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Liu S, Chen L, Shi Q, Fang Y, Da W, Xue C, Li X. Efficacy of manual therapy on shoulder pain and function in patients with rotator cuff injury: A systematic review and meta‑analysis. Biomed Rep 2024; 20:89. [PMID: 38682089 PMCID: PMC11046180 DOI: 10.3892/br.2024.1778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 03/29/2024] [Indexed: 05/01/2024] Open
Abstract
To critically evaluate the effects of manual therapy (MT) on pain and functional improvement in patients with rotator cuff injury (RCI), a systematic review of all randomized controlled trials (RCTs) on MT for RCI was conducted in the following databases: PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, Physiotherapy Evidence Database, Chinese National Knowledge Infrastructure, Wan-fang Data, Chinese Scientific Journal Database, and Chinese Biomedical Literature database from inception to March 28, 2023. A total of 1,110 participants from 24 eligible RCTs were included in the analysis. Compared with placebo, MT could not effectively relieve pain [standardized mean difference (SMD)=-0.25; 95% CI: -0.51 to 0.01; P=0.06], although its impact on functional improvement appears limited (SMD=0.20; 95% CI: -0.09 to 0.49; P=0.18). Combining MT with exercise had significant advantages over exercise alone, as combined therapy contributed to both pain reduction (SMD=0.36; 95% CI: 0.08 to 0.64; P=0.01) and functional enhancement (SMD=0.32; 95% CI: 0.11 to 0.52; P=0.002). Furthermore, MT combined with multimodal physiotherapy showed additional benefits in pain reduction (mean difference=1.57; 95% CI: 0.18 to 2.96; P=0.03) and functional improvement (SMD=0.77; 95% CI: 0.43 to 1.12; P<0.0001) compared with multimodal physiotherapy alone. These findings highlight the superior pain alleviation and functional improvement provided by MT when combined with exercise or physiotherapy. Consequently, MT has emerged as a pivotal component of therapeutic intervention for RCI.
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Affiliation(s)
- Shuang Liu
- Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, P.R. China
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, P.R. China
| | - Lin Chen
- Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, P.R. China
| | - Qi Shi
- Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, P.R. China
| | - Yide Fang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, P.R. China
| | - Weiwei Da
- Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, P.R. China
| | - Chunchun Xue
- Department of Pain, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, P.R. China
| | - Xiaofeng Li
- Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, P.R. China
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Brindisino F, Garzonio F, Giovannico G, Isaia F, Fiorentino F, Cavaggion C, Mourad F, Innocenti T. Spinal manipulation does not improve short-term pain and function in persons with painful shoulder: a systematic review with meta-analysis. Disabil Rehabil 2024:1-18. [PMID: 38420943 DOI: 10.1080/09638288.2024.2322025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 02/17/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE To investigate the benefit of spinal high-velocity low-amplitude thrust (HVLAT) in improving pain and disability in persons with painful shoulder as primary outcomes. Function, quality of life, persons (and clinicians) satisfaction, adverse events rate, and time for recovery were secondary outcomes. METHODS A systematic review with meta-analysis was conducted and MEDLINE, CENTRAL, Embase, and PEDro until 20 September 2023 were investigated. Two thousand eight hundred and ninety-nine records were retrieved and nine studies were included. Risk of bias of included studies was assessed through the Revised Cochrane risk-of-bias tool. The certainty of evidence of the pooled results was graded with GRADE approach. RESULTS The analysis included nine studies (441 persons). The pooled results showed non-significant differences between HVLAT versus sham in pain at pre-post follow-up (MD -0.13, 95% confidence interval (CI) -0.60; 0.35; p = 0.61, I2 = 0%), and at <4 days follow-up (SMD 0.16, 95%CI -0.16; 0.48; p = 0.34, I2 = 23%); in function at <4 days follow-up (SMD -0.29, 95%CI -0.69; 0.11; p = 0.16, I2 = 50%). The certainty of evidence ranged from low to very low. CONCLUSIONS HVLAT was not more effective than sham in improving pain and function at pre-post and at <4 days follow-up. When used as an "add-on technique", HVLAT did not improve pain nor disability.
