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Hao J, Yao Y, Remis A, Sun Y, Zhu D, Wu S. Effects of high-intensity laser therapy on subacromial impingement syndrome: a systematic review and meta-analysis. Lasers Med Sci 2024; 39:240. [PMID: 39317844 DOI: 10.1007/s10103-024-04190-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 09/15/2024] [Indexed: 09/26/2024]
Abstract
This systematic review and meta-analysis aims to identify, critically appraise, and summarize the effects of high-intensity laser therapy on subacromial impingement syndrome. Three databases, PubMed, Embase, and Scopus were searched from inception to March 1, 2024. Clinical trials comparing the effects of high-intensity laser therapy to conventional therapy are eligible for inclusion. Two independent reviewers conducted study selection, data extraction, and quality assessment. Methodological quality was assessed using the Physiotherapy Evidence Database scale. Meta-analyses were performed to determine the effects of high-intensity laser therapy. Five randomized controlled trials and one controlled clinical trial were included, with a total of 284 patients with subacromial impingement syndrome. All included studies were evaluated as good or above for quality assessment. Compared to conventional therapy, high-intensity laser therapy demonstrated significantly better outcomes for pain at both post-intervention (SMD = -1.01, 95%CI = -1.85 to -0.17) and three-month post-intervention (SMD = -0.51, 95%CI = -0.90 to -0.13); shoulder and arm function at both post-intervention (SMD = 0.40, 95%CI = 0.14 to 0.66) and three-month post-intervention (SMD = 0.45, 95%CI = 0.06 to 0.84); shoulder abduction active range of motion (SMD = 3.26, 95%CI = 0.49 to 6.03). No significant difference was found for shoulder flexion and external rotation range of motion. This review highlights the promising effects of high-intensity laser therapy for the rehabilitation of subacromial impingement syndrome. Rehabilitation professionals and policymakers should increase their awareness of high-intensity laser therapy as an emerging technology that may facilitate greater outcomes than current widespread standards.
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Affiliation(s)
- Jie Hao
- Department of Physical Therapy and Rehabilitation, Southeast Colorado Hospital, Springfield, Colorado, 81073, USA.
- Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska, Medical Center, Omaha, NE, USA.
| | - Yao Yao
- Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska, Medical Center, Omaha, NE, USA
| | - Andréas Remis
- Health Research Association of Keck Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Yuxiao Sun
- Department of Rehabilitation Medicine, West China Hospital, Chengdu, Sichuan, PR China
| | - Dongqi Zhu
- Department of Rehabilitation Medicine, Shanghai Sixth People's Hospital, Shanghai, PR China
| | - Siyao Wu
- Department of Rehabilitation Medicine, Beijing Hospital, National Center of Gerontology, Institution of Geriatric Medicine, Chinese Academy of Medical Science, Beijing, PR China
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Yang F, Li X, Wang J, Gao Q, Pan M, Duan Z, Ren C, Guo P, Zhang Y. Efficacy of different analgesic strategies combined with conventional physiotherapy program for treating chronic shoulder pain: a systematic review and network meta-analysis. J Orthop Surg Res 2024; 19:544. [PMID: 39238008 PMCID: PMC11378570 DOI: 10.1186/s13018-024-05037-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 08/27/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND This study aims to investigate the efficacy of five analgesic strategies combined with conventional physiotherapy program (CPT) in managing chronic shoulder pain. METHODS Two authors independently screened studies, extracted data using a pre-formatted chart, and assessed bias using the Cochrane Risk of Bias tool. A network meta-analysis was performed by the Stata 17.0 and R 4.3.2 software. RESULTS A total of 14 studies with 862 subjects were identified. These analgesic strategies included extracorporeal shock wave therapy (ESWT), suprascapular nerve block (SSNB), corticosteroid injection (CSI), hyaluronic acid injection (HAI), and kinesio taping (KT). ESWT plus CPT was the most efficient intervention in alleviating pain intensity and improving physical function. SSNB plus CPT was the optimal intervention in improving shoulder mobility. Compared to CPT alone, CSI + CPT only significantly improved the SPADI total score, but showed no difference in pain intensity or shoulder mobility. HAI + CPT showed no significant difference in improving pain intensity, physical function, or shoulder mobility compared to CPT alone. Adding KT to CPT did not yield additional benefits in improving shoulder mobility. CONCLUSION Overall, in managing chronic shoulder pain, ESWT + CPT was the most effective intervention for reducing pain intensity and improving physical function. SSNB + CPT was optimal for enhancing shoulder mobility. Future rigorous clinical trials with larger sample sizes and higher methodological rigor are strongly required to confirm the current results.
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Affiliation(s)
- Fangjie Yang
- Rehabilitation Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Xinmin Li
- School of Traditional Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Jing Wang
- Rehabilitation Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Qian Gao
- Rehabilitation Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Mengyang Pan
- Rehabilitation Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Zhenfei Duan
- Rehabilitation Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Chunlin Ren
- Rehabilitation Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Pengxue Guo
- Rehabilitation Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Yasu Zhang
- Rehabilitation Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China.
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Ferguson J, Fritsch A, Rhon DI, Young JL. Adverse Events Reported in Trials Assessing Manual Therapy to the Extremities: A Systematic Review. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:507-517. [PMID: 38452161 DOI: 10.1089/jicm.2023.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Objective: This review aimed to describe the quality and comprehensiveness of adverse event (AE) reporting in clinical trials incorporating manual therapy (MT) as an intervention for extremity conditions using the Consolidated Standards of Reporting Trials (CONSORT)-Harms extension as the benchmark. The secondary aim was to determine whether the quality of AE reporting improved after the availability of the CONSORT reporting checklist. Design: Systematic review. Methods: A literature search was conducted using multiple databases to identify trials where MT was used to treat extremity conditions. Studies that reported AEs were identified and evaluated using the CONSORT-Harms extension. The frequency of trials reporting study AEs before and after the publication of the updated 2010 CONSORT statement was calculated, along with the categorization of how study AEs were reported. Results: Of the 55,539 studies initially identified, 220 trials met all inclusion criteria. Eighty trials (36.4%) reported AE occurrence. None of the studies that reported AEs adhered to all 10 criteria proposed by the 2010 CONSORT-Harms extension. The most commonly reported criterion was number four, which clarified how AE-related information was collected (30% of trials). The least reported criterion was number six, which describes the participant withdrawals for each arm due to AEs and the experience with the allocated treatment (1.3% of trials). The nomenclature used to describe AEs varied substantially. Fifty-nine of 76 trials (33.3%) were published after the updated CONSORT Harms-checklist was available, compared to 21 of 44 trials (46.7%) published before it was available. Conclusion: Reporting of AEs in trials investigating MT for extremity conditions is poor. Every included trial lacked adherence to all 10 criteria proposed by the CONSORT-Harms Extension. The quality and comprehensiveness of AE reporting did not improve after the most recent CONSORT update recommending AE reporting. Clinicians must obtain informed consent before performing any intervention, including MT, which requires disclosing potential risks, which could be better known with improved tracking, analyzing, and reporting of AEs. The authors recommend improved adherence to best practices for adequately tracking and reporting AEs in future MT trials.
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Affiliation(s)
- Jeffrey Ferguson
- Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
| | - Adam Fritsch
- Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
| | - Daniel I Rhon
- Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
- Department of Rehabilitation Medicine, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Jodi L Young
- Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
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Kamonseki DH, da Rocha GM, Ferreira VMLM, Ocarino JM, Pogetti LS. Extracorporeal Shockwave Therapy for the Treatment of Noncalcific Rotator Cuff Tendinopathy: A Systematic Review and Meta-analysis. Am J Phys Med Rehabil 2024; 103:471-479. [PMID: 37903597 DOI: 10.1097/phm.0000000000002361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
OBJECTIVE The aim of the systematically review the short-, intermediate-, and long-term effects of extracorporeal shockwave therapy on pain intensity and shoulder function in individuals with noncalcific rotator cuff tendinopathy. DESIGN The MEDLINE, CINAHL, SPORTDiscus, and Embase were searched from inception up to June 2023. We included randomized controlled trials that investigated the effects of extracorporeal shockwave therapy on pain intensity and shoulder function. RESULTS Nine studies were included with a total sample of 543 individuals. Extracorporeal shockwave therapy was superior to sham extracorporeal shockwave therapy in improving pain intensity at short-term follow-up (standardized mean difference = -0.28; 95% confidence interval, -0.55 to -0.01). Extracorporeal shockwave therapy was not superior to sham extracorporeal shockwave therapy in improving pain intensity at intermediate- and long-term follow-ups ( P > 0.05). Extracorporeal shockwave therapy was not superior to other treatments in improving pain intensity at short- and intermediate-term follow-ups ( P > 0.05). Extracorporeal shockwave therapy was not superior to sham extracorporeal shockwave therapy and other treatments in improving shoulder function at short-, intermediate-, and long-term follow-ups ( P > 0.05). CONCLUSIONS Moderate-certainty evidence indicated that extracorporeal shockwave therapy showed small improvement in shoulder pain over sham extracorporeal shockwave therapy at short-term follow-up. In addition, extracorporeal shockwave therapy was not superior to sham extracorporeal shockwave therapy in improving function, and it was not superior to other treatments in improving shoulder pain and function.
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Affiliation(s)
- Danilo Harudy Kamonseki
- From the Department of Physical Therapy, Universidade Federal da Paraíba, João Pessoa, Brazil (DHK); Graduate Program in Rehabilitation Science, Physical Therapy Department, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (GMdR, VMLMF, JMO, LSP); and Univesidade Federal de Uberlândia, Uberlândia, Brazil (LSP)
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Melo AS, Moreira JS, Afreixo V, Moreira-Gonçalves D, Donato H, Cruz EB, Vilas-Boas JP, Sousa AS. Effectiveness of specific scapular therapeutic exercises in patients with shoulder pain: a systematic review with meta-analysis. JSES REVIEWS, REPORTS, AND TECHNIQUES 2024; 4:161-174. [PMID: 38706660 PMCID: PMC11065746 DOI: 10.1016/j.xrrt.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Background Therapeutic exercise has been considered a useful tool to rehabilitate shoulder pain, namely through its influence on scapular dynamics. Accordingly, the effectiveness of scapular therapeutic exercise needs to be explored. The present study aims to evaluate the effectiveness of scapular therapeutic exercises in shoulder pain and to identify the most effective exercise type (focal or multijoint) and ways of delivering them (as dose and progression). Methods Search was conducted at EMBASE, Cochrane Library, MEDLINE via PubMed, Web of Science, PEDro (Physiotherapy Evidence Database), and trial registration databases. The meta-analysis considered randomized controlled/crossover trials that compared the effect of scapular exercises against other types of intervention in the shoulder pain, shoulder function, scapular motion, and/or muscular activity. The risk of bias was assessed through the PEDro scale. Results From the 8318 records identified, 8 (high to low risk of bias- scoring from 4 to 8 on the PEDro scale) were included. The overall data, before sensitivity analysis, indicated that the scapular therapeutic exercises are: a) more effective than comparators in improving shoulder function (standardized mean difference [SMD] = 0.52 [95% Cl: 0.05, 0.99], P = .03, I2 = 76%); and b) as effective as comparators in reducing shoulder pain (SMD = 0.32 [95% Cl: -0.09, 0.73], P = .13, I2 = 70%). Subgroup analysis revealed that scapular exercises are more effective in improving shoulder function when the program duration is equal to or higher than 6 weeks (SMD = 0.43 [95% Cl: 0.09, 0.76] P = .01, I2 = 21%) and/or when the maximum number of exercise repetitions per session is lower than 30 (SMD = 0.79 [95% Cl: 0.15, 1.42], P = .01, I2 = 77%). Only 1 study considered scapular motion as an outcome measure, revealing therapeutic exercise effectiveness to improve scapular range of motion. Conclusions Intervention programs involving scapular therapeutic exercises are effective in improving shoulder function, presenting benefits when performed for 6 or more weeks and/or when used up to a maximum of 30 repetitions per exercise, per session.
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Affiliation(s)
- Ana S.C. Melo
- Centro de Investigação em Reabilitação (CIR), Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal
- Centro de Investigação em Actividade Física, Saúde e Lazer (CIAFEL), Faculdade de Desporto, Universidade do Porto, Porto, Portugal
- Laboratório de Biomecânica do Porto (LABIOMEP), Universidade do Porto, Porto, Portugal
- Centro Interdisciplinar de Investigação Aplicada em Saúde (CIIAS), Escola Superior de Saúde, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - Juliana S. Moreira
- Centro de Investigação em Reabilitação (CIR), Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal
| | - Vera Afreixo
- Department of Mathematics, Center for Research and Development in Mathematics and Applications – CIDMA, University of Aveiro, Portugal
| | - Daniel Moreira-Gonçalves
- Centro de Investigação em Actividade Física, Saúde e Lazer (CIAFEL), Faculdade de Desporto, Universidade do Porto, Porto, Portugal
- ITR, Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal
| | - Helena Donato
- Documentation and Scientific Information Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Eduardo B. Cruz
- Departamento de Fisioterapia, Escola Superior de Saúde, Instituto Politécnico de Setúbal, Setúbal, Portugal
- Centro de Investigação Integrada em Saúde (CHRC), Universidade Nova de Lisboa, Lisboa, Portugal
| | - J. Paulo Vilas-Boas
- Laboratório de Biomecânica do Porto (LABIOMEP), Universidade do Porto, Porto, Portugal
- Centro de Investigação, Formação, Inovação e Intervenção em Desporto (CIFI2D), Faculdade de Desporto, Universidade do Porto, Porto, Portugal
| | - Andreia S.P. Sousa
- Centro de Investigação em Reabilitação (CIR), Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal
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Goharinejad S, Ahrari MN, Moulaei K, Sarafinejad A. Evaluating the effects of mobile application-based rehabilitation on improving disability and pain in patients with disputed thoracic outlet syndrome: A randomized controlled trial. Int J Med Inform 2024; 185:105400. [PMID: 38479190 DOI: 10.1016/j.ijmedinf.2024.105400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 02/29/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Disputed thoracic outlet syndrome (D.TOS) stands as one of the primary global contributors to physical disability, presenting diagnostic and treatment challenges for patients and frequently resulting in prolonged periods of pain and functional impairment. Mobile applications emerge as a promising avenue in aiding patient self-management and rehabilitation for D.TOS. This study aimed to investigate the impact of a certain mobile application-based rehabilitation on pain relief and the improvement of disability in patients experiencing D.TOS. METHODS Eighty-eight patients diagnosed with D.TOS randomized 1:1 to either the control group (n = 44) or the intervention group (n = 44). Participants in the control group were provided with a brochure containing standard rehabilitation exercise instructions, a written drug prescription from the physician, and guidance on recommended physical activity levels, including home exercises. In contrast, all participants in the intervention group used the mobile application. Disability and pain levels in patients were assessed after six weeks in both groups. RESULT Both groups improved pain and disability based on the scaled measurements. According to the questionnaire scale, the intervention group showed a considerable decline in disability; however, there was a significant difference in just one question (P < 0.05). Furthermore, the intervention group showed significant improvement in neck pain NRS (p = 0.024) compared to the control. Based on the shoulder and head pain numeric rate scale (NRSs), both groups showed improvement in disability conditions; but there were no significant differences between the groups (p > 0.05). CONCLUSION Mobile applications are promising tools for alleviating disabilities and pain in patients with musculoskeletal conditions. This study confirmed the potential of mobile technology to enhance active and corrective physical activity, thereby reducing pain in patients with D.TOS. TRIAL REGISTRATION Iranian Registry of Clinical Trials (IRCT) with the identifier IRCT20141221020380N3 (http://www.irct.ir/).
