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Abstract Objective To evaluate the functionality in patients with adhesive capsulitis undergoing suprascapular nerve block (SSNB). Methods A before-and-after clinical prospective study in a single center was conducted with patients with secondary adhesive capsulitis treated with four nerve blocks based on anatomical limits. The sample was non-probabilistic, and it was obtained after a routine appointment at a specialized outpatient clinic. The instruments used for evaluation were the International Classification of Functioning, Disability and Health (ICF) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, which were applied at baseline (T0), one week after the fourth SSNB (T4), and three months after the first SSNB (T12). The paired t-test was used to compare the means of the ICF checklist items and DASH in the different: T0xT4;T4xT12;and T0xT12). The probability of rejecting the null hypothesis was 5%. Results The sample was composed of 25 individuals with a mean age of 58.16 years; 16 of them were female. The duration of the pain symptoms ranged from 2 to 16 months, with a mean of 5.92 months. The ICF checklist showed that all domains had already improved in T4 except for the environmental factors, which only improved at 03 months (p = 0.037). The patients reported improvements in shoulder function in T4, which increased more in T12, at the end of data collection (p = 0.019). Conclusion The SSNB technique is effective in patients with adhesive capsulitis after4 weeks of application, with improvements in individual's functionality lasting for 12 weeks.
Resumo Objetivo Avaliar a funcionalidade em pacientes com capsulite adesiva submetidos a bloqueio do nervo supraescapular (BNSE). Métodos Um estudo clínico prospectivo do tipo antes e depois foi realizado em um único centro com pacientes com capsulite adesiva secundária tratados com quatro bloqueios baseados em limites anatômicos. A amostra foi não probabilística, tendo sido obtida após consulta de rotina em ambulatório especializado. Os instrumentos utilizados para avaliação foram a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) e o questionário de Disfunções do Braço, Ombro e Mão (DASH), que foram aplicados antes da intervenção (T0), uma semana após o quarto BNSE (T4),etrêsapósoprimeiroBNSE(T12).AsmédiasdositensdaCIFedoDASHnos diferentes tempos (T0 x T4; T4 x T12; e T0 x T12) foram comparadas por meio do teste t pareado. A probabilidade de rejeitar a hipótese nula foi de 5%. Resultados A amostra foi composta por 25 indivíduos com média de idade de 58,16 anos; 16 eram mulheres. A duração dos sintomas dolorosos variou de 2 a 16 meses, com média de 5,92 meses. A CIF mostrou que todos os domínios já haviam melhorado em T4 à exceção dos fatores ambientais, que só melhoraram aos 3 meses (p = 0,037). Os pacientes já relataram melhora na função do ombro em T4 emaisainda em T12,ao finaldacoletadedados (p = 0,019). Conclusão A técnica de BNSE é eficaz em pacientes com capsulite adesiva após 4 semanas de aplicação, com melhora da funcionalidade do indivíduo e sua manutenção até 12 semanas.
Subject(s)
Humans , Bursitis , International Classification of Functioning, Disability and Health , Nerve BlockABSTRACT
Varmam- a discrete medical science and a great contribution of Siddhars to Tamil Nadu. It encompases Varma martial arts, Varma therapy, internal and external medicines. Varma therapy and medicines effectively treat neuro musculoskeletal conditions which is admirable. Shoulder pain is most common orthopaedic condition. It is the third common cause of musculoskeletal consultations in primary care. Approximately 1% of adult develops new shoulder pain annually. Common pathological conditions of shoulder like rotator cuff disorders and adhesive capsulitis etc exhibits similar clinical features like pain and stiffness of shoulder joint and restricted movements. Varma therapy rearranges and regulates the “Vaasi” and consequently helps to maintain the equilibrium of trihumours (Vatham, Pitham, Kapham). This review article explicates the Varma points for the treatment of shoulder pathological conditions, the exact anatomical location of Varma points and the appropriate method of its manipulation, certainly a key to further research articles.
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Abstract Objective The present study aimed to assess the association between anxiety and depression symptoms in patients with adhesive capsulitis. Methods This was a cross-sectional study carried out in a single center from a tertiary hospital with patients presenting with secondary adhesive capsulitis. The control group did not have shoulder disease, thyroid disease, anxiety, and/or depression. The instrument used was the Hospital Anxiety and Depression Scale (HADS). An analysis of covariance compared HADS scores between groups. The significance level was 5%. Results The final sample consisted of 17 patients (case group) and 27 (control group). The Shapiro-Wilk test revealed normal distribution (p> 0.05). A HADS score > 0.70 (Cronbach alpha) was reliable and presented good internal consistency. Patients with adhesive capsulitis reported "doubtful" (average/standard deviation = 8.88/4.50) "anxious symptoms" (p= 0.019) but no "depressive symptoms" (average/standard deviation = 6.41/3.69), despite p= 0.015. Conclusion There is a "doubtful" positive association between anxiety symptoms and adhesive capsulitis but a negative association with depressive symptoms.
