Ultrasoundhydrodistention in adhesivecapsulitis: Hospital versus home-based rehabilitation

Background: Adhesive capsulitis, or frozen shoulder, causes pain and reduces glenohumeral joint motion. Aim of the work: This study aims to assesses ultrasound-guided hydrodistention with rehabilitation in hospital versus home settings. Patients and methods: Forty patients with adhesive capsulitis were split into two groups: one received hydrodistention with hospital-assisted rehabilitation, and the other with home-based rehabilitation, following the same exercise protocol. Clinical assessments included range of motion (ROM), numeric pain rating scale (NPRS), shoulder pain and disability index (SPADI), disability of the arm, shoulder and hand (DASH), and assessment shoulder and elbow scale (ASES) Results: The hospital-based group showed more rapid and substantial improvements in ROM and NPRS scores compared to the home-based group. The hospital-based group had a mean flexion ROM of 104.3 +/- 31.6 degrees, which increased to 149.5 +/- 20.6 degrees at the final follow-up. The home-based group started with a mean flexion ROM of 103.3 +/- 29.2 degrees, improving to 161.3 +/- 23.2 degrees by the end of the study. Both groups showed significant improvements, with the home-based group slightly outperforming in flexion ROM by the third follow-up. Initial NPRS scores were 4.7 +/- 1.92 for the hospital-based group and 6.6 +/- 1.63 for the home-based group. By the six-month mark, the hospital-based group's SPADI score dropped to 17.4 +/- 19.5, while the home-based group's score was 10.5 +/- 13.03. Both groups demonstrated significant improvements, with the hospital-based group showing slightly better outcomes at various follow-ups. Conclusion: Hydrodistention combined with supervised rehabilitation is optimal for treating frozen shoulder, though home-based therapy is also effective. Both methods significantly benefit from hydrodistention, highlighting its importance in treatment strategies.