Formal Physical Therapy (PT) vs. Home PT for Adhesive Capsulitis

Boston Medical Center

Overview

This study aims to evaluate physical therapy (standard of care) and home exercise vs. home exercise alone for the treatment of adhesive capsulitis.

Patients with adhesive capsulitis receive a glenohumeral and subacromial injection routinely for treatment. In addition, the patients are routinely prescribed physical therapy with a home exercise component. The purpose of this study is to evaluate whether home exercise alone is an alternative option to physical therapy. Patients will be approached about the study after they have agreed to receive a glenohumeral and subacromial injection per standard of care for their clinical treatment. The hypothesis being tested is whether home exercise is alone is as beneficial for pain relief, restoration of range of motion, and improvement in shoulder disability from adhesive capsulitis as physical therapy. Additionally sex differences, diabetes mellitus, endocrine, and mental health histories will be noted.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Conditions

Adhesive Capsulitis

Interventions

Home Exercise ProtocolOTHER

Home exercise therapy protocol given to patient to be completed at home.

Physical Therapy ProtocolOTHER

Formal physical therapy protocol to be given to physical therapist working with patient to direct formal intervention along with a home therapy protocol.

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: 1. Clinical Diagnosis of Adhesive Capsulitis (limited range of motion) 2. Given glenohumeral and subacromial injection as part of standard care. 3. Capacity to conduct home exercise program or physical therapy (based upon physician judgment, proximity to physical therapy office and as decided by patient) 4. English speaking 5. 18 years of age or greater Exclusion Criteria: 1. Prior glenohumeral or subacromial corticosteroid injection within 6 months 2. Prior ipsilateral shoulder surgery 3. Current prescription (narcotic) pain medication use 4. Pain disorder (ex. Fibromyalgia, Reflex Sympathetic Dystrophy) 5. Cervical radiculopathy 6. Full-thickness rotator cuff tear 7. Calcific Tendinopathy (past or present) 8. Advanced Stage osteoarthritis as seen on radiograph 9. Past/present ipsilateral shoulder fracture 10. Women that may be pregnant or nursing (self report) Past/present physical therapy treatment will be documented, but will not be considered an exclusion factor. The reasoning behind this is that the physical therapy likely was not properly targeting the adhesive capsulitis for the patient to arrive in an orthopaedic clinic and is likely at a similar starting point to most other patients regardless of previous physical therapy. All patients currently enrolled in physical therapy will be assigned to either our physical therapy or home exercise program.