Resumo Objetivo Avaliar a associação entre sintomas ansiosos e depressivos em pacientes com capsulite adesiva. Métodos Trata-se de um estudo transversal realizado em centro único de um hospital terciário com pacientes portadores de capsulite adesiva secundária. O grupo controle não apresentava doença do ombro, tireoidopatias e nem ansiedade e/ou depressão. O instrumento utilizado foi a escala hospitalar de ansiedade e depressão. A análise da covariância foi utilizada para comparação dos escores do Hospital Anxiety and Depression Scale (HADS, na sigla em inglês) entre os grupos. O nível de significância foi de 5%. Resultados A amostra final foi de 17 pacientes (caso) e 27 (controle). Os dados amostrais apresentaram distribuição normal por meio do teste de Shapiro-Wilk (p> 0,05). A instrumento HADS com pontuação > 0,70 (alfa de Cronbach) se mostrou confiável e com boa consistência interna. Os pacientes com capsulite adesiva, no quesito "sintomas ansiosos" (p= 0,019), relataram sintomas no patamar de "duvidosos" (média/desvio padrão = 8,88/4,50). Eles não apresentaram "sintomas depressivos" (média/desvio padrão = 6,41/3,69), apesar do p= 0,015. Conclusão Existe uma associação positiva "duvidosa" entre sintomas ansiosos e capsulite adesiva, mas negativa para sintomas depressivos.
Subject(s)
Humans , Anxiety , Bursitis/psychology , DepressionABSTRACT
Abstract Objective Adhesive capsulitis is a condition characterized by shoulder pain and stiffness. Breast cancer treatment has been linked to the development of this condition, but its mechanisms are still little known. This study's objective was to identify predictors factors associated with the development of adhesive capsulitis in breast cancer patients. Methods A case control study was performed with women undergoing treatment for breast cancer in a single center. The sampling was nonprobabilistic and consecutive. Adhesive capsulitis was defined as constant pain associated with decreased active and passive shoulder movement in anterior elevation, external rotation at 0°/90° abduction, and internal rotation at 90° abduction. The study group consisted of patients with shoulder pain and range of motion limitations, while the control group consisted of women without any shoulder abnormalities. Sociodemographic and clinical variables were collected. A univariate logistic regression was used to assess the influence of variables on the studied outcome. For p< 0.20, a multivariate logistic regression was used. The probability of null hypothesis rejection was 5%. Results A total of 145 women were assessed, with 39 (26.9%) on the study group and 106 (73.1%) on the control group. The majority was under 60 years old. In the multivariate analysis, variables correlated to the outcome under study were shoulder immobilization (OR = 3.09; 95% CI: 1.33-7.18; p= 0.009), lymphedema (OR = 5.09; 95% CI: 1.81-14.35; p= 0.002), and obesity (OR = 3.91; 95% CI: 1.27-12.01; p= 0.017). Conclusion Lymphedema, postsurgery immobilization, and obesity are predictive factors for the development of adhesive capsulitis in breast cancer patients.
Resumo Objetivo Capsulite adesiva é uma afecção caracterizada por dor e limitação dos movimentos do ombro. O tratamento do câncer de mama está relacionado ao desenvolvimento dessa doença por meio de mecanismos ainda pouco conhecidos. O objetivo do estudo foi identificar os fatores associados ao desenvolvimento de capsulite adesiva em pacientes com câncer de mama. Métodos Um estudo caso-controle foi realizado com mulheres em tratamento para câncer de mama em um centro único. A amostra foi consecutiva e não-probabilística. A capsulite adesiva foi pré-definida como dor constante e diminuição da amplitude de movimentos em elevação anterior, rotação externa em 0°/90° abdução e rotação interna em 90° abdução. O grupo caso foi constituído por pacientes com dor e limitação de todos os movimentos do ombro, enquanto o controle por pacientes sem qualquer alteração nesta articulação. Variáveis sociodemográficas e clínicas foram coletadas. Foi realizada uma análise de regressão logística univariada para avaliar a influência das variáveis em relação ao desfecho estudado. Para valores de p< 0,20, realizou-se a análise de regressão logística multivariada. A probabilidade de se rejeitar a hipótese nula foi de 5%. Resultados Foram avaliadas 145 mulheres, sendo 39 casos (26,9%) casos e 106 controles (73,1%). Na análise multivariada, as variáveis associadas ao desfecho estudado foram imobilização do ombro (OR = 3,09; 95% IC: 1,33-7,18; p= 0,009), linfedema (OR = 5,09; 95% IC: 1,81-14,35; p= 0,002) e obesidade (OR = 3,91; 95% IC: 1,27-12,01; p= 0,017). Conclusão Linfedema, imobilização pós-cirúrgica e obesidade são fatores preditores associados ao desenvolvimento de capsulite adesiva em pacientes com câncer de mama.
