1
|
Kim JH, Kwon OY, Hwang UJ, Jung SH, Gwak GT. Prediction model of subacromial pain syndrome in assembly workers using shoulder range of motion and muscle strength based on support vector machine. ERGONOMICS 2024; 67:1237-1246. [PMID: 38039103 DOI: 10.1080/00140139.2023.2290983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/29/2023] [Indexed: 12/03/2023]
Abstract
Subacromial pain syndrome (SAPS) is the most common upper-extremity musculoskeletal problem among workers. In this study, a machine learning model was built to predict and classify the presence or absence of SAPS in assembly workers with shoulder joint range of motion (ROM) and muscle strength data using support vector machine (SVM). Permutation importance was used to determine important variables for predicting workers with or without SAPS. The accuracy of the support vector classifier (SVC) polynomial model for classifying workers with SAPS was 82.4%. The important variables in model construction were internal rotation and abduction of shoulder ROM and internal rotation of shoulder muscle strength. It is possible to accurately perform SAPS classification of workers with relatively easy-to-obtain shoulder ROM and muscle strength data using this model. In addition, preventing SAPS in workers is possible by adjusting the factors affecting model building using exercise or rehabilitation programs.Practitioner summary: This study aimed to create a machine learning model that can predict and classify SAPS using shoulder ROM and muscle strength and identify the variables that are of high importance in model construction. This model could be used to predict or classify workers' SAPS and manage or prevent SAPS.
Collapse
Affiliation(s)
- Jun-Hee Kim
- Laboratory of KEMA AI Research (KAIR), Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, South Korea
| | - Oh-Yun Kwon
- Laboratory of Kinetic Ergocise Based on Movement Analysis, Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, South Korea
| | - Ui-Jae Hwang
- Laboratory of KEMA AI Research (KAIR), Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, South Korea
| | - Sung-Hoon Jung
- Department of Physical Therapy, Division of Health Science, Baekseok University, Cheonan, South Korea
| | - Gyeong-Tae Gwak
- Laboratory of KEMA AI Research (KAIR), Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, South Korea
| |
Collapse
|
2
|
Cordes CMA, Leonardis JM, Samet J, Schnorenberg AJ, England M, Mukherjee S, Vogel LC, Seitz AL, Slavens BA. Handrim kinetics and quantitative ultrasound parameters for assessment of subacromial impingement in wheelchair users with pediatric-onset spinal cord injury. Gait Posture 2024; 113:561-569. [PMID: 39182433 DOI: 10.1016/j.gaitpost.2024.08.075] [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] [Received: 12/04/2023] [Revised: 08/12/2024] [Accepted: 08/14/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND Most manual wheelchair users with pediatric-onset spinal cord injury (SCI) will experience shoulder pain or pathology at some point in their life. However, guidelines for preservation of the upper limb in children with SCI are limited. RESEARCH QUESTION What are the relationships between manual wheelchair handrim kinetics and quantitative ultrasound parameters related to subacromial impingement in individuals with pediatric-onset SCI? METHODS Subacromial impingement risk factors including supraspinatus tendon thickness (SST), acromiohumeral distance (AHD), and occupation ratio (OR; SST/AHD) were measured with ultrasound in 11 manual wheelchair users with pediatric-onset SCI. Handrim kinetics were acquired during the stroke cycle, including peak resultant force (FR), peak rate of rise of resultant force (ROR) and fractional effective force (FEF). Variability of handrim kinetics was computed using the coefficient of variation and linear regression was performed to assess correlations between handrim metrics and quantitative ultrasound parameters. RESULTS Peak resultant force significantly increased 1.4 % and variability of FEF significantly decreased 8.0 % for every 0.1 cm increase in AHD. FEF decreased 3.5 % for every 0.1 cm increase in SST. Variability of peak resultant force significantly increased 3.6 % and variability of peak ROR of resultant force significantly increased 7.3 % for every 0.1 cm increase in SST. FEF variability significantly decreased 11.6 % for every 0.1 cm increase in SST. Peak ROR significantly decreased 1.54 % with every 10 % increase in OR. FEF variability significantly decreased 1.5 % with every 10 % increase in OR. SIGNIFICANCE This is the first study to investigate relationships among handrim kinetics and shoulder structure in manual wheelchair users with pediatric-onset SCI. Associations were identified between subacromial impingement risk factors and magnitude and variability of wheelchair handrim kinetics. These results indicate the critical need to further explore the relationships among wheelchair handrim kinetics, shoulder joint dynamics, and shoulder pathology in manual wheelchair users with pediatric-onset SCI.