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Affiliation(s)
- Saeideh Goharinejad
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Naeem Ahrari
- Physical Medicine & Rehabilitation Specialist, Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Khadijeh Moulaei
- Department of Health Information Technology, School of Paramedical, Ilam University of Medical Sciences, Ilam, Iran
| | - Afshin Sarafinejad
- Clinical Informatics Research and Development Lab, Clinical Research Development Unit, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran.
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Silveira A, Lima C, Beaupre L, Chepeha J, Jones A. Shoulder specific exercise therapy is effective in reducing chronic shoulder pain: A network meta-analysis. PLoS One 2024; 19:e0294014. [PMID: 38683828 PMCID: PMC11057978 DOI: 10.1371/journal.pone.0294014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 10/24/2023] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Exercise therapy (ET) is frequently an early treatment of choice when managing shoulder pain, yet evidence on its efficacy to expedite recovery is inconsistent. Moreover, the value of adding adjunct therapies (i.e. injections, manual therapy, electrotherapy) to ET is currently unclear. This study combined both direct and indirect evidence across studies on the effectiveness of ET with/without adjunct therapies compared to usual medical care for adults with chronic shoulder pain. METHODS AND FINDINGS Using a network meta-analysis, randomized control trials comparing ET along with adjunct therapies were identified in MEDLINE, Embase, CINAHL, Sportdiscus, CENTRAL, Conference Proceedings Citation Index-Science, clinicaltrials.gov, and association websites. Outcomes included pain, range of motion (ROM), and health-related quality of life (HRQL) measures in adult patients with chronic shoulder pain. Data analysis used a Frequentist hierarchical model. CINeMA tool assessed the confidence in the results and Cochrane Risk of Bias tool assessed quality of studies. 54 studies primarily from Europe (40.38%) included 3,893 participants who were followed up to 52 weeks. Shoulder-specific ET (Mean difference (MD) = -2.1; 95% confidence interval (CI) = -3.5 to -0.7) or in combination with electro-physical agents (MD = -2.5; 95% CI = -4.2 to -0.7), injections (MD = -2.4; 95% CI = -3.9 to-1.04) or manual therapy (MD = -2.3; 95% CI = -3.7 to -0.8) decreased pain compared to usual medical care. Trends with ROM and HRQL scores were seen; however, only Manual Therapy (MD = -12.7 and 95% CI = -24.4 to -1.0) achieved meaningfully important changes. Sensitivity analysis excluding studies with high risk of bias showed similar results, with exception of injections that did not reach significance (MD = -1.3; 95% CI = -4.3 to 1.7). CONCLUSION(S) Shoulder-specific ET provided pain relief up to 52 weeks. Adjunct therapies to shoulder-specific ET added little value in reducing pain. The quality of evidence varied between moderate and very low.
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Affiliation(s)
- Anelise Silveira
- University of Alberta, School of Public Health, Edmonton, Alberta, Canada
| | - Camila Lima
- University of Alberta, School of Public Health, Edmonton, Alberta, Canada
| | - Lauren Beaupre
- University of Alberta, Faculty of Rehabilitation Sciences, Edmonton, Alberta, Canada
- University of Alberta, Collaborative Orthopaedic Research, Edmonton, Alberta, Canada
| | - Judy Chepeha
- University of Alberta, Collaborative Orthopaedic Research, Edmonton, Alberta, Canada
| | - Allyson Jones
- University of Alberta, Faculty of Rehabilitation Sciences, Edmonton, Alberta, Canada
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Pan C, Hao X, Deng X, Lu F, Liu J, Hou W, Xu T. The roles of Hippo/YAP signaling pathway in physical therapy. Cell Death Discov 2024; 10:197. [PMID: 38670949 PMCID: PMC11053014 DOI: 10.1038/s41420-024-01972-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
Cellular behavior is regulated by mechanical signals within the cellular microenvironment. Additionally, changes of temperature, blood flow, and muscle contraction also affect cellular state and the development of diseases. In clinical practice, physical therapy techniques such as ultrasound, vibration, exercise, cold therapy, and hyperthermia are commonly employed to alleviate pain and treat diseases. However, the molecular mechanism about how these physiotherapy methods stimulate local tissues and control gene expression remains unknow. Fortunately, the discovery of YAP filled this gap, which has been reported has the ability to sense and convert a wide variety of mechanical signals into cell-specific programs for transcription, thereby offering a fresh perspective on the mechanisms by which physiotherapy treat different diseases. This review examines the involvement of Hippo/YAP signaling pathway in various diseases and its role in different physical therapy approaches on diseases. Furthermore, we explore the potential therapeutic implications of the Hippo/YAP signaling pathway and address the limitations and controversies surrounding its application in physiotherapy.
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Affiliation(s)
- Chunran Pan
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoxia Hao
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaofeng Deng
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fan Lu
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiawei Liu
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenjie Hou
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Xu
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Roubea I, Korakakis V. Rehabilitation following ulnar collateral ligament injury of the elbow in a female acrobatic athlete: A case report. J Bodyw Mov Ther 2024; 38:329-338. [PMID: 38763577 DOI: 10.1016/j.jbmt.2024.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND The mechanism of injury and the conservative rehabilitation of the ulnar collateral ligament of the elbow (UCL) are well studied and reported in overhead athletes, while research on gymnastic athletes is sparse. Evidence suggests exercise as the mainstay in UCL injury rehabilitation. With this report, we aimed to provide a complete rehabilitation protocol following a partial UCL tear of an acrobatic athlete, where exercise and adjunct treatments, such as manual therapy, were used in a progressive staged rehabilitation. CASE DESCRIPTION A 16-year-old female acrobatic athlete was diagnosed with partial tear of the anterior band of UCL. The rehabilitation included progressive exercise loading in conjunction with manual therapy for 10 sessions in 8 weeks. Pain, UCL special tests, the Disabilities of Arm, Shoulder and Hand Score Questionnaire (DASH), and the Upper Limb Functional Index (ULFI) were assessed and administered at baseline and at 3, 6, 10 weeks, and 3 months. RESULTS Improvement in all outcome measures was noted at the 3-month follow-up indicating a substantial reduction in pain and disability, and an increase in stability of the elbow joint. Return to training was achieved at 8 weeks from the initial visit, while return to sport at the pre-injury level was achieved at 3 months. CONCLUSION Progressive exercise loading along with the addition of manual therapy is an effective intervention for the rehabilitation and return to sport following a partial UCL tear. A progressive staged rehabilitation guideline for acrobatic athletes with UCL injuries has been provided to be used and guide clinical practice. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Iliana Roubea
- Physiotherapy Department, University of West Attica, Egaleo, Athens, Greece; Hellenic Orthopaedic Manipulative Therapy Education (HOMT Edu), Athens, Greece.
| | - Vasileios Korakakis
- Hellenic Orthopaedic Manipulative Therapy Education (HOMT Edu), Athens, Greece; Department of Health Sciences, School of Life Sciences and Health Sciences, PhD in Physiotherapy Program, University of Nicosia, Cyprus
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Huang T, Zhang W, Yan B, Liu H, Girard O. Comparing Telerehabilitation and Home-based Exercise for Shoulder Disorders: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2024:S0003-9993(24)00836-0. [PMID: 38432330 DOI: 10.1016/j.apmr.2024.02.723] [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: 11/01/2023] [Revised: 01/22/2024] [Accepted: 02/12/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to quantitatively compare the effects of telerehabilitation and home-based exercise for shoulder disorders. DATA SOURCES We conducted a search for eligible studies in PubMed, EMBASE, Web of Science, Cochrane Library, and MEDLINE databases following Preferred Reporting Items for Systematic Review and Meta-analyses guidelines. STUDY SELECTION Independent reviewers selected randomized controlled trials that compared the effects of telerehabilitation and home-based exercise in individuals with shoulder disorders. DATA EXTRACTION Two reviewers independently conducted data extraction and assessed the risk of bias using the Cochrane Risk of Bias tool. DATA SYNTHESIS A total of 7 studies with 508 participants were included. Compared with home-based exercise, telerehabilitation showed superior improvements in range of motion (flexion: standardized mean difference [SMD] 0.35, 95% confidence interval [CI] 0.14 to 0.56; abduction: SMD 0.37, 95% CI 0.16 to 0.58; external rotation: SMD 0.43, 95% CI 0.22 to 0.64; internal rotation: SMD 0.33, 95% CI 0.08 to 0.58), functional outcomes (Shoulder Pain and Disability Index: SMD -0.37, 95% CI -0.61 to -0.12; shortened Disabilities of the Arm, Shoulder and Hand questionnaire: mean difference [MD] -4.51, 95% CI -8.70 to -0.32), and quality of life (EuroQol Five Dimensions Questionnaire: MD 0.04, 95% CI 0.01 to 0.07). Telerehabilitation was not different from home-based exercise in terms of pain relief (SMD -0.19, 95% CI -0.60 to 0.23). Subgroup analysis demonstrated that telerehabilitation provided significant pain relief when sustained for over 12 weeks (SMD -0.46, 95% CI -0.81 to -0.11). CONCLUSIONS Telerehabilitation is more effective than home-based exercise in improving range of motion, functional outcomes, and quality of life for patients with shoulder disorders. Telerehabilitation significantly outperforms home-based exercise in relieving pain when continued for over 12 weeks.
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Affiliation(s)
- Tian Huang
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Wei Zhang
- School of Sports Engineering, Beijing Sport University, Beijing, China
| | - Bing Yan
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China.
| | - Haoyang Liu
- School of Sports Engineering, Beijing Sport University, Beijing, China
| | - Olivier Girard
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
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Tauqeer S, Arooj A, Shakeel H. Effects of manual therapy in addition to stretching and strengthening exercises to improve scapular range of motion, functional capacity and pain in patients with shoulder impingement syndrome: a randomized controlled trial. BMC Musculoskelet Disord 2024; 25:192. [PMID: 38431547 PMCID: PMC10908164 DOI: 10.1186/s12891-024-07294-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/19/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The current study aimed to measure the effectiveness of manual therapy in addition to stretching and strengthening exercises in patients with shoulder impingement syndrome to improve functional capacity, pain, and scapular range of motion. METHODS This is a single-blinded randomized controlled trial. Thirty-two participants with chronic shoulder impingement syndrome were randomly allocated into two groups. Both groups received stretching and strengthening exercises while the treatment group was given manual therapy additionally. Treatment was started after the patients signed an informed consent form. The data were collected from the University of Lahore Teaching Hospital between March 2022 and December 2022. The study aimed to measure pain using a numeric pain rating scale, functional capacity was assessed by the disability of the arm and shoulder, and goniometry was used for scapular ranges, i.e., scapular protraction and upward rotation. Each treatment session lasted 45 min for the treatment group and 30 min for the control group. The treatment comprised five days a week for four weeks, after which post-intervention measurements were taken. RESULTS Thirty-two participants were enrolled in the study, and 16 were divided into each group. The mean age of the participants in the treatment group was 38.19 ± 7.31 while the comparison group was 35.69 ± 7.98. An independent sample t-test was run on the data with a 95% confidence interval, statistically significant results were obtained, i.e., p-value < 0.05, post-intervention in the treatment group. Both groups have significantly improved functional capacity and scapular protraction (p < 0.005), however, pain and scapular upward rotation were not found statistically significant in the control group (p > 0.05). CONCLUSION The addition of manual therapy along with exercise therapy showed clinical and statistical significant results for pain, functional capacity, and scapular range of motion. It demonstrated superior effects than exercise therapy alone for the chronic condition of SIS. TRIAL REGISTRATION The trial was registered in the Iranian Registry of Clinical Trials ( https://www.irct.ir/ ) with the registration number: IRCT20230526058291N1, (Date: 12/08/2023).
