المؤلفون: Silveira A; University of Alberta, School of Public Health, Edmonton, Alberta, Canada., Lima C; University of Alberta, School of Public Health, Edmonton, Alberta, Canada., Beaupre L; University of Alberta, Faculty of Rehabilitation Sciences, Edmonton, Alberta, Canada.; University of Alberta, Collaborative Orthopaedic Research, Edmonton, Alberta, Canada., Chepeha J; University of Alberta, Collaborative Orthopaedic Research, Edmonton, Alberta, Canada., Jones A; University of Alberta, Faculty of Rehabilitation Sciences, Edmonton, Alberta, Canada.

المصدر: PloS one [PLoS One] 2024 Apr 29; Vol. 19 (4), pp. e0294014. Date of Electronic Publication: 2024 Apr 29 (Print Publication: 2024).

نوع المنشور: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

مواضيع طبية MeSH: Shoulder Pain*/therapy , Exercise Therapy*/methods , Chronic Pain*/therapy , Quality of Life*, Humans ; Range of Motion, Articular ; Network Meta-Analysis ; Randomized Controlled Trials as Topic ; Treatment Outcome ; Adult

مستخلص: Background: Exercise therapy (ET) is frequently an early treatment of choice when managing shoulder pain, yet evidence on its efficacy to expedite recovery is inconsistent. Moreover, the value of adding adjunct therapies (i.e. injections, manual therapy, electrotherapy) to ET is currently unclear. This study combined both direct and indirect evidence across studies on the effectiveness of ET with/without adjunct therapies compared to usual medical care for adults with chronic shoulder pain.
Methods and Findings: Using a network meta-analysis, randomized control trials comparing ET along with adjunct therapies were identified in MEDLINE, Embase, CINAHL, Sportdiscus, CENTRAL, Conference Proceedings Citation Index-Science, clinicaltrials.gov, and association websites. Outcomes included pain, range of motion (ROM), and health-related quality of life (HRQL) measures in adult patients with chronic shoulder pain. Data analysis used a Frequentist hierarchical model. CINeMA tool assessed the confidence in the results and Cochrane Risk of Bias tool assessed quality of studies. 54 studies primarily from Europe (40.38%) included 3,893 participants who were followed up to 52 weeks. Shoulder-specific ET (Mean difference (MD) = -2.1; 95% confidence interval (CI) = -3.5 to -0.7) or in combination with electro-physical agents (MD = -2.5; 95% CI = -4.2 to -0.7), injections (MD = -2.4; 95% CI = -3.9 to-1.04) or manual therapy (MD = -2.3; 95% CI = -3.7 to -0.8) decreased pain compared to usual medical care. Trends with ROM and HRQL scores were seen; however, only Manual Therapy (MD = -12.7 and 95% CI = -24.4 to -1.0) achieved meaningfully important changes. Sensitivity analysis excluding studies with high risk of bias showed similar results, with exception of injections that did not reach significance (MD = -1.3; 95% CI = -4.3 to 1.7).
Conclusion(s): Shoulder-specific ET provided pain relief up to 52 weeks. Adjunct therapies to shoulder-specific ET added little value in reducing pain. The quality of evidence varied between moderate and very low.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Silveira et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

المؤلفون: Onursal Kilinç Ö; Faculty of Physical Therapy and Rehabilitation, Hacettepe Universitesi, Ankara, Turkey., Kilinç M; Faculty of Physical Therapy and Rehabilitation, Hacettepe Universitesi, Ankara, Turkey., Ayvat E; Faculty of Physical Therapy and Rehabilitation, Hacettepe Universitesi, Ankara, Turkey., Düzgün I; Faculty of Physical Therapy and Rehabilitation, Hacettepe Universitesi, Ankara, Turkey., Özçakar L; Department of Physical and Rehabilitation Medicine, Hacettepe Universitesi Tip Fakultesi, Ankara, Turkey.

