Addition of Intra-articular Hyaluronate Injection to Physical Therapy Program Produces No Extra Benefits in Patients With Adhesive Capsulitis of the Shoulder: A Randomized Controlled Trial

Hsieh, Lin‐Fen; Hsu, Wei‐Chun; Lin, Yi‐Ying; Chang, Hsiao-Lan; Chen, Chiao-Chien; Huang, Vincent

doi:10.1016/j.apmr.2012.01.021

Cited by 46 publications

(56 citation statements)

References 28 publications

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“…In the most severe cases, the addition of small doses of triamcinolone acetonide exploits the favorable effect on the sliding planes. The results of our study -resolution of the clinical picture in 96.1% of cases after a mean of 5-7 weeks of treatment -were found to be superior to ones previously reported in the literature (4,11,13,15,17,19). Therefore, in our opinion, surgical treatment of adhesive capsulitis should be reserved for cases resistant to conservative treatment, which in the present study accounted for only 3.8 % of the treated patients.…”

Section: Discussioncontrasting

confidence: 33%

“…(12) pointed out that the use of intra-articular hyaluronic acid is safer than the use of intra-articular corticosteroid injections in the treatment of IAC. Hsieh et al (13) found that intra-articular injection of hyaluronic acid did not seem to offer additional benefits over the use of physical therapy, although it reduced the need for further drug treatment. Conversely, Dehghan et al (14) did not find statistically significant differences between oral drug therapy and intra-articular administration of corticosteroids in diabetic patients, while physical therapy (transcutaneous electrical nerve stimulation, thermotherapy, manual therapy) seemed to show greater efficacy if associated with bee venom acupuncture (15 All the various treatments for IAC (steroid or hyaluronic acid injections, physical therapy, acupuncture, MUA and arthroscopic distension and capsular release) have also been considered from a cost-effectiveness perspective in relation to resolution of pain and dysfunction.…”

Section: Discussionmentioning

confidence: 99%

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Conservative integrated treatment of adhesive capsulitis of the shoulder

Russo¹,

Arrighi

Vignale³

et al. 2014

jts

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Purpose: the aim of this study was to present the results of a conservative treatment for adhesive capsulitis based on an original protocol of combined pharmacological and rehabilitation treatment. Methods: fifty-two patients with idiopathic adhesive capsulitis were enrolled in the present study. The treatment protocol included the use of hyaluronic acid and anaesthetic periarticular and intra-articular injections followed by a specific program of capsule and muscle stretching. Results: the results of this treatment showed complete recovery of range of motion (ROM) in 50 of the 52 cases. The mean pre-treatment ROM values were: 85°f or forward elevation, 75° for abduction, 25° for external rotation, and 15° for internal rotation. The posttreatment mean ROM values showed marked improvements: 175° for forward elevation, 175° for abduction, 87.5° for external rotation and 75° for internal rotation. Conclusions: conservative treatment of adhesive capsulitis based on a combined pharmacological and rehabilitation approach was found to be effective in resolving pain and stiffness in 96% of the patients. Level of evidence: level IV, therapeutic case series.

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Section: Discussioncontrasting

confidence: 33%

Section: Discussionmentioning

confidence: 99%

Conservative integrated treatment of adhesive capsulitis of the shoulder

Russo¹,

Arrighi

Vignale³

et al. 2014

jts

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“…However, in the comparative study performed by Calis et al [29], IAHA was not effective in patients with adhesive capsulitis compared to physical therapy or IAS. According to a recently conducted randomized controlled trial, IAHA had no additional effect on pain, ROM, and quality of life in patients with adhesive capsulitis who had already received physical therapy [30]. Another study showed that IAHA and IAS treatments gave significant improvement in passive ROM and a visual analog scale [16].…”