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Affiliation(s)
- Sana Tauqeer
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
| | - Ayesha Arooj
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan.
| | - Hammad Shakeel
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
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Leatherwood W, Torres A, Hidalgo Perea S, Paulus M. Demographic and Diagnostic Factors in Physical Therapy Attendance. Cureus 2024; 16:e55908. [PMID: 38601391 PMCID: PMC11004832 DOI: 10.7759/cureus.55908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction Physical therapy (PT) is an effective nonoperative treatment for various orthopedic diagnoses. However, patients may have many reasons to dismiss PT, including favoring another intervention for their injury, time constraints, transportation, and cost. This dismissal of PT may contribute to inadequate patient compliance. This study aimed to elucidate patient compliance with a basic PT prescription and whether PT led to subjective injury improvement. Methods This is a retrospective study of patients observed in Stony Brook Orthopedic clinics from 08/01/2022 to 12/23/2022. Patients prescribed PT received a phone call six weeks after the PT prescription. The primary outcome was patient attendance at PT. Secondary outcomes were subjective; symptomatic improvement was listed as better, worse, or the same. Chi-square testing was used to compare outcomes. Results A total of 100 patients were enrolled in the study. Patients prescribed PT following surgery were more likely to attend compared to patients prescribed PT as a primary treatment (P value=0.027). The association between attendance at PT and a change in subjective symptoms (better, worse, same) was not significant. Patients' age, sex, and chronicity of injury were not significant factors in PT attendance. Of the 40 patients who did not attend PT, 14 cited time constraints, 11 utilized self-directed treatment, three cited insurance, two cited transportation, and 10 cited other reasons. Conclusions Overall, postoperative patients were more likely to attend PT compared to patients prescribed PT as a primary treatment. Factors such as age, sex, and chronicity of injury did not affect whether a patient attended PT. Of the patients enrolled, 71% stated subjective improvement in symptoms, but there was no association between symptoms and PT attendance. This study highlights the characteristics of those patient factors that may influence PT compliance and underscores the importance of further research into the population most likely to attend and benefit from PT.
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Affiliation(s)
| | - Adrian Torres
- Department of Orthopaedic Surgery, Stony Brook University, New York, USA
| | | | - Megan Paulus
- Department of Orthopaedic Surgery, Stony Brook University, New York, USA
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de Almeida LA, Pereira ND, Haik MN, Camargo PR. Linking patient reported shoulder outcomes to the international classification of functioning, disability and health. Disabil Rehabil 2024; 46:979-987. [PMID: 36803506 DOI: 10.1080/09638288.2023.2180544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 02/05/2023] [Accepted: 02/10/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE To link the items from shoulder-specific Patient Reported Outcome Measures (PROMs) to the International Classification of Functioning, Disability and Health (ICF) domains and categories, and to determine if the items fit into the ICF framework. MATERIALS AND METHODS The Brazilian versions of the Oxford Shoulder Score (OSS), Shoulder Pain and Disability Index (SPADI), Simple Shoulder Test (SST) and Western Ontario Rotator Cuff Index (WORC) were linked to the ICF by two researchers independently. Agreement between raters was determined by calculating the Kappa Index. RESULTS Fifty-eight items from the PROMs were linked to eight domains and 27 categories of ICF. The PROMs covered components of body functions, activities, and participation. Components of body structure and environmental factors were not covered by any of the PROMs. There was substantial agreement between raters when linking the OSS (Kappa index = 0.66), SPADI (Kappa index = 0.92), SST (Kappa index = 0.72) and WORC (Kappa index = 0.71). CONCLUSIONS WORC and SST were the PROMs that covered the highest number of ICF domains (seven and six, respectively). However, SST is short and may be less time consuming in a clinical assessment. Clinicians can benefit from this study to decide which shoulder-specific PROM may be more adequate according to the clinical demand.Implications For RehabilitationWestern Ontario Rotator Cuff Index was the shoulder-specific Patient Reported Outcome Measure (PROM) that best showed a broader view of functionality through the International Classification of Functioning, Disability and Health (ICF) domains that can influence shoulder pain and disability.Simple Shoulder Test seems to be the most recommended shoulder-specific PROM considering the number of domains covered by the ICF and the clinical evaluation time consumption.Shoulder Pain and Disability Index fails to provide a broader view of functioning through other ICF domains that may influence shoulder pain and disability.
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Affiliation(s)
- Lucas Araújo de Almeida
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Natalia Duarte Pereira
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, Brazil
- Department of Physical Therapy, Functionality and Technological Innovation in Neuro Rehabilitation Group - GFIT, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Melina Nevoeiro Haik
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Paula Rezende Camargo
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, Brazil
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Zhong Z, Zang W, Tang Z, Pan Q, Yang Z, Chen B. Effect of scapular stabilization exercises on subacromial pain (impingement) syndrome: a systematic review and meta-analysis of randomized controlled trials. Front Neurol 2024; 15:1357763. [PMID: 38497039 PMCID: PMC10940535 DOI: 10.3389/fneur.2024.1357763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/14/2024] [Indexed: 03/19/2024] Open
Abstract
Objective To evaluate the effectiveness of scapular stabilization exercises (SSE) in the treatment of subacromial pain syndrome (SAPS). Methods Clinical randomized controlled trials (RCTs) on SSE in the treatment of SAPS were searched electronically in PubMed, Science Direct, Cochrane Central Register of Controlled Trials (CENTRAL), EBSCOhost, Physiotherapy Evidence Database (PEDro), Web of Science, and other databases from 2000 to 2022, supplemented by manual search. Final RCTs were selected based on inclusion and exclusion criteria, and the Physiotherapy Evidence Database scale was used to evaluate the methodological quality of the study. A meta-analysis was conducted on data using the RevMan5.4 software. Results Eight RCTs involving 387 participants were included. The meta-analysis showed that the experimental group (SSE) had greater improvements in the Visual Analog Scale score [Weighted Mean Difference (WMD) = -0.94, 95% CI (-1.23, -0.65), p < 0.001] and the Shoulder Pain and Disability Index score [WMD = -10.10, 95% CI (-18.87, -1.33), p = 0.02] than the control group (conventional physical therapy). However, range of motion (ROM) was not found to be greater in the experimental group than in the control group. Conclusion Existing evidence moderately supports the efficacy of SSE for reducing pain and improving function in SAPS, without significant improvement in ROM. Future research should focus on larger, high-quality, standardized protocols to better understand SSE's effects across diverse SAPS populations, treatment, and outcome measures. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=307437, CRD42022307437.
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Affiliation(s)
- Ziyi Zhong
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Wanli Zang
- Postgraduate School, Harbin Sport University, Harbin, China
| | - Ziyue Tang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qiaodan Pan
- School of Medicine, Tongji University, Shanghai, China
| | - Zhen Yang
- Department of Movement Sciences, KU Leuven-University of Leuven, Leuven, Belgium
| | - Bin Chen
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
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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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Rugg B, Khondoker M, Chester R. Shoulder pain: Is the outcome of manual therapy, acupuncture and electrotherapy different for people with high compared to low pain self-efficacy? An analysis of effect moderation. Shoulder Elbow 2023; 15:680-688. [PMID: 38028933 PMCID: PMC10656971 DOI: 10.1177/17585732221105562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/20/2022] [Indexed: 12/01/2023]
Abstract
Background High baseline pain self-efficacy (PSE) predicts a better outcome for people attending physiotherapy for musculoskeletal shoulder pain. A potential contributing factor is that PSE moderates the relationship between some treatment modalities and outcome. Our aim was to investigate whether there is a difference in outcome between participants with high compared to low PSE receiving manual therapy, acupuncture, and electrotherapy. Methods Participants were stratified into high or low baseline (i) PSE, (ii) shoulder pain and disability index (SPADI), and (iii) did or did not receive the treatment. Whether the effect of treatment differs for people with high compared to low PSE was assessed using the 95% confidence interval of the difference of difference (DoD) at a 5% significance level (p < 0.05). Results Six-month SPADI scores were consistently lower (less pain and disability) for those who did not receive passive treatments compared to those who did (statistically significant less pain and disability in 7 of 24 models). However, DoD was statistically insignificant. Conclusion PSE did not moderate the relationship between treatment and outcome. However, participants who received passive treatment experienced equal or more pain and disability at 6 months compared to those who did not. Results are subject to confounding by indication but do indicate the need for further appropriately designed research. Level of Evidence Level of evidence II-b.
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Affiliation(s)
- Bradley Rugg
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk NR4 7TJ, UK
- Physiotherapy Department, The Clementine Churchill Hospital, Sudbury Hill, Harrow, HA1 3RX, UK
| | - Mizanur Khondoker
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk NR4 7TJ, UK
| | - Rachel Chester
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk NR4 7TJ, UK
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Lucha-López MO, Hidalgo-García C, Monti-Ballano S, Márquez-Gonzalvo S, Krauss J, Tricás-Vidal HJ, Tricás-Moreno JM. Diacutaneous Fibrolysis: An Update on Research into Musculoskeletal and Neural Clinical Entities. Biomedicines 2023; 11:3122. [PMID: 38137343 PMCID: PMC10741169 DOI: 10.3390/biomedicines11123122] [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: 11/10/2023] [Revised: 11/18/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
Diacutaneous Fibrolysis (DF) is an instrumentally assisted manual therapy technique defined as "a specific instrumental intervention for normalizing the musculoskeletal system function after a precise diagnosis and preserving the skin's integrity". The aim of this technique is soft tissue mobilization with the assistance of specially designed, hook-shaped steel instruments in different musculoskeletal structures, such as the myofascia, aponeurosis, tendons, ligaments and scar tissues. Due to discrepant results between previous reviews and the quite abundant new evidence provided by recently published randomized clinical trials, we propound this narrative review to provide an update on the scientific evidence related to the fundamentals and clinical efficacy of DF. Current evidence primarily supports the mechanical effect of DF on connective soft tissues. Diminished deep tendon reflex and rigidity have been registered after the implementation of DF in healthy subjects. Though there is still much to uncover, scientific evidence supports the use of the technique for the clinical treatment of subacromial impingement syndrome, chronic lateral epicondylalgia, chronic patellofemoral pain syndrome, mild to moderate carpal tunnel syndrome, hamstring shortening, temporomandibular disorders, tension-type headache and chronic low back pain. Additional data are essential for better recommendations in the clinical practice of DF.
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Affiliation(s)
- María Orosia Lucha-López
- Unidad de Investigación en Fisioterapia, Spin off Centro Clínico OMT-E Fisioterapia SLP, Universidad de Zaragoza, Domingo Miral s/n, 50009 Zaragoza, Spain; (S.M.-B.); (S.M.-G.); (H.J.T.-V.); (J.M.T.-M.)
| | - César Hidalgo-García
- Unidad de Investigación en Fisioterapia, Spin off Centro Clínico OMT-E Fisioterapia SLP, Universidad de Zaragoza, Domingo Miral s/n, 50009 Zaragoza, Spain; (S.M.-B.); (S.M.-G.); (H.J.T.-V.); (J.M.T.-M.)
| | - Sofía Monti-Ballano
- Unidad de Investigación en Fisioterapia, Spin off Centro Clínico OMT-E Fisioterapia SLP, Universidad de Zaragoza, Domingo Miral s/n, 50009 Zaragoza, Spain; (S.M.-B.); (S.M.-G.); (H.J.T.-V.); (J.M.T.-M.)
| | - Sergio Márquez-Gonzalvo
- Unidad de Investigación en Fisioterapia, Spin off Centro Clínico OMT-E Fisioterapia SLP, Universidad de Zaragoza, Domingo Miral s/n, 50009 Zaragoza, Spain; (S.M.-B.); (S.M.-G.); (H.J.T.-V.); (J.M.T.-M.)
| | - John Krauss
- School of Health Sciences, Oakland University, Rochester, MI 48309, USA;
| | - Héctor José Tricás-Vidal
- Unidad de Investigación en Fisioterapia, Spin off Centro Clínico OMT-E Fisioterapia SLP, Universidad de Zaragoza, Domingo Miral s/n, 50009 Zaragoza, Spain; (S.M.-B.); (S.M.-G.); (H.J.T.-V.); (J.M.T.-M.)
| | - José Miguel Tricás-Moreno
- Unidad de Investigación en Fisioterapia, Spin off Centro Clínico OMT-E Fisioterapia SLP, Universidad de Zaragoza, Domingo Miral s/n, 50009 Zaragoza, Spain; (S.M.-B.); (S.M.-G.); (H.J.T.-V.); (J.M.T.-M.)
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Wörner T, Sirard P, Nero H, Hörder H, Misini Ignjatovic M, Eek F. Changes in pain and disability in patients with shoulder pain after three months of digitally delivered exercise and patient education. J Rehabil Med 2023; 55:jrm9415. [PMID: 38835146 PMCID: PMC10658804 DOI: 10.2340/jrm.v55.9415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 10/09/2023] [Indexed: 06/06/2024] Open
Abstract
OBJECTIVE To describe and examine potential predictors of changes in pain and disability in patients with shoulder pain who have completed 3 months of digitally delivered treatment comprising exercise and patient education. DESIGN Retrospective cohort study (clinicaltrials.org Nr: NCT05402514). SUBJECTS Patients with shoulder pain who completed treatment (n = 682). METHODS Primary outcome was change in shoulder pain (numerical rating scale 0-10; minimal clinical important change: at least 2 points). Pain and disability were reported on the Shoulder Pain and Disability Index. Changes in outcomes were analysed with paired sample t-tests. Association with potential predictors (sex, age, education, body mass index, physical activity, symptom duration, baseline pain/function, and treatment adherence) were explored with linear regression models Results: Statistically significant improvements were found for all treatment outcomes. Minimal clinically important change in pain was reached by 54.5% (n = 372). Higher baseline level of symptoms, short symptom duration, and high treatment adherence were associated with greater changes. CONCLUSION Patients with shoulder pain reported significant reductions in pain and disability following treatment, but the clinical relevance of the improvements has not been confirmed. Satisfactory treatment adherence, higher baseline pain and shorter symptom duration predicted larger improvements. A control group is needed to evaluate the actual effect of the treatment.