المصدر: Topics in stroke rehabilitation [Top Stroke Rehabil] 2024 Jul; Vol. 31 (5), pp. 501-512. Date of Electronic Publication: 2024 Jan 09.

نوع المنشور: Journal Article; Randomized Controlled Trial

بيانات الدورية: Publisher: Taylor & Francis Country of Publication: England NLM ID: 9439750 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1945-5119 (Electronic) Linking ISSN: 10749357 NLM ISO Abbreviation: Top Stroke Rehabil Subsets: MEDLINE

مواضيع طبية MeSH: Stroke Rehabilitation*/methods , Stroke*/diagnostic imaging , Stroke*/physiopathology , Ultrasonography* , Exercise Therapy*/methods, Humans ; Male ; Female ; Middle Aged ; Aged ; Muscle, Skeletal/diagnostic imaging ; Muscle, Skeletal/physiopathology ; Shoulder Pain/rehabilitation ; Shoulder Pain/diagnostic imaging ; Shoulder Pain/etiology ; Upper Extremity/physiopathology ; Upper Extremity/diagnostic imaging ; Adult ; Scapula/diagnostic imaging ; Scapula/physiopathology ; Treatment Outcome

مستخلص: Background: After stroke, the effects of focused scapulo-humeral training with simultaneous assessment of the changes in shoulder subluxation, related muscle thicknesses and upper limb performance have not been studied in the literature.
Objectives: This study aimed to investigate the effects of an 8-week scapulo-humeral training program in addition to conventional rehabilitation on upper extremity/trunk functions, shoulder pain, and sonographic measurements of the shoulder joint and periscapular muscles.
Methods: Thirty stroke individuals were randomly separated into two groups as Group I-scapulo-humeral training (5F/10 M) and Group II - control (5F/10 M). Conventional rehabilitation program was applied to both groups, and a scapulo-humeral training exercise protocol was added for the scapulo-humeral group. All the treatments were applied for 1 hour/day, 3 days/week, 8 weeks. Clinical evaluations were made using the Fugl Meyer Assessment-Upper Extremity(FMA-UE), Action Research Arm Test(ARAT), ABILHAND, Visual Analog Scale, and Trunk Impairment Scale(TIS). Ultrasound was used to measure serratus anterior/lower trapezius muscle thicknesses, and acromion-greater tubercule/acromio-humeral distances.
Results: FMA-UE, ARAT, ABILHAND and TIS scores increased in both groups, with greater increases in most parameters in the scapulo-humeral training group. Shoulder pain decreased only in the scapulo-humeral training group. Subacromial distances were decreased on the paretic side, and muscle thicknesses increased on both sides in the scapulo-humeral training group, and in the control group, only serratus anterior muscle thickness increased on the paretic side ( p  < 0.05 for all).
Conclusions: Additional scapulo-humeral exercises to conventional rehabilitation was seen to improve upper extremity/trunk performance and shoulder pain, and to increase scapula stabilizer muscle thicknesses in stroke individuals with mild-moderate upper extremity disability.

المؤلفون: Wörner T; Department of Health Sciences, Lund University, Lund, Sweden. tobias.worner@med.lu.se., Sirard P; Joint Academy®, Malmö, Sweden., Nero H; Department of Clinical Sciences, Orthopedics, Lund University, Lund, Sweden., Hörder H; Department of Clinical Sciences, Orthopedics, Lund University, Lund, Sweden., Misini Ignjatovic M; Joint Academy®, Malmö, Sweden., Eek F; Department of Health Sciences, Lund University, Lund, Sweden.

