1
|
Miyatake K, Wakita R, Fujisawa T, Kawabata Y, Kusaba Y, Naka T, Nakamura R, Tsujiku S, Inaba Y. Satisfaction of patients with frozen shoulder following silent manipulation: a prospective observation study. Sci Rep 2024; 14:22409. [PMID: 39333124 PMCID: PMC11437121 DOI: 10.1038/s41598-024-67699-y] [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: 12/23/2023] [Accepted: 07/15/2024] [Indexed: 09/29/2024] Open
Abstract
Silent manipulation is a procedure for frozen shoulders that involves manipulating the shoulder while the patient is awake by performing C5, C6, and C7 cervical nerve root block under ultrasound guidance. This retrospective study, conducted at Yokohama City University Hospital, aimed to evaluate the clinical outcomes of silent manipulation and assess whether the experience level of the practitioner influenced treatment efficacy. Between October 2020 and January 2022, 53 patients who met the inclusion criteria underwent silent manipulation for frozen shoulder. The procedure was performed by either an experienced or a less experienced practitioner, and the patients were followed-up for up to 1 year post-treatment. Silent manipulation resulted in significant improvements in shoulder range of motion, as measured by forward flexion, abduction, external rotation, and hand-behind-back, as well as in patient-reported outcomes, including disabilities of the arm, shoulder, and hand and Shoulder 36 scores. These improvements were observed 1 week, 3 months, and 1 year after silent manipulation, indicating the short-term efficacy of the procedure. Furthermore, this study revealed that the practitioners' level of experience played a significant role in the outcomes. The experienced doctor achieved better 1st external rotation and belt tying outcomes, as well as Shoulder 36 pain, muscle strength, and activities of daily living domain scores. This suggests that technical expertise in silent manipulation is crucial to achieve optimal outcomes. Silent manipulation offers an effective therapeutic approach for frozen shoulder, leading to significant improvements in range of motion and patient satisfaction. Practitioner expertise is a vital factor in treatment success, emphasizing the importance of skilled professionals in the performance of this procedure.
Collapse
Affiliation(s)
- Kazuma Miyatake
- Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan.
| | - Ryusei Wakita
- Department of Orthopaedic Surgery, Fujisawa Shounandai Hospital, Fujisawa, Japan
| | - Takahiro Fujisawa
- Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan
| | - Yusuke Kawabata
- Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan
| | - Yohei Kusaba
- Department of Orthopaedic Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Takuma Naka
- Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan
| | - Reina Nakamura
- Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan
| | - Shinya Tsujiku
- Department of Orthopaedic Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Yutaka Inaba
- Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan
| |
Collapse
|
2
|
Brindisino F, Sciscione S, Andriesse A, Cioeta M, Struyf F, Feller D. Frozen shoulder: subjects' needs and perspectives and clinicians' beliefs and management strategies: do they align? A cross-sectional study. BMC Musculoskelet Disord 2024; 25:745. [PMID: 39289654 PMCID: PMC11406753 DOI: 10.1186/s12891-024-07803-5] [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: 03/23/2024] [Accepted: 08/20/2024] [Indexed: 09/19/2024] Open
Abstract
OBJECTIVE Physiotherapists (PTs) play a crucial role in managing individuals with Frozen Shoulder (FS), frequently being the first healthcare professionals involved in the treatment of this condition. AIM This study aimed to compare the beliefs, expectations, and perspectives of individuals with FS with the knowledge, skills, and strategies of PTs, highlighting similarities and differences. METHOD This study adhered to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). From May 1st to August 1st, 2023, a two-part survey was conducted involving PTs and individuals diagnosed with FS. The survey focused on comparing key areas such as clinical assessment, patient education, treatment expectations, and the psychological aspects of the patient-clinician relationship. RESULTS A total of 501 PTs and 110 subjects with FS participated in the survey. Most PTs showed proficiency in FS pathoanatomical conditions and were also attentive to psychological aspects (88.4%), describing the pathology evolution in three or two stages (68.2%). They also highlighted the importance of patient education (89.6%) and recognized the potential benefits of a multiprofessional collaboration in managing FS (82.2%). Reassurance was reported as a priority by 32.3% of PTs. Subjects with FS expressed a preference for PTs who are both expert and empathetic (73.6%). Regarding their understanding of FS, 29.09% of subjects reported receiving a three-phase explanation, while 26.36% felt inadequately informed. Nearly half of the subjects (49.09%) anticipated being managed independently by a PT, with 93.64% prioritizing the improvement of their range of motion. CONCLUSION This study revealed a general agreement between subjects with FS and PTs regarding aspects of the therapeutic relationship, patient education, pathology management, compliance and motivation strategies, and pain management preferences. However, significant differences emerged concerning the perception of physiotherapy effectiveness, primary treatment goals, subjects' priorities, and the importance of psychological assessment.
Collapse
Affiliation(s)
- Fabrizio Brindisino
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy.
| | | | - Arianna Andriesse
- Medical Translation Private Practice c/o Andriesse Medical Translator, Lecce, Italy
| | | | - Filip Struyf
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Daniel Feller
- Provincial Agency for Health of the Autonomous Province of Trento, Trento, Italy
- Centre of Higher Education for Health Sciences of Trento, Trento, Italy
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
3
|
Mertens MG, Meeus M, Lluch Girbes E, Dueñas L, Twickler MT, Verborgt O, Struyf F. Differences in biomechanical and metabolic factors between patients with frozen shoulder and asymptomatic individuals. A cross-sectional study. Musculoskelet Sci Pract 2024; 72:102980. [PMID: 38820869 DOI: 10.1016/j.msksp.2024.102980] [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: 10/06/2023] [Revised: 05/06/2024] [Accepted: 05/26/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND the pathogenesis of frozen shoulder (FS) is thought to be one of inflammation and fibrosis possibly influenced by hyperglycemia. Biomechanical changes of the shoulder joint in terms of muscle strength, scapular kinematics and proprioception might occur in FS. OBJECTIVES to compare muscle strength, scapular kinematics, proprioception, and blood glucose levels within patients with FS and to asymptomatic individuals. DESIGN cross-sectional study. METHOD Thirty-five patients with FS and 35 asymptomatic age and gender-matched individuals underwent physical assessment to determine muscle strength (abduction, external and internal rotation), scapular kinematics (both visually and with a plurimeter), proprioception (joint position sense), and blood glucose level. RESULTS Patients with FS showed a decrease in muscle strength in their affected shoulder compared to both the unaffected shoulder and asymptomatic individuals. Significant differences were found between the affected and unaffected shoulder in the FS group and between groups (FS versus controls) in scapular upward rotation (plurimeter) at 30° and 60° abduction. No difference in scapular kinematics (visual observation), proprioception, and blood glucose levels was found neither between shoulders in the FS group nor between groups. CONCLUSION A clinically relevant difference in muscle strength and increase in scapular upward rotation were found in the affected shoulder of patients with FS compared to their unaffected side and controls. However, no evidence of different levels of scapular kinematics (visual observation), proprioception, and blood glucose levels in the affected shoulder compared to the unaffected shoulder or controls is lacking.
Collapse
Affiliation(s)
- Michel Gcam Mertens
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium; Pain in Motion International Research Group, Belgium.
| | - Mira Meeus
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium; Pain in Motion International Research Group, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.
| | - Enrique Lluch Girbes
- Pain in Motion International Research Group, Belgium; Department of Physical Therapy, University of Valencia, Valencia, Spain; Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Lirios Dueñas
- Department of Physical Therapy, University of Valencia, Valencia, Spain.
| | - Marcel Tb Twickler
- Department of Endocrinology, Diabetology and Metabolic Disease, AZ Monica, Deurne/Antwerp, Belgium; University of Antwerp, Faculty of Medicine and Health Sciences, Antwerp, Belgium.
| | - Olivier Verborgt
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium; Department of Orthopedic Surgery and Traumatology, AZ Monica, Antwerp, Belgium; Department of Orthopedic Surgery, University Hospital Antwerp (UZA), Edegem, Belgium.
| | - Filip Struyf
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium.
| |
Collapse
|
4
|
Brindisino F, Girardi G, Crestani M, Assenza R, Andriesse A, Giovannico G, Pellicciari L, Salomon M, Venturin D. Rehabilitation in subjects with frozen shoulder: a survey of current (2023) clinical practice of Italian physiotherapists. BMC Musculoskelet Disord 2024; 25:573. [PMID: 39044183 PMCID: PMC11265321 DOI: 10.1186/s12891-024-07682-w] [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: 02/07/2024] [Accepted: 07/10/2024] [Indexed: 07/25/2024] Open
Abstract
OBJECTIVE Frozen Shoulder (FS) is a musculoskeletal pathology that leads to disability, functional decline, and a worsening in quality of life. Physiotherapists are the primary professionals involved in the treatment of FS, and it is essential to determine if their practice aligns with evidence-based suggestions. AIM The aim is to assess the knowledge, skills, and operational strategies of Italian physiotherapists regarding FS and compare them with the existing literature. METHODS A web-based, anonymous, and voluntary cross-sectional survey was developed and administered to Italian physiotherapists to evaluate their clinical practices. RESULTS A total of 501 physiotherapists (38.5% female), completed the survey. More than half were under 35 years old (67.8%), declared working in private practice settings or being self-employed (57.1%), and were primarily engaged with musculoskeletal patients (81.8%). For subjects with FS at their first access, 21.4% identified X-rays as the most useful imaging technique to recognize pathologies beyond rehabilitation competence. In terms of general management, the majority reported working with an orthopaedic or physiatrist (47.5%) or in a multidisciplinary team (33.5%). Regarding manual therapy techniques, 63.3% of physiotherapists preferred intense degree mobilization, posterior direction, and moderate pain at the end of the range of motion for low irritable/high stiffness FS; however, there is a lack of consensus for managing very irritable/low stiffness FS. The majority of physiotherapists (57.7%) concurred that stretching improves the balance between metalloproteinase and its inhibitors. Additionally, 48.3% of physiotherapists selected mobile phone videos and messages to improve patients' compliance with exercises at home and for motivational/educational purposes. DISCUSSION AND CONCLUSION The clinical practices of Italian physiotherapists in FS subjects sometimes deviate from evidence-based recommendations. While some discrepancies may be attributed to the existing uncertainties in the literature regarding knowledge and management strategies for FS patients, the authors recommend a stronger adherence to evidence-based practice.