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Affiliation(s)
- Tobias Wörner
- Department of Health Sciences, Lund University, Lund, Sweden.
| | | | - Håkan Nero
- Department of Clinical Sciences, Orthopedics, Lund University, Lund, Sweden
| | - Helena Hörder
- Department of Clinical Sciences, Orthopedics, Lund University, Lund, Sweden
| | | | - Frida Eek
- Department of Health Sciences, Lund University, Lund, Sweden
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Karanasios S, Baglatzis G, Lignos I, Billis E. Manual Therapy and Exercise Have Similar Outcomes to Corticosteroid Injections in the Management of Patients With Subacromial Pain Syndrome: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e48907. [PMID: 38111394 PMCID: PMC10726085 DOI: 10.7759/cureus.48907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2023] [Indexed: 12/20/2023] Open
Abstract
Subacromial pain syndrome (SAPS) is the most frequent diagnosis in patients with shoulder pain presenting with persistent pain and significant functional decline. Although exercise and manual therapy (EMT) and corticosteroid injections provide first-line treatment options, evidence for the best management of SAPS remains inconclusive. We aimed to evaluate the effectiveness of EMT compared with corticosteroid injections on disability, recovery rates, and pain in patients with SAPS through a systematic review and meta-analysis approach. PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), ScienceDirect, the Cochrane Library, and grey literature databases were searched. Only randomized controlled trials evaluating the effectiveness of EMT alone or as an additive intervention compared to corticosteroid injections were included. Methodological quality was evaluated with the PEDro score and certainty of evidence with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. In total, 8 trials with 946 patients were included. EMT presented no difference in disability compared with corticosteroid injections at very short- (standardized mean difference {SMD}: 0.19; 95%CI: -0.20, 0.58), short- (SMD: -0.16; 95%CI: -0.58, 0.25), mid- (SMD: -0.14; 95%CI: -0.44, 0.16), and long-term (SMD: 0.00; 95%CI: -0.25, 0.25) follow-up. No difference was found between the comparators in self-perceived recovery at very short- (risk ratio: 0.93; 95%CI: 0.71, 1.21) and mid- (risk ratio: 0.98; 95%CI: 0.90, 1.07) follow-up and in pain rating at very short- (SMD: -0.18; 95%CI: -0.73, 0.38), short- (SMD: 0.05; 95%CI: -0.26, 0.37), and long-term (SMD: 0.04; 95%CI: -0.26, 0.34) follow-ups. The addition of corticosteroid injections to EMT provided no better results in shoulder disability compared with EMT (SMD: 0.45; 95%CI: -0.47, 1.37) or corticosteroid injections alone (MD: 2.70; 95%CI: -7.70, 13.10) in the mid-term. Based on very low to moderate certainty of evidence, EMT has similar effects to corticosteroid injections on improving all outcomes in patients with SAPS at all follow-up periods. Based on low certainty of evidence the combination of both interventions does not change the treatment outcome compared with each intervention alone.
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Affiliation(s)
| | | | - Ioannis Lignos
- Department of Physiotherapy, University of Patras, Patras, GRC
| | - Evdokia Billis
- Department of Physiotherapy, University of Patras, Patras, GRC
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Kamonseki DH, Haik MN, Ribeiro LP, Almeida RF, Camargo PR. Scapular movement training is not superior to standardized exercises in the treatment of individuals with chronic shoulder pain and scapular dyskinesis: randomized controlled trial. Disabil Rehabil 2023; 45:2925-2935. [PMID: 36000960 DOI: 10.1080/09638288.2022.2114552] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 08/06/2022] [Accepted: 08/13/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To investigate whether scapular movement training (SMT) is superior to standardized exercises in improving scapular biomechanics, behavioral, and clinical aspects of individuals with shoulder pain. METHODS AND METHODS A total of 64 individuals with chronic shoulder pain were randomly assigned to receive 16 sessions of SMT or SE over 8 weeks. Outcome measures included three-dimensional scapular kinematics, muscle activity of scapulothoracic muscles, pain, disability, fear-avoidance, kinesiophobia, and self-perceived changes. Kinematics and muscle activity were assessed at baseline and after treatment, and self-reported measurements at baseline, 4, 8, and 12 weeks. RESULTS SMT significantly (p < 0.05) decreased scapular internal rotation during arm elevation and lowering at sagittal and scapular planes (mean difference [MD]: ranged from 2.8 to 4.1°), and at lower angles of arm elevation and lowering at the frontal plane (MD: 3.4° and 2.4°, respectively), increased upper trapezius (UT) activity (MD: 10.3%) and decreased middle trapezius (MT) (MD: 60.4%) and serratus anterior (MD: 9.9%) activity during arm lowering compared to SE. Both groups significantly improved pain, disability, fear-avoidance, kinesiophobia, and self-perceived changes over 4 weeks, which was sustained over the remaining 8 weeks. CONCLUSIONS SMT is not superior to standardized exercises in improving scapular biomechanics, behavioral, and clinical aspects of individuals with shoulder pain. CLINICAL TRIAL REGISTRATION NUMBER NCT03528499Implications for rehabilitationScapular movement training (SMT) showed small and likely not clinically relevant changes in scapular kinematics and muscle activity compared to standardized exercises.SMT and standardized exercises presented similar improvements in pain, disability, fear-avoidance beliefs, kinesiophobia, and self-perceived change in health condition immediately following 4-weeks of treatment, which was sustained over the following 8 weeks.The changes in patient-reported outcome measures are unlikely to be associated with changes in scapular kinematics and electromyographic activity.Clinicians should consider other factors than scapular movement during the treatment of patients with shoulder pain.
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Affiliation(s)
- Danilo Harudy Kamonseki
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Melina Nevoeiro Haik
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Larissa Pechincha Ribeiro
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Rafaela Firmino Almeida
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Paula Rezende Camargo
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, Brazil
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Hui SSC, Liu J, Yang YJ, Wan JHP, Suen BKP. Yi Jin Bang exercise versus usual exercise therapy to treat subacromial pain syndrome: a pilot randomised controlled trial. Res Sports Med 2023; 31:846-858. [PMID: 35287501 DOI: 10.1080/15438627.2022.2052070] [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: 01/21/2022] [Accepted: 02/14/2022] [Indexed: 10/18/2022]
Abstract
To evaluate the effect of Yi Jin Bang (YJB) exercise on pain, disability, flexibility, and muscular endurance in individuals with subacromial pain syndrome (SAPS). Fifty-four adults with SAPS were randomly allocated into either a YJB (n = 18), a usual exercise therapy (UET; n = 18), or a control group (n = 18). YJB and UET interventions involved 10 weeks of home-based exercise training, with four sessions per week. The control group received no treatment. Outcome measures included Shoulder Pain and Disability Index (SPADI), pain at rest and during activity, flexion and abduction range of motion (ROM), back scratch test, and shoulder abduction endurance test. These measures were assessed at baseline, immediately after a single face-to-face session (acute effects), and after 10 weeks of intervention (chronic effects). For acute effects, significant group-by-time interactions were observed for flexion ROM, abduction ROM, and the back scratch test (all p < 0.05). For chronic effects, significant group-by-time interactions were found for pain during activity, the SPADI score, and the back scratch test (all p < 0.05). Home-based YJB exercise is comparable to home-based UET in reducing pain and disability and improving flexibility.
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Affiliation(s)
- Stanley Sai-Chuen Hui
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jinde Liu
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Yi-Jian Yang
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - James Ho-Pong Wan
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong
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Zhou XC, Huang YB, Liu Z, Wu HJ, Huang HZ, Tian Y, Hong SW, Hu HJ, Lv LJ, Lv ZZ. Bibliometric Analysis of Functional Magnetic Resonance Imaging Studies on Manual Therapy Analgesia from 2002-2022. J Pain Res 2023; 16:2115-2129. [PMID: 37361428 PMCID: PMC10289250 DOI: 10.2147/jpr.s412658] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/13/2023] [Indexed: 06/28/2023] Open
Abstract
Background Research on the brain mechanisms underlying manual therapy (MT)-induced analgesia has been conducted worldwide. However, no bibliometric analysis has been performed on functional magnetic resonance imaging (fMRI) studies of MT analgesia. To provide a theoretical foundation for the practical application of MT analgesia, this study examined the current incarnation, hotspots, and frontiers of fMRI-based MT analgesia research over the previous 20 years. Methods All publications were obtained from the Science Citation Index-Expanded (SCI-E) of Web of Science Core Collection (WOSCC). We used CiteSpace 6.1.R3 to analyze publications, authors, cited authors, countries, institutions, cited journals, references, and keywords. We also evaluated keyword co-occurrences and timelines, and citation bursts. The search was conducted from 2002-2022 and was completed within one day on October 7, 2022. Results In total, 261 articles were retrieved. The total number of annual publications showed a fluctuating but overall increasing trend. Author B. Humphreys had the highest number of publications (eight articles) and J. E. Bialosky had the highest centrality (0.45). The United States of America (USA) was the country with the most publications (84 articles), accounting for 32.18% of all publications. Output institutions were mainly the University of Zurich, University of Switzerland, and the National University of Health Sciences of the USA. The Spine (118) and the Journal of Manipulative and Physiological Therapeutics (80) were most frequently cited. The four hot topics in fMRI studies on MT analgesia were "low back pain", "magnetic resonance imaging", "spinal manipulation", and "manual therapy." The frontier topics were "clinical impacts of pain disorders" and "cutting-edge technical capabilities offered by magnetic resonance imaging". Conclusion fMRI studies of MT analgesia have potential applications. fMRI studies of MT analgesia have linked several brain areas, with the default mode network (DMN) garnering the most attention. Future research should include international collaboration and RCTs on this topic.
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Affiliation(s)
- Xing-Chen Zhou
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Yu-Bo Huang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Zhen Liu
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Hong-Jiao Wu
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Hua-Zhi Huang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Yu Tian
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Shuang-Wei Hong
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Hui-Jie Hu
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Li-Jiang Lv
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Zhi-Zhen Lv
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
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Liu J, Hui SSC, Yang Y, Liu Y, Song Q, Mao D. Scapular kinematics and muscle activity during Yi Jin Bang exercises. Front Physiol 2023; 14:1169092. [PMID: 37362425 PMCID: PMC10285390 DOI: 10.3389/fphys.2023.1169092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 05/31/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction: Scapular dyskinesis is commonly associated with subacromial pain syndrome (SAPS). Addressing scapular dyskinesis is widely accepted as an important component of shoulder rehabilitation. Our previous randomized controlled trial showed that Yi Jin Bang (YJB) exercises could effectively manage SAPS, but scapular motions and muscle activity during YJB exercises remain unknown. This study examined scapular kinematics synchronously with scapular muscle activation during YJB exercises. Methods: Thirty healthy participants with no shoulder complaints were enrolled in this study. Three-dimensional (3D) scapular kinematics and electromyography (EMG) activation of the upper trapezius, middle trapezius, lower trapezius, serratus anterior, anterior deltoid, middle deltoid, and posterior deltoid were synchronously measured during nine YJB movements. Results: During all YJB movements, the scapula was upwardly rotated and anteriorly tilted, with more upward rotation and a similar or less anterior tilt than the mean resting scapular angle. Column rotation, arm crossover, shoulder support circle, and armpit support high lift generated more internal rotation than the mean resting scapular angle, with the angles of internal rotation significantly greater than the other five movements (p < 0.001). Regarding EMG activity, all YJB movements elicited low activity (1.42%-19.19% maximal voluntary isometric contraction [MVIC]) from the upper trapezius and posterior deltoid and low to moderate activity (0.52%-29.50% MVIC) from the middle trapezius, lower trapezius, serratus anterior, anterior deltoid, and middle deltoid. Conclusion: YJB exercises could be useful in the middle to later phases of shoulder rehabilitation. For patients with insufficient external rotation, some YJB movements should be prescribed with caution.
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Affiliation(s)
- Jinde Liu
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Stanley Sai-chuen Hui
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Yijian Yang
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Yanhao Liu
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Qipeng Song
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Dewei Mao
- College of Sports and Health, Shandong Sport University, Jinan, China
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Valenza-Peña G, Martín-Núñez J, Heredia-Ciuró A, Granados-Santiago M, López-López L, Valenza MC, Cabrera-Martos I. Relationship between Pain Intensity, Physical Factors, Pronociceptive Pain Modulation Profile and Psychological Vulnerability on Upper Limb Disability in Older Patients with Chronic Shoulder Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15006. [PMID: 36429726 PMCID: PMC9690165 DOI: 10.3390/ijerph192215006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/11/2022] [Accepted: 11/13/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Chronic shoulder pain is a very prevalent condition causing disability and functional impairment. The purpose of the study was to evaluate the relationship between pain intensity, physical variables, psychological vulnerability, pronociceptive pain modulation profile and disability in older people with chronic shoulder pain. METHODS A cross-sectional study was carried out. A total of 56 participants with non-specific chronic shoulder pain of the "Complejo Hospitalario Universitario" (Granada) and 56 healthy controls were included. The outcomes evaluated were pain intensity (visual analogue scale), physical factors (dynamometry for grip strength), psychological vulnerability (Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia), pronociceptive pain modulation profile (pain pressure algometry) and disability (Quick Disability Arm Shoulder Hand questionnaire). RESULTS Disability showed a positive correlation with pain and psychological vulnerability (p < 0.05) and a negative correlation with pronociceptive pain variables and dynamometry (p < 0.001). Psychological vulnerability also presented a strong negative correlation with proprioceptive pain variables and dynamometry and a positive correlation with pain (p < 0.05). In regard to the pronociceptive pain modulation profile, a strong negative correlation with pain (p < 0.001) and a positive moderate correlation with dynamometry (p < 0.001) were shown. CONCLUSIONS Our results support a strong association between disability, psychological vulnerability and pronociceptive pain modulation profile in older adults with chronic shoulder pain.