المصدر: Journal of rehabilitation medicine [J Rehabil Med] 2023 Nov 14; Vol. 55, pp. jrm9415. Date of Electronic Publication: 2023 Nov 14.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: MJS Publishing Country of Publication: Sweden NLM ID: 101088169 Publication Model: Electronic Cited Medium: Internet ISSN: 1651-2081 (Electronic) Linking ISSN: 16501977 NLM ISO Abbreviation: J Rehabil Med Subsets: MEDLINE

مواضيع طبية MeSH: Shoulder Pain*/rehabilitation , Shoulder Pain*/etiology , Shoulder Pain*/therapy , Exercise Therapy*/methods , Patient Education as Topic* , Pain Measurement* , Disability Evaluation*, Humans ; Male ; Female ; Middle Aged ; Retrospective Studies ; Adult ; Treatment Outcome ; Aged ; Disabled Persons/rehabilitation ; Cohort Studies

مستخلص: Objective: To describe and examine potential predictors of changes in pain and disability in patients with shoulder pain who have completed 3 months of digitally delivered treatment comprising exercise and patient education.
Design: Retrospective cohort study (clinicaltrials.org Nr: NCT05402514).
Subjects: Patients with shoulder pain who completed treatment (n = 682).
Methods: Primary outcome was change in shoulder pain (numerical rating scale 0-10; minimal clinical important change: at least 2 points). Pain and disability were reported on the Shoulder Pain and Disability Index. Changes in outcomes were analysed with paired sample t-tests. Association with potential predictors (sex, age, education, body mass index, physical activity, symptom duration, baseline pain/function, and treatment adherence) were explored with linear regression models Results: Statistically significant improvements were found for all treatment outcomes. Minimal clinically important change in pain was reached by 54.5% (n = 372). Higher baseline level of symptoms, short symptom duration, and high treatment adherence were associated with greater changes.
Conclusion: Patients with shoulder pain reported significant reductions in pain and disability following treatment, but the clinical relevance of the improvements has not been confirmed. Satisfactory treatment adherence, higher baseline pain and shorter symptom duration predicted larger improvements. A control group is needed to evaluate the actual effect of the treatment.

المؤلفون: Trøstrup J; Elective Surgery Centre, Silkeborg Regional Hospital, Falkevej 1-3, 8600, Silkeborg, Denmark. jeatro@rm.dk., Frost P; Centre for Social Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.; Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark., Dalbøge A; Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark.; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark., Mikkelsen LR; Elective Surgery Centre, Silkeborg Regional Hospital, Falkevej 1-3, 8600, Silkeborg, Denmark.; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark., Høybye MT; Elective Surgery Centre, Silkeborg Regional Hospital, Falkevej 1-3, 8600, Silkeborg, Denmark.; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark., Jørgensen LB; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Knowledge Centre for Neurorehabilitation of Western Denmark, Regional Hospital Central Jutland, Hammel, Denmark., Casper SD; ErgoPro, Ry, Denmark., Klebe TM; Elective Surgery Centre, Silkeborg Regional Hospital, Falkevej 1-3, 8600, Silkeborg, Denmark., Svendsen SW; Danish Ramazzini Centre, Department of Occupational Medicine, Gødstrup Hospital - University Research Clinic, Herning, Denmark.

المصدر: Journal of occupational rehabilitation [J Occup Rehabil] 2023 Sep; Vol. 33 (3), pp. 473-485. Date of Electronic Publication: 2022 Dec 13.

نوع المنشور: Randomized Controlled Trial; Journal Article; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: Springer Country of Publication: Netherlands NLM ID: 9202814 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-3688 (Electronic) Linking ISSN: 10530487 NLM ISO Abbreviation: J Occup Rehabil Subsets: MEDLINE

مواضيع طبية MeSH: Shoulder* , Exercise Therapy*, Humans ; Shoulder Pain/prevention & control ; Outcome Assessment, Health Care ; Workplace