Collapse
Affiliation(s)
- Fabrizio Brindisino
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy.
| | - Giuseppe Girardi
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Mauro Crestani
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Raffaele Assenza
- Physiotherapy Private Practice c/o Assenza Physical Therapy, Rome, Italy
| | - Arianna Andriesse
- Medical Translation Private Practice c/o Andriesse Medical Translator, Rome, Italy
| | - Giuseppe Giovannico
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | | | - Mattia Salomon
- Department of Clinical Science and Translational Medicine, University of Roma "Tor Vergata", Rome, Italy
| | - Davide Venturin
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| |
Collapse
|
5
|
Collin P, Martinho T, Denard PJ, Gain S, Pernoud A, Bothorel H, Lädermann A. Are Lower Passive Anterior Elevation and External Rotation at 6 Weeks Postoperatively Associated With Healing of Isolated Arthroscopic Supraspinatus Repairs? Am J Sports Med 2024; 52:1411-1418. [PMID: 38616551 DOI: 10.1177/03635465241241549] [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] [Indexed: 04/16/2024]
Abstract
BACKGROUND Despite advancements in surgical technique, failure of tendon healing remains a common problem after arthroscopic rotator cuff repair (ARCR). PURPOSE/HYPOTHESIS The purpose of this study was to examine the relationship between range of motion (ROM) recovery and healing after ARCR. It was hypothesized that an early loss of ROM would be associated with tendon healing. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS This was a retrospective comparative study of primary ARCR of isolated full-thickness supraspinatus (SSN) tendon tears. Cases were retrieved from a prospective rotator cuff repair database and divided into 2 groups based on healing (healed/nonhealed). A standardized clinical evaluation was performed before and at 6 weeks, 3 months, and 6 months after surgery. Collected data included passive and active ROM, visual analog scale for pain, and Constant score. Healing was assessed by ultrasound at 6 months. RESULTS Of 1397 eligible ARCRs, 1207 were included. The healing rate was 86.7%. Age was higher in the nonhealed group (57.8 ± 7.9 years vs 61.6 ± 8.8 years; P < .001). Patients with healed repairs had a larger decrease in passive anterior elevation (AE) from the preoperative to the 6-week postoperative visit (-31°± 28° vs -18°± 26°; P < .001), followed by a more substantial increase throughout the remaining follow-up period (32°± 23° vs 18°± 21°; P < .001). At 6 months postoperatively, there was no difference in AE between groups (159°± 17° vs 161°± 14°; P > .999). External rotation elbow at side (ER1) and internal rotation hand in the back (IR1) followed similar courses of recovery. Passive and active ROM had a strong positive correlation at each follow-up. Age (odds ratio [OR], 1.79; 95% CI, 1.45-2.23; P < .001) and 6-week passive AE (OR, 1.33; 95% CI, 1.20-1.48; P < .001) and ER1 (OR, 1.15; 95% CI, 1.03-1.29; P = .017) were predictors for nonhealing. CONCLUSION Lower passive AE and ER1 at 6 weeks postoperatively and younger age are associated with healing after ARCR of isolated SSN tendon tears. At 6 months postoperatively, there were no differences in ROM, regardless of tendon healing.
Collapse
Affiliation(s)
- Philippe Collin
- CHP Saint-Gregoire, Saint-Grégoire, France
- Clinique Victor Hugo, Paris, France
- American Hospital of Paris, Neuilly-sur-Seine, France
| | - Tiago Martinho
- Division of Orthopaedics and Trauma Surgery, Hôpital de La Tour, Meyrin, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | | | | | | | - Hugo Bothorel
- Research Department, La Tour Hospital, Meyrin, Switzerland
| | - Alexandre Lädermann
- Division of Orthopaedics and Trauma Surgery, Hôpital de La Tour, Meyrin, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
- FORE (Foundation for Research and Teaching in Orthopedics, Sports Medicine, Trauma, and Imaging in the Musculoskeletal System), Meyrin, Switzerland
| |
Collapse
|
6
|
Lanciego C, Puentes-Gutierrez A, Sánchez-Casado M, Cifuentes-Garcia I, Fernández-Tamayo A, Dominguez-Paillacho D, Ciampi-Dopazo JJ, Marquina-Valero MA. Transarterial Embolization for Adhesive Capsulitis of the Shoulder: Midterm Outcomes on Function and Pain Relief. J Vasc Interv Radiol 2024; 35:550-557. [PMID: 38199458 DOI: 10.1016/j.jvir.2023.12.572] [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: 09/06/2023] [Revised: 12/27/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024] Open
Abstract
PURPOSE To determine the safety and potential effectiveness of transarterial embolization for adhesive capsulitis of the shoulder. MATERIALS AND METHODS This prospective study analyzed consecutive adult patients with adhesive capsulitis referred for embolization between January 2018 and May 2023 after a poor response to treatment (symptoms and limitation of motion in ≥2 axes; ≤120° flexion, ≤50° external rotation and/or internal rotation with the shoulder abducted 90°) persisting for >3 months after having completed ≥6 weeks of analgesics and physical therapy. Different types of pain and mobility were measured before embolization and 1, 3, and 6 months after embolization. Overall upper limb function (Quick Disabilities of Arm, Shoulder, and Hand) and patient satisfaction were measured before and 6 months after embolization. Long-term follow-up comprised telephone interviews and clinical history reviews. RESULTS A total of 20 patients (12 [60%] women; median age, 50.7; interquartile ranges [IQR], 45‒55 years) were included; 6 (30%) had diabetes and 15 (75%) were off work. Median duration of symptoms before embolization was 39.4 weeks (IQR, 28‒49 weeks), and median duration of rehabilitation therapy was 12.8 weeks (IQR, 8‒16 weeks). Six months after embolization, significant improvements were observed in nocturnal pain (P = .003), pain on moving (P = .001), external rotation (P < .001), internal rotation (P < .001), active flexion (P < .001), passive flexion (P = .03), active abduction (P < .001), passive abduction (P < .001), and overall function (P < .001). Despite objective improvements, patient satisfaction was nearly unchanged. Only 1 patient experienced a mild adverse event. CONCLUSION Transarterial embolization is safe and potentially effective in treating adhesive capsulitis of the shoulder refractory to conventional treatment. Clinical improvements were maintained in the mid to long term.
Collapse
Affiliation(s)
- Carlos Lanciego
- Interventional Radiology Unit, Radiology Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain.
| | - Ana Puentes-Gutierrez
- Rehabilitation and Physical Medicine Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Marcelino Sánchez-Casado
- Biostatistics Unit, Intensive Care Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Irene Cifuentes-Garcia
- Interventional Radiology Unit, Radiology Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Ana Fernández-Tamayo
- Interventional Radiology Unit, Radiology Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - David Dominguez-Paillacho
- Interventional Radiology Unit, Radiology Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Juan J Ciampi-Dopazo
- Interventional Radiology Unit, Radiology Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Maria A Marquina-Valero
- Rehabilitation and Physical Medicine Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| |
Collapse
|
7
|
Skaliczki G, Kovács K, Antal I, Sallai I, Kovács B, Nyőgér Z, Géresi Á, Kiss B, Várnagy A. Arthroscopic capsular release is more effective in pain relief than conservative treatment in patients with frozen shoulder. BMC Musculoskelet Disord 2024; 25:145. [PMID: 38365741 PMCID: PMC10870563 DOI: 10.1186/s12891-024-07275-7] [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: 09/17/2023] [Accepted: 02/09/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Frozen shoulder is a common medical condition, but the ideal therapeutic method is yet to be determined. Our aim was to analyze the pain-relieving effect of different treatment options used for the management of this disease. METHODS Medical records of 59 patients (22 male, 37 female, average age: 55.5 years ±9.9) with early stage primary frozen shoulder were evaluated, their demographic data, physical examination, concomitant diseases and treatment specific data were registered. Life quality and the level of pain were assessed using the Oxford Shoulder Score (OSS) and Numeric Rating Scale (NRS). Different treatment modalities and their effect on pain relief were recorded. Any existing correlation between life quality, pain and demographic data, concomitant diseases or the therapeutic method used was investigated. RESULTS The level of pain measured on NRS improved from 7.9 ± 1.6 to 1.9 ± 2.2. The most effective therapeutic method in terms of pain relief was surgery, followed by physiotherapy and intraarticular steroid injection (NRS score after treatment: 2 - p < 0.0001; 3.3 - p < 0.0001; 4.9 - p < 0.0001, respectively). Non-steroidal anti-inflammatory drugs (NSAIDs) did not reduce pain significantly. OSS improved from 24 to 43.6 and was not affected by the investigated variables, time to recovery was not influenced by the demographic data, the type of treatment or concomitant diseases. CONCLUSIONS Arthroscopic capsular release, physiotherapy and intraarticular steroid injection outperformed physical therapy and NSAID treatment in terms of pain relief. Despite of slight but persistent post-therapeutic pain found in half of the cases, treatment was considered satisfactory by the patients. Nor patient specific neither therapy specific data had a significant effect on the course of the disease.