Section: Discussionmentioning

confidence: 99%

Effect of Intra-articular Hyaluronic Acid Injection on Hemiplegic Shoulder Pain After Stroke

et al. 2016

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ObjectiveTo evaluate the efficacy of intra-articular hyaluronic acid (IAHA) injection for hemiplegic shoulder pain (HSP) after stroke.MethodsThirty-one patients with HSP and limited range of motion (ROM) without spasticity of upper extremity were recruited. All subjects were randomly allocated to group A (n=15) for three weekly IAHA injection or group B (n=16) for a single intra-articular steroid (IAS) injection. All injections were administered by an expert physician until the 8th week using a posterior ultrasonography-guided approach. Shoulder joint pain was measured using the Wong-Baker Scale (WBS), while passive ROM was measured in the supine position by an expert physician.ResultsThere were no significant intergroup differences in WBS or ROM at the 8th week. Improvements in forward flexion and external rotation were observed from the 4th week in the IAHA group and the 8th week in the IAS group. Subjects experienced a statistically significant improvement in pain from the 1st week in the IAS and from the 8th week in IAHA group, respectively.ConclusionIAHA seems to have a less potent ability to reduce movement pain compared to steroid in the early period. However, there was no statistically significant intergroup difference in WBS and ROM improvements at the 8th week. IAHA might be a good alternative to steroid for managing HSP when the use of steroid is limited.

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“…71 In a high-quality trial comparing standardized PT with standardized PT plus intra-articular hyaluronic acid injection, both groups improved significantly but there was no added benefit to the injection. 72 In an acceptable-quality trial comparing SSNB injection before a course of PT with PT alone, both groups improved significantly immediately and 1 month post-intervention. However, the nerve block group had significantly greater improvement in pain and function at both intervals.…”

Section: Adhesive Capsulitismentioning

confidence: 96%

“…Five studies compared a treatment combined with standardized PT with standardized PT alone. [72][73][74][75]77 In 4 of 5, both groups improved significantly; in the fifth trial; within-group changes were not reported. 75 In the low-quality trial comparing a specific PT technique with standardized PT alone, the specific technique (Mulligan's mobilization) was superior to passive stretching at 3 weeks and 3 months post-intervention.…”

Section: Adhesive Capsulitismentioning

confidence: 99%

Systematic Review of Nondrug, Nonsurgical Treatment of Shoulder Conditions

Hawk

Minkalis

Khorsan

et al. 2017

Journal of Manipulative and Physiological Therapeutics

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Objective: The purpose of this review was to evaluate the effectiveness of conservative nondrug, nonsurgical interventions, either alone or in combination, for conditions of the shoulder. Methods: The review was conducted from March 2016 to November 2016 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and was registered with PROSPERO. Eligibility criteria included randomized controlled trials (RCTs), systematic reviews, or meta-analyses studying adult patients with a shoulder diagnosis. Interventions qualified if they did not involve prescription medication or surgical procedures, although these could be used in the comparison group or groups. At least 2 independent reviewers assessed the quality of each study using the Scottish Intercollegiate Guidelines Network checklists. Shoulder conditions addressed were shoulder impingement syndrome (SIS), rotator cuff-associated disorders (RCs), adhesive capsulitis (AC), and nonspecific shoulder pain. Results: Twenty-five systematic reviews and 44 RCTs met inclusion criteria. Low-to moderate-quality evidence supported the use of manual therapies for all 4 shoulder conditions. Exercise, particularly combined with physical therapy protocols, was beneficial for SIS and AC. For SIS, moderate evidence supported several passive modalities. For RC, physical therapy protocols were found beneficial but not superior to surgery in the long term. Moderate evidence supported extracorporeal shockwave therapy for calcific tendinitis RC. Low-level laser was the only modality for which there was moderate evidence supporting its use for all 4 conditions. Conclusion: The findings of this literature review may help inform practitioners who use conservative methods (eg, doctors of chiropractic, physical therapists, and other manual therapists) regarding the levels of evidence for modalities used for common shoulder conditions. (J Manipulative Physiol Ther 2017;40:293-319)

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Addition of Intra-articular Hyaluronate Injection to Physical Therapy Program Produces No Extra Benefits in Patients With Adhesive Capsulitis of the Shoulder: A Randomized Controlled Trial

Cited by 46 publications

References 28 publications

Conservative integrated treatment of adhesive capsulitis of the shoulder

Conservative integrated treatment of adhesive capsulitis of the shoulder

Effect of Intra-articular Hyaluronic Acid Injection on Hemiplegic Shoulder Pain After Stroke

Systematic Review of Nondrug, Nonsurgical Treatment of Shoulder Conditions

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