Collapse
Affiliation(s)
- Caleb M A Cordes
- University of Wisconsin-Milwaukee, Department of Rehabilitation Sciences and Technology, Milwaukee, WI 53211, USA; University of Wisconsin-Milwaukee, Department of Mechanical Engineering, Milwaukee, WI 53211, USA.
| | - Joshua M Leonardis
- University of Wisconsin-Milwaukee, Department of Rehabilitation Sciences and Technology, Milwaukee, WI 53211, USA; University of Illinois Urbana-Champaign, College of Applied Health Sciences, Urbana, IL 61801, USA; University of Illinois Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Urbana, IL 61801, USA
| | - Jonathan Samet
- Ann and Robert H. Lurie Children's Hospital, Department of Medical Imaging, Chicago, IL 60611, USA; Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Alyssa J Schnorenberg
- University of Wisconsin-Milwaukee, Department of Mechanical Engineering, Milwaukee, WI 53211, USA
| | - Mark England
- Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Shubhra Mukherjee
- Shriners Children's Chicago, Chicago, IL 60707, USA; Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA
| | | | - Amee L Seitz
- Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Brooke A Slavens
- University of Wisconsin-Milwaukee, Department of Rehabilitation Sciences and Technology, Milwaukee, WI 53211, USA; University of Wisconsin-Milwaukee, Department of Mechanical Engineering, Milwaukee, WI 53211, USA
| |
Collapse
|
3
|
Idowu BM, Onigbinde SO, Afolabi BI, Ogholoh OD, Nwafor NN, Okedere TA. Assessment of shoulder joint derangements with magnetic resonance imaging in adult Nigerians. JOURNAL OF THE WEST AFRICAN COLLEGE OF SURGEONS 2024; 14:307-313. [PMID: 38988419 PMCID: PMC11232785 DOI: 10.4103/jwas.jwas_144_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 09/27/2023] [Indexed: 07/12/2024]
Abstract
Objectives Shoulder pain secondary to various aetiologies is a common musculoskeletal complaint worldwide, and Magnetic Resonance Imaging (MRI) is the most accurate imaging method for evaluating shoulder pain in all age groups. While the patterns of shoulder MRI abnormalities in various demographics have been reported, data on sub-Sahara African populations are still sparse. This study aims to describe the imaging features and spectrum of shoulder joint pathologies on MRI in adult Nigerians. Materials and Methods This was a retrospective review of the shoulder MRI of 100 adult Nigerians (with and without trauma) from September 2020 to December 2021. Their clinical data and shoulder MRI findings were extracted and analysed. Statistical significance was set at P ≤ 0.05. Results There were 64 males and 36 females aged 18-82 years. Right shoulder MRI was done in 53 subjects (53%), while the left shoulder was studied in 47 (47%). Supraspinatus tendinopathy (73%), acromioclavicular joint arthropathy (68%), and subacromial-subdeltoid (SASD) bursitis (64%) were the most frequently detected pathologies. Other demonstrated derangements include glenohumeral joint effusion (24%), long head of biceps tendon sheath effusion (18%), labral abnormalities (16%), subcoracoid bursitis (4%), Hill Sach's deformity (3%), anterior glenohumeral dislocation (2%), fatty degeneration of the supraspinatus/infraspinatus muscles (2%), adhesive capsulitis (1%), and other bony abnormalities (contusion, erosion, subchondral cysts). There was no significant difference in the frequency of shoulder abnormalities between the male and female subjects. Conclusion Acromioclavicular joint arthropathy, SASD bursitis, and rotator cuff disorders were the dominant pathologies in the participants' shoulders.
Collapse
Affiliation(s)
- Bukunmi Michael Idowu
- Department of Radiology, Union Diagnostics and Clinical Services Plc, Yaba, Lagos State, Nigeria
| | | | - Babalola Ishmael Afolabi
- Department of Radiology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | | | - Nkem Nnenna Nwafor
- Department of Radiology, Faculty of Clinical Sciences, College of Health Sciences, University of Uyo, Uyo, Akwa Ibom State, Nigeria
| | | |
Collapse
|
4
|
Jácome-López R, Tejada-Gallego J, Silberberg JM, García-Sanz F, García-Muro-San José F. Glenohumeral internal rotation deficit in general population with shoulder pain: A descriptive observational study. Medicine (Baltimore) 2023; 102:e36551. [PMID: 38115341 PMCID: PMC10727574 DOI: 10.1097/md.0000000000036551] [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: 06/15/2023] [Revised: 11/08/2023] [Accepted: 11/17/2023] [Indexed: 12/21/2023] Open
Abstract
Glenohumeral internal rotation deficit (GIRD) is one of the most important factors influencing injury risk in the arm of overhead athletes. Some studies have shown that the GIRD of athletes with shoulder pain was higher than those without shoulder pain, establishing a relation between shoulder pain and GIRD. However, there are no studies that relate to GIRD and shoulder pain or the risk factors that affect GIRD in the population with this ailment. This study aimed to: determine if GIRD could be found clinically and between which values it oscillates in patients with shoulder pain, and explore if there are any potential associations between GIRD and some sociodemographic data, and orthopedic or radiological findings. A descriptive observational study design was adopted to determine if GIRD could be found clinically in patients with shoulder pain and to gain further evidence in the potential associations between GIRD and sociodemographic data, and orthopedic or radiological findings. All those patients without exclusion criteria between October 1,2020 and March 31,2021 were included. Exclusion criteria consisted of being under 18 years old but younger than 80 years old, showing shoulder pain in both shoulders and having a joint prosthesis in at least one of the 2 shoulders, tumor, or infection. A total of 67 patients aged between 25 and 75 years (52.7 ± 11.8 years, 36 male and 31 female). More than 82% of patients with shoulder pain showed a GIRD higher than 20º. The mean GIRD was 37.6 ± 17.09º. The 95th percentile was 66.22º. From sociodemographic data could be extracted that: patients who have children showed a lower GIRD, patients with right shoulder pain, or whose dominance coincided with a painful shoulder showed a higher GIRD. The orthopedic findings revealed that patients with a positive Jobe test showed a lower GIRD. The linear model considering both sociodemographic and orthopedic findings showed that GIRD was reduced by having children and by BMI. GIRD shows a high incidence in patients with shoulder pain. The descendant, BMI, and positive Jobe test were negatively associated with the GIRD.