Collapse
Affiliation(s)
- Gábor Skaliczki
- Department of Orthopedics, Semmelweis University, Korányi Sándor utca 2, Budapest, 1083, Hungary.
| | - Krisztián Kovács
- Department of Orthopedics, Semmelweis University, Korányi Sándor utca 2, Budapest, 1083, Hungary
| | - Imre Antal
- Department of Orthopedics, Semmelweis University, Korányi Sándor utca 2, Budapest, 1083, Hungary
| | - Imre Sallai
- Department of Orthopedics, Semmelweis University, Korányi Sándor utca 2, Budapest, 1083, Hungary
| | - Beáta Kovács
- Department of Orthopedics, Semmelweis University, Korányi Sándor utca 2, Budapest, 1083, Hungary
| | - Zoltán Nyőgér
- Department of Orthopedics and Traumatology, Petz Aladár University Teaching Hospital, Vasvári Pál utca 2-4, Győr, 9024, Hungary
| | - Áron Géresi
- Department of Orthopedics, Semmelweis University, Korányi Sándor utca 2, Budapest, 1083, Hungary
| | - Balázs Kiss
- Department of Biophysics and Radiation Biology, Semmelweis University, Tűzoltó utca 37-47, Budapest, 1094, Hungary
| | - Anna Várnagy
- Department of Orthopedics, Semmelweis University, Korányi Sándor utca 2, Budapest, 1083, Hungary
| |
Collapse
|
8
|
Lädermann A, Cikes A, Zbinden J, Martinho T, Pernoud A, Bothorel H. Hydrotherapy after Rotator Cuff Repair Improves Short-Term Functional Results Compared with Land-Based Rehabilitation When the Immobilization Period Is Longer. J Clin Med 2024; 13:954. [PMID: 38398267 PMCID: PMC10889507 DOI: 10.3390/jcm13040954] [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: 12/19/2023] [Revised: 01/31/2024] [Accepted: 02/03/2024] [Indexed: 02/25/2024] Open
Abstract
Background: The evidence of hydrotherapy after rotator cuff repair (RCR) is limited as most studies either used it as an adjuvant to standard land-based therapy, or have different initiation timing. This study aimed to compare hydrotherapy and land-based therapy with varying immobilization time. Methods: Patients who underwent RCR with a 10-days or 1-month immobilization duration (early or late rehabilitation) were prospectively randomized. Results: Constant scores significantly differed at three months only, with the best score exhibited by the late hydrotherapy group (70.3 ± 8.2) followed by late land-based (61.0 ± 5.7), early hydrotherapy (55.4 ± 12.8) and early land-based (54.6 ± 13.3) groups (p < 0.001). There was a significant interaction between rehabilitation type and immobilization duration (p = 0.004). The effect of hydrotherapy compared to land-based therapy was large at three months when initiated lately only (Cohen's d, 1.3; 95%CI, 0.9-1.7). However, the relative risk (RR) of postoperative frozen shoulder or retear occurrence for late hydrotherapy was higher compared to early hydrotherapy (RR, 3.9; 95%CI, 0.5-30.0). Conclusions: Hydrotherapy was more efficient compared to land-based therapy at three months only and if initiated lately. Even though initiating hydrotherapy later brought greater constant scores at three months, it might increase the risk of frozen shoulders or retear compared to early hydrotherapy.
Collapse
Affiliation(s)
- Alexandre Lädermann
- Division of Orthopaedics and Trauma Surgery, La Tour Hospital, 1217 Meyrin, Switzerland
- Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
- Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Alec Cikes
- Division of Orthopaedics and Trauma Surgery, Genolier Clinic, 1272 Genolier, Switzerland
- Synergy Medical Centre, Medbase Group, 1007 Lausanne, Switzerland
| | - Jeanni Zbinden
- Division of Orthopaedics and Trauma Surgery, La Tour Hospital, 1217 Meyrin, Switzerland
| | - Tiago Martinho
- Division of Orthopaedics and Trauma Surgery, La Tour Hospital, 1217 Meyrin, Switzerland
| | - Anthony Pernoud
- Research Department, La Tour Hospital, 1217 Meyrin, Switzerland
| | - Hugo Bothorel
- Research Department, La Tour Hospital, 1217 Meyrin, Switzerland
| |
Collapse
|
9
|
Ouyang Y, Dai M. Anxiety disorders and adhesive capsulitis: a bidirectional Mendelian randomization study. Front Immunol 2024; 14:1297477. [PMID: 38259492 PMCID: PMC10800800 DOI: 10.3389/fimmu.2023.1297477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024] Open
Abstract
Background Previous epidemiological investigations and related research efforts consistently have outlined an observable association between anxiety disorders and adhesive capsulitis (AC). However, the intricate nature of the causal connection between these entities has yet to be fully clarified. Therefore, this investigative study aims to thoroughly examine and delineate the causal interrelationship between anxiety disorders and AC using a bidirectional, two-sample Mendelian randomization (MR) approach. Methods To pursue this inquiry, datasets related to anxiety disorders and AC were meticulously obtained from a publicly accessible genomewide association study. Instrumental variables, in the form of single nucleotide polymorphisms, were subsequently identified, undergoing a rigorous screening process that included intensity adjustment and the amelioration of linkage disequilibrium. The primary analytical tool for scrutinizing causal ramifications was the inverse variance weighting (IVW) methodology, complemented by supplementary analytical techniques such as weighted median, MR-Egger, simple mode, and weighted mode. Additionally, evaluations of heterogeneity and pleiotropy were meticulously conducted. Heterogeneity was assessed using Cochran's Q-test in conjunction with the IVW and MR-Egger methods, while pleiotropy was appraised through the MR-Egger intercept and MR-PRESSO analysis methods. A leave-one-out analysis was undertaken to enhance the reliability of our findings. Finally, AC was utilized to infer reverse causality concerning the risk of anxiety disorders. Results The random effects IVW analysis results yielded statistical significance (P = 9.362 × 10-6), demonstrating a causal link between anxiety disorders and elevated susceptibility to AC, reflected in an odds ratio of 1.267 (95% confidence interval: 1.141-1.407). Conversely, the inverse MR analysis predominantly produced null findings. Furthermore, sensitivity analyses underscored the robustness of our conclusions. Conclusion In summary, our meticulously conducted study unequivocally supports the presence of a causal connection between anxiety disorders and an increased propensity for AC. Unfortunately, the reverse MR analysis failed to provide compelling evidence indicative of a reciprocal genetic causative relationship between AC and anxiety disorders.
Collapse
Affiliation(s)
- Yi Ouyang
- Department of Joint Surgery, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde, Foshan), Foshan, Guangdong, China
| | - Miaomiao Dai
- Department of Ophthalmology, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde, Foshan), Foshan, Guangdong, China
| |
Collapse
|
10
|
Sahu D. Authors' response-how are vaccines related to frozen shoulder development? JSES Int 2024; 8:237-238. [PMID: 38312280 PMCID: PMC10837685 DOI: 10.1016/j.jseint.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024] Open
Affiliation(s)
- Dipit Sahu
- Mumbai Shoulder Institute, Mumbai, India
- Jupiter Hospital Thane, Thane, India
| |
Collapse
|
11
|
Schiltz M, Goudman L, Moens M, Nijs J, Hatem SM. The diagnostic value of physical examination tests in adhesive capsulitis: a systematic review. Eur J Phys Rehabil Med 2023; 59:724-730. [PMID: 37737049 PMCID: PMC10792672 DOI: 10.23736/s1973-9087.23.07940-6] [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: 02/23/2023] [Revised: 09/06/2023] [Accepted: 09/14/2023] [Indexed: 09/23/2023]
Abstract
INTRODUCTION Adhesive capsulitis, a condition marked by pain and stiffness of the shoulder, can have a frustrating clinical course for patients and health care professionals. Despite huge research interest, a universally accepted and used definition of clinical criteria for the diagnosis of adhesive capsulitis is currently still lacking. This systematic review aimed to identify diagnostic values for clinical examinations tests used in the diagnosis of adhesive capsulitis. EVIDENCE ACQUISITION A total of 5 electronic databases (PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials [CENTRAL] and PEDro) were searched for relevant studies from 2002 until October 2022 using the terms: "adhesive capsulitis AND diagnosis" and "frozen shoulder AND diagnosis." The Downs and Black Checklist (modified) was used to assess the risk of bias. The study protocol was prospectively registered at the International prospective register of systematic reviews (PROSPERO, CRD42022365993). EVIDENCE SYNTHESIS The initial database search identified 1799 studies, of which 9 (0.50%) were eventually included in the systematic review. Non-intrusive shoulder range of motion measurements in patients with adhesive capsulitis using the Kinect for Windows (Microsoft, Redmond, WA, USA) showed high correlation with clinical range of motion measurement. Two specific clinical tests, the affected-unaffected shoulder approach of the Coracoid Pain Test and the Distension Test in Passive External Rotation, were identified and presented excellent sensibility and specificity in the diagnosis of adhesive capsulitis, in their original study. Comparison between clinical tests was not possible due to the heterogeneity in clinical tools. CONCLUSIONS This systematic review identified several physical examination tests developed for the diagnosis of adhesive capsulitis but could not compare them nor advance a set of clinical diagnostic tests that are scientifically validated. Further research is warranted to obtain validation of clinical diagnosis tools for adhesive capsulitis.