مستخلص: Purpose: To evaluate if a group-based Shoulder-Café intervention could reduce shoulder complaints more effectively than an individual-based control intervention in employees with shoulder complaints and high occupational shoulder exposures.
Methods: A cluster-randomised controlled study of 109 participants from 60 companies in Central Denmark Region. Companies were randomised and allocated to either Shoulder-Café or control intervention. Participants in both interventions received a pamphlet on home-based shoulder exercises and a pamphlet with general information on reducing occupational shoulder exposures. They also had their occupational shoulder exposures assessed. Shoulder-Café participants additionally received three café-meetings with casual discussion, clinical shoulder evaluation, education about shoulder anatomy and occupational shoulder exposures, supervised exercises, workplace-oriented counselling, and an optional workplace visit. The primary outcome measure was the Oxford Shoulder Score (OSS) at 6-month follow-up. Secondary outcome measures were the OSS at 12 months, Fear-Avoidance Beliefs Questionnaire - Physical Activity at 6 and 12 months, and Patients' Global Impression of Change at 6 months. The study also included seven supplementary outcome measures.
Results: Both groups improved from baseline to 6 months with respect to the primary outcome (P < 0.01). No group differences were found for the primary outcome (mean difference (MD) [95% confidence interval]: 0.3 [- 1.6; 2.2]) or secondary outcomes. The supplementary outcomes "felt informed about handling shoulder complaints" and "felt informed about reducing occupational exposures" at 6 months, and "Patients' Global Impression of Change" and "overall satisfaction" at 12 months favoured the Shoulder-Café intervention.
Conclusion: The Shoulder-Café intervention did not reduce shoulder complaints more effectively than the control intervention.
Trial Registration: The trial was registered at Clinicaltrials.gov on 19 May 2017 (ID: NCT03159910).
(© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

المؤلفون: Dolsø M; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark., Juul-Kristensen B; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark., Skou ST; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark., Søgaard K; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Søndergaard J; Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark., Juhl CB; 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., Liaghat B; 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. Electronic address: bliaghat@health.sdu.dk.

المصدر: Musculoskeletal science & practice [Musculoskelet Sci Pract] 2023 Aug; Vol. 66, pp. 102798. Date of Electronic Publication: 2023 Jun 09.

نوع المنشور: Randomized Controlled Trial; Journal Article; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 101692753 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2468-7812 (Electronic) Linking ISSN: 24687812 NLM ISO Abbreviation: Musculoskelet Sci Pract Subsets: MEDLINE

مواضيع طبية MeSH: Shoulder* , Exercise Therapy*, Humans ; Shoulder Pain/therapy ; Quality of Life ; Exercise

مستخلص: Background: Shoulder symptoms are common in patients with hypermobility spectrum disorders (HSD), but few studies focus on identifying factors associated with treatment effects.
Aim: To identify baseline and clinical characteristics associated with a better outcome 16 weeks after starting an exercise-based treatment in patients with HSD and shoulder symptoms.
Design: Exploratory secondary analysis of data from a randomised controlled trial.
Method: Self-reported treatment outcome was reported as change between baseline and follow-up after 16 weeks of high-load or low-load shoulder strengthening. Multiple linear and logistic regressions were used to investigate associations of patient expectations of treatment effect, self-efficacy, fear of movement, and symptom duration with change in shoulder function, shoulder pain, quality of life, and patient reported health change. All regression models were performed firstly with adjustments for covariates (age, sex, body mass index, hand dominance, treatment group, and baseline score of the outcome variable) and secondly with additional adjustments for exposure variables.
Results: Expectations of complete recovery were associated with an increased odds of perceiving an important improvement in physical symptoms after a 16-week exercise-based treatment program. Higher self-efficacy at baseline seemed to be associated with improved shoulder function, shoulder pain and quality of life. A higher fear of movement seemed to be associated with increased shoulder pain and decreased quality of life. A longer symptom duration was associated with decreased quality of life.
Conclusion: Expectations of complete recovery, higher self-efficacy, lower fear of movement and shorter symptom duration seem to be important for better treatment outcomes.
(Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

المؤلفون: Liu J; Department of Sports Science and Physical Education, Chinese University of Hong Kong, Shatin, Hong Kong SAR., Sai-Chuen Hui S; Department of Sports Science and Physical Education, Chinese University of Hong Kong, Shatin, Hong Kong SAR. Electronic address: hui2162@cuhk.edu.hk., Yang Y; Department of Sports Science and Physical Education, Chinese University of Hong Kong, Shatin, Hong Kong SAR., Rong X; Department of Sports Science and Physical Education, Chinese University of Hong Kong, Shatin, Hong Kong SAR., Zhang R; School of Physical Education and Sports Science, South China Normal University, Guangzhou, China.

