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Liaghat B, Juul-Kristensen B, Faber DA, Christensen EO, Søgaard K, Skou ST, Søndergaard J, Juhl CB. One-year effectiveness of high-load compared with low-load strengthening exercise on self-reported function in patients with hypermobile shoulders: a secondary analysis from a randomised controlled trial. Br J Sports Med 2024; 58:373-381. [PMID: 38253436 PMCID: PMC10982631 DOI: 10.1136/bjsports-2023-107563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2023] [Indexed: 01/24/2024]
Abstract
OBJECTIVES To investigate the long-term effectiveness of high-load versus low-load strengthening exercise on self-reported function in patients with hypermobility spectrum disorder (HSD) and shoulder symptoms. METHODS A secondary analysis of a superiority, parallel-group, randomised trial (balanced block randomisation 1:1, electronic concealment) including adult patients (n=100) from primary care with HSD and shoulder pain and/or instability ≥3 months. Patients received 16 weeks of shoulder exercises (three sessions/week): HEAVY (n=50, full-range, high-load, supervised twice/week) or LIGHT (n=50, neutral/mid-range, low-load, supervised three times in total). The 1-year between-group difference in change in self-reported function was measured using the Western Ontario Shoulder Instability Index (WOSI, scale 0-2100, 0=best). Secondary outcomes were self-reported measures including changes in shoulder-related symptoms, function, emotions and lifestyle, quality of life, patient-perceived effect, treatment utility and adverse events. A blinded analyst conducted the analyses using linear mixed model repeated measurements analysis. RESULTS One-year data were available in 86 out of 100 participants (79% women, mean age 37.8 years) (LIGHT 84%, HEAVY 88%). The mean WOSI score between-group difference favoured HEAVY (-92.9, 95% CI -257.4 to 71.5, p=0.268) but was not statistically significant. The secondary outcomes were mostly inconclusive, but patients in HEAVY had larger improvement in the WOSI emotions subdomain (-36.3; 95% CI -65.4 to -7.3, p=0.014). Patient-perceived effect favoured HEAVY anchored in WOSI-emotions (55% vs 31%, p=0.027) and WOSI-lifestyle (50% vs 29%, p=0.042). CONCLUSION High-load shoulder strengthening exercise was not superior to low-load strengthening exercise in improving self-reported function at 1 year. High-load strengthening exercise may be more effective in improving patient emotions about shoulder pain and function, but more robust data are needed to support these findings. TRIAL REGISTRATION NUMBER NCT03869307.
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Affiliation(s)
- Behnam Liaghat
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Centre for Evidence-Based Orthopaedics (CEBO), Department of Orthopaedic Surgery, Zealand University Hospital, Køge, Denmark
| | - Birgit Juul-Kristensen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Daniel A Faber
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Emil O Christensen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Søren T Skou
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
| | - Jens Søndergaard
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Carsten B Juhl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Denmark
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Liu S, Liu JT, Chen L, Fan TY, Cui XJ, Cheng SD, Chen YJ, Shi Q, Xue CC, Li XF. Efficacy of five-step shoulder manipulation for rotator cuff-related shoulder pain: protocol for a multicenter randomized controlled trial. Trials 2023; 24:498. [PMID: 37550698 PMCID: PMC10405406 DOI: 10.1186/s13063-023-07540-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 07/25/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Rotator cuff-related shoulder pain (RCRSP) is the most common cause of shoulder disorders. In China, manipulation has been used extensively for the treatment of patients with RCRSP. However, high-quality clinical evidence to support the therapeutic effect of manipulation is still limited. METHODS A multicenter, participant-, outcome assessor-, and data analyst-blinded, randomized, placebo-controlled trial will be conducted. A total of 280 participants with RCRSP will be recruited from three hospitals and randomly assigned to a five-step shoulder manipulation (FSM) group or a sham manipulation (SM) group. Each group will receive four weekly treatment sessions, with all participants performing exercises at home for 12 weeks. Assessments, namely the Constant-Murley score, visual analog scale, range of motion, and 36-Item Short Form Survey, will be made at baseline, 4, 12, 18, and 24 weeks. Adverse events during the study will also be recorded. DISCUSSION This is a pragmatic clinical trial to evaluate the efficacy and safety of FSM in patients with RCRSP. The findings of this study will provide worthy clinical evidence for manual therapy for RCRSP. TRIAL REGISTRATION China Registered Clinical Trial Registration Center ChiCTR2000037577. Registered on 29 August 2020.