Collapse
Affiliation(s)
- Marc Schiltz
- Department of Physical and Rehabilitation Medicine, Universitair Ziekenhuis Brussel, Brussels, Belgium -
- Department of Physical and Rehabilitation Medicine, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium -
- STIMULUS Consortium, Vrije Universiteit Brussel, Brussels, Belgium -
| | - Lisa Goudman
- STIMULUS Consortium, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Jette, Belgium
- Center for Neurosciences, Vrije Universiteit Brussel, Jette, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Jette, Belgium
- Research Foundation-Flanders, Brussels, Belgium
| | - Maarten Moens
- STIMULUS Consortium, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Jette, Belgium
- Center for Neurosciences, Vrije Universiteit Brussel, Jette, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Jette, Belgium
| | - Jo Nijs
- Department of Physical and Rehabilitation Medicine, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Department of Physical and Rehabilitation Medicine, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Jette, Belgium
| | - Samar M Hatem
- Department of Physical and Rehabilitation Medicine, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Department of Physical and Rehabilitation Medicine, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- STIMULUS Consortium, Vrije Universiteit Brussel, Brussels, Belgium
| |
Collapse
|
12
|
Mertens MG, Struyf F, Verborgt O, Dueñas L, Balasch-Bernat M, Navarro-Ledesma S, Fernandez-Sanchez M, Luque-Suarez A, Lluch Girbes E, Meeus M. Exploration of the clinical course and longitudinal correlations in frozen shoulder: The role of autonomic function, central pain processing, and psychological variables. A longitudinal multicenter prospective observational study. Musculoskelet Sci Pract 2023; 67:102857. [PMID: 37725869 DOI: 10.1016/j.msksp.2023.102857] [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: 04/11/2023] [Revised: 08/29/2023] [Accepted: 09/11/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Altered central pain processing (CPP) and dysautonomia might play a role in the clinical course of frozen shoulder and psychological factors, like pain catastrophizing and hypervigilance, might influence clinical variables in frozen shoulder. OBJECTIVES To explore the clinical course of frozen shoulder regarding CPP, dysautonomia, pain catastrophizing, and hypervigilance and to explore whether longitudinal correlations between these outcomes and pain intensity were present. DESIGN prospective longitudinal observational study. METHOD Participants with frozen shoulder were recruited at hospitals and general practitioner practices and followed for 9 months. They completed six questionnaires (about demographics, shoulder pain and disability, pain intensity, pain catastrophizing, pain hypervigilance, and autonomic symptoms) and underwent tactile sensitivity (allodynia), pressure pain thresholds (hyperalgesia), temporal summation, and conditioned pain modulation during four timeframes (3-month intervals). RESULTS Initially, 149 participants with frozen shoulder were recruited and 88 completed all the measurements. An improvement from baseline to at least one follow-up measurement was found for shoulder pain and disability, pain intensity, pain catastrophizing, hypervigilance, and dysautonomia. A fair longitudinal correlation was found between pain intensity and catastrophizing and hypervigilance (r = 0.301-0.397). Poor longitudinal correlations were found between pain intensity and allodynia and hyperalgesia (r = -0.180-0.193), between pain catastrophizing and dysautonomia (r = 0.209) and between hypervigilance and hyperalgesia (r = -0.159). CONCLUSION Patients with frozen shoulder showed an early improvement that flattened with time in several pain and psychological variables over the course of 9 months. However, autonomic symptoms rather showed a late improvement over 9 months.
Collapse
Affiliation(s)
- Michel Gcam Mertens
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium.
| | - Filip Struyf
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium.
| | - Olivier Verborgt
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium; Department of Orthopedic Surgery and Traumatology, AZ Monica, Antwerp, Belgium; Department of Orthopedic Surgery, University Hospital (UZA), Edegem, Belgium.
| | - Lirios Dueñas
- Physiotherapy in Motion, Multi-Specialty Research Group (PTinMOTION), Department of Physical Therapy, University of Valencia, 46010, Valencia, Spain.
| | - Mercè Balasch-Bernat
- Physiotherapy in Motion, Multi-Specialty Research Group (PTinMOTION), Department of Physical Therapy, University of Valencia, 46010, Valencia, Spain.
| | - Santiago Navarro-Ledesma
- Department of Physiotherapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Querol Street 5, 52004, Melilla, Spain.
| | | | | | - Enrique Lluch Girbes
- Pain in Motion International Research Group(1), Belgium; Physiotherapy in Motion, Multi-Specialty Research Group (PTinMOTION), Department of Physical Therapy, University of Valencia, 46010, Valencia, Spain; Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Mira Meeus
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium; Pain in Motion International Research Group(1), Belgium; Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| |
Collapse
|
13
|
Brindisino F, Girardi G, Crestani M, Fiore A, Giovannico G, Garzonio F, Venturin D, Struyf F. Effectiveness of electrophysical agents in subjects with frozen shoulder: a systematic review and meta-analysis. Disabil Rehabil 2023:1-22. [PMID: 37667875 DOI: 10.1080/09638288.2023.2251880] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE This systematic review with meta-analysis aimed to assess the effectiveness of electrophysical agents in improving pain, function, disability, range of motion, quality of life, perceived stiffness, and time to recovery in subjects with frozen shoulder (FS). METHODS A thorough search of MEDLINE, Cochrane Library, PEDro, and EMBASE yielded 1143 articles, of which 23 randomized controlled trials were included. Risk of bias (RoB) was assessed through Cochrane Risk of Bias 2 tool. The certainty of evidence was evaluated through the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). RESULTS The analysis included a total of 1073 subjects. None of the studies were judged as low RoB. Potentially clinically significant differences were observed in pain at 6 weeks and 5 months after extracorporeal shockwave therapy (ESWT), and in disability up to 3 months with laser therapy, albeit with uncertain results due to the high RoB and to the study heterogeneity. Ultrasound (US) therapy did not yield significant differences in any outcomes. The certainty of evidence was very low. CONCLUSIONS Based on the high heterogeneity and low quality and certainty of evidence, ESWT, laser, and US cannot be recommended for FS treatment. Caution should be exercised in interpreting the findings.
Collapse
Affiliation(s)
- Fabrizio Brindisino
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, Campobasso, Italy
| | - Giuseppe Girardi
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, Campobasso, Italy
| | - Mauro Crestani
- Rehabilitation Unit, Azienda ULSS n.9 Scaligera, Verona, Italy
| | | | - Giuseppe Giovannico
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, Campobasso, Italy
| | - Fabiola Garzonio
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, Campobasso, Italy
| | - Davide Venturin
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, Campobasso, Italy
| | - Filip Struyf
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
14
|
Mertens MG, Meeus M, Verborgt O, Girbes EL, Horno SMD, Aguilar-Rodriguez M, Dueñas L, Navarro-Ledesma S, Fernandez-Sanchez M, Luque-Suarez A, Struyf F. Exploration of the clinical course of frozen shoulder: A longitudinal multicenter prospective study of functional impairments. Braz J Phys Ther 2023; 27:100539. [PMID: 37639942 PMCID: PMC10474583 DOI: 10.1016/j.bjpt.2023.100539] [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: 01/11/2023] [Revised: 08/09/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Contradictory evidence exists regarding the clinical course of frozen shoulder (FS). OBJECTIVES To explore the clinical course of FS regarding disabilities, pain, range of motion (ROM), muscle strength, scapular upward rotation, and proprioception and to establish longitudinal correlations between these variables. METHODS Patients with FS were prospectively followed for 9 months at 3-month intervals. Assessment included the Disabilities of the Arm, Shoulder and Hand questionnaire; visual analogue scale for pain; an inclinometer for shoulder external rotation (ER), internal rotation (IR), flexion, and abduction ROM, and scapular upward rotation and proprioception, as well as handheld dynamometry for muscle strength in shoulder abduction, ER, and IR. RESULTS Initially, 149 patients (98 females; mean (SD) age 53 (9) years) were included, with 88 completing all follow-up assessments. Most variables showed early improvement in the clinical course of FS, particularly ER and IR at 90° abduction, which continued to improve from 6 to 9 months of follow-up. Associations were observed between disabilities and pain (r = 0.61), disabilities/pain and ROM (r=-0.62 to -0.59 and r=-0.47 to -0.39, respectively), disabilities/pain and muscle strength (r=-0.24 to -0.35 and r=-0.36 to -0.17, respectively), and between disabilities/pain and scapular upward rotation below shoulder level (r = 0.23 to 0.38 and r = 0.24 to 0.30, respectively). ROM correlated with muscle strength (r = 0.14 to 0.44), while both ROM and ER muscle strength correlated with scapular upward rotation below shoulder level (r=-0.37 to -0.23 and r=-0.17 to -0.12, respectively). Muscle strength correlated with scapular upward rotation above shoulder level (r = 0.28 to 0.38) and lift-off muscle strength correlated with joint repositioning (r=-0.17 to -0.15). CONCLUSION Almost all factors improved in the early phase (3-6 months) after baseline assessment, while ER and IR ROM at shoulder level continued to improve long term.