المصدر: Archives of physical medicine and rehabilitation [Arch Phys Med Rehabil] 2022 Oct; Vol. 103 (10), pp. 2036-2050. Date of Electronic Publication: 2022 Jun 02.

نوع المنشور: Journal Article; Meta-Analysis; Review; Systematic Review

بيانات الدورية: Publisher: W.B. Saunders Country of Publication: United States NLM ID: 2985158R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-821X (Electronic) Linking ISSN: 00039993 NLM ISO Abbreviation: Arch Phys Med Rehabil Subsets: MEDLINE

مواضيع طبية MeSH: Exercise Therapy* , Shoulder Pain*/therapy, Exercise ; Humans ; Range of Motion, Articular ; Shoulder

مستخلص: Objective: To evaluate the effectiveness of home-based exercise to treat nonspecific shoulder pain (NSSP).
Data Sources: MEDLINE, Embase, Cumulative Index to Nursing and Allied Health, Cochrane Controlled Register of Trials, and Physiotherapy Evidence Database were searched from inception to January 2022.
Study Selection: Independent reviewers selected randomized controlled trials that compared the effects of home-based exercise alone with no treatment or other conservative treatments in individuals with nonsurgical painful shoulder disorders. The primary outcomes were shoulder pain intensity and function, and the secondary outcome was shoulder range of motion (ROM).
Data Extraction: Two reviewers independently conducted data extraction. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool, and the overall quality of the evidence was evaluated using the Grading of Recommendation Assessment, Development, and Evaluation approach.
Data Synthesis: Twelve studies were included in the review, and 10 studies were included in the meta-analysis. Low to moderate quality of evidence indicated that home-based exercise alone and other conservative treatments showed equal improvements in pain intensity reduction (mean difference [MD], 0.27; 95% confidence interval [CI], -0.12 to 0.65; I ² =30%), function (standardized mean difference [SMD], 0.12; 95% CI, -0.14 to 0.38; I ² =16%), flexion ROM (MD, 4.61; 95% CI, -1.16 to 10.38; I ² =54%), and abduction ROM (MD, 3.74; 95% CI, -12.44 to 19.93; I ² =82%). Very low quality of evidence indicated that home-based exercise alone was more effective than no treatment for pain intensity reduction (MD, -1.47; 95% CI, -2.33 to -0.61) and function improvement (SMD, -0.81; 95% CI, -1.31 to -0.31; large effect).
Conclusions: Home-based exercise alone may be equally effective as other conservative treatments and superior to no treatment for the treatment of NSSP. To draw firmer conclusions, further research is required to validate these findings.
(Copyright © 2022 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