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Affiliation(s)
- Fabrizio Brindisino
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, C/da Tappino, Campobasso, Italy
| | - Fabiola Garzonio
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, C/da Tappino, Campobasso, Italy
| | - Giuseppe Giovannico
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, C/da Tappino, Campobasso, Italy
| | | | - Fabio Fiorentino
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, C/da Tappino, Campobasso, Italy
| | - Claudia Cavaggion
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Antwerp, Belgium
| | - Firas Mourad
- Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, Differdange, Luxembourg
- Luxembourg Health & Sport Sciences Research Institute A.s.b.l., Differdange, Luxembourg
| | - Tiziano Innocenti
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- GIMBE Foundation, Bologna, Italy
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3
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Flowers DW, Swanson BT, Shaffer SM, Clewley DJ, Riley SP. Is there 'trustworthy' evidence for using manual therapy to treat patients with shoulder dysfunction?: A systematic review. PLoS One 2024; 19:e0297234. [PMID: 38236928 PMCID: PMC10796022 DOI: 10.1371/journal.pone.0297234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/01/2024] [Indexed: 01/22/2024] Open
Abstract
The primary objective of this review was to create a 'trustworthy,' living systematic review and meta-analysis for the application of manual therapy interventions in treating patients with shoulder dysfunction. Included studies were English-language randomized controlled trials published between 1/1/2010 and 8/3/2023, with searches performed in: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), CINHAL, ProQuest Nursing & Allied Health, EBSCO Medline, and PEDro. The population of focus included adults 18 years and older with musculoskeletal impairments related to shoulder dysfunction. Our primary outcomes included pain and region-specific outcome measures. We excluded trials, including participants having shoulder dysfunction resulting from surgery, radicular pain, instability/dislocation, fracture, lymphedema, and radiation. Our screening methodology was based upon a previously published 'trustworthy' systematic review protocol. This included the application of our PICOTS criteria in addition to screening for prospective clinical trial registration and following of prospective intent, as well as assessment of PEDro scores, risk-of-bias ratings, GRADE scoring, and examination of confidence in estimated effects. Twenty-six randomized controlled trials met our PICOTS criteria; however, only 15 of these were registered. Only three were registered prospectively. Two of these did not have discussions and conclusions that aligned with their primary outcome. The remaining single study was found to have a high risk-of-bias, meaning the remainder of the protocol could not be employed and that no randomized controlled trials could undergo further assessment or meta-analysis. The results of this systematic review indicate there are no 'trustworthy' randomized controlled trials examining the effectiveness of manual therapy interventions for the treatment of patients with shoulder dysfunction, as defined by the prospectively established methodology. Therefore, these findings signal that creating a 'trustworthy,' living systematic review on this clinically relevant topic is not yet possible due to a lack of 'trustworthy' randomized controlled trials.
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Affiliation(s)
- Daniel W. Flowers
- Doctor of Physical Therapy Program, Louisiana State University Health Sciences Center at Shreveport, Shreveport, Louisiana, United States of America
| | - Brian T. Swanson
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, Connecticut, United States of America
| | - Stephen M. Shaffer
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, Connecticut, United States of America
| | - Derek J. Clewley
- Doctor of Physical Therapy Division, School of Medicine, Duke University, Durham, North Carolina, United States of America
- Duke Center for Excellence in Manual and Manipulative Therapy, Duke University, Durham, North Carolina, United States of America
| | - Sean P. Riley
- Hartford Healthcare Rehabilitation Network, Glastonbury, Connecticut, United States of America
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4
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Ferlito R, Testa G, McCracken KL, Moscato S, Zerbito GM, Panvini FMC, Blatti C, Pavone V, Sapienza M. Effectiveness of Therapeutical Interventions on the Scapulothoracic Complex in the Management of Patients with Subacromial Impingement and Frozen Shoulder: A Systematic Review. J Funct Morphol Kinesiol 2023; 8:jfmk8020038. [PMID: 37092370 PMCID: PMC10123708 DOI: 10.3390/jfmk8020038] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/14/2023] [Accepted: 03/22/2023] [Indexed: 04/25/2023] Open
Abstract
Shoulder pain is one the most common musculoskeletal complaints. The most common pathological causes of shoulder pain in the general population are subacromial impingement syndrome and adhesive capsulitis, commonly referred to as "frozen shoulder". The purpose of this study was to evaluate the role of the scapulo-thoracic complex, particularly in scapular kinematic functions, in rehabilitative interventions for shoulder pain in patients suffering from these two common conditions. This systematic review was performed using the scientific search engines PubMed, PEDro and Cochrane Library, considering only randomized controlled clinical trials. Selected articles were evaluated according to the level of evidence and methodological quality. Thirteen randomized clinical trials were selected. Interventions have been divided into three macro-categories: (1) manual therapy in patients with subacromial impingement, (2) therapeutic exercise programs including interventions on the scapulothoracic complex in patients with subacromial impingement syndrome, and (3) therapeutic exercise programs including interventions on the scapulothoracic complex in patients with frozen shoulder. Following this, a qualitative analysis was performed according to outcomes such as pain, shoulder function, and scapular kinematics. Physiotherapy exercise programs that included scapular motor control training and scapular mobilizations, in particular, those of the scapulo-thoracic complex in scapular kinematic function, represent valid alternatives in the management of patients with subacromial impingement syndrome.