Collapse
Affiliation(s)
- Michel Gcam Mertens
- Research Group MOVANT, Department of Rehabilitation Sciences and Physical Therapy (REVAKI), University of Antwerp, Wilrijk, Belgium; Pain in Motion International Research Group, Belgium
| | - Mira Meeus
- Research Group MOVANT, Department of Rehabilitation Sciences and Physical Therapy (REVAKI), University of Antwerp, Wilrijk, Belgium; Pain in Motion International Research Group, Belgium; Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Olivier Verborgt
- Research Group MOVANT, Department of Rehabilitation Sciences and Physical Therapy (REVAKI), University of Antwerp, Wilrijk, Belgium; Department of Orthopedic Surgery and Traumatology, AZ Monica, Antwerp, Belgium; Department of Orthopaedic Surgery, University Hospital (UZA), Edegem, Belgium
| | - Enrique Lluch Girbes
- Pain in Motion International Research Group, Belgium; Physiotherapy in Motion, Multi-Specialty Research Group (PTinMOTION), Department of Physical Therapy, University of Valencia, Valencia, Spain; Department of Physical Therapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Marta Aguilar-Rodriguez
- Physiotherapy in Motion, Multi-Specialty Research Group (PTinMOTION), Department of Physical Therapy, University of Valencia, Valencia, Spain
| | - Lirios Dueñas
- Physiotherapy in Motion, Multi-Specialty Research Group (PTinMOTION), Department of Physical Therapy, University of Valencia, Valencia, Spain
| | - Santiago Navarro-Ledesma
- Department of Physical Therapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Melilla, Spain
| | | | | | - Filip Struyf
- Research Group MOVANT, Department of Rehabilitation Sciences and Physical Therapy (REVAKI), University of Antwerp, Wilrijk, Belgium.
| |
Collapse
|
15
|
Venturin D, Giannotta G, Pellicciari L, Rossi A, Pennella D, Goffredo M, Poser A. Reliability and validity of the Shoulder Pain and Disability Index in a sample of patients with frozen shoulder. BMC Musculoskelet Disord 2023; 24:212. [PMID: 36949437 PMCID: PMC10032005 DOI: 10.1186/s12891-023-06268-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 02/23/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND The Shoulder and Pain Disability Index (SPADI) is a widely used outcome measure. The aim of this study is to explore the reliability and validity of SPADI in a sample of patients with idiopathic frozen shoulder. METHODS The SPADI was administered to 124 patients with idiopathic frozen shoulder. A sub-group of 29 patients were retested after 7 days. SPADI scores were correlated with other outcome measures (i.e., Disabilities of the Arm, Shoulder and Hand Questionnaire - DASH; Numerical Pain Rating Scale-NPRS; and 36-item Short Form Health Survey-SF-36) to examine construct validity. Structural validity was assessed by a Two-Factors Confirmatory Factor Analysis (CFA). Internal consistency, test-retest reliability, and measurement error were also analyzed. RESULTS The construct validity was satisfactory as seven out of eight of the expected correlations formulated (≥ 75%) for the subscales were satisfied. The CFA showed good values of all indicators for both Pain and Disability subscales (Comparative Fit Index = 0.999; Tucker-Lewis Index = 0.997; Root Mean Square Error of Approximation = 0.030). Internal consistency was good for pain (α = 0.859) and disability (α = 0.895) subscales. High test-retest reliability (Intraclass correlation coefficient [ICC]) was found for pain (ICC = 0.989 [95% Confidence Interval (CI = 0.975-0.995]) and disability (ICC = 0.990 [95% CI = 0.988-0.998]). Standard Error of Measurement values of 2.27 and 2.32 and Minimal Detectable Change values of 6.27 and 6.25 were calculated for pain and disability subscales, respectively. CONCLUSION The SPADI demonstrated satisfactory reliability and validity properties in a sample of patients with idiopathic frozen shoulder.
Collapse
Affiliation(s)
- Davide Venturin
- Kinè Physiotherapic and Orthopedic Center, San Vendemiano, Treviso, Italy
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Gabriele Giannotta
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
- In Corpore Sano, Physiotherapic Clinic, Lecce, Italy
| | | | - Alex Rossi
- Kinè Physiotherapic and Orthopedic Center, San Vendemiano, Treviso, Italy
- University of Rome "Tor Vergata", Rome, Italy
| | - Denis Pennella
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
- "Manual Therapy Lab" Clinic, Bari, Italy
| | - Michela Goffredo
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Via Della Pisana 235, 00163, Rome, Italy.
| | - Antonio Poser
- Kinè Physiotherapic and Orthopedic Center, San Vendemiano, Treviso, Italy
- University of Padua, Padua, Italy
| |
Collapse
|
16
|
Goffin P, Forthomme B, Lecoq JP, Benmouna K, Kaux JF, Fontaine R. Evaluation of intensive rehabilitation under continuous suprascapular nerve blockade for the treatment of refractory adhesive shoulder capsulitis. Case series. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2022; 69:625-631. [PMID: 36344404 DOI: 10.1016/j.redare.2021.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 06/24/2021] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Treatment of refractory adhesive shoulder capsulitis is a challenge. This observational retrospective study evaluated the long-term effectiveness of intensive physiotherapy protocol under a continuous peripheral blockade of the suprascapular nerve (cSSNB). METHOD We reviewed 29 medical records of patients suffering from adhesive capsulitis and treated with intensive physiotherapy under cSSNB during 10 days. The "disabilities of the arm, shoulder and hand" outcome questionnaire (DASH score) and shoulder movements were recorded at the beginning, 10 days after local anesthetic infusion and three months after. RESULTS Twenty six patients significant improved shoulder movements after 10 days of treatment. Sixteen patients were followed completely until 3 months after rehabilitation program. Range of four shoulder motion compatible with a normal daily life was acquired in nine patients at three months. There is no significant difference in shoulder motion between the end of LA infusion and at three months. At the end of infusion, DASH score is significantly decreased to 59.3 (n = 26), and persists three months 42.1 (n = 16). At three months, 33% of the initial population objectively reach the 4 goals, compatible with a correct quality of life. CONCLUSION Rehabilitation under cSSNB is associated with a significant long term improvement in shoulder motion and quality of life in patients with adhesive capsulitis. Randomized controlled trials will be necessary to demonstrate our encouraging results.
Collapse
Affiliation(s)
- P Goffin
- Anesthesia & Intensive Care Department, MontLegia Hospital, Groupe Santé CHC, Liège, Belgium.
| | - B Forthomme
- Department of Physical Medicine and Rehabilitation, University Hospital of Liège, Liège, Belgium
| | - J P Lecoq
- Anesthesia & Intensive Care Department, University Hospital of Liège, Liège, Belgium
| | - K Benmouna
- Physical Medicine and Sports Traumatology Department, University Hospital of Liège, Liège, Belgium
| | - J F Kaux
- Physical Medicine and Sports Traumatology Department, University Hospital of Liège, Liège, Belgium
| | - R Fontaine
- Anesthesia & Intensive Care Department, University Hospital of Liège, Liège, Belgium
| |
Collapse
|
17
|
Mertens MG, Struyf F, Lluch Girbes E, Dueñas L, Verborgt O, Meeus M. Autonomic Nervous System Function and Central Pain Processing in People With Frozen Shoulder: A Case-control Study. Clin J Pain 2022; 38:659-669. [PMID: 36111678 DOI: 10.1097/ajp.0000000000001070] [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: 04/13/2022] [Accepted: 08/30/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The pathophysiology of a frozen shoulder (FS) is thought to be related to chronic inflammation. Chronic inflammation may disturb the immune system and consequently the nervous system as part of an overarching system. The aim of this study was to determine the presence of disturbed autonomic nervous system function and altered central pain processing (CPP) in patients with FS. Secondarily, the presence of psychological variables (catastrophizing and hypervigilance) and self-reported associated symptoms of altered CPP in patients with FS were investigated. METHODS Patients with FS and healthy controls completed the Composite Autonomic Symptom Score (autonomic function) and underwent quantitative sensory testing to assess tactile sensitivity (ie, allodynia), pressure pain thresholds (PPTs, ie, hyperalgesia), temporal summation of pain, and Conditioned Pain Modulation (CPM). Psychological issues were explored with the Pain Catastrophizing Scale and the Pain Vigilance and Awareness Questionnaire, and self-reported symptoms associated with altered CPP were determined with the Central Sensitization Inventory. RESULTS Thirty-two patients with FS and 35 healthy controls were analyzed in the study. Patients with FS showed more self-reported autonomic symptoms and symptoms of altered CPP, higher levels of pain catastrophizing and hypervigilance, and are more sensitive to tactile touches and mechanical pressure compared with controls. DISCUSSION On the basis of the effect sizes, between-group differences in allodynia, hyperalgesia, catastrophizing, and hypervigilance were clinically relevant, but only local allodynia, hyperalgesia, catastrophizing, and hypervigilance were statistically different. Therefore, obvious altered CPP was not present at the group level in patients with FS compared with controls.