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Affiliation(s)
- Shuang Liu
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiangzhong Road, Shanghai, 200071 China
- LongHua Hospital Shanghai University of Traditional Chinese Medicine, 725 Wanpingnan Road, Shanghai, 200032 China
| | - Jin-Tao Liu
- Suzhou Hospital of Traditional Chinese Medicine, 899 Wuzhongxi Road, Suzhou, 215009 Jiangsu China
| | - Lin Chen
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiangzhong Road, Shanghai, 200071 China
| | - Tian-You Fan
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiangzhong Road, Shanghai, 200071 China
| | - Xue-Jun Cui
- LongHua Hospital Shanghai University of Traditional Chinese Medicine, 725 Wanpingnan Road, Shanghai, 200032 China
| | - Shao-Dan Cheng
- Shanghai GuangHua Hospital of Integrated Traditional Chinese and Western Medicine, 540 Xinhua Road, Shanghai, 200052 China
| | - Yan-Jiao Chen
- Shanghai Research Institute of Acupuncture and Meridian, YueYang Hospital of Integrated Traditional Chinese and Western Medicine, 650 Wanpingnan Road, Shanghai, 200030 China
| | - Qi Shi
- LongHua Hospital Shanghai University of Traditional Chinese Medicine, 725 Wanpingnan Road, Shanghai, 200032 China
- Qi Shi’s Studio of Famous Chinese Medicine Physician, 274 Zhijiangzhong Road, Shanghai, 200032 China
| | - Chun-Chun Xue
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiangzhong Road, Shanghai, 200071 China
| | - Xiao-Feng Li
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiangzhong Road, Shanghai, 200071 China
- Qi Shi’s Studio of Famous Chinese Medicine Physician, 274 Zhijiangzhong Road, Shanghai, 200032 China
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Frasie A, Houry M, Plourde C, Robert MT, Bouyer LJ, Roy JS. Feedback for the prevention and rehabilitation of work-related musculoskeletal disorders: A systematic review. Work 2023; 76:61-94. [PMID: 36872834 DOI: 10.3233/wor-220545] [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] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Work-related musculoskeletal disorders (WRMSDs) remain a challenge despite research aimed at improving their prevention and treatment. Extrinsic feedback has been suggested for the prevention and rehabilitation of WRMSDs to improve sensorimotor control, and ultimately to reduce pain and disability. However, there are few systematic reviews on the effectiveness of extrinsic feedback for WRMSDs. OBJECTIVE To perform a systematic review investigating the effect of extrinsic feedback for the prevention and rehabilitation of WRMSDs. METHODS Five databases (CINAHL, Embase, Ergonomics Abstract, PsycInfo, PubMed) were searched. Studies of various designs assessing the effects of extrinsic feedback during work tasks on three outcomes (function, symptoms, sensorimotor control) in the context of prevention and rehabilitation of WRMSDs were included. RESULTS Forty-nine studies were included, for a total sample of 3387 participants (including 925 injured) who performed work-related tasks in the workplace (27 studies) or in controlled environments (22 studies). The use of extrinsic feedback was shown to be effective in controlled environments for short-term prevention of functional limitations and sensorimotor alterations (very limited to moderate evidence) and for improving, in injured participants, function, symptoms and sensorimotor control (moderate evidence). In the workplace, it was shown to be effective for short-term prevention of functional limitations (limited evidence). There was conflicting evidence regarding its effect for WRMSD rehabilitation in the workplace. CONCLUSION Extrinsic feedback is an interesting complementary tool for the prevention and rehabilitation of WRMSDs in controlled environments. More evidence is needed regarding its effect for the prevention and rehabilitation of WRMSDs in the workplace.