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Affiliation(s)
- Rosario Ferlito
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise C/da Tappino c/o Cardarelli Hospital, 86100 Campobasso, Italy
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Gianluca Testa
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, P.O. "Policlinico Gaspare Rodolico", University of Catania, 95124 Catania, Italy
| | | | - Salvatore Moscato
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Giovanni Maria Zerbito
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, P.O. "Policlinico Gaspare Rodolico", University of Catania, 95124 Catania, Italy
| | - Flora Maria Chiara Panvini
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, P.O. "Policlinico Gaspare Rodolico", University of Catania, 95124 Catania, Italy
| | - Chiara Blatti
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, P.O. "Policlinico Gaspare Rodolico", University of Catania, 95124 Catania, Italy
| | - Vito Pavone
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, P.O. "Policlinico Gaspare Rodolico", University of Catania, 95124 Catania, Italy
| | - Marco Sapienza
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, P.O. "Policlinico Gaspare Rodolico", University of Catania, 95124 Catania, Italy
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Molina-Álvarez M, Arribas-Romano A, Rodríguez-Rivera C, García MM, Fernández-Carnero J, Armijo-Olivo S, Goicoechea Garcia C. Manual Therapy Effect in Placebo-Controlled Trials: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14021. [PMID: 36360901 PMCID: PMC9654326 DOI: 10.3390/ijerph192114021] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 06/01/2023]
Abstract
PURPOSE Background: Evaluate whether the design of placebo control groups could produce different interpretations of the efficacy of manual therapy techniques. METHODS Nine databases were searched (EMBASE, CINAHL, PsycINFO, MEDLINE, PubMed, SCOPUS, WEB of SCIENCE, COCHRANE, and PEDro). Randomized placebo-controlled clinical trials that used manual therapy as a sham treatment on subjects suffering from pain were included. Data were summarized qualitatively, and meta-analyses were conducted with R. RESULTS 53 articles were included in the qualitative analysis and 48 were included in the quantitative analyses. Manipulation techniques did not show higher effectiveness when compared with all types of sham groups that were analyzed (SMD 0.28; 95%CI [-0.24; 0.80]) (SMD 0.28; 95%CI [-0.08; 0.64]) (SMD 0.42; 95%CI [0.16; 0.67]) (SMD 0.82; 95%CI [-0.57; 2.21]), raising doubts on their therapeutic effect. Factors such as expectations of treatment were not consistently evaluated, and analysis could help clarify the effect of different sham groups. As for soft tissue techniques, the results are stronger in favor of these techniques when compared to sham control groups (SMD 0.40; 95%CI [0.19, 0.61]). Regarding mobilization techniques and neural gliding techniques, not enough studies were found for conclusions to be made. CONCLUSIONS The literature presents a lack of a unified placebo control group design for each technique and an absence of assessment of expectations. These two issues might account for the unclear results obtained in the analysis.
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Affiliation(s)
- Miguel Molina-Álvarez
- Escuela Internacional de Doctorado, Faculty of Health Sciences, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Rey Juan Carlos University, Unidad Asociada I+D+i Instituto de Química Médica (IQM) CSIC-URJC, 28922 Alcorcón, Spain
| | - Alberto Arribas-Romano
- Escuela Internacional de Doctorado, Faculty of Health Sciences, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, 28922 Alcorcón, Spain
| | - Carmen Rodríguez-Rivera
- Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Rey Juan Carlos University, Unidad Asociada I+D+i Instituto de Química Médica (IQM) CSIC-URJC, 28922 Alcorcón, Spain
- High Performance Experimental Pharmacology Research Group, Rey Juan Carlos University (PHARMAKOM), 28922 Alcorcón, Spain
| | - Miguel M. García
- Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Rey Juan Carlos University, Unidad Asociada I+D+i Instituto de Química Médica (IQM) CSIC-URJC, 28922 Alcorcón, Spain
- High Performance Experimental Pharmacology Research Group, Rey Juan Carlos University (PHARMAKOM), 28922 Alcorcón, Spain
- Grupo Multidisciplinar de Investigación y Tratamiento del Dolor, Grupo de Excelencia Investigadora URJC-Banco de Santander, 28922 Alcorcón, Spain
| | - Josué Fernández-Carnero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, 28922 Alcorcón, Spain
- Grupo Multidisciplinar de Investigación y Tratamiento del Dolor, Grupo de Excelencia Investigadora URJC-Banco de Santander, 28922 Alcorcón, Spain
- La Paz Hospital Institute for Health Research, IdiPAZ, 28029 Madrid, Spain
| | - Susan Armijo-Olivo
- Faculty of Business and Social Sciences, University of Applied Sciences, 30A, 49076 Osnabruck, Germany
- Faculties of Rehabilitation Medicine and Medicine and Dentistry, 3-48 Corbett Hall, Edmonton, AB T6G 2G4, Canada
| | - Carlos Goicoechea Garcia
- Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Rey Juan Carlos University, Unidad Asociada I+D+i Instituto de Química Médica (IQM) CSIC-URJC, 28922 Alcorcón, Spain
- High Performance Experimental Pharmacology Research Group, Rey Juan Carlos University (PHARMAKOM), 28922 Alcorcón, Spain
- Grupo Multidisciplinar de Investigación y Tratamiento del Dolor, Grupo de Excelencia Investigadora URJC-Banco de Santander, 28922 Alcorcón, Spain
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6
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Schenk R, Donaldson M, Parent-Nichols J, Wilhelm M, Wright A, Cleland JA. Effectiveness of cervicothoracic and thoracic manual physical therapy in managing upper quarter disorders - a systematic review. J Man Manip Ther 2022; 30:46-55. [PMID: 34252013 PMCID: PMC8865095 DOI: 10.1080/10669817.2021.1923313] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