Collapse
Affiliation(s)
- Rafael Jácome-López
- Physiotherapy Unit, Clínica Universidad de Navarra, c/ Marquesado de Sta. Marta, Madrid, Spain
- CEU International Doctoral School (CEINDO), University San Pablo-CEU, C/Tutor, Madrid, Spain
| | - Javier Tejada-Gallego
- Orthopaedic Surgery and Traumatology Department, Clínica Universidad de Navarra, c/ Marquesado de Sta. Marta, Madrid, Spain
| | - José María Silberberg
- Orthopaedic Surgery and Traumatology Department, Clínica Universidad de Navarra, c/ Marquesado de Sta. Marta, Madrid, Spain
| | - Fernando García-Sanz
- Physiotherapy Service, Clínica CEMTRO, Av. Ventisquero de la Condesa, Mirasierra, Madrid, Spain
| | - Francisco García-Muro-San José
- Department of Physiotherapy, Faculty of Medicine, University San Pablo-CEU, Urbanización Montepríncipe, Boadilla del Monte, Spain
| |
Collapse
|
5
|
Damani A, Osmani H, Patel J, Robinson P, Dattani R, Ahmed N. Imaging for patients presenting with a painful shoulder. Br J Hosp Med (Lond) 2023; 84:1-10. [PMID: 37364877 DOI: 10.12968/hmed.2023.0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Shoulder pain is a common cause of musculoskeletal presentation in primary care, where both traumatic and atraumatic pathologies can also lead to emergency department attendances. This article discusses common acute and chronic presentations of a painful shoulder, looking at the typical history of patients presenting with a painful shoulder, examination findings and the most appropriate imaging modalities to consider. Strengths and weaknesses of each imaging modality are discussed along with their role in aiding diagnosis, as well as management of the various pathologies encountered in primary and secondary care.
Collapse
Affiliation(s)
- Arees Damani
- Department of Radiology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Humza Osmani
- Department of Orthopaedic Surgery, Addenbrooke's Hospital, Cambridge, UK
| | - Jugal Patel
- Department of Radiology, King's College Hospital NHS Foundation Trust, London, UK
| | - Philip Robinson
- Department of Radiology, Chapel Allerton Hospital, Leeds, UK
| | - Rupen Dattani
- Department of Orthopaedic Surgery, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Naeem Ahmed
- Department of Radiology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| |
Collapse
|
6
|
Karartı C, Basat HÇ, Özsoy İ, Özyurt F, Özsoy G, Kodak Mİ, Özüdoğru A, Uçar İ. Biopsychosocial Approach in Identifying Risk Factors of Kinesiophobia in Persons with Subacromial Pain Syndrome and Developing a Clinical Prediction Tool. Indian J Orthop 2023; 57:124-136. [PMID: 36660479 PMCID: PMC9789244 DOI: 10.1007/s43465-022-00781-7] [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] [Received: 03/22/2022] [Accepted: 11/15/2022] [Indexed: 11/27/2022]
Abstract
Introduction Although the negative effects of kinesiophobia on functional status in subacromial pain syndrome (SAPS) patients are clearly demonstrated, no study examines the risk factors of kinesiophobia in individuals with SAPS from a biopsychosocial perspective. The present study aims to determine the risk factors of kinesiophobia in individuals with SAPS using a biopsychosocial approach. This study also aims to explore the compounding effects of multiple associative risk factors by developing a clinical prediction tool to identify SAPS patients at higher risk for kinesiophobia. Materials and methods This cross-sectional study included 549 patients who were diagnosed with SAPS. The Tampa-Scale of Kinesiophobia (TSK) was used to assess kinesiophobia. Visual analog scale (VAS), The Shoulder Pain and Disability Index (SPADI), Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, the presence of metabolic syndrome, using any non-steroidal anti-inflammatory drugs, Pain Catastrophizing Scale (PCS), Illness Perception Questionnaire-revised (IPQ-R), Hospital Anxiety and Depression Scale (HADS), behavioral pattern of the patient, sociodemographic characteristics, and treatment expectancy were outcome measures. Results Thirteen significant risk factors of having kinesiophobia were: VASat rest (≥ 5.2), VASduring activity (≥ 7.1), DASH (≥ 72.1), presence of metabolic syndrome, PCShelplessness (≥ 16.1), IPQ-Rpersonal control (≤ 17.1), IPQ-Rtreatment control (≤ 16.3), HADSdepression (≥ 7.9), avoidance behavior type, being female, educational level (≤ high school), average hours of sleep (≤ 6.8), and treatment expectancy (≤ 6.6). The presence of seven or more risk factors increased the probability of having high level of kinesiophobia from 34.3 to 51%. Conclusions It seems necessary to address these factors, increase awareness of health practitioners and individuals. Level of evidence Level IV.
