Ultrasound-guided infiltrative treatment associated with early rehabilitation program in adhesive capsulitis in “Post-Covid syndrome”

Research Objectives: The aim of the study is to evaluate the efficacy of ultrasound-guided infiltrative treatment associated with early rehabilitation program in patients with adhesive capsulitis devoleped in Post-Covid syndrome.

Design: This is an observational study.

Setting: The setting for patient assessment is ambulatory.

Participants: Six consecutive patients regarded to outclinic for adhesive capsulitis in the post-covid syndrome are clinically and ultrasonographically evaluated and undergo an interventional ultrasound procedure associated with early rehabilitation treatment.

Interventions: Patients are treated with infiltrative hydrodistension therapy under ultrasound guidance. This technique consists in injecting a saline solution combined with corticosteroids and anesthetic that relax the capsule thanks to the increase in hydrostatic pressure (called hydrodistension) increasing the volume capacity of the shoulder. The rehabilitation treatment is undertaken immediately after the infiltrative treatment in order to improve the joint ROM.

Main Outcome Measures: Attive shoulder range of motion (ROM), Visual Analogic Scale for Pain ( VAS), Shoulder Pain and Disability Index (SPADI) and Disability of the Arm, Shoulder and Hand (DASH ) are used for clinical assessment.

Results: In patients with adhesive capsulitis, before the treatment, a fairly reduced shoulder range of motion is seen with mean elevation values allowed for 55°; abduction 40 °, internal rotation allowed for 30 ° with arm abducted to 90 °, external rotation allowed for 40 ° with arm abducted to 90 °. After 2 months from the treatment we obtain an almost complete recovery of the range of motion (elevation 150 °; abduction 130 °, internal rotation allowed in for 70 ° with arm abducted to 90 °, external rotation allowed for 80 ° with arm abducted at 90 °). The VAS mean score before the treatment is 6,9, after 2 months of treatment the VAS score is 1.

Conclusions: In patients with adhesive capsulitis developed in post-Covid Syndrome, infiltrative hydrodistension therapy associated with early rehabilitation treatment provides more successful results in terms of active ROM of the joint and reduction of pain.

Author(s) Disclosures: The author declares no conflict of interest.