STUDY DESIGN Systematic review. BACKGROUND Physical therapists often use cervicothoracic and thoracic manual techniques to treat musculoskeletal disorders of the upper quarter ,however, the overall effectiveness of this approach remains to be elucidated. OBJECTIVE This systematic review explored studies that examined the short- and long-term effectiveness of manual physical therapy directed at the cervicothoracic and thoracic region in the management of upper quarter musculoskeletal conditions. METHODS The electronic databases MEDLINE, AMED, CINAHL, and Embase were searched from their inception through 30 October 2020. Eligible clinical trials included those where human subjects treated with cervicothoracic and/or thoracic manual procedures were compared with a control group or other interventions. The methodological quality of individual studies was assessed using the PEDro scale. RESULTS The initial search returned 950 individual articles. After the screening of titles and abstracts, full texts were reviewed by two authors, with 14 articles determined to be eligible for inclusion. PEDro scores ranged from 66 to 10 (out of a maximum score of 10). In the immediate to 52-week follow-up period, studies provided limited evidence that cervicothoracic and thoracic manual physical therapy may reduce pain and improve function when compared to control/sham or other treatments. CONCLUSIONS Evidence provides some support for the short-termeffectiveness of cervicothoracic and thoracic manual physical therapy in reducing pain and improving function in people experiencing upper quarter musculoskeletal disorders. Evidence is lacking for long-term effectiveness as only two studies explored outcomes beyond 26 weeks and this was for patient-perceived improvement. PROSPERO ID CRD42020219456.
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Affiliation(s)
- Ronald Schenk
- Department of Public Health and Community Medicine, Program in Physical Therapy, Tufts University School of Medicine, Boston, MA, USA
| | - Megan Donaldson
- Department of Public Health and Community Medicine, Program in Physical Therapy, Tufts University School of Medicine, Boston, MA, USA
| | - Jennifer Parent-Nichols
- Department of Public Health and Community Medicine, Program in Physical Therapy, Tufts University School of Medicine, Boston, MA, USA
| | - Mark Wilhelm
- Department of Public Health and Community Medicine, Program in Physical Therapy, Tufts University School of Medicine, Boston, MA, USA
| | - Alexis Wright
- Department of Public Health and Community Medicine, Program in Physical Therapy, Tufts University School of Medicine, Boston, MA, USA
| | - Joshua A. Cleland
- Department of Public Health and Community Medicine, Program in Physical Therapy, Tufts University School of Medicine, Boston, MA, USA
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Yu H, Côté P, Wong JJ, Shearer HM, Mior S, Cancelliere C, Randhawa K, Ameis A, Carroll LJ, Nordin M, Varatharajan S, Sutton D, Southerst D, Jacobs C, Stupar M, Taylor-Vaisey A, Gross DP, Brison RJ, Paulden M, Ammendolia C, Cassidy JD, Marshall S, Bohay RN, Stapleton J, Lacerte M. Noninvasive management of soft tissue disorders of the shoulder: A clinical practice guideline from the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration. Eur J Pain 2021; 25:1644-1667. [PMID: 33942459 DOI: 10.1002/ejp.1788] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Objective of this study is to develop an evidence-based guideline for the noninvasive management of soft tissue disorders of the shoulder (shoulder pain), excluding major pathology. METHODS This guideline is based on high-quality evidence from seven systematic reviews. Multidisciplinary experts considered the evidence of effectiveness, safety, cost-effectiveness, societal and ethical values, and patient experiences when formulating recommendations. Target audience is clinicians; target population is adults with shoulder pain. RESULTS When managing patients with shoulder pain, clinicians should (a) rule out major structural or other pathologies as the cause of shoulder pain and reassure patients about the benign and self-limited nature of most soft tissue shoulder pain; (b) develop a care plan in partnership with the patient; (c) for shoulder pain of any duration, consider low-level laser therapy; multimodal care (heat/cold, joint mobilization, and range of motion exercise); cervicothoracic spine manipulation and mobilization for shoulder pain when associated pain or restricted movement of the cervicothoracic spine; or thoracic spine manipulation; (d) for shoulder pain >3-month duration, consider stretching and/or strengthening exercises; laser acupuncture; or general physician care (information, advice, and pharmacological pain management if necessary); (e) for shoulder pain with calcific tendinitis on imaging, consider shock-wave therapy; (f) for shoulder pain of any duration, do not offer ultrasound; taping; interferential current therapy; diacutaneous fibrolysis; soft tissue massage; or cervicothoracic spine manipulation and mobilization as an adjunct to exercise (i.e., range of motion, strengthening and stretching exercise) for pain between the neck and the elbow at rest or during movement of the arm; (g) for shoulder pain >3-month duration, do not offer shock-wave therapy; and (h) should reassess the patient's status at each visit for worsening of symptoms or new physical, mental, or psychological symptoms, or satisfactory recovery. CONCLUSIONS Our evidence-based guideline provides recommendations for non-invasive management of shoulder pain. The impact of the guideline in clinical practice requires further evaluation. SIGNIFICANCE Shoulder pain of any duration can be effectively treated with laser therapy, multimodal care (i.e., heat/cold, joint mobilization, range of motion exercise), or cervicothoracic manipulation and mobilization. Shoulder pain (>3 months) can be effectively treated with exercises, laser acupuncture, or general physician care (information, advice, and pharmacological pain management if necessary).