Subject(s)
Humans , Female , Shoulder , Breast Neoplasms , Bursitis , Lymphedema , ObesityABSTRACT
This study aims to construct the core outcome set for the clinical trials of adhesive capsulitis treated with acupuncture and moxibustion. Using systematic review, semi-structured interview, Delphi questionnaire survey, analytic hierarchy process and expert consensus meeting, the primary outcomes are obtained, i.e. local tenderness, pain degree during movement, range of motion, changes in range of motion, function score, and score of local symptoms of shoulder joint. The secondary outcomes are myofascial thickness, thickness of the inferior wall of the joint capsule, health status, activity of daily living, incidence of adverse events, laboratory indexes, vital signs, cost-effectiveness, total effective rate, and patient satisfaction. It is expected to provide a reference for the outcome selection in clinical trials and the generation of medical evidences in the treatment of adhesive capsulitis with acupuncture and moxibustion.
Subject(s)
Humans , Acupuncture Therapy , Bursitis/therapy , Consensus , Moxibustion , Outcome Assessment, Health CareABSTRACT
@#Introduction: Shoulder injury related to vaccine administration (SIRVA) is a group of pathologies defined by pain and stiffness after intramuscular administration of vaccine to the upper arm and has been reported after COVID-19 vaccination. We aim to discuss its pathophysiology, clinical presentation, treatment and outcomes. Materials and methods: We retrospectively identified patients presenting with adhesive capsulitis within four weeks of administration of COVID-19 vaccine to the affected arm at our tertiary institution from March 2021 to December 2022. Result: Based on the above criteria, we identified seven cases of adhesive capsulitis, comprising one male and six female patients, with average age of 60 years. We present initial symptoms, signs and the duration from when the vaccine was administered. We have highlighted our treatment strategies as well as the clinical and functional outcomes reported by these patients after treatment. We have reported improvement in both Visual Analogue Scale (VAS) and range of motion (ROM) in all our patients after nonsurgical management which included physiotherapy and, in some cases, hydrodilatation. Conclusion: SIRVA related adhesive capsulitis is rare and under-reported with limited information in current literature. This study highlights that adhesive capsulitis is a potential complication arising from improper COVID-19 vaccine administration and reinforces traditional wisdom of administering vaccinations on the non-dominant arm. Conservative treatment strategies appear to be effective, particularly hydrodilatation combined with physiotherapy, and patients are expected to have a good return of function.
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@#Introduction: Various non-operative treatment modalities have been advocated for a frozen shoulder. In the present study we compared the efficacy of single intra-articular steroid injection vs hydrodilatation with intra-articular steroids for frozen shoulder (FS) in the frozen phase. Materials and methods: This was a prospective, randomised control trial (RCT) done at a tertiary care centre. A total of 108 participants were randomised into two groupsone group received intra-articular steroid with hydrodilatation (HDS) and other group received intraarticular steroid injection only (S). Shoulder Pain and Disability Index (SPADI) scores were taken, and statistical analysis was done to measure the outcome at two weeks, six weeks and three-month intervals after the injection. Result: There was significant improvement in symptoms at each interval for both the groups (p=0.0). There was no statistically significant difference in the SPADI score between the two groups at two weeks post injection, however at six weeks (p=0.04) and 3 months (p=0.001) significant difference in the SPADI score was demonstrated with better scores in group S. The mean duration of analgesia required in group HDS was 5.17 days (S.D.=1.73) and for group S was 4.28 days (S.D.=1.01), with a statistical significance (p=0.002). Conclusion: Better clinical results were obtained at six weeks and three months with the group receiving corticosteroid only and also had a lesser requirement of analgesia post-intervention. Thus, intra-articular steroid injection only seems to be a more desirable method of management during the frozen phase of FS than that of hydrodilatation with intra-articular steroid injection.
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Background: Type-2 Diabetes mellitus (T2DM) is a metabolic disease characterized by hyperglycemia and may causes long term organs dysfunctions like retinopathy, nephropathy, neuropathy, cardiovascular and autonomic dysfunction. Musculoskeletal and nervous system can also be affected by T2DM resulting pain, dysfunctions and disabilities. Objectives: This study is to find the prevalence of different pain conditions in patients with T2DM.Material & Methods:The study was conducted in public and private hospitals of four cities (Brahmanbaria, Dhaka, Gazipur and Faridpur) of Bangladesh from 1st April to 31st September, 2021. The patients of type II diabetes mellitus with both gender and age above 40 were included, and patients with other active systemic disease of bones and soft tissues were excluded. A self-structured questionnaire was developed. The questionnaire was distributed among 500 patients, out of whom 450 patients responded. The non-probability convenient sampling technique was used for data collection. The data was analyzed by SPSS and percentages were calculated to estimate the musculoskeletal complications in patients with T2DM.Results:The result showed high prevalence of pain conditions in T2DM patients. Older age groups of 61-65 (24%) years suffering from T2DM for more than 3 years having higher bloodsugar level 17-19 mmol/L with positive family history of DM were affected mostly. The prevalence of musculoskeletal pain condition in T2DM was 71.11%, while the low back pain was (42.88%), frozen shoulder was 31.33%, diabetic neuropathy was (26.89%) were the most common musculoskeletal problems, followed by knee pain (17.33%). Conclusions:It is concluded that the prevalence of different pain conditions are high among patients of T2DM and low back pain, shoulder pain, peripheral neuropathy and knee pain are common. These are mostly manageable conservatively.