Collapse
Affiliation(s)
- Michel G Mertens
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk
- Pain in Motion International Research group
| | - Filip Struyf
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk
| | - Enrique Lluch Girbes
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels
- Pain in Motion International Research group
- Department of Physical Therapy, University of Valencia, Valencia, Spain
| | - Lirios Dueñas
- Department of Physical Therapy, University of Valencia, Valencia, Spain
| | - Olivier Verborgt
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk
- Department of Orthopedic Surgery and Traumatology, AZ Monica, Antwerp
- Department of Orthopedic Surgery, University Hospital (UZA), Edegem, Belgium
| | - Mira Meeus
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent
| |
Collapse
|
18
|
Mertens MGCAM, Meeus M, Pieters L, Balasch-Bernat M, Dueñas L, Verborgt O, Struyf F. An Instrument-Assisted Coracoid Pain Test: An Exploratory Diagnostic Accuracy Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12735. [PMID: 36232033 PMCID: PMC9566369 DOI: 10.3390/ijerph191912735] [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: 09/09/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
The coracoid pain test (CPT) could contribute to the diagnosis of frozen shoulder (FS) with palpation. However, due to assessor performance these values might be unreliable. Therefore, the aim was to explore the diagnostic accuracy of an instrument-assisted CPT and two alternative approaches (pain severity and side comparison) for assistance in the diagnosis of FS. Patients with FS and healthy age-matched controls were recruited. All participants underwent the instrument-assisted CPT on both shoulders with a pressure algometer. Sensitivity, specificity, and likelihood ratios were determined for the three approaches. In total, 35 patients with FS and 35 healthy participants were included. The original approach was positive in eight participants (11.4%), with only sufficient specificity to draw a conclusion. The pain severity approach was positive in 31 participants (44.3%) with sufficient sensitivity, specificity and likelihood ratios. The side comparison approach was positive in 10 participants (14.3%) with excellent specificity and positive likelihood ratio. The specificity of the instrument-assisted CPT can be used to increase the probability of FS with both the original and alternative approaches. Only the pain severity approach can draw a conclusion with a negative test result. This study should be repeated with a cross-sectional design to strengthen and confirm the conclusions.
Collapse
Affiliation(s)
- Michel GCAM Mertens
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Mira Meeus
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Louise Pieters
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Mercè Balasch-Bernat
- Physiotherapy in Motion, Multi-Specialty Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, C/Gasco Oliag 5, 46010 Valencia, Spain
| | - Lirios Dueñas
- Physiotherapy in Motion, Multi-Specialty Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, C/Gasco Oliag 5, 46010 Valencia, Spain
| | - Olivier Verborgt
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
- Department of Orthopedic Surgery and Traumatology, AZ Monica, Harmoniestraat 68, 2018 Antwerp, Belgium
| | - Filip Struyf
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| |
Collapse
|
19
|
Koraman E, Turkmen I, Uygur E, Akyurek M, Poyanli O. Ultrasound Guıded Multisıte Injectıon Technıque in the Treatment of Frozen Shoulder. Arthrosc Tech 2022; 11:e1823-e1826. [PMID: 36311325 PMCID: PMC9596867 DOI: 10.1016/j.eats.2022.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 06/19/2022] [Indexed: 02/03/2023] Open
Abstract
Frozen shoulder (FS) is an elusive condition that affects patients' mental and emotional quality of their lives. Corticosteroid injection technique is one of the first-line treatment methods in the treatment of FS. Ultrasound (USG) guidance allows visualization of the shoulder anatomy and improves the accuracy of the injection site. This study describes an USG-guided injection technique for FS treatment. The aim of this technique was to affect glenohumeral joint and capsule, subacromial space, the long head of biceps tendon sheath, and the coracohumeral ligament. For this purpose, four different sites were injected by USG guidance. Patients with FS can be effectively treated through this technique that is detailed in this article.
Collapse
Affiliation(s)
- Emre Koraman
- Istanbul Tuzla State Hospital, Department of Orthopaedics and Traumatology, Istanbul, Turkey,Address correspondence to Emre Koraman, M.D., Istanbul Tuzla State Hospital, Department of Orthopaedics and Traumatology, Goztepe mh Tanzimat sk 34730 Kadikoy Istanbul, Turkey.
| | - Ismail Turkmen
- Istanbul Medeniyet University Goztepe Training and Research Hospital, Department of Orthopaedics and Traumatology, Istanbul, Turkey
| | - Esat Uygur
- Istanbul Medeniyet University Goztepe Training and Research Hospital, Department of Orthopaedics and Traumatology, Istanbul, Turkey
| | - Muhlik Akyurek
- Maria-Josef-Hospital, Department of Orthopaedics and Traumatology, Greven, Germany
| | - Oguz Poyanli
- Istanbul Medeniyet University Goztepe Training and Research Hospital, Department of Orthopaedics and Traumatology, Istanbul, Turkey
| |
Collapse
|
20
|
Heo JW, Jo JH, Lee JJ, Kang H, Choi TY, Lee MS, Kim JI. Electroacupuncture for the treatment of frozen shoulder: A systematic review and meta-analysis. Front Med (Lausanne) 2022; 9:928823. [PMID: 36059821 PMCID: PMC9433806 DOI: 10.3389/fmed.2022.928823] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundElectroacupuncture (EA) has reportedly been successful in controlling pain, but there have been no systematic reviews examining the impact of EA on patients with frozen shoulder (FS). The purpose of this review is to provide evidence on the safety and efficacy of EA for pain management in patients with FS.MethodsWe searched 11 databases from their inception: EMBASE, the Cochrane Library, PubMed, AMED, one Chinese medical database, and six Korean medical databases. Two researchers independently performed the study selection, data extraction, and assessment. Bias-related risk was evaluated using the Cochrane risk-of-bias assessment tool.ResultsThis review included thirteen studies involving 936 patients. The EA group exhibited improvements in FS pain (MD −1.11, 95% CI −1.61 to −0.61, p < 0.0001, I2 = 97%), function (SMD 2.02, 95% CI 0.36–3.69, p < 0.00001, I2 = 97%), and response rates (RR 1.16, 95% CI 1.07–1.25; p = 0.0002; I2 = 0%) over the manual acupuncture (MA) group. As an adjunct treatment, EA improved FS pain (SMD −1.12, 95% CI −1.52 to −0.71, P < 0.00001, I2 = 0) compared to the control treatments. No adverse effects were reported.ConclusionEA is reported to improve FS pain and function compared with control treatments. Additionally, EA can be used as an adjunct therapy for FS pain. EA could emerge as a potent intervention against FS.Systematic review registration[http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42021247090], identifier [CRD42021247090]
Collapse
Affiliation(s)
- Jeong-Weon Heo
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Jeong-Hun Jo
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Jung-Ju Lee
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Hee Kang
- Humanitas College, Kyung Hee University, Yongin, South Korea
| | - Tae-Young Choi
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
- *Correspondence: Myeong Soo Lee,
| | - Jong-In Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
- Jong-In Kim,
| |
Collapse
|
21
|
Park K, Matsuzaki M, Okamoto M, Sakaki A, Ikuta F. Effect of manipulation technique using ultrasound-guided cervical nerve root block on range of motion at the shoulder joint in frozen shoulder: a retrospective study. J Exp Orthop 2022; 9:63. [PMID: 35792941 PMCID: PMC9259775 DOI: 10.1186/s40634-022-00500-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose The aim of this study was to evaluate the range of motion (ROM) at the shoulder joint before and after silent manipulation. Methods This retrospective study included all patients who underwent silent manipulation at our institution between January 2013 and December 2017. In total, 1,665 shoulders in 1,610 patients (519 men, 1,146 women; mean age 55.4 ± 8.8 years) were treated during the study period. The mean symptom duration was 6.6 ± 7.1 months. ROM at the shoulder joint was measured in flexion, abduction, and external rotation before silent manipulation and at 1 week and 1, 2, and 3 months after the procedure. Results Mean ROM at the shoulder was 98.8° (95% confidence interval [CI] 97.9–99.8) before silent manipulation and 155.5° (154.1–156.8) after 3 months in flexion (p = 0.0000), 75.6° (74.5–76.8) and 152.9° (151.0–154.9), respectively, in abduction (p = 0.0000), and 12.7° (12.0–13.4) and 45.9° (44.4–47.4) in external rotation (p = 0.0000). All ROM values were significantly increased at all time points after the procedure. There were no unanticipated adverse events or serious adverse reactions. Conclusions This study reports on the efficacy and safety of manipulation using conduction anesthesia for shoulder contractures in a large group of patients. Silent manipulation can increase ROM at the shoulder safely and effectively. Supplementary Information The online version contains supplementary material available at 10.1186/s40634-022-00500-z.
