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1.
Article | IMSEAR | ID: sea-235017

ABSTRACT

Introduction: Several treatments for frozen shoulder have been advocated over the time, and the superiority of one treatment over the other is not proven. The aim of treatment is pain reduction and preservation of shoulder range of motion. The common practice for frozen shoulder includes benign neglect, treated as supervised physical therapy with non-steroid anti-in?ammatory drugs (NSAIDs), physiotherapy, intra-articular corticosteroids, distention arthrography, close manipulation and surgical or arthroscopic capsular release. The aim of this study was to compare the treatment outcome of combination of corticosteroid injection with physiotherapy and physiotherapy alone in patients with frozen shoulder. Materials and Methods: In this comparative study 42 patients diagnosed with frozen shoulder were enrolled to compare the treatment outcome of combination of corticosteroid injection with physiotherapy and physiotherapy alone. The enrolled patients were randomly distributed in two groups A (ICS with physiotherapy) and B (Physiotherapy) with equal number of patients. Shoulder function was evaluated and documented at the time of presentation and at each subsequent visit by Shoulder Pain and Disability Index (SPADI) and ROM at forward ?exion and abduction. Similarly, improvement in pain score was assessed at subsequent visits by using a visual analog scale (VAS). Flexion and abduction of the shoulder was done by measurement of the angle formed between the arm and thorax. Mean SPADI score at inclusion was 71.4 � 8.28 and 70.9 盧esults: 7.82 in group A and B respectively, (p-value 0.408). After 6-week mean SPADI score was 33.2 � 3.98 and 35.7 � 4.10 in group A and group B respectively, statistically signi?cant in both groups (p-value 0.365). Mean VAS score at inclusion, in group A was 5.7 � 1.88 and in group B was 5.4 � 1.92, (p-value 0.843). While at the follow-up of 6 weeks, mean VAS score in group A was 1.8 � 0.56 and in group B was 52.5 � 0.78. A signi?cant reduction was seen in group A as compared to group B at the follow-up of 6 weeks, (p-value 0.001). ROM demonstrated the most signi?cant and rapid recovery among both groups with greatest improvement in group A. Flexion and abduction demonstrated signi?cant recovery in group A in comparison to group B (p < 0.05) at 6 weeks. Combination of corticosteroid injection and physiotherapy was more effective than theConclusion: physiotherapy alone in resolving the shoulder pain and disability.

2.
J Indian Med Assoc ; 2024 Jul; 122(7): 52-54
Article | IMSEAR | ID: sea-238891

ABSTRACT

Background : Rotator Cuff Tear is likely due to trauma and age related degeneration. The incidence of rotator cuff tears increases with age. Symptomatic large full thickness tear can be progress, so needed early intervention. In management of rotator cuff pros and cons of operative and non-operative treatment should be consider along with patient age and occupation of patient. Aims and Objectives : (1) To evaluate the outcome of rotator cuff repair by mini open technique. (2) To assess post operative pain in rotator cuff repair patients. Materials and Methods : In this prospective study, 30 patient treated with mini open rotator cuff repair between March, 2021 to March, 2023 are considered. Outcome of this patient was evaluated with oxford shoulder score. Results : 30 patient with operated for rotator cuff tear with mini open rotator cuff repair between age 18 to 65 were studied. Most common cause was degenerative (43.4%), by chronic impingement (33.3%) and by Traumatic (23.3%). Optimum range of movement was achieved in these patient in mean time to 1.5 months with minimal residual pain or discomfort. 86.7% patients had 40-48 Oxford shoulder score. 56.7% patients had no difficulties postoperatively in follow-up. Conclusion : Result of this study indicate that rotator cuff tear repair with mini open technique shows good outcome in term of range of movement at shoulder joint and minimal or no postoperative pain with minimal postoperative complication.

3.
Article | IMSEAR | ID: sea-228823

ABSTRACT

Background: Controlling bleeding during arthroscopic shoulder surgery helps improve the clarity of the arthroscopic visual field. Adrenaline is considered an effective and safe method to reduce bleeding. Two doses of adrenaline (0.33 mg/l and 1 mg/l) have been evaluated in the literature, but never against each other. Methods: This prospective, double-blind, randomized controlled trial will study the clarity of the visual field using a numerical scale (NS) during rotator cuff surgery on 180 patients across 5 centres. The secondary objectives include: the duration of the operation, volume of saline used, increase in baseline pressure, number of arthropump hyperpressures, mean systolic blood pressure and heart rate, as well as sudden variability. Results: Among the 154 patients in the Clinical Trial Group, 70/154 (45%) continued to have proteinuria, while 84/154 (55%) had no proteinuria (remission) compared to 41 (28%) in remission and 104 (72%) with continued proteinuria in the Usual Care group (p<0.001). Conclusions: This study aims to determine which of the two dosages previously studied in the literature (0.33 mg/l versus 1 mg/l) provides better clarity. Trial Registration Number: 2021-A02773-38.