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Affiliation(s)
- Geraldine Valenza-Peña
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | - Javier Martín-Núñez
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | - Alejandro Heredia-Ciuró
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | - María Granados-Santiago
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18001 Granada, Spain
| | - Laura López-López
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | - Marie Carmen Valenza
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | - Irene Cabrera-Martos
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
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25
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Ferenczi A, Ostertag A, Lasbleiz S, Lefèvre C, Petrover D, Yelnik A, Orcel P, Beaudreuil J. Value of a clinical test of sub-acromial impingement to predict response to physiotherapy with dynamic humeral centering: A preliminary study. J Back Musculoskelet Rehabil 2022; 35:1119-1124. [PMID: 35342077 DOI: 10.3233/bmr-210214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Dynamic humeral centering (DHC) is a physiotherapy modality that aims to prevent sub-acromial impingement of rotator cuff tendons. We recently developed a new clinical manoeuver - the Viggo-Cochin test - to enhance the ability of the Neer test to detect sub-acromial impingement. Here we hypothesised whether the DHC effect may differ between individuals with positive and negative Viggo-Cochin test results. OBJECTIVE To assess the association between DHC and Viggo-Cochin test results. METHODS Individuals with shoulder pain due to sub-acromial impingement underwent the Neer and Viggo-Cochin tests at baseline. They were assessed before and after DHC by the Shoulder Pain and Disability Index (SPADI). A positive response to DHC was defined as a 20% reduction in the SPADI. RESULTS We included 50 individuals (53 shoulders). The response to DHC did not differ by Neer test result at baseline: OR 0.73 [95% CI 0.22-2.38] (p= 0.601). By contrast, the response to DHC was 5-fold higher with a positive than negative Viggo-Cochin test result: OR 5.11 [95% CI 1.47-17.78] (p= 0.010). CONCLUSIONS We found a higher clinical response to DHC with a positive than negative Viggo-Cochin test result at baseline in individuals with shoulder pain due to rotator cuff disease.
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Affiliation(s)
- Antoine Ferenczi
- Service de Médecine Physique et de Réadaptation, Hôpital Lariboisière-Fernand-Widal, Département Médico-Universitaire Locomotion, AP-HP, Université Paris Cité, Paris, France
| | - Agnès Ostertag
- Service de Rhumatologie, Hôpital Lariboisière-Fernand-Widal, Département Médico-Universitaire Locomotion, AP-HP, Université Paris Cité, Paris, France
| | - Sandra Lasbleiz
- Service de Rhumatologie, Hôpital Lariboisière-Fernand-Widal, Département Médico-Universitaire Locomotion, AP-HP, Université Paris Cité, Paris, France
| | - Clémence Lefèvre
- Service de Rhumatologie, Hôpital Lariboisière-Fernand-Widal, Département Médico-Universitaire Locomotion, AP-HP, Université Paris Cité, Paris, France
| | - David Petrover
- Service de Rhumatologie, Hôpital Lariboisière-Fernand-Widal, Département Médico-Universitaire Locomotion, AP-HP, Université Paris Cité, Paris, France
| | - Alain Yelnik
- Service de Médecine Physique et de Réadaptation, Hôpital Lariboisière-Fernand-Widal, Département Médico-Universitaire Locomotion, AP-HP, Université Paris Cité, Paris, France
| | - Philippe Orcel
- Service de Rhumatologie, Hôpital Lariboisière-Fernand-Widal, Département Médico-Universitaire Locomotion, AP-HP, Université Paris Cité, Paris, France
| | - Johann Beaudreuil
- Service de Médecine Physique et de Réadaptation, Hôpital Lariboisière-Fernand-Widal, Département Médico-Universitaire Locomotion, AP-HP, Université Paris Cité, Paris, France
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26
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Çelik MS, Sönmezer E, Acar M. Effectiveness of proprioceptive neuromuscular facilitation and myofascial release techniques in patients with subacromial impingement syndrome. Somatosens Mot Res 2022; 39:97-105. [PMID: 34991428 DOI: 10.1080/08990220.2021.2018293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE To compare the effectiveness of proprioceptive neuromuscular facilitation and myofascial release technique in patients with subacromial impingement syndrome on pain, range of motion, muscle strength, quality of life, functionality and disability. METHODS Thirty patients were randomly divided into two groups: proprioceptive neuromuscular facilitation group (n = 15) and proprioceptive neuromuscular facilitation combined with myofascial release technique group (n = 15). Both treatment methods were performed 3 times a week for 4 weeks. Pain severity was assessed by Visuel Analog Scale, range of motion by a goniometer, muscle strength by digital hand dynamometer, quality of life by Nottingham health profile, functionality by arm, shoulder and hand problems questionnaire, disability by shoulder pain and disability index. All measurements were used before and after treatments. Pain severity, range of motion and muscle strength were also evaluated after the first session. RESULTS After the treatment, shoulder pain, range of motion, muscle strength, functionality and disability were improved in two groups (p < 0.05). Proprioceptive neuromuscular facilitation showed improvement in pain, whereas myofascial release technique improved pain, physical activity, emotional state, sleep and total dimensions of life quality (p < 0.05). Proprioceptive neuromuscular facilitation was more effective in reducing activity pain, whereas myofascial release technique was more effective in increasing flexion, external and internal rotation range of motion, flexion and abduction muscle strength after the first session (p < 0.05). CONCLUSIONS The combined application of proprioceptive neuromuscular facilitation and myofascial release technique has a more acute and cumulative positive effect on pain, range of motion, muscle strength, functionality, disability and quality of life in patients with subacromial impingement syndrome.
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Affiliation(s)
- Merve Sinem Çelik
- Physiotherapy and Rehabilitation Department, Baskent University Hospital, Ankara, Turkey
| | - Emel Sönmezer
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Atilim University, Ankara, Turkey
| | - Manolya Acar
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Baskent University, Ankara, Turkey
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de Oliveira AKA, da Costa KSA, de Lucena GL, de Oliveira Sousa C, Filho JFM, Brasileiro JS. Comparing exercises with and without electromyographic biofeedback in subacromial pain syndrome: A randomized controlled trial. Clin Biomech (Bristol, Avon) 2022; 93:105596. [PMID: 35183878 DOI: 10.1016/j.clinbiomech.2022.105596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 02/07/2022] [Accepted: 02/10/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Deficits in movement and muscle activation of scapulohumeral joint are related to Subacromial Pain Syndrome. Electromyography biofeedback during exercise may enhance muscle activation and coordination, and consequently improve pain and shoulder function. METHODS This study compared the effects of an exercise protocol with and without using electromyographic biofeedback on pain, function and movement of the shoulder complex in subjects with Subacromial Pain Syndrome. A total of 24 patients with subacromial pain (mean age = 46.2 + 8.1;18 women) were randomized to either therapeutic exercise or exercise plus biofeedback to the trapezius and serratus muscles. Pain and shoulder function were evaluated as the primary outcome and range of motion, muscle strength, electromyographic activity and scapulohumeral kinematics as secondary outcomes. The subjects underwent eight weeks of intervention and comparisons were made between groups in baseline, at 4 weeks, 8 weeks, and at 4 weeks post intervention. FINDINGS There were differences between groups for pain [mean difference = 1.5 (CI 0.3, 3.2) p = 0.01] at 8 weeks in the Exercise group and scapular upward rotation at 60° of arm elevation [mean difference = 13.9 (CI 0.9, 9.3), p = 0.006] in the Biofeedback group. There was no difference for the other variables of scapular kinematics as well as for shoulder function (DASH), muscle strength, range of motion and electromyographic variables. INTERPRETATION The addition of Biofeedback to the exercise protocol increased upward rotation of the scapula. However, the volunteers who performed only the Exercises had a better response in reducing pain.
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Affiliation(s)
- Araken Kleber Azevedo de Oliveira
- Universidade Federal do Rio Grande do Norte, Departamento de Fisioterapia, Campus Universitário Lagoa Nova, CEP 59078-970, Natal/RN, Brazil
| | - Karinna Sonálya Aires da Costa
- Universidade Federal do Rio Grande do Norte, Departamento de Fisioterapia, Campus Universitário Lagoa Nova, CEP 59078-970, Natal/RN, Brazil
| | - Gildásio Lucas de Lucena
- Universidade Federal do Rio Grande do Norte, Departamento de Fisioterapia, Campus Universitário Lagoa Nova, CEP 59078-970, Natal/RN, Brazil
| | - Catarina de Oliveira Sousa
- Universidade Federal do Rio Grande do Norte, Departamento de Fisioterapia, Campus Universitário Lagoa Nova, CEP 59078-970, Natal/RN, Brazil
| | - João Felipe Medeiros Filho
- Universidade Federal do Rio Grande do Norte, Departamento de Fisioterapia, Campus Universitário Lagoa Nova, CEP 59078-970, Natal/RN, Brazil
| | - Jamilson Simões Brasileiro
- Universidade Federal do Rio Grande do Norte, Departamento de Fisioterapia, Campus Universitário Lagoa Nova, CEP 59078-970, Natal/RN, Brazil.
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Gava V, Ribeiro LP, Barreto RPG, Camargo PR. Effectiveness of physical therapy given by telerehabilitation on pain and disability of individuals with shoulder pain: A systematic review. Clin Rehabil 2022; 36:715-725. [PMID: 35230167 DOI: 10.1177/02692155221083496] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To systematically review the effects of physical therapy given by telerehabilitation on pain and disability in individuals with shoulder pain. DATA SOURCES PubMed, Embase, CINAHL, LILACS, Cochrane, Web of Science, SCOPUS, SciELO and Ibecs were searched in January/2022. METHODS This systematic review followed PRISMA guidelines. Randomized controlled trials investigating the effects of physical therapy given by telerehabilitation on pain and disability in patients with shoulder pain were included. The quality and level of the evidence were assessed with the Cochrane Risk of Bias tool and GRADE, respectively. The effect sizes of the main outcomes were also calculated. RESULTS Six randomized controlled trials were included with a total sample of 368 patients with shoulder pain. Four and two randomized controlled trials were assessed as low and high risk of bias, respectively. Three randomized controlled trials assessed shoulder post-operative care, two assessed chronic shoulder pain, and one assessed frozen shoulder. Very low to low evidence suggests that there is no difference between telerehabilitation and in-person physical therapy or home-based exercises programs to improve pain and disability in patients with shoulder pain. Low evidence suggests that telerehabilitation is superior to advice only to improve shoulder pain (effect size: 2.42; 95% Confidence Interval: 1.72, 3.06) and disability (effect size: 1.61; 95% Confidence Interval: 1.01, 2.18). CONCLUSIONS Although telerehabilitation may be a promising tool to treat patients with shoulder pain and disability, the very low to low quality of evidence does not support a definite recommendation of its use in this population.
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Affiliation(s)
- Vander Gava
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, 67828Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Larissa Pechincha Ribeiro
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, 67828Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | | | - Paula Rezende Camargo
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, 67828Universidade Federal de São Carlos, São Carlos, SP, Brazil
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29
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Gava V, Rosa DP, Pereira ND, Phadke V, Camargo PR. Ratio between 3D glenohumeral and scapulothoracic motions in individuals without shoulder pain. J Electromyogr Kinesiol 2021; 62:102623. [PMID: 34979438 DOI: 10.1016/j.jelekin.2021.102623] [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: 02/23/2021] [Revised: 11/25/2021] [Accepted: 11/30/2021] [Indexed: 10/19/2022] Open
Abstract
This study determined the ratio between glenohumeral and three-dimensional scapular motion during arm elevation and lowering in 91 individuals without shoulder pain. Scapular kinematics were assessed using an electromagnetic tracking device. Individuals performed 3 repetitions of elevation and lowering of the arm in the sagittal plane. Two-way ANOVAs (interval: 30-60°, 60-90°, 90-120° x phase: elevation and lowering) and paired t-tests were used for data analysis. For scapular internal/external rotation, lesser scapular internal rotation contribution was found during the 60-90° interval as compared to the 90-60° interval. Lesser scapular external rotation was identified in the 60-30° interval of arm lowering. The ratio was greater during arm elevation (1.89) compared to lowering (1.74) across the entire motion arc. For scapular upward rotation, greater upward rotation contribution was observed during arm elevation at the 30-60° interval, and less scapular downward rotation contribution in the final range of arm lowering. For scapular tilt, lesser scapular posterior tilt contribution during arm elevation was observed compared to arm lowering. The ratios between glenohumeral elevation/lowering and each individual scapulothoracic motion showed either differences between intervals and/or between elevation and lowering during specific intervals in healthy individuals.
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Affiliation(s)
- Vander Gava
- Department of Physical Therapy, Universidade Federal de São Carlos, Rodovia Washington Luis km 235, São Carlos, SP 13565-905, Brazil
| | - Dayana Patricia Rosa
- Department of Physical Therapy, Universidade Federal de São Carlos, Rodovia Washington Luis km 235, São Carlos, SP 13565-905, Brazil
| | - Natalia Duarte Pereira
- Department of Physical Therapy, Universidade Federal de São Carlos, Rodovia Washington Luis km 235, São Carlos, SP 13565-905, Brazil
| | - Vandana Phadke
- Department of Clinical Research, Indian Spinal Injuries Center, Vasant Kunj, New Delhi 110070, India
| | - Paula Rezende Camargo
- Department of Physical Therapy, Universidade Federal de São Carlos, Rodovia Washington Luis km 235, São Carlos, SP 13565-905, Brazil.