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Ayurveda is boon for mankind. Panchakarma is the most important part of Ayurveda to uproot the disease as well as achieving the perfect balance of vitiated Doshas, Dhatus and Agni. Avabahuka is a disease that affects the day to day activities like cooking, dressing, bathing, eating etc. Shoulder pain is a common clinical symptom of Avabahuka. The symptom of Avabahuka may be correlated with frozen shoulder because symptoms as well as pathogenesis are more or less similar to Avabahuka. Acharya Vangasena had mentioned Swedana Karma for Avabahuka. Aim: To evaluate the effectiveness of Jambira Pinda Sweda in the management of Avabahuka. Method: In our Panchakarma OPD 56 years old female patient came with complain of pain in the right shoulder joint and unable to perform her normal daily activities. Patient was admitted to the Panchakrma IPD of R.A.M&H and she had been treated with Jambira Pinda Sweda for 15 days. Result: After taking Panchakarma therapy, patient showed marked improvement of the symptoms like Shula (Pain), Sthambha (Stiffness) etc. Conclusion: It was found that Jambira Pinda Sweda had significant role in the management of Avabahuka.
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RESUMEN El hombro se considera la articulación más móvil e inestable del cuerpo humano. La capsulitis adhesiva es una patología frecuente en el hombro, es de causa desconocida, curso variable, y de tratamiento controversial, frecuentemente asociada a diabetes mellitus. La rehabilitación de la misma, tradicionalmente ha correspondido a ejercicios con peso y movimientos pendulares. La kinesioterapia propioceptiva es pilar fundamental durante la rehabilitación de esta patología. El objetivo de la investigación es demostrar la influencia de los ejercicios físico-propioceptivos en el alivio del dolor y la recuperación de la fuerza muscular, en pacientes con capsulitis adhesiva. Se realizó un estudio experimental de corte explicativo, longitudinal, cualitativo-cuantitativo con grupo control, en una población de 30 pacientes que recibieron tratamiento rehabilitador de hombro, en el Instituto de Medicina Deportiva de La Habana, Cuba, durante tres meses consecutivos, en el período comprendido entre enero y diciembre de 2017. A ambos grupos, se les realizó evaluación clínica, historia clínica y aplicación de la Escala de Constant antes y después del tratamiento. Los pacientes del Grupo Experimental realizaron un sistema de ejercicios propioceptivos y los pacientes del Grupo Control realizaron ejercicios pendulares. El alivio del dolor se alcanzó durante el primer mes de tratamiento en el grupo experimental, pues presentó mejores resultados en la recuperación de la fuerza muscular que el Grupo Control entre el segundo y tercer mes de tratamiento (p=1,000). En conclusión, los ejercicios propioceptivos permiten, en poco tiempo, aliviar el dolor de hombro, así como recuperar la fuerza muscular en pacientes con capsulitis adhesiva.
RESUMO O ombro é considerado a articulação mais móvel e instável do corpo humano. A capsulite adesiva é uma patologia comum do ombro, de causa desconhecida, curso variável e tratamento controverso, frequentemente associada ao diabetes mellitus. A reabilitação tem envolvido tradicionalmente exercícios de peso e movimentos pendulares. A Kinesioterapia proprioceptiva é um pilar fundamental durante a reabilitação desta patologia. O objetivo da pesquisa é demonstrar a influência dos exercícios físicos-proprioceptivos no alívio da dor e na recuperação da força muscular em pacientes com capsulite adesiva. Foi realizado um estudo experimental explicativo, longitudinal, qualitativo-quantitativo com um grupo de controle em uma população de 30 pacientes que receberam tratamento de reabilitação do ombro no Instituto de Medicina Esportiva em Havana, Cuba, durante três meses consecutivos, no período de janeiro a dezembro de 2017. Ambos os grupos foram submetidos a avaliação clínica, histórico clínico e aplicação da Escala Constante antes e depois do tratamento. Os pacientes do Grupo Experimental realizaram um sistema de exercícios proprioceptivos e os pacientes do Grupo de Controle realizaram exercícios de pêndulo. O alívio da dor foi alcançado durante o primeiro mês de tratamento no Grupo Experimental, que mostrou melhores resultados na recuperação da força muscular do que no Grupo de Controle entre o segundo e terceiro mês de tratamento (p=1.000). Em conclusão, os exercícios proprioceptivos permitem, em pouco tempo, aliviar a dor no ombro, assim como recuperar a força muscular em pacientes com capsulite adesiva.
