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OBJECTIVE: We investigated the associations between adhesive capsulitis (AC) and a specific psychological profile. METHODS: We assessed 72 patients with phase-II AC. In our study, 36 patients were affected by primary disease and 36 by secondary disease. The inclusion criteria were as follows: unilateral AC and pain in the shoulder for at least two months. The exclusion criteria were: psychiatric and neurological manifestations with a previous diagnosis and inability to comprehend the instruments. Outcomes were determined at 52 weeks. Shoulder pain severity was assessed with the Visual Analog Scale. We also measured the range of motion with a universal goniometer and the strength with the Medical Research Council. We assessed the personality traits of our patients with the Cloninger's Temperament and Character Inventory and the Multidimensional Perfectionism Scale. RESULTS: Patients with primary AC needed more time to improve the symptomatology compared to the group with the secondary disease (p<0.01). Patients with primary AC complained of severe and lasting pain more frequently than patients with the secondary disease (p< 0.01). In patients with primary disease, the prevalence of perfectionism, low levels of novelty seeking, and high levels of harm avoidance were 88.2 and 86.2%, and 80.4, respectively, and below 20 percent in patients with secondary AC disease. CONCLUSION: We found a significant correlation between primary AC and particular personality traits, indicating an interaction between psychological and somatic factors.

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SUMMARY OBJECTIVE We investigated the associations between adhesive capsulitis (AC) and a specific psychological profile. METHODS We assessed 72 patients with phase-II AC. In our study, 36 patients were affected by primary disease and 36 by secondary disease. The inclusion criteria were as follows: unilateral AC and pain in the shoulder for at least two months. The exclusion criteria were: psychiatric and neurological manifestations with a previous diagnosis and inability to comprehend the instruments. Outcomes were determined at 52 weeks. Shoulder pain severity was assessed with the Visual Analog Scale. We also measured the range of motion with a universal goniometer and the strength with the Medical Research Council. We assessed the personality traits of our patients with the Cloninger's Temperament and Character Inventory and the Multidimensional Perfectionism Scale. RESULTS Patients with primary AC needed more time to improve the symptomatology compared to the group with the secondary disease (p<0.01). Patients with primary AC complained of severe and lasting pain more frequently than patients with the secondary disease (p< 0.01). In patients with primary disease, the prevalence of perfectionism, low levels of novelty seeking, and high levels of harm avoidance were 88.2 and 86.2%, and 80.4, respectively, and below 20 percent in patients with secondary AC disease. CONCLUSION We found a significant correlation between primary AC and particular personality traits, indicating an interaction between psychological and somatic factors.

RESUMO OBJETIVO Investigar as associações entre a capsulite adesiva (CA) e um perfil psicológico específico. METODOLOGIA Foram avaliados 72 pacientes com CA fase II. Em nosso estudo, 36 pacientes foram afetados pela doença primária e 36 pela secundária. Os critérios de inclusão foram os seguintes: CA unilateral e dor no ombro durante por pelo menos dois meses. Os critérios de exclusão foram: manifestações neurológicas e psiquiátricas com um diagnóstico prévio e incapacidade de compreender os instrumentos de medição utilizados. Os resultados foram determinados após 52 semanas. A intensidade da dor no ombro foi avaliada usando a Escala Visual Analógica. Também medimos a amplitude de movimento com um goniômetro universal e a força com a escala do Conselho de Pesquisa Médica. Avaliamos os traços da personalidade dos nossos pacientes através do Inventário de Temperamento e Caráter de Cloninger e da Escala Multidimensional de Perfeccionismo. RESULTADOS Pacientes com CA primária precisaram de mais tempo para melhorar a sintomatologia quando comparados ao grupo secundário (p<0,01). Pacientes com CA primária apresentaram mais queixas de dor intensa e duradoura do que pacientes secundários (p< 0,01). Em pacientes com a doença primária, a prevalência de perfeccionismo, baixos níveis de procura por novidade, e altos níveis de prevenção de danos foram 88,2, 86,2% e 80,4, respectivamente, e abaixo de 20% em pacientes secundários. CONCLUSÃO Encontramos uma correlação significativa entre CA primária e traços de personalidade específicos, indicando uma interação entre fatores psicológicos e somáticos.

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PURPOSE: To evaluate the clinical outcomes and complications in a series of patients with painful partial articular cuff tears treated with the arthroscopic transtendinous repair with a minimum 2-year follow-up. METHODS: Eighty patients with a mean age of 51 ± 5.4 years who had undergone an arthroscopic transtendon repair for a painful articular-sided rotator cuff tear with a minimum of 2-year follow-up were contacted. Clinical outcomes using a patient-based questionnaire, the University of California at Los Angeles score, the American Shoulder and Elbow Surgeons score, and the visual analog scale were evaluated. Postoperative complications were also assessed. RESULTS: After arthroscopic repair, the University of California at Los Angeles scores improved from 13.6 to 31.5; the American Shoulder and Elbow Surgeons scores improved from 44.4 to 76.1; and the visual analog scale scores improved from 6.3 to 1.3 (P < .0001). A total of 92.5% of patients were satisfied with their results. Only 5 patients developed a postoperative adhesive capsulitis that responded favorably to physical therapy. Eleven patients had concurrent procedures performed at the time of surgery. We found no difference between these patients and those who had an isolated tendon repair. CONCLUSIONS: Arthroscopic transtendon repair of partial-thickness articular-side rotator cuff tears is a reliable procedure that can be expected to produce satisfactory functional improvements and pain relief in most patients with a low rate of complications in the midterm follow-up. Concurrent procedures performed at the time of supraspinatus repair do not change functional outcomes. LEVEL OF EVIDENCE: Level IV, therapeutic case series.

