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• W2078796789 abstract "Stiffness in the shoulder is a frequent symptom associated with a number of clinical entities whose management remains inadequately defined. This prospective study of 235 cases of stiffness in the shoulder compared six therapeutic techniques with a mean follow-up of 13 months (range, 3–28 months) (T1: 58 cases, conventional rehabilitation under the pain threshold, T2: 59 cases, self-rehabilitation over the pain threshold, T3: 31 cases, T2 + supervision, T4: 11 cases, T1 + capsular distension, T5: 31 cases, T1 + locoregional anesthesia, T6: 45 cases, T1 + T5 + capsulotomy). The therapeutic power of each technique and its impact on the result were assessed at each self-rehabilitation and rehabilitation session during the first 6 weeks and then at 3 months, 6 months, and at the final revision depending on subjective criteria (pain, discomfort, and morale) and objective criteria (Constant score, goniometric measurements). Conventional rehabilitation (T1) is less effective than self-rehabilitation over the pain threshold (T2 & T3) during the first 6 weeks (P < 0.05). Self-rehabilitation stagnates between the 6th and 12th week except when it is supervised by a therapist (T3). Anesthesia (T4) and capsular distension (T5) do not lead to significantly different progression beyond 6 months. Capsulotomy does not demonstrate greater therapeutic power but its failure rate (persisting stiffness at 1 year) is 0% versus 14–17% for the other techniques (P < 0.05). The techniques are complementary and therapeutic success stems from an algorithm adapted to the individual patient with, over the first 3 months, successive self-rehabilitation and conventional rehabilitation, possibly completed by capsular distension or anesthesia between the 3rd and 6th months. In case of failure at 6 months, endoscopic capsulotomy can be proposed. Therapeutic patient education and active participation are the key to treatment success or failure. Level III, case–control, prospective comparative." @default.
• W2078796789 created "2016-06-24" @default.
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• W2078796789 date "2011-12-01" @default.
• W2078796789 modified "2023-09-28" @default.
• W2078796789 title "Management of the stiff shoulder. A prospective multicenter comparative study of the six main techniques in use: 235 cases" @default.
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• W2078796789 doi "https://doi.org/10.1016/j.otsr.2011.09.004" @default.
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• W2078796789 hasPublicationYear "2011" @default.
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