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30
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Leggit JC, Wu H, Janvrin M, Korona-Bailey J, Koehlmoos TP, Schneider EB. Non-Operative Shoulder Dysfunction in the United States Military. Mil Med 2021; 188:e1003-e1009. [PMID: 34865115 DOI: 10.1093/milmed/usab468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/14/2021] [Accepted: 10/27/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Recent epidemiological evidence shows that shoulder and upper-arm complaints impose a substantial burden on the armed forces of the United States and create significant challenges for all components of the physical fitness domain of total force fitness. Clinicians, epidemiologists, and health-services researchers interested in shoulder and upper-arm injuries and their functional limitations rarely have objective, validated criteria for rigorously evaluating diagnostic practices, prescribed treatments, or the outcomes of alternative approaches. We sought to establish and quantify patient volume, types of care, and costs within the Military Health System (MHS) in assessing and managing active duty members with nonoperative shoulder and upper-arm dysfunction. MATERIALS AND METHODS We performed a retrospective cohort study using data from the MHS Data Repository and MHS MART (M2) from fiscal year 2014 to identify active duty individuals with a diagnosis of shoulder and upper-arm injury or impairment defined by one of the International Classification of Disease Ninth Edition diagnosis codes that were selected to reflect nonoperative conditions such as fractures or infections. Statistical analyses include descriptive statistics on patient demographics and clinical visits, such as the range and frequency of diagnoses, number and types of appointments, and clinical procedure information following the diagnosis. We also examined treatment costs related to shoulder dysfunction and calculated the total cost to include medications, radiological, procedural, and laboratory test costs for all shoulder dysfunction visits in 2014 and the average cost for each visit. We further examined the category of each medication prescribed. RESULTS A total of 55,643 individuals met study criteria and accrued 193,455 shoulder-dysfunction-related clinical visits in fiscal year 2014. This cohort represents approximately 4.8% of the 1,155,183 active duty service members assigned to the United States and its territories during FY 2014. Most patients were male (85.32%), younger (85.25% were under 40 years old), and Caucasian/White (71.12%). The most common diagnosis code was 719.41 (pain in joint, shoulder region; 42.48%). The majority of the patients 42,750 (76.8%) had four or fewer medical visits during the study period and 12,893 (23.2%) had more than four visits. A total of 4,733 patients (8.5%) underwent arthrocentesis aspiration or injection. The total cost for all visits was $65,066,767.89. The average and median cost for each visit were $336.34 (standard deviation was $1,493.87) and $163.11 (range was from 0 to $84,183.88), respectively. Three out of four patients (75.3%) underwent radiological examinations, and 74.2% of these individuals had more than one radiological examination. Medications were prescribed to 50,610 (91.0%) patients with the three most common being IBUPROFEN (12.21%), NAPROXEN (8.51%), and OXYCODONE-ACETAMINOPHEN (5.04%), respectively. CONCLUSIONS Nearly 1 in 20 active duty military service members presented for nonoperative care of shoulder and/or upper-arm dysfunction during FY2014. Further examinations of the etiology and potential impact of shoulder/upper-arm dysfunction on force readiness are clearly warranted, as are additional studies directed at identifying best practices for preventing injury-related dysfunction and determining best practices for the treatment of shoulder dysfunction to optimize service member fitness and force readiness.
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Affiliation(s)
- Jeffrey C Leggit
- Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Hongyan Wu
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20814, USA
| | - Miranda Janvrin
- Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20814, USA
| | - Jessica Korona-Bailey
- Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20814, USA
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Hodgetts C, Walker B. Epidemiology, common diagnoses, treatments and prognosis of shoulder pain: A narrative review. INT J OSTEOPATH MED 2021. [DOI: 10.1016/j.ijosm.2021.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Igrek S, Colak TK. Comparison of the effectiveness of proprioceptive neuromuscular facilitation exercises and shoulder mobilization patients with Subacromial Impingement Syndrome: A randomised clinical trial. J Bodyw Mov Ther 2021; 30:42-52. [DOI: 10.1016/j.jbmt.2021.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 08/09/2021] [Accepted: 10/30/2021] [Indexed: 11/26/2022]
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Paley CA, Wittkopf PG, Jones G, Johnson MI. Does TENS Reduce the Intensity of Acute and Chronic Pain? A Comprehensive Appraisal of the Characteristics and Outcomes of 169 Reviews and 49 Meta-Analyses. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:1060. [PMID: 34684097 PMCID: PMC8539683 DOI: 10.3390/medicina57101060] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 12/11/2022]
Abstract
Background and Objectives: Uncertainty about the clinical efficacy of transcutaneous electric nerve stimulation (TENS) to alleviate pain spans half a century. There has been no attempt to synthesise the entire body of systematic review evidence. The aim of this comprehensive review was to critically appraise the characteristics and outcomes of systematic reviews evaluating the clinical efficacy of TENS for any type of acute and chronic pain in adults. Materials and Methods: We searched electronic databases for full reports of systematic reviews of studies, overviews of systematic reviews, and hybrid reviews that evaluated the efficacy of TENS for any type of clinical pain in adults. We screened reports against eligibility criteria and extracted data related to the characteristics and outcomes of the review, including effect size estimates. We conducted a descriptive analysis of extracted data. Results: We included 169 reviews consisting of eight overviews, seven hybrid reviews and 154 systematic reviews with 49 meta-analyses. A tally of authors' conclusions found a tendency toward benefits from TENS in 69/169 reviews, no benefits in 13/169 reviews, and inconclusive evidence in 87/169 reviews. Only three meta-analyses pooled sufficient data to have confidence in the effect size estimate (i.e., pooled analysis of >500 events). Lower pain intensity was found during TENS compared with control for chronic musculoskeletal pain and labour pain, and lower analgesic consumption was found post-surgery during TENS. The appraisal revealed repeated shortcomings in RCTs that have hindered confident judgements about efficacy, resulting in stagnation of evidence. Conclusions: Our appraisal reveals examples of meta-analyses with 'sufficient data' demonstrating benefit. There were no examples of meta-analyses with 'sufficient data' demonstrating no benefit. Therefore, we recommend that TENS should be considered as a treatment option. The considerable quantity of reviews with 'insufficient data' and meaningless findings have clouded the issue of efficacy. We offer solutions to these issues going forward.
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Affiliation(s)
- Carole A. Paley
- Centre for Pain Research, Leeds Beckett University, Leeds LS1 3HE, UK; (C.A.P.); (P.G.W.); (G.J.)
- Research and Development Department, Airedale National Health Service (NHS) Foundation Trust, Skipton Road, Steeton, Keighley BD20 6TD, UK
| | - Priscilla G. Wittkopf
- Centre for Pain Research, Leeds Beckett University, Leeds LS1 3HE, UK; (C.A.P.); (P.G.W.); (G.J.)
| | - Gareth Jones
- Centre for Pain Research, Leeds Beckett University, Leeds LS1 3HE, UK; (C.A.P.); (P.G.W.); (G.J.)
| | - Mark I. Johnson
- Centre for Pain Research, Leeds Beckett University, Leeds LS1 3HE, UK; (C.A.P.); (P.G.W.); (G.J.)
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Bilek F, Karakaya MG, Karakaya İÇ. Immediate effects of TENS and HVPS on pain and range of motion in subacromial pain syndrome: A randomized, placebo-controlled, crossover trial. J Back Musculoskelet Rehabil 2021; 34:805-811. [PMID: 33935058 DOI: 10.3233/bmr-191833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Transcutaneous electrical nerve stimulation (TENS) is one of the most common methods for managing shoulder pain, and high voltage pulsed currents (HVPS) may be used for reducing pain. However, their immediate effects on resting pain and pain-free active range of shoulder motion (pfROM) in patients with subacromial pain syndrome (SAPS) have not been studied comparatively, yet. OBJECTIVES The aim of this study was to compare the immediate effects of TENS, HVPS and placebo stimulation on shoulder resting pain and pfROM in patients with SAPS. METHODS Randomized, placebo-controlled, double-blind, crossover study. One hundred and six patients with SAPS received placebo (predetermined 1st day application), TENS and HVPS with 1-day interval, in a random sequence. Before and after each application, resting pain and pfROM were evaluated by 0-10 cm visual analogue scales and a digital inclinometer, respectively. RESULTS Intensity of pain decreased significantly after TENS, HVPS and placebo interventions (p< 0.05). While pfROMs increased significantly after TENS and HVPS (p< 0.05), remained unchanged after placebo, except for internal and external rotations (p> 0.05). The most obvious effects on pain and pfROMs occurred after HVPS (p< 0.05). CONCLUSION In patients with SAPS, both HVPS and TENS, but preferably HVPS can be used effectively to decrease pain and increase pfROM.
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Affiliation(s)
- Furkan Bilek
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Fırat University, Elazığ, Turkey
| | - Mehmet Gürhan Karakaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - İlkim Çıtak Karakaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Muğla Sıtkı Koçman University, Muğla, Turkey
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Hall K, Grinstead A, Lewis JS, Mercer C, Moore A, Ridehalgh C. Rotator cuff related shoulder pain. Describing home exercise adherence and the use of behavior change interventions to promote home exercise adherence: a systematic review of randomized controlled trials. PHYSICAL THERAPY REVIEWS 2021. [DOI: 10.1080/10833196.2021.1935106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Kevin Hall
- Physiotherapy Musculoskeletal Outpatients, Western Sussex Hospitals NHS Foundation Trust, West Sussex, United Kingdom
| | - Anthony Grinstead
- Physiotherapy Musculoskeletal Outpatients, Western Sussex Hospitals NHS Foundation Trust, West Sussex, United Kingdom
| | - Jeremy S. Lewis
- School of Health and Social Work, University of Hertfordshire, Hertfordshire, United Kingdom
- Therapy Department, Central London Community Healthcare National Health Service Trust, London, United Kingdom
- Department of Physical Therapy & Rehabilitation Science, College of Health Sciences, Qatar University, Doha, Qatar
| | - Chris Mercer
- Physiotherapy Musculoskeletal Outpatients, Western Sussex Hospitals NHS Foundation Trust, West Sussex, United Kingdom
| | - Ann Moore
- School of Health Sciences, University of Brighton, Eastbourne, East Sussex, United Kingdom
| | - Colette Ridehalgh
- School of Health Sciences, University of Brighton, Eastbourne, United Kingdom
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Boland K, Smith C, Bond H, Briggs S, Walton J. Current concepts in the rehabilitation of rotator cuff related disorders. J Clin Orthop Trauma 2021; 18:13-19. [PMID: 33987078 PMCID: PMC8082254 DOI: 10.1016/j.jcot.2021.04.007] [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: 02/27/2021] [Revised: 04/01/2021] [Accepted: 04/03/2021] [Indexed: 02/06/2023] Open
Abstract
Rotator cuff related disorders (RCRD) are common. Exercise-based rehabilitation can improve outcomes, yet uncertainty exists regarding the characteristics of these exercises. This scoping review paper summarises the key characteristics of the exercise-based rehabilitation of rotator cuff related disorders (RCRD). An iterative search process was used to capture the breadth of current evidence and a narrative summary of the data was produced. 57 papers were included. Disagreement around terminology, diagnostic standards, and outcome measures limits the comparison of the data. Rehabilitation should utilise a biopsychosocial approach, be person-centred and foster self-efficacy. Biomedically framed beliefs can create barriers to rehabilitation. Pain drivers in RCRSD are unclear, as is the influence of pain during exercise on outcomes. Expectations and preferences around pain levels should be discussed to allow the co-creation of a programme that is tolerated and therefore engaged with. The optimal parameters of exercise-based rehabilitation remain unclear; however, programmes should be individualised and progressive, with a minimum duration of 12 weeks. Supervised or home-based exercises are equally effective. Following rotator cuff repair, rehabilitation should be milestone-driven and individualised; communication across the MDT is essential. For individuals with massive rotator cuff tears, the anterior deltoid programme is a useful starting point and should be supplemented by functional rehabilitation, exercises to optimise any remaining cuff and the rest of the kinetic chain. In conclusion, exercise-based rehabilitation improves outcomes for individuals with a range of RCRD. The optimal parameters of these exercises remain unclear. Variation exists across current physiotherapy practice and post-operative rehabilitation protocols, reflecting the wide-ranging spectrum of individuals presenting with RCRD. Clinicians should use their communication and rehabilitation expertise to plan an exercise-based program in conjunction with the individual with RCRSD, which is regularly reviewed and adjusted.
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Affiliation(s)
- Katy Boland
- Upper Limb Department, Wrightington Hospital, Wigan, UK
| | - Claire Smith
- Upper Limb Department, Wrightington Hospital, Wigan, UK
| | - Helena Bond
- Upper Limb Department, Wrightington Hospital, Wigan, UK
| | - Sarah Briggs
- Upper Limb Department, Wrightington Hospital, Wigan, UK
| | - Julia Walton
- Upper Limb Department, Wrightington Hospital, Wigan, UK
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Picón SPB, Batista GDA, Pitangui ACR, de Araújo RC. Effects of Workplace-Based Intervention for Shoulder Pain: A Systematic Review and Meta-analysis. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:243-262. [PMID: 33006720 DOI: 10.1007/s10926-020-09927-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/18/2020] [Indexed: 06/11/2023]
Abstract
The main objective of this study is to update the evidence related to the effectiveness of exercise and ergonomic interventions in the perception of shoulder pain intensity in workers considering the shoulder pain intensity and the minimum clinically important change in the analysis. The bibliographic search was conducted in seven databases (Cochrane, EMBASE, SciELO, PubMed, PEDro, Web of Science and Scopus) from March to April 2019. The study selection included randomized controlled trials (RCTs) involving workers with shoulder pain who underwent physical exercises, ergonomics, and combined interventions. To analyze the RCTs, the intensity of pain was divided into two subgroups < 3 and ≥ 3 (0-10 points scale). A total of 27 RCTs were included in the qualitative synthesis considering the perception scales of shoulder pain intensity and the PEDro scale score of assessment of RCTs quality and risk of bias. Within these, seven RCTs were included in the quantitative synthesis. The overall effectiveness of interventions was calculated using a meta-analysis method, and the associated measurement used as a mean difference. The meta-analysis revealed that exercise interventions in workers with shoulder pain > 3 presented a minimally clincially important difference (MCID), but with no difference in workers with pain < 3. The interventions with exercise in workers with pain ≥ 3 at baseline reported a beneficial effect in reducing shoulder pain intensity, and a MCID. However, there was no significant difference for workers with pain < 3 and the effects of ergonomic interventions are still uncertain to reduce shoulder pain in workers.