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BACKGROUND: Intra-articular corticosteroid injection is a common therapy for adhesive capsulitis, but there is a lack of prospective randomized controlled studies analyzing the efficacy of single injections applied blindly to accelerate improvement in pain and function. HYPOTHESIS: In patients with adhesive capsulitis, a single intra-articular corticosteroid injection without image control applied before the beginning of a physical therapy program will accelerate pain relief and recovery of function compared with oral nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: A total of 74 patients with primary adhesive capsulitis in the freezing stage were randomized to receive either intra-articular injections with betamethasone or oral NSAIDs. Clinical outcome was documented at baseline and after 2, 4, 8, and 12 weeks and comprised a visual analog scale (VAS) for pain, the American Shoulder and Elbow Surgeons (ASES) Shoulder Score, the abbreviated Constant-Murley score, and the abbreviated Disabilities of the Arm, Shoulder and Hand (QuickDASH) score for function. Passive range of motion was measured with a goniometer. RESULTS: Patients treated with corticosteroid injections achieved faster pain relief compared with control patients during the first 8 weeks after treatment (P < .001). However, no significant difference in pain was observed among the groups at final follow-up. Likewise, shoulder function and motion improved significantly in both groups at all follow-up points. Shoulder function scores and most motion parameters improved faster in the injection group up to week 8 (P < .001). Again, no significant differences in function or motion were seen at final follow-up. CONCLUSION: In patients with adhesive capsulitis, a single corticosteroid injection applied without image control provides faster pain relief and earlier improvement of shoulder function and motion compared with oral NSAIDs.

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Objetivo: Describir las características clínico-epidemiológicas y su manejo rehabilitador de los pacientes con capsulitis adhesiva atendidos en el Instituto Nacional de Rehabilitación en el periodo comprendido del 2008-2012. Material y método: Se realizó un estudio descriptivo, de corte transversal en 155 pacientes atendidos con el diagnóstico de capsulitis adhesiva, en el Departamento de Investigación, Docencia y Rehabilitación Integral de la Unidad Motora y de Dolor en el Instituto Nacional de Rehabilitación en el periodo comprendido del 2008-2012. Resultados: Hay un predominio por el sexo femenino (71.3 por ciento), una edad promedio 55.61 años, un tiempo de enfermedad 6.01 meses, el tipo de capsulitis mas frecuente es la primaria (89.6 por ciento); la secundaria relacionada con diabetes mellitus; encontramos una intensidad del dolor promedio EVA de 6.28 y los rangos articulares más afectados son la rotación interna y externa; la Kinesioterapia (93 por ciento) es el más indicado, seguido del ultrasonido, el láser, 10 que está en relación con la intensidad del dolor además de existir una diferencia significativa con la U de Mann Whitney, al igual que para el ultrasonido, electroterapia, bloqueo para vertebral e infiltración. Conclusiones: Es más frecuente en el sexo femenino entre los 38 a 70 años y probablemente la elección del tipo de tratamiento Rehabilitador es elegido e influenciado por la intensidad del dolor percibido por los pacientes, además en nuestro estudio la diabetes mellitus está relacionada con la presencia de capsulitis adhesiva y actividades repetitivas.

Objective: To describe clinical and epidemiological characteristics and rehabilitation treatment in patients with adhesive capsulitis treated at National Institute of Rehabilitation between 2008 and 2012. Methods: Descriptive cross-sectional study. 115 patients were included, all suffering from adhesive capsulitis at Research, Teaching and Integral Rehabilitation Department of the Motor and Pain Unit, at the National Institute of Rehabilitation, between 2008 and 2012. Results: Female were predominant (71.3 per cent), average age of 55.61 years old, average time of disease 6.01 months. Primary capsulitis was the most frequent (89.6 per cent). We found average pain intensity of 6.28 and most affected articular ranges are internal and external rotation motion. Kinesiology therapy is the predominant treatment (93 per cent) followed by ultrasound and lasers all of them significantly related with pain intensity. Also significantly were ultrasound, electrotherapy, para-spinal block and infiltration. Conclusions: Female are the predominant sex, between 38 and 70 years old. Probably rehabilitation treatment type is related according to pain intensity suffered by patients. Also in our study diabetes mellitus is related with adhesive capsulitis and repetitive activities.

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Os autores apresentam estudo de revisäo de 175 pacientes portadores de capsulite adesiva do ombro, tratados no período de 1987 a 1994. Destes, foram excluídos todos os casos tratados por manipulaçöes, infiltraçöes, distensäo hídrica ou cirurgica artroscópica, resultando num grupo final de 51 pacientes, com 59 ombros acometidos, que compareceram para avaliaçäo clínica. Catorze pacientes foram caracterizados como portadores da forma primária e 37 pacientes, como da forma secundária, tratados indistintamente apenas por meios clínicos e fisioterapia de suporte. Os autores baseiam a metodologia do tratamento empregado no fato de ser a capsulite adesiva uma patologia autolimitante e seguem os passos da história natural da doença, para reduzir seu tempo de evoluçäo

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