Collapse
Affiliation(s)
- Kieun Park
- PAKU Painclinic, Gitex Ascent Building 5F, 6-1-20 Miyuki-dori, Chuo-ku, Kobe, Hyogo, 651-0087, Japan
| | - Masashi Matsuzaki
- Sonic Japan Holdings Co., Ltd, 26-11 Maruyama-cho, Hachioji, Tokyo, 192-0021, Japan
| | - Mitsuji Okamoto
- PAKU Painclinic, Gitex Ascent Building 5F, 6-1-20 Miyuki-dori, Chuo-ku, Kobe, Hyogo, 651-0087, Japan
| | - Akihiro Sakaki
- Riseisha College of Medicine and Sports, 3-4-21 Jusohonmachi, Yodogawa-ku, Osaka, Osaka, 532-0024, Japan
| | - Futoshi Ikuta
- School of Health Sciences, Tokyo International University, 1-13-1 Matobakita, Kawagoe, Saitama, 350-1197, Japan.
| |
Collapse
|
22
|
Brindisino F, Silvestri E, Gallo C, Venturin D, Di Giacomo G, Peebles AM, Provencher MT, Innocenti T. Depression and Anxiety Are Associated With Worse Subjective and Functional Baseline Scores in Patients With Frozen Shoulder Contracture Syndrome: A Systematic Review. Arthrosc Sports Med Rehabil 2022; 4:e1219-e1234. [PMID: 35747628 PMCID: PMC9210488 DOI: 10.1016/j.asmr.2022.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/26/2022] [Accepted: 04/01/2022] [Indexed: 01/07/2023] Open
Abstract
Purpose To investigate whether psychological factors, such as avoidance behavior, fear, pain catastrophization, kinesiophobia, anxiety, depression, optimism, and expectation are associated with different subjective and functional baseline scores in patients with frozen shoulder contracture syndrome (FSCS). Methods Searches were conducted in MEDLINE, Cochrane Library (CENTRAL Database), PEDro, Pubpsych, and PsychNET.APA without restrictions applied to language, date, or status of publication. Two authors reviewed study titles, abstract, and full text based on the following inclusion criteria: adult population (≥ 30 < 70 years old) with FSCS. Results Seven hundred and seventy-six records were included by the search strategies. After title final screening, 6 studies were included for the qualitative synthesis. Psychological features investigated were anxiety, depression, pain-related fear, pain catastrophizing, and pain self-efficacy; reported outcomes included pain, function, disability, quality of life, and range of motion. Data suggest that anxiety and depression impact self-assessed function, pain, and quality of life. There is no consensus on the correlation between psychological variables and range of motion. Associations were suggested between pain-related fear, pain-related beliefs, and pain-related behavior and perceived arm function; pain-related conditions showed no significant correlation with range of motion and with perceived stiffness at baseline. Conclusion Scores traditionally thought to assess physical dimensions like shoulder pain, disability, and function seem to be influenced by psychological variables. In FSCS patients, depression and anxiety were associated with increased pain perception and decreased function and quality of life at baseline. Moreover, pain-related fear and catastrophizing seem to be associated with perceived arm function.
Collapse
Affiliation(s)
- Fabrizio Brindisino
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | | | | | | | - Giovanni Di Giacomo
- Department of Orthopaedic and Trauma Surgery, Concordia Hospital for Special Surgery, Rome, Italy
| | | | - Matthew T Provencher
- Steadman Clinic and Steadman Philippon Research Institute, Vail, Colorado, U.S.A
| | - Tiziano Innocenti
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands.,GIMBE Foundation, Bologna, Italy
| |
Collapse
|
23
|
Aquatic Therapy versus Standard Rehabilitation after Surgical Rotator Cuff Repair: A Randomized Prospective Study. BIOLOGY 2022; 11:biology11040610. [PMID: 35453809 PMCID: PMC9028498 DOI: 10.3390/biology11040610] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 12/03/2022]
Abstract
Introduction: Post-operative rehabilitation following rotator cuff tear repair (RCR) is important to promote tendon healing, restore strength, and recover normal function. Aquatic therapy in hot water allows body relaxation, which promotes patient conditioning for efficient rehabilitation. The aim of this study was to assess whether aquatic therapy is more efficient than standard (land-based) rehabilitation in terms of range of motion (ROM), function, and pain after arthroscopic RCR. Methods: We prospectively randomized 86 patients scheduled for arthroscopic RCR to either aquatic therapy (n = 44) or standard rehabilitation (n = 42) using block sizes of four or six. Patients were evaluated clinically at 1.5, 3, 6, and 24 months and using ultrasound (US) at 6 months. Two-way mixed ANOVA tests were performed to evaluate the effects of rehabilitation type (between-subjects factor) on ROM and patient reported outcome measures (PROMs) over time (within-subjects factor). Post-hoc inter-group comparisons at each time point were also conducted using Wilcoxon rank sum tests or unpaired Student t-tests and adjusted for multiple comparisons using the Bonferroni correction. Results: The two groups did not differ significantly in terms of demographic data or pre-operative characteristics, except for the Single Assessment Numeric Evaluation (SANE) score, which was lower in the aquatic therapy group (37.9 ± 23.6 vs. 55.6 ± 24.9, p = 0.019). The mixed model revealed the absence of interaction effect between the type of rehabilitation and time on PROMs and ROM except on the SANE score (p < 0.001), which was biased by the existing pre-operative difference mentioned above. Furthermore, none of the post-operative outcomes were statistically different between the two groups at 1.5, 3, 6, and 24 months. In addition, no significant difference could be noted regarding tendon healing rate (p = 0.443), complication (p = 0.349), workstop duration (0.585), or patient satisfaction (p = 0.663). Conclusion: Compared to the standard rehabilitation, the aquatic therapy did not yield superior clinical and functional outcomes after arthroscopic RCR when started immediately after the surgery.
Collapse
|
24
|
Aïm F, Chevallier R, Marion B, Klouche S, Bastard C, Bauer T. Psychological risk factors for the occurrence of frozen shoulder after rotator cuff repair. Orthop Traumatol Surg Res 2022; 108:103212. [PMID: 35077897 DOI: 10.1016/j.otsr.2022.103212] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/24/2021] [Accepted: 08/03/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Frozen shoulder is a dreaded complication after rotator cuff repair. HYPOTHESIS There are psychological determinants for this complication. MATERIALS AND METHODS We prospectively included 77 consecutive patients who underwent arthroscopic rotator cuff repair between May 2018 and April 2019. Along with a functional evaluation, we determined the Constant score, anxiety and depression levels based on the HADS, and kinesiophobia based on the Tampa Scale preoperatively and 6months after the surgery. RESULTS At the 6-month follow-up, 8 patients had been diagnosed with frozen shoulder (group A), 65 patients had satisfactory joint range of motion (group B) and 4 were lost to follow-up. In the frozen shoulder group, the preoperative anxiety rate was significantly higher than in group B (50% versus 17%, p=0.04). Furthermore, there were significantly more women (p=0.028) and more patients with an occupational disease in group A (75% versus 18%, p=0.027). At 6months postoperative, the Constant score was 55 in the group with a frozen shoulder versus 72 in group B (p=0.004). Neither depression nor kinesiophobia were risk factors for the development of frozen shoulder after rotator cuff repair. CONCLUSION Preoperative anxiety, the female sex and occupational disease are all risk factors for the occurrence of frozen shoulder after rotator cuff repair. Knowing these predisposing factors will help us better manage at-risk patients. LEVEL OF EVIDENCE III, prospective study.