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Affiliation(s)
- Hainan Yu
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College (CMCC), Oshawa, Ontario, Canada.,Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Pierre Côté
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College (CMCC), Oshawa, Ontario, Canada.,Canada Research Chair in Disability Prevention and Rehabilitation, Ontario Tech University, Oshawa, Ontario, Canada.,Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada.,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Jessica J Wong
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College (CMCC), Oshawa, Ontario, Canada.,Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Heather M Shearer
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College (CMCC), Oshawa, Ontario, Canada.,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Silvano Mior
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College (CMCC), Oshawa, Ontario, Canada.,Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada.,Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Carol Cancelliere
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College (CMCC), Oshawa, Ontario, Canada.,Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
| | | | - Arthur Ameis
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
| | - Linda J Carroll
- School of Public Health and Injury Prevention Centre, University of Alberta, Edmonton, Alberta, Canada
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, Occupational and Industrial Orthopedic Center, NYU School of Medicine, New York University, New York, NY, USA
| | - Sharanya Varatharajan
- Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada.,Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Deborah Sutton
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College (CMCC), Oshawa, Ontario, Canada
| | - Danielle Southerst
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College (CMCC), Oshawa, Ontario, Canada
| | - Craig Jacobs
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College (CMCC), Oshawa, Ontario, Canada.,Division of Clinical Education, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Maja Stupar
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College (CMCC), Oshawa, Ontario, Canada
| | - Anne Taylor-Vaisey
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College (CMCC), Oshawa, Ontario, Canada
| | - Douglas P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada.,Rehabilitation Research Centre, University of Alberta, Edmonton, Alberta, Canada
| | - Robert J Brison
- Clinical Research, Kingston General Hospital, Kingston, Ontario, Canada.,Department of Emergency Medicine, School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Mike Paulden
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Carlo Ammendolia
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Institute for Work and Health, Toronto, Ontario, Canada
| | - J David Cassidy
- Divison of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Richard N Bohay
- Western University, London, Ontario, Canada.,College of Dentistry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Michel Lacerte
- Université de Montréal, Montreal, Quebec, Canada.,Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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8
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Almeida RF, Pereira ND, Ribeiro LP, Barreto RPG, Kamonseki DH, Haik MN, Camargo PR. Is the Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire Adequate to Assess Individuals With Subacromial Pain Syndrome? Rasch Model and International Classification of Functioning, Disability and Health. Phys Ther 2021; 101:6145042. [PMID: 33609355 DOI: 10.1093/ptj/pzab065] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/25/2020] [Accepted: 12/31/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is widely used to assess patients with symptoms of subacromial pain syndrome (SPS). No study has analyzed the DASH by using the Rasch model in these patients and related the level of difficulty of the items with the International Classification of Functioning Disability and Health (ICF) domains. The purpose of this study was to evaluate the measurement properties of the DASH in individuals with SPS and to describe which ICF components are influenced by SPS based on the DASH. METHODS The full version of the DASH was used to assess upper limb pain and function in individuals with SPS. Responses were assessed using the Rasch model. DASH items were grouped according to the level of difficulty and associated with the ICF domains to identify the most compromised aspect in these individuals. RESULTS Reliability and internal consistency for the DASH were shown to be 0.93 and 0.95, respectively. Item 3 ("Turn a key") was the easiest and 25 ("Pain during specific activity") the most difficult. Only item 30 ("Less capable/confident/useful") was as an erratic item. Item 15 ("Put on a sweater") showed differential functioning by age and item 11 ("Carry a heavy object") by sex. Seven items showed differential functioning related to the angular onset of pain during arm elevation. Sixty percent of the most difficult items belonged to the "Body function" domain of the ICF. CONCLUSION Although some psychometric properties of the DASH are adequate according to the Rasch model, adjustments to some items are necessary for individuals with SPS. Clinicians should be cautious when interpreting the DASH, especially in patients with angular onset of pain above 120 degrees of arm elevation. IMPACT The information contained in this study should be used by clinicians to interpret the results of the DASH when assessing individuals with SPS. The DASH may not be adequate to assess those with shoulder pain above 120 degrees of arm elevation. These results are not generalizable to other shoulder pathologies.