Collapse
Affiliation(s)
- Caner Karartı
- Department of Physiotherapy and Rehabilitation, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Hakkı Çağdaş Basat
- Department of Orthopedics and Traumatology, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - İsmail Özsoy
- Department of Physiotherapy and Rehabilitation, Selçuk University, Konya, Turkey
| | - Fatih Özyurt
- Department of Physiotherapy and Rehabilitation, Beykent University, Istanbul, Turkey
| | - Gülşah Özsoy
- Department of Physiotherapy and Rehabilitation, Selçuk University, Konya, Turkey
| | - Muhammed İhsan Kodak
- Department of Physiotherapy and Rehabilitation, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Anıl Özüdoğru
- Department of Physiotherapy and Rehabilitation, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - İlyas Uçar
- Department of Anatomy, Erciyes University, Kayseri, Turkey
| |
Collapse
|
7
|
Ekeberg OM, Pedersen SJ, Natvig B, Brox JI, Biringer EK, Endresen Reme S, Engebretsen KB, Joranger P, Mdala I, Juel NG. Making should er p ain simple in g eneral p ractice: implementing an evidence-based guideline for shoulder pain, protocol for a hybrid design stepped-wedge cluster randomised study (EASIER study). BMJ Open 2022; 12:e051656. [PMID: 34996788 PMCID: PMC8744118 DOI: 10.1136/bmjopen-2021-051656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Research suggests that current care for shoulder pain is not in line with the best available evidence. This project aims to assess the effectiveness, cost-effectiveness and the implementation of an evidence-based guideline for shoulder pain in general practice in Norway. METHODS AND ANALYSIS A stepped-wedge, cluster-randomised trial with a hybrid design assessing clinical effectiveness, cost-effectiveness and the effect of the implementation strategy of a guideline-based intervention in general practice. We will recruit at least 36 general practitioners (GPs) and randomise the time of cross-over from treatment as usual to the implemented intervention. The intervention includes an educational outreach visit to the GPs, a computerised decision tool for GPs and a self-management application for patients. We will measure outcomes at patient and GP levels using self-report questionnaires, focus group interviews and register based data. The primary outcome measure is the patient-reported Shoulder Pain and Disability Index measured at 12 weeks. Secondary outcomes include the EuroQol Quality of Life Measure (EQ5D-5L), direct and indirect costs, patient's global perceived effect of treatment outcome, Pain Self-Efficacy and Brief Illness Perception Questionnaire. We will evaluate the implementation process with focus on adherence to guideline treatment. We will do a cost-minimisation analysis based on direct and selected indirect costs and a cost-utility analysis based on EQ5D-5L. We will use mixed effect models to analyse primary and secondary outcomes. ETHICS AND DISSEMINATION Ethics approval was granted by the Regional Committee for Medical and Health Research Ethics-South East Norway (ref. no: 2019/104). Trial results will be submitted for publication in a peer-reviewed medical journal in accordance with Consolidated Standards of Reporting Trials. TRIAL REGISTRATION NUMBER NCT04806191.
