CPRS RECOVERY COACHING SKILLS AND
ETHICS LEARNING MODULE REVIEW
SHEET FULL ANSWER COLLECTION
●● Adhesive capsulitis CPG - Stage 1 (time, character, arthroscopy)
Answer: Time = 3 months
Character = sharp pain at EROM, achy pain at rest, sleep disturbances
Arthroscopy = diffuse synovial reaction without adhesions or
contracture
●● Adhesive capsulitis CPG - Stage 2 (time, character, arthroscopy)
Answer: Time = 3-9 months
Character = gradual loss of motion in all directions due to pain
Arthroscopy = aggressive synovitis/angiogenesis and some loss of
motion under anesthesia
●● Adhesive capsulitis CPG - Stage 3 (time, character, arthroscopy)
Answer: Time = 9-15 months
Character = pain and loss of motion
Arthroscopy = synovitis/angiogenesis lessens but the progressive
capsuloligamentous fibrosis results in loss of axillary fold and ROM
,●● Adhesive capsulitis CPG - Stage 4 (time, character, arthroscopy)
Answer: Time = 15-24 months
Character = pain beings to resolve, but significant stiffness persists
Arthroscopy = capsuloligamentous complex fibrosis and receding
synovial involvement
●● Adhesive capsulitis CPG - primary vs secondary
Answer: Primary = not associated with systemic condition or history
Secondary = relationship between disease/pathology (systemic,
extrinsic, intrinsic)
●● Adhesive capsulitis CPG - Key findings
Answer: (1) ROM loss > 25% in at least 2 planes of motion
(2) passive ER loss that is > 50% of uninvolved shoulder or < 30* ER
●● GH ligament restrictions
Answer: Inferior = resist anterior translation when arm is abducted >
90*
Middle = resist anterior translation when arm is in mid-range of
abduction up to 45* and ER when arm is at side
Superior = resist inferior translation when arm is in adducted position
●● Adhesive capsulitis CPG - low irritability (symptoms and treatment)
,Answer: Pain < 3/10
No night/resting pain
Minimal levels of disability
Pain occurs with overpressure and into EPROM
AROM = PROM
Treatment: self care/home management training, manual therapy,
stretching, neuro re-ed
●● Adhesive capsulitis CPG - moderate irritability (symptoms and
treatment)
Answer: 4-6/10 pain
Intermittent night/resting pain
Moderate levels of disability
Pain at EPROM and EAROM
AROM = PROM
Treatment: modalities (heat and estim), self care/home management,
manual therapy, stretching, neuro re-ed
●● Adhesive capsulitis CPG - high irritability (symptoms and treatment)
Answer: >7/10 pain
Consistent night/resting pain
High levels of disability
Pain occurs before EPROM and EAROM
, AROM < PROM
Treatment: modalities (heat and estim), self care/ home management,
manual therapy, mobility exercises (pain free PROM and AAROM)
●● DASH - MCID and what
Answer: 10.2 points
symptoms and activity
●● SPADI - MCID and what
Answer: 8-13.1 points
pain and disability
●● ASES - MCID and what
Answer: 6.4 points
pain and activities/participation
●● Adhesive capsulitis CPG - lvl A evidence (1)
Answer: Cortisone injection - best used during early and freezing stages
●● Adhesive capsulitis CPG - lvl B evidence (2)
Answer: Patient education
Stretching exercises
ETHICS LEARNING MODULE REVIEW
SHEET FULL ANSWER COLLECTION
●● Adhesive capsulitis CPG - Stage 1 (time, character, arthroscopy)
Answer: Time = 3 months
Character = sharp pain at EROM, achy pain at rest, sleep disturbances
Arthroscopy = diffuse synovial reaction without adhesions or
contracture
●● Adhesive capsulitis CPG - Stage 2 (time, character, arthroscopy)
Answer: Time = 3-9 months
Character = gradual loss of motion in all directions due to pain
Arthroscopy = aggressive synovitis/angiogenesis and some loss of
motion under anesthesia
●● Adhesive capsulitis CPG - Stage 3 (time, character, arthroscopy)
Answer: Time = 9-15 months
Character = pain and loss of motion
Arthroscopy = synovitis/angiogenesis lessens but the progressive
capsuloligamentous fibrosis results in loss of axillary fold and ROM
,●● Adhesive capsulitis CPG - Stage 4 (time, character, arthroscopy)
Answer: Time = 15-24 months
Character = pain beings to resolve, but significant stiffness persists
Arthroscopy = capsuloligamentous complex fibrosis and receding
synovial involvement
●● Adhesive capsulitis CPG - primary vs secondary
Answer: Primary = not associated with systemic condition or history
Secondary = relationship between disease/pathology (systemic,
extrinsic, intrinsic)
●● Adhesive capsulitis CPG - Key findings
Answer: (1) ROM loss > 25% in at least 2 planes of motion
(2) passive ER loss that is > 50% of uninvolved shoulder or < 30* ER
●● GH ligament restrictions
Answer: Inferior = resist anterior translation when arm is abducted >
90*
Middle = resist anterior translation when arm is in mid-range of
abduction up to 45* and ER when arm is at side
Superior = resist inferior translation when arm is in adducted position
●● Adhesive capsulitis CPG - low irritability (symptoms and treatment)
,Answer: Pain < 3/10
No night/resting pain
Minimal levels of disability
Pain occurs with overpressure and into EPROM
AROM = PROM
Treatment: self care/home management training, manual therapy,
stretching, neuro re-ed
●● Adhesive capsulitis CPG - moderate irritability (symptoms and
treatment)
Answer: 4-6/10 pain
Intermittent night/resting pain
Moderate levels of disability
Pain at EPROM and EAROM
AROM = PROM
Treatment: modalities (heat and estim), self care/home management,
manual therapy, stretching, neuro re-ed
●● Adhesive capsulitis CPG - high irritability (symptoms and treatment)
Answer: >7/10 pain
Consistent night/resting pain
High levels of disability
Pain occurs before EPROM and EAROM
, AROM < PROM
Treatment: modalities (heat and estim), self care/ home management,
manual therapy, mobility exercises (pain free PROM and AAROM)
●● DASH - MCID and what
Answer: 10.2 points
symptoms and activity
●● SPADI - MCID and what
Answer: 8-13.1 points
pain and disability
●● ASES - MCID and what
Answer: 6.4 points
pain and activities/participation
●● Adhesive capsulitis CPG - lvl A evidence (1)
Answer: Cortisone injection - best used during early and freezing stages
●● Adhesive capsulitis CPG - lvl B evidence (2)
Answer: Patient education
Stretching exercises