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Affiliation(s)
- Rafaela F Almeida
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Natalia D Pereira
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Larissa P Ribeiro
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Rodrigo Py G Barreto
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Danilo H Kamonseki
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Melina N Haik
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Paula R Camargo
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
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Rosa DP, Borstad JD, Ferreira JK, Gava V, Santos RV, Camargo PR. Comparison of specific and non-specific treatment approaches for individuals with posterior capsule tightness and shoulder impingement symptoms: A randomized controlled trial. Braz J Phys Ther 2021; 25:648-658. [PMID: 34001426 DOI: 10.1016/j.bjpt.2021.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 03/11/2021] [Accepted: 04/06/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Posterior capsule tightness (PCT) is associated with shoulder pain and altered shoulder kinematics, range of motion (ROM), external rotation (ER) strength, and pain sensitization. OBJECTIVE To assess the effects of two interventions on shoulder kinematics, Shoulder Pain and Disability Index (SPADI) scores, ROM, strength, and pressure pain threshold (PPT) in individuals with PCT and shoulder impingement symptoms. METHODS In this prospectively registered randomized controlled trial 59 individuals were randomized to either an Experimental Intervention Group (EIG, n=31) or a Control Intervention Group (CIG, n=28). The low flexion (LF) test was used to determine the presence of PCT. Shoulder kinematics, SPADI scores, internal rotation (IR) and ER ROM, ER strength, and PPT were measured pre- and post-treatment. Those in the EIG received an intervention specific to pain and PCT and those in the CIG received a non-specific intervention, both 4 weeks in duration. RESULTS Individuals in the EIG demonstrated more scapular upward rotation (P=.03; mean difference (MD)=3.3°; 95% Confidence Interval (CI)=1.3°, 4.9°) and improved value on the LF test (P=.02; MD=4.6°; 95%CI=0.7°, 8.6°) than those in the CIG after treatment. Both groups presented less anterior (P<.01; MD=-0.7mm; 95%CI=-1.3mm, -0.2mm) and superior (P<.01; MD=-0.5mm; 95%CI=-0.9mm, -0.2mm) humeral translations, decreased SPADI score (P<.01; MD=-23.6; 95%CI=-28.7, -18.4), increased IR ROM (P<.01; MD=4.6°; 95%CI=1.8°, 7.8°) and PPTs for upper trapezius (P<.01; MD=60.1kPa; 95%CI=29.3kPa, 90.9kPa), infraspinatus (P=.04; MD=47.3kPa; 95%CI=2.1kPa, 92.5kPa), supraspinatus (P<.01; MD=63.7kPa; 95%CI=29.6kPa, 97.9kPa), and deltoid (P<.01; MD=40.9kPa; 95%CI=12.3kPa, 69.4kPa) after treatment. CONCLUSION The experimental intervention was more effective at improving PCT as measured through changes in the LF test. No benefit of the specific approach over the non-specific intervention was noted for the remaining variables.
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Affiliation(s)
- Dayana P Rosa
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - John D Borstad
- Department of Physical Therapy, The College of St. Scholastica, Duluth, MN, USA
| | - Julia K Ferreira
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Vander Gava
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Rodrigo V Santos
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Paula R Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil.
