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Musculoskeletal and Sports Medicine

Session: Comparing functional outcomes between physical therapy and hydrodilatation for treatment of adhesive capsulitis: a systematic review with meta-analysis

Comparing Functional Outcomes Between Physical Therapy and Hydrodilatation for Treatment of Adhesive Capsulitis: A Systematic Review with Meta-analysis

Thursday, October 23, 2025
12:45 PM - 2:15 PM MT
Location: Kiosk 7

    Poster Presenter(s)

  • JR

    Joseph Ruiz, MD

    Resident Physician
    MassGeneral Brigham/Spaulding Rehabilitation/Harvard Medical School PM&R Program
    Somerville, Massachusetts

    • Co-Author(s)

  • Jaehyung Shin, BS

    Undergraduate Student (Graduated)
    Georgia Institute of Technology
    Corona, California

  • Grace Olson, Other

    Medical Student
    Boston University Chobanian & Avedisian School of Medicine
    Roxbury, Massachusetts

  • Rachel Fetterman, MA (she/her/hers)

    Medical Student
    University of Massachusetts Medical School
    Worcester, Massachusetts

  • Raymond Guo, MD

    Resident Physician
    MassGeneral Brigham/Spaulding Rehabilitation/Harvard Medical School PM&R Program
    Plano, Texas

  • Dylan B. Combs, MD

    Resident Physician
    MassGeneral Brigham/Spaulding Rehabilitation/Harvard Medical School PM&R Program
    Charlestown, Massachusetts

  • XP

    Xiaoyu Pan, MD,MPH

    Resident physician
    University of Texas Southwestern Medical Center
    Framingham, Massachusetts

  • HR

    Hye Chang Rhim, MD

    Sports Medicine Fellow
    Spaulding Rehabilitation Hospital/Harvard Medical School PM&R Program
    Charlestown, Massachusetts

Disclosure(s):
Joseph Ruiz, MD: No financial relationships to disclose
Jaehyung Shin, BS: No financial relationships to disclose
Grace Olson, Other: No financial relationships to disclose
Rachel Fetterman, MA: No financial relationships to disclose
Raymond Guo, MD: No financial relationships to disclose
Dylan B. Combs, MD: No financial relationships to disclose
Background and/or Objectives: Hydrodilatation and physical therapy are both treatments shown to be effective for patients with adhesive capsulitis. However, the efficacy of hydrodilatation with physical therapy compared to physical therapy alone remains unknown. The objective of this study was to compare functional outcomes between hydrodilatation with physical therapy and physical therapy alone when treating adhesive capsulitis.

Design: Systematic review and meta-analysis

Setting : Outpatient clinics

Participants : 455 patients (182 males and 273 females, mean age 53.4)

Interventions: Hydrodilatation with physical therapy (or exercise program) compared to physical therapy alone

Main Outcome Measures: Visual analogue scale (VAS); flexion, abduction, and external rotation ROM; shoulder pain and disability index (SPADI)

Results: A total of 679 studies were identified through searching PubMed, Embase, and Web of Science databases. After screening and removing duplicates, a total of 6 randomized controlled trials (RCTs) were included with high risk of bias for 5 RCTs and some concerns for the other RCT. Meta-analyses revealed that hydrodilatation with physical therapy (or exercise program) resulted in better pain scores (4 RCTs, SMD 0.288, 95% CI 0.01 to 0.57, I2 20.7%) and SPADI scores (3 RCTs, SMD 0.52, 95% CI 0.08 to 0.96, I2 52.3%) at 12 weeks. However, there were no additional benefits in abduction (4 RCTs, SMD 0.23, 95% CI -0.55 to 1.018, I2 89.1%), external rotation (SMD 0.40, 95% CI -0.31 to 1.10, I2 86.5%), and forward flexion (SMD 0.22, 95% CI -0.56 to 1.00, I2 89%).

Conclusions: When compared to physical therapy alone, hydrodilatation with physical therapy may lead to greater improvements in pain and SPADI scores for patients with adhesive capsulitis at 12 weeks, though there is no difference in shoulder abduction, external rotation, or forward flexion.