ABSTRACT The shoulder is considered the most mobile and unstable joint of the human body. Adhesive capsulitis is a common pathology in the shoulder, with unknown cause, variable course, and controversial treatment, often associated with diabetes mellitus. The rehabilitation of the same traditionally has corresponded to weight-bearing exercises and pendulum movements. Proprioceptive kinesiotherapy is a fundamental pillar during the rehabilitation of this pathology. The objective of this research is to demonstrate the influence of physical proprioceptive exercises in pain relief and muscle strength recovery in patients with adhesive capsulitis. An experimental study of explanatory cut, longitudinal, qualitative-quantitative with control group, in a population of 30 patients who received rehabilitative treatment of shoulder, in the Institute of Sports Medicine of Havana, Cuba, during three consecutive months, in the period between January and December 2017 was carried out. Both groups underwent clinical evaluation, clinical history and application of the Constant Scale before and after treatment. Patients in the Experimental Group performed a proprioceptive exercise system and patients in the Control Group performed pendulum exercises. Pain relief was achieved during the first month of treatment in the experimental group, since it presented better results in the recovery of muscle strength than the Control Group between the second and third month of treatment (p=1.000). In conclusion, proprioceptive exercises allow, in a short time, to relieve shoulder pain, as well as to recover muscle strength in patients with adhesive capsulitis.
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A capsulite adesiva é uma condição dolorosa comum e debilitante da articulação glenohumeral que afeta cerca de 2 a 5% da população. Os órgãos internos e o sistema musculoesquelético são interligados por meio das membranas de sustentação. A tensão nessas membranas pode causar ainda mais restrições mecânicas, dor nas estruturas musculoesqueléticas e também restringir a mobilidade de órgãos viscerais. OBJETIVO: Explorar o efeito da manipulação visceral específica de órgãos na capsulite adesiva em pessoas afetadas no ombro direito. METODOLOGIA: Vinte indivíduos com capsulite adesiva foram avaliados para elegibilidade, dos quais 14 foram recrutados usando o método de amostragem por conveniência. Duas sessões de manipulação visceral comparada com manipulação placebo foram administradas nas primeiras duas semanas, seguidas de duas sessões de manipulação visceral do fígado nas duas semanas seguintes. O goniômetro digital, o nível de dor, a incapacidade no ombro e o esfigmomanômetro modificado foram usados para medir os resultados pré e pós intervenção. RESULTADOS: A comparação dos resultados entre os grupos mostrou uma diferença estatisticamente significativa nos escores de amplitude de movimentos [flexão (p = 0,001), rotação externa (p = 0,001), rotação interna (p = 0,001)], dor no ombro e escore do índice de incapacidade (0,004). Nenhuma mudança significativa foi observada no resultado de força. CONCLUSÃO: Duas sessões de manipulação visceral para o fígado podem ser benéficas na melhora da mobilidade do ombro direito, dor e incapacidade.
Adhesive capsulitis is a common, painful and debilitating condition of the glenohumeral joint affecting about 2-5% of the population. Internal organs and musculoskeletal system are inter-connected through the support membranes. Tension in these support membranes may further cause mechanical restrictions and pain in musculoskeletal structures and also restrict the mobility of the visceral organ. OBJECTIVE: To explore the effect of organ specific visceral manipulation on adhesive capsulitis in subjects with right shoulder adhesive capsulitis. METHODOLOGY: Twenty subjects with adhesive capsulitis were assessed for eligibility, out of which fourteen subjects were recruited using convenience sampling method. Two sessions of Placebo Visceral Manipulation was administered for the first two weeks, followed by a two sessions of visceral manipulation of liver for next two weeks. Digital goniometer, Shoulder pain and disability index and Modified sphygmomanometer were used to measure the pre and post outcomes. RESULTS: Between group comparison of the outcomes showed a statistically significant difference in the shoulder range of motions scores [flexion (p=0.001), external rotation (p=0.001) and internal rotation (p=0.001)] and Shoulder pain and disability index score (0.004). No significant changes were observed in the strength outcome. CONCLUSION: Two sessions of visceral manipulation for the liver may be beneficial in improving the right shoulder mobility, pain and disability
Subject(s)
Bursitis , Pain , Career MobilityABSTRACT
Abstract Objective To clarify the association of thyroid disorders and primary frozen shoulder by comparing this group with controls without shoulder disease and with patients with rotator cuff tears. Methods We evaluated 166 patients who presented frozen shoulder with treatment in progress or already treated, which were compared with 129 patients with diagnosis of rotator cuff tears and 251 control subjects. All of the participants answered the questionnaire on the following variables: age, gender, body mass index (BMI), occupation, physical activity, presence of thyroid disorders and other comorbidities, smoking and use of alcohol. Results When comparing the frozen shoulder group with the control and rotator cuff groups, there is a specific association between the presence of thyroid disorders and frozen shoulder. By calculating relative risk, it is possible to state that an individual with thyropathy has 2.69 more chance of developing frozen shoulder. Also, there was an association with gender, since women with frozen shoulder exceeded significantly the risk. Conclusions Thyroid disorders, especially hypothyroidism and the presence of benign thyroid nodules, are risk factors significantly associated with frozen shoulder, rising the chances to 2.69 times of developing frozen shoulder. This is the first study that uses, in addition to the control group, a second group with rotator cuff tears, so it was shown that there is a specific association of thyroid disorders and frozen shoulder, but not with shoulder disorders in general.
