings consistent with AC undergoing physical therapy (PT) differs to those with AC in the absence of these MRI findings.

Patients and methods: Between January 2012 and October 2012, a total of 30 patients (8 males, 22 females; mean age 55.6±12.1 years; range, 35 to 85 years) with a clinical diagnosis of AC underwent MRI of the index shoulder. The MRI scans were evaluated for findings associated with AC: intensity of the inferior glenohumeral ligament (IGHL) and rotator interval (RI). All patients received a total of 15 sessions of PT: hot pack, transcutaneous electrical nerve stimulation, ultrasound, and shoulder exercises. The patients were assessed for shoulder range of motion (ROM) using the Visual Analog Scale (VAS) for shoulder pain, Quick Disabilities of the Arm Shoulder and Hand (Q-DASH), and Health Assessment Questionnaire (HAQ) prior to and following completion of PT.

Results: Of the patients, 21 had no MRI findings consistent with AC (Group 1), nine patients had changes in the IGHL and/or RI characteristic of AC (Group 2). In both groups, there was a significant improvement in active and passive shoulder ROM and VAS scores for shoulder pain at rest (Group 1: p<0.001, Group 2: p=0.017) with movement (Group 1: p<0.001, Group 2: p=0.007) and at night (Group 1: p<0.001, Group 2: p=0.012) following PT. However, there was no significant inter-group difference in scores. Similar findings were recorded for Q-DASH and HAQ.

Conclusion: Based on these study findings, the presence of characteristic MRI findings of AC with a clinical diagnosis do not predict clinical response to physical therapy. Keywords : Adhesive capsulitis, frozen shoulder, physical therapy modality