Collapse
Affiliation(s)
- Florence Aïm
- Service de chirurgie orthopédique, centre de référence des infections ostéoarticulaires, groupe hospitalier Diaconnesses Croix Saint-Simon, Paris, France.
| | - Romain Chevallier
- Service de chirurgie orthopédique, hôpital Henri-Mondor, Créteil, France
| | - Blandine Marion
- Service de chirurgie orthopédique, centre de référence des infections ostéoarticulaires, groupe hospitalier Diaconnesses Croix Saint-Simon, Paris, France
| | | | - Claire Bastard
- Service de chirurgie orthopédique, hôpital Henri-Mondor, Créteil, France
| | - Thomas Bauer
- Service de chirurgie orthopédique, AP-HP, hôpital Ambroise-Paré, Boulogne-Billancourt, France
| |
Collapse
|
25
|
Debeer P, Commeyne O, De Cupere I, Tijskens D, Verhaegen F, Dankaerts W, Claes L, Kiekens G. The outcome of hydrodilation in frozen shoulder patients and the relationship with kinesiophobia, depression, and anxiety. J Exp Orthop 2021; 8:85. [PMID: 34591188 PMCID: PMC8484410 DOI: 10.1186/s40634-021-00394-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/19/2021] [Indexed: 02/08/2023] Open
Abstract
Purpose The aims of this study were to (1) investigate the effect of hydrodilatation in frozen shoulder patients on objective indices of shoulder functionality and subjective outcomes of pain, mobility, kinesiophobia, depression, and anxiety, and (2) progress knowledge about the reciprocal temporal relationship between psychological parameters at baseline and objective and subjective outcomes at 3-month follow-up. Methods We evaluated the clinical and psychological status of 72 patients with a frozen shoulder before and after hydrodilatation, using the Constant Murley score, the Visual Analogue score, the Tampa Scale for Kinesiophobia, the Hospital Anxiety and Depression Scale, and the Shoulder Pain And Disability Index. Results We noted a significant improvement in functionality, pain and disability (p < .001). Depression and anxiety improved significantly (p < .001) between baseline and 3-month follow-up. Prospective analyses demonstrated that psychological factors are more likely to predict outcomes of hydrodilatation than vice versa. Conclusion Hydrodilatation followed by physiotherapy is an excellent way to treat patients with recalcitrant frozen shoulder, resulting in a continuous improvement of ROM and pain. Physiotherapists and physicians should be aware that psychological factors might have an impact on the treatment outcome.
Collapse
Affiliation(s)
- Philippe Debeer
- Orthopedics, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium. .,Department of Development and Regeneration, KU Leuven, Leuven, Belgium. .,Institute for Orthopaedic Research and Training, Leuven, Belgium.
| | - Olivia Commeyne
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Ianthe De Cupere
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Dorien Tijskens
- Orthopedics, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Institute for Orthopaedic Research and Training, Leuven, Belgium
| | - Filip Verhaegen
- Orthopedics, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Institute for Orthopaedic Research and Training, Leuven, Belgium
| | - Wim Dankaerts
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.,Faculty of Medicine and Health Sciences, University Antwerp, Antwerp, Belgium
| | - Glenn Kiekens
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.,Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| |
Collapse
|
26
|
Audigé L, Aghlmandi S, Grobet C, Stojanov T, Müller AM, Felsch Q, Gleich J, Flury M, Scheibel M. Prediction of Shoulder Stiffness After Arthroscopic Rotator Cuff Repair. Am J Sports Med 2021; 49:3030-3039. [PMID: 34310220 DOI: 10.1177/03635465211028980] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Postoperative shoulder stiffness (POSS) is a prevalent adverse event after arthroscopic rotator cuff repair (ARCR) that is associated with major limitations in everyday activities and prolonged rehabilitation. PURPOSE/HYPOTHESIS The purpose was to develop a predictive model for determining the risk of POSS within 6 months after primary ARCR. We hypothesized that sufficient discrimination ability of such a model could be achieved using a local institutional database. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS Consecutive primary ARCRs documented in a local clinical registry between 2013 and 2017 were included, and patients who experienced POSS before the final clinical 6-month follow-up were identified. A total of 29 prognostic factor candidates were considered, including patient-related factors (n = 7), disease-related factors (n = 9), rotator cuff integrity factors (n = 6), and operative details (n = 7). We used imputed data for the primary analysis, and a sensitivity analysis was conducted using complete case data. Logistic regression was applied to develop a model based on clinical relevance and statistical criteria. To avoid overfitting in the multivariable model, highly correlated predictors were not included together in any model. A final prognostic model with a maximum of 8 prognostic factors was considered. The model's predictive accuracy was assessed by the area under the receiver operating characteristic curve (AUC). Internal validation was performed using bootstrapping. RESULTS Of 1330 ARCR cases (N = 1330 patients), 112 (8.4%) patients had POSS. Our final model had a moderate predictive ability with an AUC of 0.67. The predicted risks of POSS ranged from 2.3% to 38.9% and were significantly higher in women; patients with partial tears, low baseline passive shoulder abduction, and lack of tendon degeneration; and when no acromioplasty was performed. CONCLUSION A prognostic model for POSS was developed for patients with ARCR, offering a personalized risk evaluation to support the future decision process for surgery and rehabilitation.
Collapse
Affiliation(s)
- Laurent Audigé
- Research and Development, Shoulder and Elbow Surgery, Schulthess Clinic, Zurich, Switzerland.,Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland.,Department of Orthopedic Surgery and Traumatology, University Hospital of Basel, Switzerland
| | - Soheila Aghlmandi
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - Cécile Grobet
- Research and Development, Shoulder and Elbow Surgery, Schulthess Clinic, Zurich, Switzerland
| | - Thomas Stojanov
- Research and Development, Shoulder and Elbow Surgery, Schulthess Clinic, Zurich, Switzerland.,Department of Orthopedic Surgery and Traumatology, University Hospital of Basel, Switzerland
| | - Andreas M Müller
- Department of Orthopedic Surgery and Traumatology, University Hospital of Basel, Switzerland
| | - Quinten Felsch
- Shoulder and Elbow Surgery, Schulthess Clinic, Zurich, Switzerland
| | - Johannes Gleich
- Shoulder and Elbow Surgery, Schulthess Clinic, Zurich, Switzerland
| | - Matthias Flury
- Center for Orthopedics & Neurosurgery, In-Motion, Wallisellen, Switzerland
| | - Markus Scheibel
- Shoulder and Elbow Surgery, Schulthess Clinic, Zurich, Switzerland
| |
Collapse
|
27
|
Hydrodilatation with corticosteroids is the most effective conservative management for frozen shoulder. Knee Surg Sports Traumatol Arthrosc 2021; 29:2553-2563. [PMID: 33420809 DOI: 10.1007/s00167-020-06390-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/24/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The purpose of this overview is to summarise the findings of meta-analyses of randomised controlled trials that compare conservative treatment options for frozen shoulder. METHODS The authors conducted an electronic literature search for meta-analyses published using PubMed, Web of Science and the Cochrane Library. Two researchers independently applied selection criteria and assessed quality of meta-analyses using A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2). Short-, medium- and long-term outcomes were synthesised narratively. RESULTS A total of 319 studies were identified, of which 8 meta-analyses were eligible for inclusion. All included meta-analyses were judged to be low or critically low quality according to AMSTAR-2, however, their data synthesis and interpretation was considered valid. Physiotherapy, intra-articular and subacromial corticosteroid injection (CSI), and arthrographic distension/hydrodilatation with corticosteroid were reported with sufficient evidence. Intra-articular CSI and arthrographic distension/hydrodilatation with corticosteroid provide advantages over placebo in short-term pain relief, range of motion (ROM) and shoulder function, with improvements in ROM continuing into the medium and long term. Arthrographic distension/hydrodilatation with corticosteroid provides medium-term and long-term improvements in ROM over intra-articular CSI and physiotherapy. Proprioceptive neuromuscular facilitation provides advantages over conventional physiotherapy for pain improvement and external rotation in the short term. CONCLUSIONS Arthrographic distension/hydrodilatation with corticosteroid provides superior pain relief in the short term and improvement in range of motion across all time frames for frozen shoulder when compared to CSI or physiotherapy. LEVEL OF EVIDENCE Level IV.
Collapse
|
28
|
Atici T, Ermutlu C, Akesen S, Özyalçin A. High-dose short-course oral corticosteroid protocol for treatment of primary frozen shoulder: a retrospective cohort study. J Int Med Res 2021; 49:3000605211024875. [PMID: 34229518 PMCID: PMC8267043 DOI: 10.1177/03000605211024875] [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] [Indexed: 11/29/2022] Open
Abstract
Objective To evaluate the effect of high-dose prednisolone on the functional outcome of patients with early-stage primary frozen shoulder. Methods Eighteen patients treated with oral prednisolone at an initial dose of 1 mg/kg/day for primary frozen shoulder were retrospectively evaluated. The patients’ range of motion, Disabilities of the Arm, Shoulder, and Hand (DASH) score, Constant–Murley score, American Shoulder and Elbow Surgeons (ASES) score, and visual analog scale score were recorded at baseline and at 4 weeks and 6 months after treatment. Results Rapid recovery of shoulder motion was noted at 4 weeks with the exception of abduction, which was maintained at 6 months. Significant improvement in pain perception and the Constant–Murley score was evident at 4 weeks and extended to 6 months. The DASH and ASES scores did not show significant improvement in the first 4 weeks but were significantly improved at 6 months. Conclusion High-dose oral prednisolone treatment provides rapid symptom resolution that persists long after drug discontinuation. The early treatment period is characterized by marked reduction in pain and rapid recovery of shoulder motion. Improvements in functional outcomes and disability indices tend to be more subtle in the early period but significantly improve during late treatment.
Collapse
Affiliation(s)
- Teoman Atici
- Department of Orthopaedics and Traumatology, 64048Uludag University Faculty of Medicine, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Cenk Ermutlu
- Department of Orthopaedics and Traumatology, 64048Uludag University Faculty of Medicine, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Selcan Akesen
- Department of Anesthesiology and Intensive Care, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Ali Özyalçin
- Department of Orthopaedics and Traumatology, 64048Uludag University Faculty of Medicine, Uludag University Faculty of Medicine, Bursa, Turkey
| |
Collapse
|