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Affiliation(s)
| | | | | | - Rodrigo Cappato de Araújo
- Associated Graduate Program in Physical Education UPE/UFPB, Recife, Brazil
- Department of Physical Therapy, University of Pernambuco, Petrolina, Brazil
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Salamh PA, Hanney WJ, Cory CS, Condon HE, Liu X, Kolber MJ. The Efficacy and Treatment Fidelity of Kinesiology Taping in Conjunction With Conservative Treatment Interventions Among Individuals With Shoulder Pain: A Systematic Review with Meta-Analysis. Int J Sports Phys Ther 2021; 16:606-619. [PMID: 34123514 PMCID: PMC8168987 DOI: 10.26603/001c.24251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 11/26/2020] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Kinesiology taping is a common intervention used to treat individuals with shoulder pain. While there have been several studies published to date evaluating the effectiveness of this intervention, a systematic review with meta-analysis synthesizing the collective effectiveness of kinesiology taping is not available. Therefore, the purpose of this study was to perform a systematic review with meta-analysis investigating the efficacy and treatment fidelity of kinesiology taping (KT) in combination with conservative interventions for shoulder pain. METHODS Databases (PubMed, EMBASE, SportDiscus, CINAHL) of studies published in English meeting criteria were searched to October 2019. Methodologic quality was assessed utilizing the Modified Downs and Black checklist. Treatment fidelity was evaluated using a modified fidelity tool. Random effects meta-analyses were performed when an outcome (disability, pain, range of motion (ROM)) was reported by two or more studies. Overall effect size (pooled random effects) was estimated for studies with acceptable clinical homogeneity. RESULTS When KT was used with conservative treatments, meta-analysis revealed large effect sizes for improvements in disability (standard mean difference (SMD) = -1.35; 95% CI, -2.09 to -0.60) and ROM (SMD = 0.96; 95% CI, 0.60-1.33) with no significant effects for pain. The average Modified Downs & Black score for bias was 11.5 ± 3.9. Of 10 retained studies, only two had good treatment fidelity. CONCLUSIONS Adding KT to interventions performed in clinical settings appears to demonstrate efficacy regarding disability and ROM when compared to conservative interventions alone. However, despite reasonably good methodologic quality, fidelity was lacking in a majority of studies. Because of its impact on the implementation of evidence-based practice, lower fidelity should be considered when interpreting results.
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Supervised Training Compared With No Training or Self-training in Patients With Subacromial Pain Syndrome: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2021; 102:2428-2441.e10. [PMID: 33930326 DOI: 10.1016/j.apmr.2021.03.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/28/2021] [Accepted: 03/29/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To study the effects of supervised training in adults with subacromial pain syndrome. DATA SOURCES Embase, MEDLINE, Cochrane Library, Cumulative Index to Nursing and Allied Health, and Physiotherapy Evidence Database were searched from inception to March 2020. STUDY SELECTION Independent reviewers selected randomized controlled trials comparing supervised training with (1) no training or (2) self-training in adults with subacromial pain syndrome lasting for at least 1 month. Critical outcomes were shoulder pain, function, and patient-perceived effect. Important outcomes included other potential benefits and adverse events at 3-month follow-up. DATA EXTRACTION Two independent reviewers extracted data for the meta-analysis. Risk of bias was assessed using the Cochrane Risk of Bias tool 1, and certainty of evidence was evaluated using the Grades of Recommendation Assessment, Development, and Evaluation (GRADE). DATA SYNTHESIS Ten studies (n=597, 43% female) were included. Supervised training resulted in larger improvements than no training on pain (at rest: n=286; mean difference [MD], 1.68; 95% confidence interval [CI], 0.31-3.06 on 0-10 scale; during movement: n=353; MD, 1.84; 95% CI,0.91-2.76), function (n=396; standardized MD, 0.30; 95% CI, 0.07-0.52), and patient-perceived effect (n=118; risk ratio, 1.43; 95% CI, 0.87-2.34). Supervised training had potential benefits regarding quality of life, return to work, dropout, and training adherence, albeit more patients reported mild, transient pain after training. Supervised training and self-training showed equal improvements on pain (n=44) and function (n=76), with no data describing patient-perceived effect. Certainty of evidence was low for critical outcomes and low-moderate for other outcomes. CONCLUSIONS Supervised training might be superior to no training and equally effective as self-training on critical and important outcomes. Based on low-moderate certainty of evidence, these findings support a weak recommendation for supervised training in adults with subacromial pain syndrome.
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Short- and Long-Term Effects of a Scapular-Focused Exercise Protocol for Patients with Shoulder Dysfunctions-A Prospective Cohort. SENSORS 2021; 21:s21082888. [PMID: 33924207 PMCID: PMC8074594 DOI: 10.3390/s21082888] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/11/2021] [Accepted: 04/12/2021] [Indexed: 12/22/2022]
Abstract
Current clinical practice lacks consistent evidence in the management of scapular dyskinesis. This study aims to determine the short- and long-term effects of a scapular-focused exercise protocol facilitated by real-time electromyographic biofeedback (EMGBF) on pain and function, in individuals with rotator cuff related pain syndrome (RCS) and anterior shoulder instability (ASI). One-hundred and eighty-three patients were divided into two groups (n = 117 RCS and n = 66 ASI) and guided through a structured exercise protocol, focusing on scapular dynamic control. Values of pain and function (shoulder pain and disability index (SPADI) questionnaire, complemented by the numeric pain rating scale (NPRS) and disabilities of the arm, shoulder, and hand (DASH) questionnaire) were assessed at the initial, 4-week, and 2-year follow-up and compared within and between. There were significant differences in pain and function improvement between the initial and 4-week assessments. There were no differences in the values of DASH 1st part and SPADI between the 4-week and 2-year follow-up. There were no differences between groups at the baseline and long-term, except for DASH 1st part and SPADI (p < 0.05). Only 29 patients (15.8%) had a recurrence episode at follow-up. These results provide valuable information on the positive results of the protocol in the short- and long-term.
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Phillips R, Perraton L, Cridland K, Maloney S, Harris IA, Malliaras P. Patient knowledge of rotator cuff related shoulder pain condition and treatment and validation of a patient-reported knowledge questionnaire. Musculoskeletal Care 2021; 19:504-514. [PMID: 33734551 DOI: 10.1002/msc.1547] [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: 02/06/2021] [Revised: 02/10/2021] [Accepted: 02/14/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Rotator cuff related shoulder pain (RCRSP) knowledge is an important contributor to compliance with clinical practice guidelines and providing best practice care. However, there are no validated instruments for measuring health literacy levels among people with RCRSP. This study aimed to design a valid and reliable instrument to measure RCRSP health literacy and use it to evaluate an education intervention for people with RCRSP. METHODS Development of the patient knowledge questionnaire (PKQ-RCRSP) included three phases. Phase 1 was developed based on available literature and input from expert clinicians, researchers and patients. Face validity, pilot testing and readability assessment were also undertaken. In Phase 2, internal consistency and predictive validity were assessed in people with RCRSP and other shoulder pain diagnoses. In Phase 3, RCRSP health literacy was assessed. RESULT Face validity was acceptable and pilot testing identified minor accuracy issues that were corrected. Literacy level was rated as 'difficult to read' which reflects the medical terminology within the questionnaire. Internal consistency was very good and 81% of questions demonstrated acceptable predictive validity. Health literacy was heterogeneous depending on the question with less than 40% of respondents answering correctly for questions related to the indications, process and the known benefits of RCRSP surgery. CONCLUSION The PKQ-RCRSP demonstrated acceptable face validity, predictive validity and reliability (internal consistency) in assessing RCRSP health literacy. Health literacy among our small sample was poor for questions related to surgery for RCRSP.
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Affiliation(s)
- Rebecca Phillips
- Department of Physiotherapy, School of Primary Health Care, Monash University, Frankston, Australia
| | - Luke Perraton
- Department of Physiotherapy, School of Primary Health Care, Monash University, Frankston, Australia
| | - Kate Cridland
- Department of Physiotherapy, School of Primary Health Care, Monash University, Frankston, Australia
| | - Stephen Maloney
- Department of Physiotherapy, School of Primary Health Care, Monash University, Frankston, Australia
| | - Ian A Harris
- Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW, Sydney, Australia
| | - Peter Malliaras
- Department of Physiotherapy, School of Primary Health Care, Monash University, Frankston, Australia
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Kamonseki DH, Haik MN, Camargo PR. Scapular movement training versus standardized exercises for individuals with chronic shoulder pain: protocol for a randomized controlled trial. Braz J Phys Ther 2021; 25:221-229. [PMID: 32855073 PMCID: PMC7990736 DOI: 10.1016/j.bjpt.2020.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 07/31/2020] [Accepted: 08/05/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Scapular focused exercise interventions are frequently used to treat individuals with shoulder pain. However, evidence for changes in scapular motion after intervention is limited. OBJECTIVE To compare the effects of scapular movement training versus standardized exercises for individuals with shoulder pain. METHODS This will be a single-blinded randomized controlled trial. Sixty-four individuals with shoulder pain for at least 3 months, scapular dyskinesis, and a positive scapular assistance test will be randomly allocated to one of two groups: Scapular Movement Training (group 1) and Standardized Exercises (group 2). Group 1 will receive education about scapular position and movement, and be trained to modify the scapular movement pattern. Group 2 will perform stretching and strengthening exercises. Both groups will be treated twice a week for eight weeks. Three-dimensional scapular kinematics and muscle activity of the serratus anterior and upper, middle, and lower trapezius during elevation and lowering of the arm will be assessed at baseline and after 8 weeks of treatment. Pain intensity, function, fear avoidance beliefs, and kinesiophobia will be assessed at baseline and after 4 and 8 weeks of treatment, and 4 weeks after the end of treatment. CONCLUSIONS The results of this study may contribute to a better understanding of the efficacy of scapular focused treatments for individuals with shoulder pain. CLINICAL TRIAL REGISTRATION NCT03528499.
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Affiliation(s)
- Danilo Harudy Kamonseki
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Melina Nevoeiro Haik
- Department of Physical Therapy, Center of Health and Sport Science, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | - Paula Rezende 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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Ribeiro DC, Spiers K, Thomas L, Leilua K, Wilkes M, Norton S, Lamb SE. Monitoring, implementation and reporting of interventions in a selection of trials assessing exercise therapy for the management of shoulder subacromial pain: a cross-sectional investigation. BMJ Open 2021; 11:e044462. [PMID: 33593786 PMCID: PMC7888324 DOI: 10.1136/bmjopen-2020-044462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/25/2021] [Accepted: 02/03/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To review the reporting of monitoring and implementation of interventions in a selection of trials that assessed the effectiveness of manual therapy and exercise in the management of shoulder subacromial pain. DESIGN A review of trials assessing the effectiveness of manual therapy and exercise in the management of patients with shoulder subacromial pain. METHODS We included in our review a selection of 10 trials that were included in a Cochrane review and compared manual therapy and exercise intervention with another intervention. Trials were assessed independently by two reviewers using two checklists: the Template for Intervention Description and Replication (TIDieR) and the Health Behavior Change Consortium treatment fidelity (National Institutes of Health Behaviour Change Consortium/NIHBCC). RESULTS TIDieR overall scores for individual trials ranged from 11.1% to 45% and fidelity scores ranged from 7% to 50%. On average, trials scored the following within each domain of NIHBCC: study design 51%; training of providers 8%; treatment delivery 15%; treatment receipt 14% and treatment enactment 2.5%. CONCLUSIONS Little information about the monitoring, implementation and reporting of interventions was provided by trials and that is a barrier for implementing or replicating these interventions. The lack of information regarding the implementation of interventions needs to be taken into account when assessing whether effectiveness of interventions was impacted by their design or due to deviations from the protocol within trials.
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Affiliation(s)
- Daniel C Ribeiro
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Kate Spiers
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Laura Thomas
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Kiriffi Leilua
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Matthew Wilkes
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Shontal Norton
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Sarah E Lamb
- College of Medicine and Health, University of Exeter, Exeter, UK
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Smythe A, Rathi S, Pavlova N, Littlewood C, Connell D, Haines T, Malliaras P. Self-reported management among people with rotator cuff related shoulder pain: An observational study. Musculoskelet Sci Pract 2021; 51:102305. [PMID: 33249362 DOI: 10.1016/j.msksp.2020.102305] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/12/2020] [Accepted: 11/14/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Rotator cuff related shoulder pain is the most common cause of shoulder pain. Whilst guidelines recommend conservative management prior to imaging, injection or surgical management, recent findings suggest that patients experience management contrary to guideline recommendations. OBJECTIVES The aim of this study was to investigate self-reported management among people with rotator cuff related shoulder pain (RCRSP) and their beliefs towards management. MATERIALS AND METHODS Cross-sectional survey of people with RCRSP recruited when referred for imaging (n = 120). Electronic survey about demographic factors, management people had had (including imaging, injections, surgery, exercise, adjuncts), and beliefs about treatments. The frequency of various treatments was reported (separately for each cohort and traumatic onset) as well as the timing of interventions related to first-line care. RESULTS Most people had tried exercise (99/120, 82.5%) but only one in five people reported exercise was helpful, and one in six reported it was unhelpful or made their symptoms worse. Approximately a third of the cohort reported not receiving activity modification advice (34.2%, 41/120), those that did received inconsistent information. People with both traumatic (imaging 31/43, 72.1%; injections 13/24, 54.2%, surgery 8/21, 38.1%) and atraumatic onset pain (imaging 43/77, 55.8%; injections 31/51, 60.8%, surgery 4/19, 21.1%) had similarly high rates of intervention prior to trialling conservative management. Patient beliefs in regards to management showed trends towards interventionalist care. CONCLUSION Patient reported management of RCRSP is often inconsistent with guideline recommended management.