Resumo Objetivo Verificar a asssociação entre tireopatias e ombro congelado primário, comparando com grupo controle e com grupo de pacientes com lesão no manguito rotador. Métodos Foram avaliados 166 pacientes com diagnóstico de ombro congelado primário com tratamento em andamento ou já tratados. Este grupo foi comparado com 129 pacientes com diagnóstico de lesão de manguito rotador e com um terceiro grupo controle formado por 251 indivíduos sem acometimento dos ombros. Todos os participantes responderam questionário sobre as seguintes variáveis: idade, gênero, índice de massa corpórea (IMC), profissão, atividade física, presença de tireopatia e de outras comorbidades, hábito tabagista e etilismo. Resultados Quando comparamos o grupo de ombro congelado com os grupos controle e lesão de manguito rotador, percebemos que existe uma associação específica entre presença de doenças da tireoide (tireoidite, hipotireoidismo, hipertireoidismo, nódulos e câncer) e ombro congelado. Através do cálculo do risco relativo, é possível afirmar que um indivíduo com tireopatia tem probabilidade 2.69 maior de desenvolver ombro congelado. Também houve associação com gênero, já que as mulheres com ombro congelado elevam significativamente esse risco. Conclusão Os distúrbios da tireoide, especialmente o hipotireoidismo e a presença de nódulos tireoidianos benignos, são fatores de risco significativamente associados ao ombro congelado, aumentando as chances em 2,69 vezes de desenvolver a doença. Este é o primeiro estudo que utiliza, além do grupo controle, um segundo grupo com lesões do manguito rotador, de modo que foi demonstrada uma associação específica de distúrbios da tireoide e ombro congelado.
Subject(s)
Humans , Thyroid Diseases , Bursitis , Control Groups , HypothyroidismABSTRACT
Background: The available treatments for frozen shoulder yield variable results. Physical therapy andanalgesics are considered as the first-line treatment for this disorder, but the effects are not uniform.There is some evidence to support that alternative medicine may have a role in its management.Objective(s): This study was designed to examine the short-term effects of yoga therapy in patients withfrozen shoulder of mild to moderate severity.Materials and methods: A prospective randomized controlled trial was conducted on patients with frozenshoulder between 30 and 60 years of age. They were divided into two groups: yoga (Y) and control (NY).A set of Asana exercises called “Standing Group of Asana” was practiced by the yoga group in addition tothe conventional therapy as received by the control group. The patients were reviewed at 1, 2 and 4weeks. The pain and functional assessment were done at baseline and at each review using the ShoulderPain and Disability Index (SPADI).Results: There were 16 male and 20 female participants in the Y group, and 15 males and 21 females inthe NY group. There was no statistically significant difference in age, sex, and pre-treatment SPADI scorebetween the groups. At the end of the four weeks, the SPADI pain scores in the Y and NY group were20.47 and 20.14, respectively (p ¼ 0.666). The SPADI disability scores in the Y and NY group were 20.4 and19.7, respectively (p ¼ 0.599). Overall SPADI scores were 40.67 and 40.03 in the Y and NY group,respectively (p ¼ 0.736). Both groups had a significant reduction in SPADI pain and disability scores.However, there was no significant difference between the groups in terms of SPADI scores.Conclusion: The effect of the Standing Group of Asana has no added advantage relative to standard frozenshoulder treatment when practiced for one month.© 2019 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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Background: Adhesive Capsulitis usually involves the posterior capsule tightness, which can be stretched either by sleepers or cross-body stretch techniques. The present study aimed to compare and see the effectiveness of two stretching techniques on horizontal adduction and internal rotation range of motion along with pain and disability. Methodology: The study was conducted on 30 subjects diagnosed with adhesive capsulitis (12 females and 18 males) of age group 40-65 years and meeting the inclusion as well as the exclusion criteria. Subjects were divided into three groups- Cross body stretch group (Group 1), Sleeper Stretch group (Group 2), and Control group (Group 3) randomly. Both groups 1 & 2 received the intervention given to group 3 along with the different stretching techniques three times a week for four weeks. Clinical outcome measures were horizontal adduction and internal rotation as measured with a goniometer, pain intensity on a numeric pain rating scale, and shoulder disability with the help of shoulder pain and disability index. Result: Data was collected at baseline and after four weeks of intervention in all three groups. Data were checked for normal distribution. For non-normally distributed data, Kruskal Wallis test-Pain (p-value> 0.419) and Function (p-value>0.665) and for normally distributed data, one-way repeated measure ANOVA-Shoulder Horizontal Adduction (p-value>0.284) and Internal Rotation (p-value>0.334) was used and the p-value was fixed to < 0.05. Conclusion: Both the type of stretches were equally effective for four weeks.
