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Hydraulic Distension with Pumping Technique for Treating Frozen Shoulder: A Case-Controlled, Retrospective, Comparative Study with 6-Month Follow-Up.

BACKGROUND
We have applied a new method called "the pumping technique" to the capsule-preserving hydraulic distension for frozen shoulder. With this technique, the stretching effect can be directly applied to the joint capsule of the affected shoulder.


OBJECTIVES
We attempted to evaluate the effect of capsule-preserving hydraulic distension using the pumping technique by comparing capsule-preserving hydraulic distension without it.


STUDY DESIGN
A case-controlled, retrospective, comparative study.


SETTING
Outpatient clinic of department of rehabilitation medicine in a single university hospital.


METHODS
Patients (n = 47) with frozen shoulder who were treated with hydraulic distension were assigned into the pumping group (n = 24) and the nonpumping group (n = 23). Range of motion (ROM), Shoulder Pain and Disability Index (SPADI), and Visual Analog Scale (VAS) scores were assessed.


RESULTS
Significant improvement of VAS, ROM, and SPADI scores was observed after the second injection in each group (P < 0.05). There were significant differences in total passive ROM, abduction, and flexion after the fifth injection between the 2 groups (P < 0.05). There was a significant difference in the disability domain of SPADI after the second injection between the 2 groups (P < 0.05). However, there was no significant interaction between time and group with respect to VAS scores. There were no serious complications after procedures.


LIMITATIONS
This was a retrospective study. There might be some limitations in gathering comprehensive records of outcome measurements. In addition, because the objective of this study was to determine the effect of the new pumping technique, included patients range was very narrow. This study only included patients who were treated 5 times with capsule-preserving hydraulic distensions with or without the pumping technique.


CONCLUSIONS
Although the effect on pain was excellent in both groups, the superiority of the new pumping technique was demonstrated by reduction of SPADI disability subscale score and improvement of ROM of the shoulder compared with the nonpumping technique.


KEY WORDS
Shoulder pain, injections, stretch, exercise, ultrasonography, joint capsule, steroids, range of motion.