Collapse
Affiliation(s)
- Ole Marius Ekeberg
- Department of Research and innovation, Helse Fonna HF, Haugesund, Norway
| | | | - Bård Natvig
- Department of General Practice, University of Oslo, Oslo, Norway
| | - Jens Ivar Brox
- Department of Physical Medicine and rehabilitation, Oslo University Hospital, Oslo, Norway
- Medical Faculty, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | | | | | - Kaia Beck Engebretsen
- Department of Physical Medicine and rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Pål Joranger
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Ibrahimu Mdala
- Department of General Practice, University of Oslo, Oslo, Norway
| | - Niels Gunnar Juel
- Department of General Practice, University of Oslo, Oslo, Norway
- Department of Physical Medicine and rehabilitation, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
8
|
Özel D, Demir Y, Özel BD, Adaş M. A novel measurement to evaluate supraspinatus tendinopathies with strain elastography. Acta Radiol 2021; 62:1365-1373. [PMID: 33115244 DOI: 10.1177/0284185120968567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND In addition to the traditional strain ratio (STR), a novel measurement termed hard percent of the whole tendon, provided by the device's software and resembling shear-wave elastography, was included in the study. PURPOSE To evaluate the correlation between magnetic resonance imaging (MRI) and strain elastography findings in cases with rotator cuff tendinopathy, including tears. MATERIAL AND METHODS As a prospective study, cases suggestive of rotator cuff tendinopathy were included. After MRI evaluation by two observers, grading of the elastography examination was performed by a third radiologist. For the first measurement, the region of interest (ROI) was chosen from the gray-scale evaluation corresponding to the area showing a MRI pathological signal. Stiffness was assessed with the STR. For the second measurement, the whole visible tendon was measured as the ROI. The hard percent (unaffected areas as a percent) was measured. Correlation coefficients between MRI grade and the two strain value measurements were calculated. RESULTS There were 93 cases (31 men, 62 women) with 112 involved tendons. The correlation coefficient between MRI grade and age was calculated as 0.56, between MRI grade and STR it was -0.51, and with the novel measurement the correlation coefficient was -0.53. CONCLUSION This study showed a good association of findings of tendon stiffness with those of tendinopathy on MRI. Using the hard ratio as a novel measurement, its correlation with MRI grade was as reliable as the STR. We also experienced that the benefit of elastography is a challenging issue for defining small ruptures.
Collapse
Affiliation(s)
- Deniz Özel
- Department of Radiology, Sağlık Bilimleri University, Prof. Dr Cemil Taşcıoğlu şehir hastanesi, Istanbul, Turkey
| | - Yüksel Demir
- Department of Radiology, Sağlık Bilimleri University, Prof. Dr Cemil Taşcıoğlu şehir hastanesi, Istanbul, Turkey
| | - Betül Duran Özel
- Department of Radiology, Sağlık Bilimleri University, Hamidiye Etfal Research and Education Hospital, Istanbul, Turkey
| | - Müjdat Adaş
- Department of Orthopedics, Sağlık Bilimleri University, Prof. Dr Cemil Taşcıoğlu şehir hastanesi, Istanbul, Turkey
| |
Collapse
|
9
|
Araya-Quintanilla F, Gutiérrez-Espinoza H, Gana-Hervias G, Cavero-Redondo I, Álvarez-Bueno C. Association between type of rotator cuff tear and functional outcomes in patients with massive and irreparable rotator cuff tear: A pre-post intervention study. J Shoulder Elbow Surg 2021; 30:1393-1401. [PMID: 32920107 DOI: 10.1016/j.jse.2020.08.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/07/2020] [Accepted: 08/17/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND The aim of this study was to analyze: (1) the differences in the pre-post change in functional outcomes after a physical therapy program by the type of massive and irreparable rotator cuff tear (MIRCT) controlling for potential confounders, and (2) the influence of lifestyle behaviors and demographic and tear tendon characteristics on function in patients over 60 years of age with conservatively treated MIRCT. MATERIALS AND METHODS In this pre-post intervention study, 92 patients were prospectively recruited at the Clinical Hospital San Borja Arriaran, with atraumatic MIRCT, between 60 and 75 years of age (mean: 67.9 ± 4.5 years), and the mean of length of symptoms was 16.5 months (±5.7 months). Patients received a physical therapy program consisting of manual therapy and a specific exercise program of 2 sessions per week for 12 weeks. The imaging findings were performed by 2 medical radiologists who classified the rotator cuff tear according to the criteria proposed by Collins. Shoulder function, upper limb function, and pain intensity were assessed with the Constant-Murley; Disabilities of the Arm, Shoulder, and Hand; and visual analog scale (VAS), respectively. Analysis of covariance models were estimated to assess differences in MIRCT categories between functional outcomes. Multiple regression model analysis was used for the association between the change in functional outcomes and lifestyle behaviors, and demographic and tear tendon characteristics. RESULTS The results showed no pre-post change in functional outcomes by type of MIRCT in all models (P > .05). There is an association between length of symptoms (P = .000), and the baseline values of the 3 functional measures (P = .000) are associated with changes in Constant-Murley; Disabilities of the Arm, Shoulder, and Hand; and VAS. In addition, changes in VAS are associated with body mass index (BMI) (P = .000), and changes in Constant-Murley are associated with gender (P = .023), BMI (P = .000), and tobacco consumption (P = .000). CONCLUSION There is no difference in functional outcomes by type of MIRCT after a physical therapy program controlling for potential confounders. In addition, there is an association of length of symptoms with all functional outcomes, an association of BMI with VAS and Constant-Murley questionnaire, and an association between tobacco consumption and Constant-Murley questionnaire. Our results could influence the orthopedic surgeon's decisions; thus, not predicting the functional outcome through imaging findings could lead clinicians to reconsider the need for surgery in the treatment algorithm in patients over 60 years with MIRCT. In addition, demographic characteristics and lifestyle behaviors might be considered within the patient's evaluation and follow-up to decide on surgical interventions and evaluate the clinical course of the disease. Further studies measuring additional variables and longer follow-up are needed to confirm these results.
