Proportional limitations of shoulder motion associated with adhesive capsulitis

Dr. James Cyriax, in 1947, described a systematic assessment system which relied on (a) a series of selective tissue tension tests (active range of motion (ROM), passive ROM, and resisted movements) on a number of soft tissue structures and (b) the presence or absence of pain during each of the tests, in order to identify the involved structure(s). The presence of a proportional (percent reduction) pattern of restriction or "capsular pattern" during the passive ROM testing component was felt to be indicative of inflammation involving the joint capsule of the synovial joint being tested. The capsular pattern for the glenohumeral joint was described as lateral rotation being more restricted than abduction, and abduction being more restricted than medial rotation (Cyriax, 1982). The presence of this pattern has not been well established and therefore the purpose of this study was to determine: (1) if a pattern of restricted movement is present in patients with adhesive capsulitis, and (2) whether this pattern is comparable to the capsular pattern described by Cyriax. (Abstract shortened by UMI.)...