Research Information System
Thesis Type: Postgraduate
Institution Of The Thesis: Gazi University, Turkey
Approval Date: 2016
Thesis Language: Turkish
Student: Tuba Zoroğlu
Supervisor: SELDA BAŞAR
Open Archive Collection: AVESIS Open Access Collection
Abstract:Adhesive capsulitis (AC) is a musculoskeletal condition that is characterised by capsular thickness and adhesion by the formation of fibrosis and thick nodular collagen bands as a result of fibroblastic activity growing secondary to inflammation of joint capsule. It is suggested that thickness and adhesion in the capsule affect proprioceptive acuity with the stimulation of mechanoreceptors, and limitations result from contracture of shoulder ligaments disrupt scapulohumeral rhythm. The aim of this study is to assess proprioception and scapular biomechanics in patients with AC and to determine the differences comparing with the control group (CG). This study included 16 subjects dominant side affected (Group I) and 19 subjects nondominant side affected with AC (Group II) and 26 subjects without the condition (Group III [dominant side] and Group IV [non-dominant side]) for the test group and the CG, respectively. Pain was assessed by a numeric rating scale, and range of motion was assessed by the goniometer. Scapular position and mobility were determined by Kibler s observational evaluation and lateral scapular slide test. A tape measure and a goniometer were used for the evaluation of the capsule and ligament tightness. Joint position sense (JPS) was analysed by a digital inclinometer. In addition SPADI, DASH, Constant scores for assessing functional status and disability, SF-12v2 for quality of life and Hamilton Anxiety Rating scales were applied. R Foundation for Statistical Computing and Minitab version 14 were utilised for the statistical analysis. Pain level was found higher in AC groups (Group I-II) compared to the CG (Group III-IV) especially at night and elevation, and range of motion was shown to be less in the AC groups. Static scapular position in 90° abduction at T7 level was found pathological. Scapular dyskinesis was determined in 63% of group I, 84% of group II, 56% of group III and 77% of group IV. Posterior capsule, glenohumeral and coracohumeral ligament tightness were higher in patients with AC compared to the CG. JPS was less at mid range and end range of external rotation in group I compared to group III. While JPS in group I and III were similar at other directions except external rotation, that in group II and IV showed similarity at all directions. JPS at end ranges were better than that at mid ranges at least in two directions of movement in intragroup (group II, III and IV) comparisons. Functional situation, disability and quality of life were observed to decrease in AC group, and patients with AC showed the signs of minor anxiety. To conclude, AC is shown to affect scapular biomechanics negatively by imparing scapulothoracic movements, and proprioception was similar to the CG except external rotation in patients dominant side affected with AC. It is suggested here to further investigate whether proprioception is compensated by other physiological mechanisms, and synovitis and capsular fibrosis affect the number and the activity of the mechanoreceptors in capsule, ligament and dynamic structures.