Collapse
Affiliation(s)
- Felipe Araya-Quintanilla
- Rehabilitation in Health Research Center, CIRES, Universidad de Las Americas, Santiago, Chile; Faculty of Health Sciences, Universidad SEK, Santiago, Chile
| | - Héctor Gutiérrez-Espinoza
- Rehabilitation in Health Research Center, CIRES, Universidad de Las Americas, Santiago, Chile; School of Health Sciences, Physiotherapy Department, Universidad Gabriela Mistral, Santiago, Chile
| | - Gonzalo Gana-Hervias
- School of Health Sciences, Physiotherapy Department, Universidad Gabriela Mistral, Santiago, Chile
| | - Iván Cavero-Redondo
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain; Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay.
| | - Celia Álvarez-Bueno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain; Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| |
Collapse
|
10
|
Engebretsen KB, Robinson HS, Vollestad NK. Shoulder patients in primary and specialist health care. A cross-sectional study. Scand J Pain 2021; 21:345-354. [PMID: 34387955 DOI: 10.1515/sjpain-2020-0094] [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: 06/17/2020] [Accepted: 11/13/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Shoulder pain is a prevalent problem and has a considerable impact on the use of primary and specialist health care in Norway. It is important to improve short-term recovery and reduce long-term consequences regarding pain and disability, the high costs of treatment and the amount of sick-leave. Treatment for non-specific shoulder pain is mainly non-operative. The aims of this study were to investigate if there are differences in main characteristics, pain and disability (SPADI-score) and psycho-social factors between patients in primary and specialist health care. METHODS This cross-sectional study included patients consulting physiotherapy in primary health care and patients at an outpatient clinic in specialist health care. Well-known and tested questionnaires for these populations were used and variables were divided into clinical, sociodemographic, psycho-social, and shoulder pain and disability. Descriptive statistics were applied. Two-sample t-test and linear regression were used for continuous data whereas chi-square tests and logistic regression were applied to test differences in categorical data between the two study populations. RESULTS Two hundred and 36 patients were recruited from primary health care (FYSIOPRIM, Physiotherapy In Primary Care) and 167 from specialist health care. Patients in primary health care reported less regular use of pain medication (30.7 vs. 61.3%) and fewer patients had symptom duration >12 months (41.9 vs. 51.0%). Furthermore, they reported lower pain intensity, less shoulder pain and disability (SPADI-score), lower scores on psycho-social factors, but higher on expectations of recovery. CONCLUSIONS Patients with shoulder pain treated in primary health care and in specialist health care are different according to factors such as duration of symptoms, pain and disability, and some of the psycho-social variables. However, the differences are small and the variations within the two study samples is large. Patients treated in primary health care seemed to be less affected and to have higher expectations concerning their recovery. However, based on our results we may question why many patients are referred to specialist health care rather than continuing treatment in primary health care.
