Event Abstract

Resolution of adhesive capsulitis using limb mobilization and cutaneous afferent stimulation

  • 1 Life University, United States

Background A 61-year-old female presented with a chief complaint of right frozen shoulder syndrome of 6 months duration. Her history reveals the symptoms began following a dislocation and relocation procedure. She was unable to raise her arm above her shoulder and had minimal extension which limited her from performing her job duties as a dog groomer. Her pain was described as burning and stabbing and occurred intermittently and it prevented her from sleeping on her right side. The intensity of the shoulder pain, when present, ranged from 3-10 out of 10 on a Visual Analog scale for pain (VAS). Methods Examination of the right shoulder revealed a positive Mazion shoulder maneuver. Active range of motion (ROM) was restricted in all directions with flexion and abduction limited to 90 degrees and extension limited to 10 degrees. Passive ROM increased flexion and abduction by 20 degrees. The sensory exam showed decreased sensation to pinwheel throughout the upper and lower extremity on the right (C6-T2 and L4-S1). Additional findings include motor weakness graded at 4+ on the Wexler grading scale during elbow flexion, wrist flexion and wrist extension. The initial treatment plan included the goals of mobilization of the shoulder and improve joint and arm proprioception. Cutaneous stimulation was performed using a light-brushing stroke over the anterior and posterior aspects of the right arm. The cutaneous stimulation was used with the goal of sending sensory information to the somatosensory cortex in a pattern similar to what would be experienced if the patient were to volitionally flex at the glenohumeral joint. The cutaneous input was applied by hand in a superior direction on the anterior arm, and inferior on the posterior arm simultaneously. Results The patient immediately experienced considerable improvement with regard to range of motion. At the end of the first visit the patient was able to painlessly flex and abduct the shoulder to 180 degrees and extend 30 degrees. Two subsequent visits over a three-week period demonstrated maintenance of full shoulder range of motion as well as reduction in pain levels 0-1/10 on the VAS. The patient was able to perform all work duties with ease. Conclusion This case study highlights the successful use of mobilization and cutaneous sensory therapy in restoration of ROM to an individual with frozen shoulder syndrome

Keywords: Adhesive capsulitis, Frozen shoulder syndrome, somatosensory, Chiropractic, Functional Neurology

Conference: International Symposium on Clinical Neuroscience 2018, Orlando, Florida, United States, 24 May - 26 May, 2018.

Presentation Type: Poster

Topic: Clinical Applications in health, disease, and injury to the nervous system

Citation: Ellis M, Campbell M and Mullin Elkins L (2018). Resolution of adhesive capsulitis using limb mobilization and cutaneous afferent stimulation. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience 2018. doi: 10.3389/conf.fneur.2018.60.00120

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Received: 04 Apr 2018; Published Online: 14 Dec 2018.

* Correspondence:
Ms. Melissa Campbell, Life University, Marietta, GA, 30060, United States, melissa.chisholm1@gmail.com
Dr. Linda Mullin Elkins, Life University, Marietta, GA, 30060, United States, mullin@life.edu