المؤلفون: Feder KM; Department of Physiotherapy, Vejle Hospital, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark. kim.michele.feder@rsyd.dk.; Department of Regional Health Research, University of Southern Denmark, 5230, J.B. Winsløws Vej 19, Odense M, Denmark. kim.michele.feder@rsyd.dk.; Research Unit for Applied Health Science, University College South (UC SYD), Lembckesvej 3-7, 6100, Haderslev, Denmark. kim.michele.feder@rsyd.dk.; Section for Biostatistics and Evidence-Based Research, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark. kim.michele.feder@rsyd.dk.; OPEN - Open Patient data Explorative Network, Odense University Hospital, University of Southern Denmark, J.B. Winsløws Vej 9a, 5000, Odense C, Denmark. kim.michele.feder@rsyd.dk., Rahr HB; Department of Regional Health Research, University of Southern Denmark, 5230, J.B. Winsløws Vej 19, Odense M, Denmark.; Department of Surgery, Vejle Hospital, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark., Lautrup MD; Department of Surgery, Vejle Hospital, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark.; Department of Plastic and Breast Surgery, Aarhus University Hospital, Palle Juul-Jensens, Boulevard 35, 8200, Aarhus N, Denmark., Egebæk HK; Research Unit for Applied Health Science, University College South (UC SYD), Lembckesvej 3-7, 6100, Haderslev, Denmark.; Research Unit of Exercise Epidemiology, Institut for Idræt, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark., Christensen R; Section for Biostatistics and Evidence-Based Research, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark.; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Campusvej 55, 5230, Odense M, Denmark., Ingwersen KG; Department of Physiotherapy, Vejle Hospital, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark.; Department of Regional Health Research, University of Southern Denmark, 5230, J.B. Winsløws Vej 19, Odense M, Denmark.; Section for Biostatistics and Evidence-Based Research, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark.; OPEN - Open Patient data Explorative Network, Odense University Hospital, University of Southern Denmark, J.B. Winsløws Vej 9a, 5000, Odense C, Denmark.

المصدر: Trials [Trials] 2022 Aug 20; Vol. 23 (1), pp. 701. Date of Electronic Publication: 2022 Aug 20.

نوع المنشور: Clinical Trial Protocol; Journal Article

بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101263253 Publication Model: Electronic Cited Medium: Internet ISSN: 1745-6215 (Electronic) Linking ISSN: 17456215 NLM ISO Abbreviation: Trials Subsets: MEDLINE

مواضيع طبية MeSH: Breast Neoplasms*/surgery , Exercise Therapy*/methods , Shoulder Pain*/diagnosis , Shoulder Pain*/etiology , Shoulder Pain*/prevention & control, Female ; Humans ; Randomized Controlled Trials as Topic ; Treatment Outcome

مستخلص: Background: In breast cancer patients, late-term upper limb sequelae, such as shoulder pain and impaired shoulder function, remain common after primary breast cancer surgery. The aim of this trial is to evaluate whether an expert assessment of shoulder impairments, followed by an individualised treatment plan, is superior to a minimal physiotherapeutic rehabilitation program in reducing shoulder symptoms, among women with late-term shoulder impairments after primary breast cancer.
Methods/design: The study is designed as a stratified, parallel-group, assessor-blinded, randomised, controlled trial conducted in Denmark; 130 participants with late-term shoulder impairments 3-7 years after primary surgery for breast cancer will be recruited. Participants will be randomised (allocation 1:1) to either an expert assessment of shoulder impairments followed by an individualised treatment plan or to follow a minimal physiotherapeutic rehabilitation program delivered in a pamphlet. The primary outcome will be a change in shoulder pain and function from baseline to 12 weeks after initiating the treatment, as measured by the patient-reported outcome Shoulder Pain and Disability Index (SPADI) questionnaire.
Discussion: There has been an insufficient focus in research and clinical practice on late-term shoulder impairment in women following surgery for breast cancer. This trial will focus on interventions towards late-term shoulder impairments and is expected to provide evidence-based knowledge to physiotherapists and women about the management of shoulder pain and impaired shoulder function.
Trial Registration: ClinicalTrials.gov NCT05277909. Registered on 11 March 2022.
(© 2022. The Author(s).)

المؤلفون: Çelik D; Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey., Yasacı Z; Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Harran University, Sanliurfa, Turkey. Electronic address: zeynalyasaci@gmail.com., Erşen A; Department of Orthopaedics and Traumatology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.

المصدر: Journal of shoulder and elbow surgery [J Shoulder Elbow Surg] 2023 Jun; Vol. 32 (6), pp. 1127-1134. Date of Electronic Publication: 2023 Feb 25.

