Tanake and associates wished to clarify the optimal management of rehabilitative intervention for limited glenohumeral joint mobility (LGHM) arising from adhesive capsulitis, particularly focusing on the frequency of sessions for joint mobilization and the self-exercise compliance. The functional results of 120 patients with LGHM were prospectively investigated as follows: Differences in improved angle of the shoulder joint (IA) and the time required to reach the range of motion plateau point (T) were compared by (1) age, (2) gender, (3) handedness, (4) duration before rehabilitative intervention, (5) frequency of sessions for joint mobilization by physical therapists in the hospital setting, and (6) self-exercise compliance in the home setting. The lengths of therapy and follow-up were 4.6 and 5.9 months, respectively. IA significantly decreased in the 71-year-old and above group. There were no significant differences in IA between male and female. IA of the dominant-handed group was significantly higher than that of the non-dominant-handed group. There were no significant differences in T in each item. IA of the group that had experienced more than 7 months of the condition was significantly low. Although the frequency of joint mobilization by physical therapists in the hospital setting showed no relationship with IA or T, IA was significantly higher and T was significantly shorter in the group that performed self-exercise every day than in the groups that performed less.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that early intervention and self-exercise in the home setting are more important factors than session frequency of joint mobilization in the hospital setting for the successful management of rehabilitation for LGHM.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE CONSUMER: If you have joint mobilization, having your provider prepare a self-management for you results in better results than returning to the hospital time and time again. It is simply more cost-effective.

K Tanake, et al. Joint mobilization versus self-exercises for limited glenohumeral joint mobility: randomized controlled study of management of rehabilitation. Clinical Rheumatology, June 29, 2010.