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Affiliation(s)
- Antoine Frasie
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), QuebecCity, QC, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Maxime Houry
- Centre d'Études des Transformations des Activités Physiques etSportives (CETAPS), Université de Rouen, Rouen, France
| | - Charles Plourde
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), QuebecCity, QC, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Maxime T Robert
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), QuebecCity, QC, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Laurent J Bouyer
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), QuebecCity, QC, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Jean-Sébastien Roy
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), QuebecCity, QC, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
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Dos Anjos FV, Boccia G, Brustio PR, Rainoldi A, Gazzoni M. Optimal bipolar system positioning to provide information about the trapezius activity associated with scapular retraction during shoulder exercises for resistance training. Physiol Meas 2022; 43. [PMID: 36179706 DOI: 10.1088/1361-6579/ac96cc] [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: 05/12/2022] [Accepted: 09/30/2022] [Indexed: 02/07/2023]
Abstract
Objective. Recently, the use of EMG biofeedback to make subjects aware of the stabilizer activation associated with scapular retraction during exercise has been of interest, and challenges related to EMG detection have been addressed. Whether there is an optimal bipolar positioning that discriminates the stabilizer activation with retraction from a neutral scapular position during resistance exercises is an open issue that we address here by simultaneously mapping different positions using high-density surface electromyography (HD-sEMG).Approach. Sixteen resistance-trained males performed five pulling exercises with and without scapular retraction, namely barbell rows, dumbbell rows, pull-downs at a lat machine, seated rows, and TRX (total resistance exercises) system rows. HD-sEMG was acquired in a monopolar mode from the medial and lower trapezius (8 × 4 electrodes and inter-electrode distance (ied): 10 mm) and different bipolar systems were simulated in terms of positioning, interelectrode distance, and orientation with respect to the spine: longitudinal with three ieds (20 mm, 30 mm, and 40 mm), one transversal, and two diagonals (ied: 20 mm), totalling six EMG sets. To identify the optimal electrode pair that was able to distinguish between the presence or absence of scapular retraction, we computed: (i) the root mean square (RMS) map for each condition and the difference between them, obtaining a differential RMS map per subject; and (ii) the intersection of cumulative maps, by summing the differential (binary) maps from all subjects.Main results. For the lower trapezius, the results revealed that the diagonal direction (45 degrees; ied: 20 mm) obtained the greater occurrence of intersecting segments within and between exercises than the other electrode configurations, showing low variability for the optimal positioning across exercises. Electrode configuration varied within and between the pulling exercises for the medial trapezius.Significance. This study allows us to identify an optimal bipolar positioning (consistent across subjects and exercises) for lower trapezius activity assessment, representing a guideline for electrode positioning when EMG biofeedback is adopted for selective activation of the lower trapezius during pulling exercises.
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Affiliation(s)
- F V Dos Anjos
- Laboratory for Engineering of the Neuromuscular System (LISiN), Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy.,PolitoBIOMed Lab, Politecnico di Torino, Turin, Italy.,Postgraduate Program of Rehabilitation Sciences, Augusto Motta University (UNISUAM), Rio de Janeiro, Brazil
| | - G Boccia
- Department of Clinical and Biological Sciences, University of Turin, Italy.,NeuroMuscular Function Research Group, University of Turin, Italy
| | - P R Brustio
- Department of Clinical and Biological Sciences, University of Turin, Italy.,NeuroMuscular Function Research Group, University of Turin, Italy.,Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - A Rainoldi
- NeuroMuscular Function Research Group, University of Turin, Italy.,Department of Medical Sciences, University of Turin, Italy
| | - M Gazzoni
- Laboratory for Engineering of the Neuromuscular System (LISiN), Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy.,PolitoBIOMed Lab, Politecnico di Torino, Turin, Italy
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Domingues MDF, Sciarrone A, Radwan A. Special Issue "Wearable and BAN Sensors for Physical Rehabilitation and eHealth Architectures". SENSORS 2021; 21:s21248509. [PMID: 34960602 PMCID: PMC8708758 DOI: 10.3390/s21248509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Maria de Fátima Domingues
- Instituto de Telecomunicações, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal;
- Correspondence:
| | - Andrea Sciarrone
- Department of Electrical, Electronic, Telecommunications Engineering, and Naval Architecture (DITEN), University of Genoa, Via dell’Opera Pia 13, 16145 Genoa, Italy;
| | - Ayman Radwan
- Instituto de Telecomunicações, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal;
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