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Journal of the Korean Academy of Rehabilitation Medicine 2009;33(2):205-214.
Biomechanical Evaluation of the Capsular Stiffness and Clinical Features in Adhesive Capsulitis of Shoulders.
Kim, Keewon , Kim, Tae Uk , Leigh, Ja Ho , Lee, Kyu Jin , Kim, Hee Chan , Chung, Sun Gun
1Department of Rehabilitation Medicine, Seoul National University College of Medicine, Korea. suncg@snu.ac.kr
2Department of Rehabilitation Medicine, Dankook University College of Medicine, Korea.
3Bio-electronics Lab. Material Solutions Technology Co., Ltd., Korea.
4Department of Biomedical Engineering, Seoul National University College of Medicine, Korea.
동결견 환자에서 관절낭의 강직도의 생역학적 평가와 임상 양상과의 관계
서울대학교 의과대학 재활의학교실, 1단국대학교 의과대학 재활의학교실, 2바이오 전자 연구소 (주)머티리얼솔루션 테크놀로지, 3서울대학교 의과대학 의공학교실
To evaluate the capsular stiffness of the gleno-humeral joint by measuring the slope of pressure- volume curves generated during intra-articular hydraulic distension (IHD) and analyze its correlation with clinical variables and outcomes in terms of limitation of range of motion (LOM) and severity of pain.
IHD with real-time intra-articular pressure mo-nitoring was performed for 53 patients with adhesive capsulitis and the capsular stiffness was measured from pressure-volume curves by calculating the slope of elastic deformation region. LOM, measured by LOM score and sum of ROMs (range of motion), and degree of pain, measured by visual analog scale (VAS), were evaluated before and after IHD: three days (3D) and one month (1M) after IHD.
In patients with stiffer capsules, LOM and pain were severe before IHD (Pearson's correlation coefficient (r)= 0.291, -0.348, 0.381 and p=0.065, 0.026, 0.014 for LOM score, sum of ROMs and VAS, respectively. By this order, henceforth). On 3D follow up, the correlation between the stiffness and LOM or pain was maintained (r=0.291, -0.348, 0.381 and p=0.065, 0.026, 0.014). The improvement of LOM score on 3D follow up was less as the capsules were stiffer (r=-0.368, p=0.023). On 1M follow up, LOM remained severer in stiffer capsules whereas pain did not (r=0.372, -0.402, 0.183 and p=0.039, 0.025, 0.342).
The stiffness of the glenohumeral joint capsule, measured from the slope of pressure-volume curves during IHD, showed significant correlation with the severity of LOM and pain in patients with adhesive capsulitis of shoulder. (J Korean Acad Rehab Med 2009; 33: 205-214)
Key Words: Adhesive capsulitis, Intra-articular hydraulic distension, Pressure-volume curve, Capsule, Shoulder


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