نوع المنشور: Randomized Controlled Trial; Journal Article

بيانات الدورية: Publisher: Mosby Country of Publication: United States NLM ID: 9206499 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-6500 (Electronic) Linking ISSN: 10582746 NLM ISO Abbreviation: J Shoulder Elbow Surg Subsets: MEDLINE

مواضيع طبية MeSH: Bursitis*/therapy , Bursitis*/complications , Exercise Therapy*/methods, Humans ; Adrenal Cortex Hormones/administration & dosage ; Adrenal Cortex Hormones/therapeutic use ; Pain ; Prospective Studies ; Range of Motion, Articular ; Shoulder Pain/etiology ; Treatment Outcome ; Administration, Oral

مستخلص: Background: Many treatment strategies have been described for the management of frozen shoulder. However, to date no randomized controlled trial has directly compared the efficacy of exercise and oral corticosteroids. The aim of this study was to determine whether pain, range of motion (ROM), and function differ between patients with frozen shoulder randomized to treatment with exercise or oral corticosteroids.
Methods: This prospective, randomized, assessor-blinded trial was performed to compare the effectiveness of exercise and oral corticosteroids in patients with frozen shoulder. Overall, 33 patients with frozen shoulder were randomly assigned to receive either exercise (n = 17) or oral corticosteroids (n = 16). The exercise was applied 2 times per week for 6 weeks for 12 visits; patients in the oral corticosteroids group received prednisolone for 4 weeks. Participants were assessed at baseline, after 6 weeks and at the 12-week follow-up. The primary outcome was the Disabilities of the Arm, Shoulder and Hand and visual analog scale. Secondary outcomes were American Shoulder and Elbow Surgeons Standardized Shoulder Assessment, ROM, and Hospital Anxiety and Depression Scale. Repeated-measures analysis of covariance with baseline scores as the covariates was used to determine between-group differences. An intention-to-treat analysis was performed using the multiple imputation method to impute values for all missing data.
Results: Planned pairwise comparisons demonstrated significant improvements in pain relief and functional outcomes in both groups at the 6- and 12-week follow-ups compared to baseline. There were no significant time-by-group interactions between-group differences noted for the Disabilities of the Arm, Shoulder and Hand (F = 0.470, P = .93), visual analog scale (F = 0.006, P = .94), flexion ROM (F = 2.78, P = .1), internal rotation ROM (F = 3.440, P = .07) and American Shoulder and Elbow Surgeons Standardized Shoulder Assessment (F = 0.470, P = .49). The overall group-by-time interaction for the 2 × 3 mixed-model analysis of covariance using baseline scores as a covariate was significant for the abduction range (F = 4.460, P = .04) and external rotation ROM (F = 12.100, P = .002) in favor of the exercise group.
Conclusions: The study demonstrated that while both groups achieved significant improvements at the 6-, and 12-week follow-ups, the exercise group was superior in terms of abduction and external rotation ROM. Additionally, even though both groups were improved, the effect sizes were larger in the exercise group. Considering the systemic side effects of oral corticosteroids, even at low doses, a well-planned exercise program that considers pain may be a good option for frozen shoulder.
(Copyright © 2023 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)

المؤلفون: Saul H; NIHR Centre for Engagement and Dissemination, Twickenham, UK., Gursul D; NIHR Centre for Engagement and Dissemination, Twickenham, UK., Hopewell S; Clinical Trials Research Unit, University of Oxford, UK.

المصدر: BMJ (Clinical research ed.) [BMJ] 2022 Jul 29; Vol. 378, pp. o1776. Date of Electronic Publication: 2022 Jul 29.