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Affiliation(s)
- A Smythe
- Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Building B, Peninsula Campus, Monash University, Victoria, 3199, Australia; A-Game Physiotherapy, Somerville, Victoria, 3912, Australia.
| | - S Rathi
- Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Building B, Peninsula Campus, Monash University, Victoria, 3199, Australia
| | - N Pavlova
- Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Building B, Peninsula Campus, Monash University, Victoria, 3199, Australia
| | - C Littlewood
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, M15 6GX, UK. https://twitter.com/ChrisLittlew00d
| | - D Connell
- Imaging at Olympic Park, AAMI Park, Melbourne, Australia; Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - T Haines
- School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Building G, Peninsula Campus, Monash University, Victoria, 3199, Australia
| | - P Malliaras
- Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Building B, Peninsula Campus, Monash University, Victoria, 3199, Australia. https://twitter.com/DrPeteMalliaras
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Kamonseki DH, Calixtre LB, Barreto RPG, Camargo PR. Effects of electromyographic biofeedback interventions for shoulder pain and function: Systematic review and meta-analysis. Clin Rehabil 2021; 35:952-963. [PMID: 33517777 DOI: 10.1177/0269215521990950] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To systematically review the effectiveness of electromyographic biofeedback interventions to improve pain and function of patients with shoulder pain. DESIGN Systematic review of controlled clinical trials. LITERATURE SEARCH Databases (Medline, EMBASE, CINAHL, PEDro, CENTRAL, Web of Science, and SCOPUS) were searched in December 2020. STUDY SELECTION CRITERIA Randomized clinical trials that investigated the effects of electromyographic biofeedback for individuals with shoulder pain. Patient-reported pain and functional outcomes were collected and synthesized. DATA SYNTHESIS The level of evidence was synthesized using GRADE and Standardized Mean Differences and 95% confidence interval were calculated using a random-effects inverse variance model for meta-analysis. RESULTS Five studies were included with a total sample of 272 individuals with shoulder pain. Very-low quality of evidence indicated that electromyographic biofeedback was not superior to control for reducing shoulder pain (standardized mean differences = -0.21, 95% confidence interval: -0.67 to 0.24, P = 0.36). Very-low quality of evidence indicated that electromyographic biofeedback interventions were not superior to control for improving shoulder function (standardized mean differences = -0.11, 95% confidence interval: -0.41 to 0.19, P = 0.48). CONCLUSION Electromyographic biofeedback may be not effective for improving shoulder pain and function. However, the limited number of included studies and very low quality of evidence does not support a definitive recommendation about the effectiveness of electromyographic biofeedback to treat individuals with shoulder pain.
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Affiliation(s)
- Danilo Harudy Kamonseki
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Letícia Bojikian Calixtre
- Department of Dental Materials and Prosthodontics, Araraquara Dental School, Universidade Estadual Paulista (UNESP), Araraquara, São Paulo, Brazil
| | - Rodrigo Py Gonçalves Barreto
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Paula Rezende Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, Brazil
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Malliaras P, Cridland K, Hopmans R, Ashton S, Littlewood C, Page R, Harris I, Skouteris H, Haines T. Internet and Telerehabilitation-Delivered Management of Rotator Cuff-Related Shoulder Pain (INTEL Trial): Randomized Controlled Pilot and Feasibility Trial. JMIR Mhealth Uhealth 2020; 8:e24311. [PMID: 33206059 PMCID: PMC7710452 DOI: 10.2196/24311] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/14/2020] [Accepted: 10/21/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Rotator cuff-related shoulder pain (RCRSP) is a common and disabling musculoskeletal condition. Internet-based and telerehabilitation delivery of recommended care may improve access to care and improve adherence and outcomes. OBJECTIVE The primary aim of this pilot randomized controlled trial was to assess the feasibility of a 12-week internet-delivered intervention for RCRSP comparing advice only, recommended care, and recommended care with group-based telerehabilitation. METHODS Reporting was in accordance with the Consolidated Standards of Reporting Trials (CONSORT) checklist for pilot and feasibility trials. People with a primary complaint of RCRSP for 3 months or longer were identified via a paid Facebook strategy. Screening involved an online questionnaire followed by a 20-minute telehealth assessment. Participants were randomly allocated (via a Zelen design) to receive (1) advice only, (2) recommended care (internet-delivered evidence-based exercise and education), or (3) recommended care and telerehabilitation (including a weekly group teleconference session). Progression criteria for a full-scale trial included (1) recruitment of 20% or greater of eligible participants, (2) acceptable adherence (two or more of the three prescribed weekly sessions) among 70% or greater of participants, (3) 80% or greater retention of participants, (4) absence of intervention-related serious adverse events, and (5) 80% or greater response rates to questionnaires. Secondary clinical and patient knowledge outcomes were collected (via email or text) at baseline, six weeks, and 12 weeks (for clinical and patient knowledge), and within-group change was reported descriptively. RESULTS We enrolled 36 of 38 (95%) eligible participants and all participants were recruited within a 3-week period. Of the 36 participants, 12 participants were allocated to each of the three trial arms. The mean age of participants was between 51 and 56 years, and 83% (10/12) to 92% (11/12) were female. Retention at the 12-week endpoint was 94% (34/36) and response to email questionnaires at other time points was 83% or greater. We found acceptable adherence (defined as greater than 70% of participants performing exercise 2 or 3 times/week) in the recommended care group with telerehabilitation but not in the recommended care group without telerehabilitation. There was a total of 24 adverse events over 108 person-months of observation. All adverse events were mild or moderate (mainly muscle and shoulder symptoms), with the exception of one instance of elective surgery (unrelated to the person's shoulder condition). CONCLUSIONS Our prespecified success criteria were met or exceeded, but there was a gender imbalance toward women. It is feasible to progress to a fully powered trial, but strategies to address the gender imbalance need to be implemented. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ACTRN12620000248965); https://tinyurl.com/yy6eztf5.
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Affiliation(s)
- Peter Malliaras
- Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Monash University, Melbourne, Australia
| | - Kate Cridland
- Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Monash University, Melbourne, Australia
| | - Ruben Hopmans
- Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Monash University, Melbourne, Australia
| | - Simon Ashton
- Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Monash University, Melbourne, Australia
| | - Chris Littlewood
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
| | - Richard Page
- Barwon Orthopaedic Research and Education, Barwon Health and School of Medicine, Deakin University, Geelong, Australia
| | - Ian Harris
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, Australia.,Liverpool Hospital, Sydney, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Terry Haines
- School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Monash University, Melbourne, Australia
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Haik MN, Alburquerque-Sendín F, Fernandes RAS, Kamonseki DH, Almeida LA, Liebano RE, Camargo PR. Biopsychosocial Aspects in Individuals with Acute and Chronic Rotator Cuff Related Shoulder Pain: Classification Based on a Decision Tree Analysis. Diagnostics (Basel) 2020; 10:diagnostics10110928. [PMID: 33182699 PMCID: PMC7696199 DOI: 10.3390/diagnostics10110928] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/02/2020] [Accepted: 11/04/2020] [Indexed: 01/10/2023] Open
Abstract
Biopsychosocial aspects seem to influence the clinical condition of rotator cuff related shoulder pain (RCRSP). However, traditional bivariate and linear analyses may not be sufficiently robust to capture the complex relationships among these aspects. This study determined which biopsychosocial aspects would better classify individuals with acute and chronic RCRSP and described how these aspects interact to create biopsychosocial phenotypes in individuals with acute and chronic RCRSP. Individuals with acute (<six months of pain, n = 15) and chronic (≥six months of pain, n = 38) RCRSP were included. Sociodemographic data, biological data related to general clinical health status, to shoulder clinical condition and to sensory function, and psychosocial data were collected. Outcomes were compared between groups and a decision tree was used to classify the individuals with acute and chronic RCRSP into different phenotypes hierarchically organized in nodes. Only conditioned pain modulation was different between the groups. However, the tree combined six biopsychosocial aspects to identify seven distinct phenotypes in individuals with RCRSP: three phenotypes of individuals with acute, and four with chronic RCRSP. While the majority of the individuals with chronic RCRSP have no other previous painful complaint besides the shoulder pain and low efficiency of endogenous pain modulation with no signs of biomechanical related pain, individuals with acute RCRSP are more likely to have preserved endogenous pain modulation and unilateral pain with signs of kinesiophobia.
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Affiliation(s)
- Melina N Haik
- Department of Physical Therapy, Center of Health and Sport Science (CEFID), Universidade do Estado de Santa Catarina, Rua Pascoal Simone 358, Florianópolis, SC 88080-350, Brazil
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, Rodovia Washington Luis km 235, São Carlos, SP 13565-905, Brazil; (D.H.K.); (L.A.A.); (P.R.C.)
- Correspondence:
| | - Francisco Alburquerque-Sendín
- Department of Nursing, Pharmacology and Physical Therapy, Universidad de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain;
| | - Ricardo A S Fernandes
- Department of Electrical Engineering, Center for Exact Sciences and Technology (CCET), Universidade Federal de São Carlos, Rodovia Washington Luis km 235, São Carlos, SP 13565-905, Brazil;
| | - Danilo H Kamonseki
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, Rodovia Washington Luis km 235, São Carlos, SP 13565-905, Brazil; (D.H.K.); (L.A.A.); (P.R.C.)
| | - Lucas A Almeida
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, Rodovia Washington Luis km 235, São Carlos, SP 13565-905, Brazil; (D.H.K.); (L.A.A.); (P.R.C.)
| | - Richard E Liebano
- Physiotherapeutic Resources Laboratory, Department of Physical Therapy, Universidade Federal de São Carlos, Rodovia Washington Luis km 235, São Carlos, SP 13565-905, Brazil;
| | - Paula R Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, Rodovia Washington Luis km 235, São Carlos, SP 13565-905, Brazil; (D.H.K.); (L.A.A.); (P.R.C.)
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Malliaras P, Johnston R, Street G, Littlewood C, Bennell K, Haines T, Buchbinder R. The Efficacy of Higher Versus Lower Dose Exercise in Rotator Cuff Tendinopathy: A Systematic Review of Randomized Controlled Trials. Arch Phys Med Rehabil 2020; 101:1822-1834. [DOI: 10.1016/j.apmr.2020.06.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/07/2020] [Accepted: 06/15/2020] [Indexed: 01/29/2023]
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Brindisino F, Giovannico G, Maselli F. Conservative management in a patient with massive rotator cuff tear and rheumatoid arthritis. J Back Musculoskelet Rehabil 2020; 33:329-337. [PMID: 31356189 DOI: 10.3233/bmr-171069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Shoulder pain is one of the most common problems affecting people older than 60 years. Among the shoulder pathologies, the disorders of the periarticular soft tissue (e.g. rotator cuff) are considered to be the most common; moreover, these disorders are found in approximately 75% of patients with seropositive rheumatoid arthritis. The incidence of structural rotator cuff tendon pathology, including full-thickness rotator cuff tendon tears, increases with age. Recent researchers suggested that non-operative treatment of full-thickness rotator cuff tears could be successful in some patients; furthermore, in rheumatoid arthritis patients, there was a greater possibility of developing surgical complications compared with non-rheumatoid arthritis patients. MATERIALS AND METHODS A case report of a woman, 72 years old, with rheumatoid arthritis, shoulder pain and pseudo-paralytic arm presented with a massive tear of Supraspinatus and Infraspinatus tendon. In accordance with evidence, the case was managed using pain education and exercise therapy for 2.5 months. The shoulder pain, the function and the range of motion improved following a physiotherapy program. CONCLUSION Pain education in combination with exercise therapy was effective for improving pain and function in a full-thickness tear of Supraspinatus and Infraspinatus tendon in a patient also suffering from rheumatoid arthritis.
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Affiliation(s)
- Fabrizio Brindisino
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy.,Physiotherapy and Manual Therapy, Physiotherapy Department, Lecce, Italy
| | - Giuseppe Giovannico
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy.,Physiotherapy and Manual Therapy, Physiotherapy Department, Lecce, Italy
| | - Filippo Maselli
- Dinogmi Department, Genova University, Genova, Italy.,Sovrintendenza Sanitaria Regionale Puglia INAIL Bari, Italy
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50
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Cupler ZA, Alrwaily M, Polakowski E, Mathers KS, Schneider MJ. Taping for conditions of the musculoskeletal system: an evidence map review. Chiropr Man Therap 2020; 28:52. [PMID: 32928244 PMCID: PMC7491123 DOI: 10.1186/s12998-020-00337-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 07/12/2020] [Indexed: 12/14/2022] Open
Abstract
Background Taping is a common treatment modality used by many rehabilitation providers. Several types of tapes and taping methods are used in the treatment of musculoskeletal dysfunction and pain. Purpose To summarize and map the evidence related to taping methods used for various joints and conditions of the musculoskeletal system, and to provide clinicians and researchers with a user-friendly reference with organized evidence tables. Data sources The PEDro, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register for Controlled Trials, PubMed, and PROSPERO databases were searched from inception through October 31, 2019. Study selection Eligible studies were selected by two independent reviewers and included either systematic reviews (SRs) or randomized controlled trials (RCTs) and included a musculoskeletal complaint using a clinical outcome measure. Data extraction Data was extracted by two investigators independently. Risk of bias and quality were assessed using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) for SRs or the Physiotherapy Evidence Database (PEDro) scale for RCTs. The protocol was registered with PROSPERO (CRD42019122857). Data synthesis Twenty-five musculoskeletal conditions were summarized from forty-one SRs and 127 RCTs. There were 6 SRs and 49 RCTs for spinal conditions. Kinesio tape was the most common type of tape considered. Four evidence tables representing the synthesized SRs and RCTs were produced and organized by body region per condition. Limitations Inclusion of only English language studies. Also, the heterogeneous nature of the included studies prevented a meta-analysis. Conclusions There is mixed quality evidence of effectiveness for the different types of taping methods for different body regions and conditions. All of the SRs and RCTs found during our search of the taping literature have been organized into a series of appendices. A synthesis of the results have been placed in evidence tables that may serve as a useful guide to clinicians and researchers.
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Affiliation(s)
- Zachary A Cupler
- Physical Medicine & Rehabilitation Services, Butler VA Healthcare System, 353 N. Duffy Road, Butler, Pennsylvania, USA.
| | - Muhammad Alrwaily
- Division of Physical Therapy, School of Medicine, West Virginia University, Morgantown, West Virginia, USA.,Department of Physical Therapy, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Emily Polakowski
- Private Practice, Independence Physical Therapy, Mystic, Connecticut, USA
| | - Kevin S Mathers
- VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
| | - Michael J Schneider
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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