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Capsular Pattern Pada Idiopathic Frozen Shoulder
Capsular Pattern Pada Idiopathic Frozen Shoulder
frozen shoulder
Oleh Sugijanto
IDIOPHATIC FROZEN SHOULDER
Anatomic impairment
Internal factors External factors
Nerves
GH Capsels Muscle
AC Capsels Autonom
Nocisensoric
system
Chronic Scapulo thoracal
inflamation muscle weakness
Inter fiber Sympathic
Cuff ms Vascular
adhesion hyperactivity
tightness
Contracture, anterior Micro circular Functional Activity Participation
- inferior capsel most constriction impairment limitation restriction
contracted
Stretched Muscle
Capsular pain Activity with
imbalance Work
pattern mobility/ADL
Pain
Driving Sport
Recreation
Hypomobility
Sugijanto, 2015
PEMERIKSAAN FISIOTERAPI YG
DIBUTUHKAN
Diutamakan pemilihan evidence untuk:
Pemeriksaan terhadap frozen shoulder:
◦ Abduction-elevation: Reverse
Humeroscapular rhythm
◦ Passive external rotation: the most limited
Pemeriksaan Capsels:
◦ Passive test other: External rotation <
Abduction < internal rotation with elastic
end feel.
◦ Joint Play Movement Test: Taction at end
range position elastic end feel
Sugijanto, 2015
Capsular pattern Hypomobility
Frozen Shoulder
Abd-elevation Reverse
Humeroscapular Rhythm
Sugijanto, 2015
TES EVIDENCE BASE FROZEN
SHOULDER
Scapulohumeral rhythm: Abduksi
elevasi
Scratch Test: Hand Behind Head and
Hand Behind Back
Capsular contracture: rotasi
eksternal
Sugijanto, 2015
TES PASIF
Abduksi
Rotasi eksternal
Rotasi internal
◦ Capsular pattern (rot. eksternal
< abduksi < rot. internal): elastic-
firm end feel
Sugijanto, 2015
TES KHUSUS
Sugijanto, 2015
Pemeriksaan panjang otot: Contract
relax stretch test:
◦ Terbatas atau lemah
Pemeriksaan Otot stabilisator:
◦ Isometric test
◦ Sabilizing test
Pemeriksaan Scapular mobility:
◦ Abduction-elevation
◦ Tolak pinggang
Pemeriksaan
◦ ULTT (upper limb tension test)
Sugijanto, 2015
FISIOTERAPI YG DIBUTUHKAN
MODALITAS DAN METODA
◦ Anatomic Impairment target:
US / SWD contra planar tepat utk capsel
yg tegang
Scapular mobilization
Shoulder joint mobilization, traction at
end range position and Roll glide
Stabilizing exercise tepat utk kelemahan
otot bahu.
◦ Functional Impairment target:
Latihan mobilisasi sendi
Latihan stabilisasi bahu
◦ Disability target
Sugijanto, 2015
INTERVENSI
Scapulo-thoracal mobilization
Glenohumeral mobilization:
◦ Oscillated traction in MLPP
◦ Roll glide abduction
◦ Roll glide horizontal abd.
◦ Roll glide horizontal add.
ACJ mobilization
Sugijanto, 2015
ALAT UKUR/EVALUASI
FISIOTERAPI YG DIBUTUHKAN
Pengukuran nyeri
Pengukuran ROM,
Pengukuran fleksibilitas/ekstensibilitas
otot
Pengukuran disabilitas
Sugijanto, 2015