Фізична терапія у лікуванні адгезивного капсуліту плечового суглобу

Abstract

The purpose of the study was to perform an analysis of the results of research devoted to the study of the effectiveness of physical therapy in the treatment of patients with adhesive capsulitis of the shoulder joint. Materials and methods. This study is the result of an analysis of research devoted to the study of the effect of physical therapy on shoulder range of motion, pain on the visual analog scale, shoulder pain and disability index, Oxford shoulder scale, work capacity in patients with adhesive capsulitis of the shoulder joint, as well as a comparison of effectiveness of physical therapy with other methods of treatment. Results and discussion. There are works which indicate a lack of certainty regarding the superiority of certain treatment methods over others. Systematic reviews identified large gaps in the evidence and indicated the need for high quality research. At the same time, manipulation under anesthesia and arthroscopic capsular release are increasingly used to promote faster recovery, despite the lack of reliable evidence. The analysis of literature sources allowed us to establish that therapeutic exercises and manual therapy are recommended to be used separately or as a supplement to intra-articular injection of glucocorticosteroids, manipulations under anesthesia or arthroscopic capsular release. There are results that indicate a lack of effectiveness in terms of shoulder pain or work capacity from adding manipulation under anesthesia to physical therapy; indicate аn equal effectiveness of manipulation under anesthesia, therapeutic exercises, and structured physical therapy on pain, disability, and function assessments. A large study of the clinical and cost-effectiveness of invasive and expensive surgery and early structured physical therapy found no advantage for either approach during 12 months from the start of treatment, provided all patients received steroid injection. Regarding the comparison of physical therapy with steroid injections, there is evidence of benefit from the use of injections alone or in combination with physical therapy in the short term. However, there are results regarding their equal effectiveness. At the same time, all the considered works indicated the same effect in the long term. Conclusion. The use of physical therapy in the treatment of patients with adhesive capsulitis of the shoulder joint is useful and effective. Physical therapy has no worse effectiveness than surgical interventions and steroid injections. Adding steroid injections to physical therapy may improve the short-term effectiveness of treatment. The conclusions of the vast majority of studies confirm the effectiveness of physical therapy, which should be taken into account when determining treatment tactics