Collapse
Affiliation(s)
- Kaia B Engebretsen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital HF, Oslo, Norway
| | - Hilde S Robinson
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Nina K Vollestad
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway
| |
Collapse
|
11
|
Baeske R, Hall T, Silva MF. The inclusion of mobilisation with movement to a standard exercise programme for patients with rotator cuff related pain: a randomised, placebo-controlled protocol trial. BMC Musculoskelet Disord 2020; 21:744. [PMID: 33183274 PMCID: PMC7663889 DOI: 10.1186/s12891-020-03765-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 11/03/2020] [Indexed: 11/15/2022] Open
Abstract
Background Rotator cuff related pain (RCRP) is one of the most common sources of musculoskeletal shoulder pain affecting the general population. Conservative treatment, in the form of exercise, is considered the first line approach, nonetheless, improvements seem to be modest. One therapeutic modality that might be an adjunct to the treatment of this condition is mobilisation with movement (MWM). MWM is a pain-free manual procedure that targets restricted and painful movements, commonly seen in patients with RCRP. The purpose of clinical trial is to determine whether MWM with exercise has benefits over sham MWM with exercise in RCRP. Methods A randomised, sham-controlled trial of 70 adults complaining of RCRP will compare the effects of MWM combined with exercise over sham MWM with exercise. Participants will be allocated to one of two groups: exercise and MWM (EG) or exercise and sham MWM (CG). Two weekly individual treatment sessions will be conducted over five weeks. All assessments will be performed by a blinded assessor. Primary outcome measures will be the shoulder pain and disability index (SPADI) and the numeric pain rating scale (NPRS), assessed at baseline, discharge and one-month follow-up. Secondary outcome measures will be active range of motion, self-efficacy and the global rating of change scale. The analyses will be conducted considering a statistically significant p-value ≤0.05. Normality will be assessed with the Kolmogorov-Smirnov test and homogeneity with the Levene’s test. For the primary outcome measures (SPADI and NPRS) and self-efficacy, a 2 × 3 ANOVA with treatment group (EG versus CG) and time (baseline, end of the treatment and follow-up) factors will be performed. Separate 2 × 2 ANOVA will be used for range of motion (baseline and end of the treatment). Global rating scale of change analysis will be conducted using descriptive statistics. Intention-to-treat analysis will be adopted. Discussion As there is a paucity of longitudinal studies investigating the use of MWM in patients with RCRP, this study will help to better understand its role together with a structured exercise programme. Trial registration Clinical Trials Registry number NCT04175184. November, 2019.
Collapse
Affiliation(s)
- Rafael Baeske
- Science of Rehabilitation programme at Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Sarmento Leite, 245, Porto Alegre, Rio Grande do Sul, CEP 90050-170, Brazil. .,, São Leopoldo, Brazil.
| | - Toby Hall
- School of Physiotherapy & Exercise Science, Curtin University, Kent Street, Bentley, Western Australia, 6102
| | - Marcelo Faria Silva
- Department of Physical Therapy, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Sarmento Leite, 245, Porto Alegre, Rio Grande do Sul, CEP 90050-170, Brazil
| |
Collapse
|
12
|
Abstract
The aim of this article is to review the use of magnetic resonance imaging (MRI) for the evaluation of shoulder pain, which is a common clinical complaint of the musculoskeletal system. MRI is an essential auxiliary tool to evaluate these patients because of its high resolution and high sensitivity in depicting the soft tissues. This article will review the imaging technique, normal imaging anatomy, and most common imaging findings of disorders of tendons, labrum, and ligaments of the shoulder. It will also discuss common systemic diseases that manifest in the shoulder as well as disorders of the acromioclavicular joint and bursae. New advances and research in MRI have provided additional potential uses for evaluating shoulder derangements.
Collapse
|
13
|
Hesse EM, Atanasoff S, Hibbs BF, Adegoke OJ, Ng C, Marquez P, Osborn M, Su JR, Moro PL, Shimabukuro T, Nair N. Shoulder Injury Related to Vaccine Administration (SIRVA): Petitioner claims to the National Vaccine Injury Compensation Program, 2010-2016. Vaccine 2020; 38:1076-1083. [PMID: 31771864 PMCID: PMC9169064 DOI: 10.1016/j.vaccine.2019.11.032] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/12/2019] [Accepted: 11/14/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Since 2010, petitioner claims of shoulder injury related to vaccine administration (SIRVA) to the National Vaccine Injury Compensation Program (VICP) have been increasing. OBJECTIVE To conduct a scientific review of clinical characteristics of SIRVA petitions to the VICP. METHODS We queried the VICP's Injury Compensation System database for medical reports of alleged SIRVA and SIRVA-like injuries. Medical reports are summaries of petitioner claims and supporting documentation along with a VICP clinician reviewer diagnosis and assessment of criteria for concession. We conducted a descriptive analysis of SIRVA petitioner claims recommended by the VICP for concession as SIRVA injuries. RESULTS We identified 476 petitioner claims recommended for concession. Claims per year increased from two in 2011, the first full year in the analytic period, to 227 in 2016. Median age was 51 years, 82.8% were women, and median body mass index was 25.1 (range 17.0-48.9). Four hundred cases (84.0%) involved influenza vaccine. Pharmacy or store (n = 168; 35.3%) was the most common place of vaccination followed by doctor's office (n = 147; 30.9%). Fewer than half of cases reported a suspected administration error; 172 (36.1%) reported 'injection too high' on the arm. Shoulder pain, rotator cuff problems, and bursitis were common initial diagnoses. Most (80.0%) cases received physical or occupational therapy, 60.1% had at least one steroid injection, and 32.6% had surgery. Most (71.9%) healthcare providers who gave opinions on causality considered the injury was caused by vaccination. A minority (24.3%) of cases indicated that symptoms had resolved by the last visit available in medical records. CONCLUSIONS Most conceded claims for SIRVA were in women and involved influenza vaccines. Injection too high on the arm could be a factor due to the risk of injecting into underlying non-muscular tissues. Healthcare providers should be aware of proper injection technique and anatomical landmarks when administering vaccines.