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Introduction: In freezing phase of adhesive capsulitisintraarticular corticosteroid and/or physiotherapy arecommon treatment options . Physiotherapy is an establishedtreatment . This study can help to know if steroids have anysignificant effect over physiotherapy. Study aimed to study theeffectiveness of local steroid injection in early-stage adhesivecapsulitis and to formulate guidelines for the treatment ofadhesive capsulitis patients.Materials and methods: 30 patients at a tertiary care hospitalwere randomly divided into two groups .The questionnaire PartA had sociodemographic details and Part B had Shoulder Painand Disability Index. Group A participants were administereda 40 mg triamcinolone intraarticularly. Both groups weregiven physiotherapy .After 4, 6 and 8 weeks SPADI was againrecorded for both groups.Results: Mean age of Group A and B was 54.2 ± 7.2 and 48.5± 6.9 years respectively. There were 73.3 and 66.67 percentfemales in group A and B respectively. Change in SPADI forboth groups at the end of week 4 and 6 were significant .Aftereight weeks, change in the Disability Score seen in Group Awas 51.09 ± 2.6, and for Group B was 23.42 ± 1.26.Conclusion: A combination of intra-articular steroids andphysiotherapy for the treatment of adhesive capsulitis providesbetter results than just physiotherapy.
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Background: After breast cancer treatment, many complications are seen in breast cancer survivors (BCS). In that musculoskeletal dysfunctions are common. These dysfunctions are one of the common sources of pain and disability. A recent study states that extreme pain after breast cancer treatment is often. Severe pain can be a source of a lot of limitations and psychological distress. Before the time assessment and rehabilitation can be inserted to reduce pain level, improve strength and mobility which will be helpful in minimize restrictions in daily living and improve quality of life (QOL). The objectives of the study were as follows: To determine the prevalence of myofascial dysfunctions in BCS. To study the association of myofascial dysfunctions and demographic variables in BCS. Methods: A total of 74 females who underwent breast cancer surgeries along with chemotherapy or radiotherapy or hormone therapy, were included based on inclusion criteria. Subjects were assessed for pectoralis tightness, postmastectomy pain syndrome (PMPS), rotator cuff diseases, adhesive capsulitis, lymphedema and axillary web syndrome (AWS) by using Visual Analogue Scale (VAS), Musculoskeletal Assessment and pectoral tightness test. Results: Primary outcomes used for the result were Musculoskeletal Assessment, Visual Analogue Scale, posture Assessment, pectoral tightness test. The most common type of myofascial dysfunctions was Pectoral tightness (p=0.1344), post-mastectomy pain syndrome (p=0.0116), rotator cuff disease (p= 0.1344), adhesive capsulitis (p= 0.9388) and axillary web syndrome (p= 0.9193) and the result was extremely significant. Conclusion: The major postoperative myofascial dysfunctions above the age of 50 years are pectoralis tightness, rotator cuff, and then by adhesive capsulitis and that of below 50 years was adhesive capsulitis followed by lymphedema and by rotator cuff disease.
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Background: The shoulder is a complex joint that plays a crucial role in many activities of daily living. Adhesive capsulitis is defined as a painful and disabling condition in which the capsule and the connective tissue surrounding the glenohumeral (GH) joint becomes inflamed, leading to restriction of range of motion in the joint. A wide range of physical therapy interventions are used to improve the joint range of motion in subjects with adhesive capsulitis. Earlier, isolated studies were done on the effectiveness of paraffin wax therapy and ultrasound therapy in subjects with adhesive capsulitis. The need of the present study was to compare the effect of paraffin wax therapy with manual mobilization and ultrasound therapy with manual mobilization on pain, shoulder ROM and functional status in diabetic subjects with adhesive capsulitis. Methods: Subjects for the study were recruited from the outpatient department of endocrinology and physiotherapy. The size of the sample is 80 (eighty subjects) 40 in each group, and study design is an experimental study design (Non-randomized open-label study). The pretreatment values of pain and functional status of the shoulder were assessed using Shoulder Pain and Disability Index (SPADI) scale and ROM was assessed using a universal goniometer. The subjects in the paraffin wax therapy group received wax therapy for 10 minutes and undergone manual mobilization. The subjects in the ultrasound therapy group received ultrasound therapy (3MHz) for 10 minutes and undergone manual mobilization. The treatment was given for 3 sessions per week for 6 weeks and post-treatment values were noted for the subjects of both the groups. Results: There was an improvement of ROM of external rotation, pain & functional status of the shoulder in subjects who underwent paraffin wax therapy with mobilization and ultrasound therapy with mobilization. When comparing both the groups, the subjects who underwent paraffin wax therapy with mobilization have better outcomes than ultrasound therapy with the mobilization group (p< 0.05). Conclusion: There was an improvement of ROM of external rotation, pain & functional status of the shoulder in subjects who underwent paraffin wax therapy with mobilization and ultrasound therapy with mobilization. When comparing both the groups, the subjects who underwent paraffin wax therapy with mobilization have better outcomes than ultrasound therapy with the mobilization group.