نوع المنشور: Journal Article; Multicenter Study; Randomized Controlled Trial

بيانات الدورية: Publisher: British Medical Association Country of Publication: England NLM ID: 8900488 Publication Model: Electronic Cited Medium: Internet ISSN: 1756-1833 (Electronic) Linking ISSN: 09598138 NLM ISO Abbreviation: BMJ Subsets: MEDLINE

مواضيع طبية MeSH: Exercise Therapy* , Shoulder Pain*/therapy, Exercise ; Humans ; Physical Therapy Modalities ; Rotator Cuff ; Treatment Outcome

مستخلص: The studyHopewell S, Keene DJ, Marian IR, et al. Progressive exercise compared with best practice advice, with or without corticosteroid injection, for the treatment of patients with rotator cuff disorders (GRASP): a multicentre, pragmatic, 2 × 2 factorial, randomised controlled trial. Lancet 2021;398:416-28.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/one-off-physiotherapy-session-effective-for-shoulder-pain/.
Competing Interests: Competing interests: The BMJ has judged that there are no disqualifying financial ties to commercial companies. The authors declare the following other interests: none. Further details of The BMJ policy on financial interests are here: https://www.bmj.com/about-bmj/resources-authors/forms-policies-and-checklists/declaration-competing-interests
(Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

المؤلفون: Powell JK; Faculty of Health Science and Medicine, Bond Institute of Health and Sport, Bond University, Robina, Queensland, Australia., Schram B; Faculty of Health Science and Medicine, Bond Institute of Health and Sport, Bond University, Robina, Queensland, Australia., Lewis J; Therapy Department, Central London Community Healthcare National Health Service Trust, London, UK.; Musculoskeletal Research, Clinical Therapies, University of Limerick, Limerick, Ireland., Hing W; Faculty of Health Science and Medicine, Bond Institute of Health and Sport, Bond University, Robina, Queensland, Australia.

المصدر: Musculoskeletal care [Musculoskeletal Care] 2023 Mar; Vol. 21 (1), pp. 253-263. Date of Electronic Publication: 2022 Sep 11.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: John Wiley & Sons Ltd Country of Publication: England NLM ID: 101181344 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-0681 (Electronic) Linking ISSN: 14782189 NLM ISO Abbreviation: Musculoskeletal Care Subsets: MEDLINE

مواضيع طبية MeSH: Exercise Therapy* , Physical Therapists* , Rotator Cuff Injuries*/therapy, Humans ; Cross-Sectional Studies ; Prescriptions ; Rotator Cuff ; Shoulder Pain

مستخلص: Background and Aims: This cross-sectional international survey explored the beliefs of physiotherapists regarding the possible mechanisms of benefit of exercise for rotator cuff-related shoulder pain (RCRSP). Clinical practice guidelines recommend physiotherapists use exercise as a primary treatment to help people with RCRSP, but the explanations provided to patients by physiotherapists regarding its mechanism of effect is unknown.
Materials and Methods: Registered physiotherapists were surveyed about 'how and why' they believe exercise provides a clinical benefit for people with RCRSP. Information was also gathered about commonly used exercise types and preferred diagnostic labels. The survey was designed and reported in concordance with Consensus-Based Checklist for Reporting of Survey Studies guidelines.
Results: Four hundred and eighty physiotherapists from forty-nine countries completed the survey. Psychosocial and biomedical mechanisms of exercise were evenly selected by participants. Improving muscle strength, muscle endurance, pain self-efficacy and reducing kinesiophobia, and fear avoidance beliefs were the most common individual mechanisms thought to underpin exercise therapy for RCRSP. Rotator cuff-related shoulder pain was the most commonly used diagnostic label.
Discussion and Conclusion: Physiotherapists hold beliefs regarding exercise mechanisms that is largely concordant with the current evidence base, which is commendable. Future research should consider the patients perspective and consider testing commonly selected mechanisms of exercise, such as shoulder muscle strength, pain self-efficacy and kinesiophobia as possible mediators of recovery.
(© 2022 The Authors. Musculoskeletal Care published by John Wiley & Sons Ltd.)