Eficácia do bloqueio do nervo supraescapular associado à fisioterapia comparado à fisioterapia no tratamento da capsulite adesiva: um ensaio clínico randomizado

Abstract

Adhesive capsulitis (AC) is one of the primary causes of shoulder girdle dysfunction, characterized by pain and restricted mobility in the glenohumeral joint. There is no consensus concerning treatment, with various clinical and surgical approaches proposed. The purpose of this paper is to compare the results of AC treatment in patients who underwent suprascapular nerve block (SSNB) associated with physiotherapy (PT) and those who only underwent physiotherapy. Patients with AC were randomized into two groups: a Block group (SSNB + PT) and a Control group (PT). Four serial blocks were administered with 6 ml of 0.25% bupivacaine at 15-day intervals. Both groups were analyzed using range of motion (ROM) measured with digital goniometry, UCLA score, and visual analog scale (VAS) before treatment and at 2, 4, and 6 months. Analyses with a 95% confidence interval and p < 0.05 were considered statistically significant. A total of 290 patients were randomized, with 182 of them being followed up (FU). Sixty-nine patients received nerve block and physiotherapy (SSNB+PT), and 113 were controls (only PT). The t-test showed no statistical difference between the two groups at baseline, and at 2, 4, and 6 months (p > 0.05) for all evaluated scores. After 6 months, 15 patients underwent surgery, with no difference between groups. Serial suprascapular nerve block was not statistically superior in improving the parameters measured compared to the control group for AC treatment.