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Background: Intact sensory-motor system provides kinesthesia for maintaining joint stability. Joint proprioception or joint kinesthetic sensation is often used alternately to describe a deep sensation of joint motion and joint position sense. Mechanoreceptors located in superficial layer of joint capsule, muscle spindle, golgi tendon organ complex and ligaments around joint provides joint kinesthetic sensation. Frozen shoulder or adhesive capsulitis is one of the common musculoskeletal disorders encountered in Indian population with a prevalence of almost 50% older patients with diabetes and 2-10% in non-diabetic patients. This study assessed joint kinesthetic sensation during shoulder movements in people with frozen shoulder and healthy controls which may be affected due to presence of disease process or pain. Authors hypothesized that pain and alterations in non-contractile tissues (mainly capsule) around shoulder joint due to frozen shoulder may interfere with the joint kinesthetic sensation.Methods: Case group consisted of 41 participants with frozen shoulder and 41 healthy participants without shoulder pathology. Joint kinesthesia was assessed in frozen shoulders and dominant shoulders using angle reproduction test by actively reproducing the target angle placed passively by the therapist during flexion, abduction, medial and lateral rotation movements. The angle reproduced was measured using universal goniometer by the same therapist and 3 readings were recorded.Results: Results indicate significant differences between the mean difference of angle reproduction test during shoulder movements in cases of frozen shoulder and healthy group (p value <0.05).Conclusions: Significant shoulder kinesthetic deficits were observed in patients with unilateral frozen shoulder. Therefore, clinicians should consider rehabilitation of kinesthesia in treatment of patients with frozen shoulder.
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Background: Adhesive Capsulitis most commonly referred to as ”Frozen Shoulder” is an insidious Painful Condition with progressive and gradual restriction of all planes of movement in the glenohumeral joint. Evidence shows Mulligan's mobilization with movement (MWM) mobilization technique is more effective than muscle energy techniques (MET) and conventional therapy in improving shoulder function. Therefore the present study intends to determine the efficacy of muscle energy techniques along with Mulligan’s mobilization with movement, in adhesive capsulitis of the shoulder joint. Methods: The present randomized controlled trial was conducted among 30 subjects including both sex groups aged between 40-60 years diagnosed with adhesive capsulitis of the shoulder. They were randomly assigned into two groups with 15 subjects each. Group A received Mulligan’s mobilization alone, and Group B received Mulligan’s mobilization along with MET. Both the groups received the treatment protocol six times a week for three weeks. Pre and post evaluation of pain was done by using the short-form McGill pain questionnaire, range of motion by the Universal Goniometer and the functional disability by using Shoulder Pain and Disability Index (SPADI). Results: There was a significant improvement (P<0.05) in pre and post-intervention levels in both groups. Between groups analysis, the results are: a range of motion improved 30%, and the values are flexion with a p-value of 0.010, for abduction, internal and external rotations with a p-value of 0.000 except for extension with a p-value of 0.109. On comparison of SPADI using Mann Whitney U test, it showed 50% improvement with a significant difference with a p-value of 0.001 and McGill improved for more than 70% with a p-value of 0.000. Conclusion: Mulligan’s mobilization along with Muscle Energy Technique is found to be more effective in improving quality of life among subjects with adhesive capsulitis of shoulder than Mulligan’s mobilization alone.
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PURPOSE: Retrospectively, the purpose of this study is to investigate the necessity for early operation for patients with rotator cuff tears and concomitant adhesive capsulitis. METHODS: From March 2013 to March 2017, we conducted a retrospective study on patients with rotator cuff tears and concomitant adhesive capsulitis. We analyzed 32 cases out of 39 cases who have small to medium rotator cuff tears, excluding patients who were unable to follow up over 1 years. We evaluated range of motion, visual analog scale (VAS) score, and Constant score. We compared patients of non-symptom and symptomatic patients related to rotator cuff tear. RESULTS: Among patients in the 32 cases, 21 cases of total patients improved without discomfort after recovering their range of motion and pain (group 1), and 11 cases were developed symptoms related to rotator cuff tear for the last 1 year (group 2). Average age of group 1 patients was 53.4 years old, and recovered from forward elevation 95.5° to 163.2°, external rotation from 8.5° to 68.7°, mean VAS score improved from 6.2 to 1.2. Average age of group 2 patients was 58.4 years old, and recovered from forward elevation 96.2° to 162.2°, external rotation from 8.1° to 67.8°, mean pain VAS score improved from 6.4 to 4.4. But there was statistically significant difference in pain reduction after restoration of motion compared to asymptomatic group. CONCLUSION: We do not need surgical treatment at the same time because the symptoms of rotator cuff tear may not be manifested in patients with rotator cuff tear associated with adhesive capsulitis. Sufficient follow-up should be considered after restoration of shoulder motion related to adhesive capsulitis.