AB0841-HPR The effect of active cervical lateral flexion range on shoulder joint range of motion in adhesive capsulitis patients: a pilot study
Authors: O. Cinar Medeni, E. Camci, I. Duzgun
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Muscles affecting scapulahumeral motion have their orijin on spine. Upper trapezius and levator scapula muscles’ orijin is cervical region. In patients with adhesive capsulitis arm elevation is achieved by increased upper trapezius activation. So, scapulahumeral rhythm is affected from increased activity of these muscles.<sup>1</sup> These altered muscle activation strategies might affect cervical motion. <h3>Objectives</h3> The aim of this study is to investigate cervical range of motion in adhesive capsulitis patients. <h3>Methods</h3> Eight adhesive capsulitis patients without any injury or diagnosis related to spine were evaluated. Patients do not have cervical spine problem prior to adhesive capsulitis. Active and passive shoulder flexion, abduction, internal rotation and external rotation range of motions were assessed with universal goniometer.<sup>2</sup> Active total elevation measurement was done with goniometer measuring the angle between trunk and arm.<sup>3</sup> As a functional test active internal rotation was assessed measuring the distance between fifth toracal processus spinosus and the thumb.<sup>4</sup> Active cervical flexion, extension and lateral flexion to affected and healthy side were evaluated with goniometer.<sup>5</sup> The data were analyzed using the Statistical Package for the Social Sciences (SPSS version 15.00). The relationship between cervical and shoulder range of motion was analyzed by using Spearman Correlation co-efficient. Significance level was set a p value of ≤.05. <h3>Results</h3> There were positive relationships between affected side cervical lateral flexion and, active and passive flexion range, respectively (r=.71, p=.04; r=.73, p=.03). Passive external rotation, active and passive internal rotation range of motion was correlated well with affected side cervical lateral flexion, respectively (r=.70, p=.05; r=.95, p&lt;.001; r=.85, p=.007). Also active internal rotation and active total elevation were correlated with affected side cervical lateral flexion, respectively (r=.90, p=.002; r=.77 p=.02). Cervical range of motion in other directions did not correlate with shoulder range of motion (p&gt;.05). <h3>Conclusions</h3> Limited shoulder range of motion decreases affected side cervical lateral flexion. This relationship highlights that, treatment of cervical region should be considered in adhesive capsulitis patients. Clinical outcomes should be doing stretching exercises to scapular muscles, which have cervical origin to decrease cervical impression. <h3>References</h3> Rundquist PJ, Anderson DD, Guanche CA, Ludewig PM. Shoulder kinematics in subjects with frozen shoulder. <i>Arch Phys Med Rehabil.</i> 2003;84(10):1473-1479. Richards RR, An KN, Bigliani LU, et al. A standardized method for the assessment of shoulder function. <i>J Shoulder Elbow Surg.</i> 1994;3(6):347-352. Page P, Labbe A. Adhesive capsulitis: use the evidence to integrate your interventions. <i>N Am J Sports Phys Ther.</i> 2010;5(4):266-273. Edwards TB, Bostick RD, Greene CC, Baratta RV, Drez D. Interobserver and intraobserver reliability of the measurement of shoulder internal rotation by vertebral level. <i>J Shoulder Elbow Surg.</i> 2002;11(1):40-42. Youdas JW, Carey JR, Garrett TR. Reliability of measurements of cervical spine range of motion--comparison of three methods. <i>Phys Ther.</i> 1991;71(2):98-104; discussion 105-106. <h3>Disclosure of Interest</h3> None Declared