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10
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Brindisino F, Ristori D, Lorusso M, Miele S, Pellicciari L, Rossettini G, Bonetti F, Heick JD, Testa M. Subacromial impingement syndrome: a survey of Italian physiotherapists and orthopaedics on diagnostic strategies and management modalities. Arch Physiother 2020; 10:16. [PMID: 32905154 PMCID: PMC7465722 DOI: 10.1186/s40945-020-00087-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 07/29/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND AIM The subacromial impingement syndrome (SIS) represents a common cause of disability in approximately 74% of patients with Shoulder Pain (SP). Even if contemporary research suggests that this mechanism is not (always) the dominant driver in SP, SIS is still a source of debate among scholars and clinicians. From a clinical point of view, evidence has suggested that clinicians can use both medical and physiotherapy approaches as effective methods to treat SIS.This survey aims to investigate models of management of patients with SIS in a sample of Italian physiotherapist specialists (Orthopaedic Manipulative Physical Therapists, -OMPTs-) and orthopaedic surgeons. MATERIALS AND METHODS An online survey with 29-item questionnaire was administered to assess the knowledge of OMPTs and orthopaedic surgeons about: a) strategies of clinical examination; b) the role of imaging in the diagnostic process; c) the physiotherapy management; and d) the pharmacological and surgical management in patients with SIS. RESULTS Six-hundred and twenty-nine respondents completed the survey (511 OMPTs (79.97%) and 128 orthopaedic surgeons (20.03%)). Ninety-two percent (n = 470) of the OMPTs and 80.5% (n = 103) of orthopaedic surgeons stated that in patients with SIS, a combination of diagnostic tests produced better accuracy (p = < 0.001). Twenty point seven % of OMPTs (n = 106) and 4.7% of orthopaedic surgeon (n = 6) stated that the Lift off was the most specific test (p = < 0.001). Four-hundred-and-twenty-four OMPTs (83%) and 40 orthopaedic surgeons (31.3%) answered that the gold standard for diagnosis of a patient with SIS are history and clinical examination (p < 0.001). CONCLUSION OMPTs and orthopaedic surgeons approach patients with SIS differently during both the assessment and the treatment. OMPTs appear to be appropriate in planning and managing clinical examination and therapeutic strategies to use with patients with SIS.
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Affiliation(s)
- Fabrizio Brindisino
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise C/da Tappino c/o Cardarelli Hospital, 86100 Campobasso, Italy
- Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Diego Ristori
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health – University of Genova – Campus of Savona, Savona, Italy
| | - Mariangela Lorusso
- Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Simone Miele
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health – University of Genova – Campus of Savona, Savona, Italy
| | | | - Giacomo Rossettini
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health – University of Genova – Campus of Savona, Savona, Italy
| | - Francesca Bonetti
- Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - John Duane Heick
- Department of Physical Therapy and Athletic Training, Northern Arizona University Flagstaff, Flagstaff, AZ USA
| | - Marco Testa
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health – University of Genova – Campus of Savona, Savona, Italy
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11
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Nazari G, MacDermid JC, Bobos P. Conservative versus Surgical Interventions for Shoulder Impingement: An Overview of Systematic Reviews of Randomized Controlled Trials. Physiother Can 2020; 72:282-297. [PMID: 35110797 DOI: 10.3138/ptc-2018-0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: Numerous systematic reviews (SRs) of randomized controlled trials (RCTs) have emerged that investigate the effectiveness of conservative (supervised exercises) versus surgical (arthroscopic subacromial decompression) interventions for patients with shoulder impingement; however, there are disparities in the quality of the evidence synthesized. The purpose of this study was to conduct an overview of SRs of RCTs to critically appraise the evidence and establish the current state of effectiveness of conservative versus surgical interventions on clinical outcomes among patients with shoulder impingement. Method: The MEDLINE, EMBASE, CINAHL, and PubMed electronic databases were searched for January 2008 to September 2018, and we found SRs of RCTs of patients with shoulder impingement, subacromial pain syndrome, or subacromial impingement syndrome who had received conservative versus surgical interventions to improve outcomes. Two authors extracted the data, and two independent review authors assessed the risk of bias and quality. Results: A total of 15 SRs were identified. One was rated as high quality, 7 as moderate quality, 5 as low quality, and 2 as critically low quality. The results were in line with one another, indicating that no differences in outcomes existed between conservative and surgical interventions among patients with shoulder impingement. Conclusion: There were no clinically important or statistically significant differences in outcomes between conservative versus surgical interventions among patients with subacromial impingement syndrome. To enhance clinical outcomes in this patient population, shoulder-specific exercises that aim to improve muscle strength and flexibility must be considered as the first line of conservative treatment.