Collapse
Affiliation(s)
- Elisabeth M Hesse
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 1600 Clifton Rd, MS V24-5, Atlanta, GA 30329, United States; Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 1600 Clifton Rd, MSV18-4, Atlanta, GA 30329, United States.
| | - Sarah Atanasoff
- National Vaccine Injury Compensation Program, Health Resources and Services Administration, U.S. Department of Health and Human Services, 5600 Fishers Lane, Rockville, MD 20857, United States
| | - Beth F Hibbs
- Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 1600 Clifton Rd, MSV18-4, Atlanta, GA 30329, United States
| | - Oluwasegun J Adegoke
- Public Health Informatics Fellowship Program, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, United States; Global Immunizations Division, Center for Global Health, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 1600 Clifton Rd, MS H24-2, Atlanta, GA 30329, United States
| | - Carmen Ng
- Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 1600 Clifton Rd, MSV18-4, Atlanta, GA 30329, United States
| | - Paige Marquez
- Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 1600 Clifton Rd, MSV18-4, Atlanta, GA 30329, United States
| | - Mark Osborn
- National Vaccine Injury Compensation Program, Health Resources and Services Administration, U.S. Department of Health and Human Services, 5600 Fishers Lane, Rockville, MD 20857, United States
| | - John R Su
- Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 1600 Clifton Rd, MSV18-4, Atlanta, GA 30329, United States
| | - Pedro L Moro
- Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 1600 Clifton Rd, MSV18-4, Atlanta, GA 30329, United States
| | - Tom Shimabukuro
- Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 1600 Clifton Rd, MSV18-4, Atlanta, GA 30329, United States
| | - Narayan Nair
- National Vaccine Injury Compensation Program, Health Resources and Services Administration, U.S. Department of Health and Human Services, 5600 Fishers Lane, Rockville, MD 20857, United States
| |
Collapse
|
14
|
Reports of atypical shoulder pain and dysfunction following inactivated influenza vaccine, Vaccine Adverse Event Reporting System (VAERS), 2010-2017. Vaccine 2019; 38:1137-1143. [PMID: 31784231 DOI: 10.1016/j.vaccine.2019.11.023] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 11/07/2019] [Accepted: 11/11/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Vaccines administered into or too close to underlying joint structures have the potential to cause shoulder injuries. Limited data exist on the epidemiology of such events. OBJECTIVE To describe case reports of atypical shoulder pain and dysfunction following injection of inactivated influenza vaccine (IIV). METHODS We searched the Vaccine Adverse Event Reporting System (VAERS) database from July 2010 to June 2017 for reports of atypical shoulder pain and dysfunction following IIV. When identifying reports, we made no assumptions about true incident injury or causality with respect to vaccination. Pain had to begin <48 h after vaccination and signs and symptoms had to continue for >7 days to differentiate from self-limited local reactions. We conducted descriptive analysis. RESULTS We identified 1220 reports that met our case definition (2.0% of all IIV reports, range 1.5%-2.5% across influenza seasons). Median age was 52 years (range 16-94) and most patients (82.6%) were female. Shoulder pain (44.1%), injected limb mobility decreased (40.8%), joint range of motion decreased (21.2%), rotator cuff syndrome (9.2%), and bursitis (9.0%) were frequently reported. In 86.6% of reports, signs and symptoms had not resolved by the time of report submission. In reports that included descriptions suggesting contributing factors (n = 266), vaccination given "too high" on the arm was cited in 81.2%. Nearly half (n = 605, 49.6%) of reports described a healthcare provider evaluation. Treatments included non-narcotic analgesics, physical therapy, and corticosteroid injection. Vaccinations were most commonly administered in a pharmacy or retail store (41.0%) or doctor's office or hospital (31.6%). CONCLUSIONS Reports of atypical shoulder pain and dysfunction following IIV were uncommon, considering the amount of IIV use, and stable across influenza seasons. While specific etiology of cases is unknown, improperly administered vaccine, which is preventable, might be a factor. Prevention strategies include education, training, and adherence to best practices for vaccine administration.
Collapse
|
15
|
Exposure–response relationships between cumulative occupational shoulder exposures and different diagnoses related to surgery for subacromial impingement syndrome. Int Arch Occup Environ Health 2019; 93:375-380. [DOI: 10.1007/s00420-019-01485-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 11/03/2019] [Indexed: 10/25/2022]
|