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Affiliation(s)
- Goris Nazari
- School of Physical Therapy, Faculty of Health Sciences.,Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University
| | - Joy C MacDermid
- School of Physical Therapy, Faculty of Health Sciences.,Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University.,Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, Ont
| | - Pavlos Bobos
- School of Physical Therapy, Faculty of Health Sciences.,Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University
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12
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Seven Key Themes in Physical Therapy Advice for Patients Living With Subacromial Shoulder Pain: A Scoping Review. J Orthop Sports Phys Ther 2020; 50:285-a12. [PMID: 32476583 DOI: 10.2519/jospt.2020.9152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To systematically scope the reported advice and education in physical therapy management of patients with subacromial shoulder pain, and to define key themes of the advice and education. DESIGN Scoping review. LITERATURE SEARCH We searched MEDLINE, Scopus, Web of Science, and CINAHL, with publication dates from 2007 to September 2019. STUDY SELECTION CRITERIA We included quantitative and qualitative research that reported on physical therapy interventions for subacromial shoulder pain. DATA SYNTHESIS We performed a qualitative synthesis that identified items included in patient advice and education. RESULTS Of 89 original studies included, there were 61 randomized controlled trials; 5 prospective studies; 16 nonrandomized observational intervention studies or case series; and 7 surveys, audits of physical therapy patient records, and focus groups with physical therapists. We identified 7 key themes for advice and education: exercise intensity and pain response, activity modification advice, posture advice, pain self-management advice, pathoanatomical and diagnosis information, behavioral approaches, and pain biology advice. CONCLUSION While advice focused predominantly on the local tissue pathology model, 10% of studies included information about pain neuroscience education, psychosocial factors, motor imagery, or behavior change. J Orthop Sports Phys Ther 2020;50(6):285-293. doi:10.2519/jospt.2020.9152.
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Silva ACD, Santos GM, Marques CMDG, Marques JLB. Immediate Effects of Spinal Manipulation on Shoulder Motion Range and Pain in Individuals With Shoulder Pain: A Randomized Trial. J Chiropr Med 2019; 18:19-26. [PMID: 31193215 PMCID: PMC6522436 DOI: 10.1016/j.jcm.2018.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 07/23/2018] [Accepted: 10/28/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The purpose of this study was to investigate the influence of thoracic spinal manipulation (SM) on shoulder pain and ranges of motion in individuals with shoulder pain. METHODS The sample was composed of 60 individuals, randomly allocated into the manipulation group (n = 30), who received the SM, and the placebo group (n = 30) who received a placebo manipulation. Pain evaluation was performed using the visual analog scale, and evaluation of shoulder flexion and abduction ranges of motion was assessed using a goniometer pre- and post-intervention. The intervention was performed by either upper thoracic SM or a placebo manipulation. RESULTS The manipulation group demonstrated increased flexion and abduction of the painful shoulder (P < .01) and increased abduction of the nonpainful shoulder (P = .03), but only the abduction of the painful shoulder reached the minimal detectable change. The placebo group showed a post-intervention increase in the flexion (P = .03) and abduction (P < .01) movement of the painful shoulder. Both groups presented a statistically significant reduction in post-intervention pain (P < .01), but not clinically significant. CONCLUSION Although the SM demonstrated a statistically significant difference for shoulder pain, this was not over the clinically meaningful change. Only the abduction of the painful shoulder reached the minimal detectable change.
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Affiliation(s)
- Alyssa Conte da Silva
- Centre of Health and Sports Sciences, University of the State of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Gilmar Moraes Santos
- Centre of Health and Sports Sciences, University of the State of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | | | - Jefferson Luiz Brum Marques
- Department of Electrical and Electronic Engineering, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
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Normalization of the trapezius sEMG signal - a reliability study on women with and without neck-shoulder pain. Braz J Phys Ther 2017; 22:110-119. [PMID: 29033217 PMCID: PMC5883997 DOI: 10.1016/j.bjpt.2017.09.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 08/01/2017] [Indexed: 12/19/2022] Open
Abstract
Objective To evaluate within- and between-days reliability of two normalization methods of surface electromyography (sEMG) recordings of the trapezius muscle. Methods Nineteen women were allocated into 2 groups (healthy and with neck-shoulder pain). The sEMG was recorded in two sessions with 7 days in between sessions. The four portions of the trapezius muscle (the clavicular and acromial fibers of the upper trapezius, the middle and the lower trapezius) were evaluated during maximal and submaximal isometric voluntary contractions. The within- and between-days reliability of both maximal and submaximal contractions were assessed through Intraclass Correlation Coefficient (ICC(2,1) was used for within-day analyses of both maximal and submaximal contractions, and for between-days analyses of maximal contractions while ICC(2,3) was used for between-days analyses of submaximal contractions), Coefficient of Variation, Standard Error of Measurement, and Bland–Altman analysis. Results In general, submaximal contractions presented higher within-day reliability, with higher ICC values (e.g., middle trapezius – mean of 0.97), smaller Coefficient of Variation and Standard Error of Measurement ranges compared to maximal contractions (ICC values, e.g. for middle trapezius – mean of 0.94) in both groups. The same pattern was observed for between-days analyses, with submaximal contractions presenting higher ICC values (e.g., middle trapezius – mean of 0.84), smaller Coefficient of Variation and Standard Error of Measurement ranges than maximal contractions (ICC values, e.g. for middle trapezius – mean of 0.73) in both groups. Conclusion Submaximal contractions are recommended for normalization procedures of trapezius sEMG, in both subjects with neck-shoulder pain and healthy individuals.
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