4.
Article | IMSEAR | ID: sea-240227

ABSTRACT

Background: Adhesive capsulitis is also termed periarthritis of the shoulder joint or frozen shoulder. It is the most common cause of pain in and around the shoulder joint, extending up to the insertion of the deltoid muscle in the middle of the arm. The incidence of adhesive capsulitis ranges from 2% to 5%. It is prevalent in the middle-aged (40–60 years) group. Females suffer more from this condition. In the recent past, the infiltration of steroids into the shoulder joint was the mainstay of the treatment. Platelet-rich plasma (PRP) has appeared as a new hope for such patients, as it is believed to enhance the revascularization of the soft tissue and also increase the concentration of growth factors to improve and accelerate tendon healing. Aims and Objectives: This present study was done to evaluate the relative efficacy of ultrasonically guided infiltration of PRP and triamcinolone acetonide. Materials and Methods: The present clinical prospective study was conducted on 50 patients in a tertiary institute in Punjab, India, from June 2018 to December 2020 to evaluate the comparative efficacy of ultrasonically guided infiltration through the posterior approach of PRP and triamcinolone acetonide in the outdoor patient department of the department of orthopedics. The patients selected for the intra-articular infiltration were in their middle age (40–60 years), diagnosed as having adhesive capsulitis with non-resolution of signs and symptoms for the last 12 weeks. Results: PRP was a superior alternative to triamcinolone acetonide in the management of adhesive capsulitis as it resulted in long-term improvement in the visual analog score and disability of arm, shoulder, and hand scores with significant margins. Conclusion: PRP is definitively a newer, effective, cost-effective, autogenously derived alternative to the corticosteroids used till date, as it not only provides a long lasting effect but also helps in regenerative medicine.

5.
Int. j. morphol ; 42(3): 735-740, jun. 2024. ilus
Article in English | LILACS | ID: biblio-1564605

ABSTRACT

SUMMARY: This study aimed to determine the benefits of a combined technique of muscle energy with and myofascial release more effective than using each in isolation in glenohumeral internal rotator deficits. An interventional study was designed for this study. Thirty-eight patients were diagnosed with painful shoulder syndrome. Patients were randomly allocated into 4 groups where Group A was treated with combined muscle energy and myofascial release; Group B with muscle energy technique; Group C with myofascial release and Group D used as control. The evaluation of the passive joint range of the glenohumeral internal rotation and sociodemographic data for each of the groups were measured, before and after interventions. Despite the use of myofascial release and muscle energy techniques being significantly beneficial in their respective groups, when both were combined; it outcomes were highly successful. A combination therapy treatment applied with the Muscle Energy and Myofascial Release Techniques in patients with painful shoulder syndrome will be more effective in increasing the range of motion of the glenohumeral internal rotation joint than any of the techniques applied individually.


Este estudio tuvo como objetivo determinar los beneficios de una técnica combinada de energía muscular con liberación miofascial más efectiva que usar cada una de manera aislada en los déficits de los músculos rotadores internos glenohumerales. Para este estudio se diseñó un protocolo de intervención. En 38 pacientes se diagnosticó síndrome de hombro doloroso. Los pacientes fueron asignados aleatoriamente a 4 grupos; el grupo A fue tratado con energía muscular combinada y liberación miofascial; Grupo B con técnica de energía muscular; Grupo C con liberación miofascial y Grupo D utilizado como control. Se midió la evaluación del rango articular pasivo de la rotación interna de la articulación glenohumeral y datos sociodemográficos de cada uno de los grupos, antes y después de las intervenciones. A pesar de que el uso de técnicas de liberación miofascial y energía muscular resultó significativamente beneficioso en sus respectivos grupos, cuando ambas se combinaron; Sus resultados fueron muy exitosos. Un tratamiento de terapia combinada aplicado con las Técnicas de Energía Muscular y Liberación Miofascial en pacientes con síndrome de hombro doloroso será más efectivo para aumentar el rango de movimiento de la articulación de rotación interna glenohumeral que cualquiera de las técnicas aplicadas individualmente.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Shoulder Joint/physiopathology , Range of Motion, Articular , Physical Therapy Modalities , Combined Modality Therapy , Myofascial Release Therapy
6.
Rev. Bras. Ortop. (Online) ; 59(3): 429-434, May-June 2024. tab
Article in English | LILACS | ID: biblio-1569763

ABSTRACT

Abstract Objective To investigate whether patients undergoing anatomic total shoulder arthroplasty (ATSA) between January and March 2020 experienced different postoperative outcomes than patients in 2019. We hypothesized that patients in 2020 would have less access to physical therapy (PT) and experience different postoperative outcomes. Methods Records from patients who received ATSA between January 1st, 2019, and March 17th, 2019, and January 1st, 2020, to March 17th, 2020, were analyzed. Patient data, including demographic information, range of motion (ROM), strength, and PT was collected and compared between the two groups. The 2020 patients were contacted by phone during October 2022 and patient-reported metrics were gathered. Results The present study identified 24 patients in 2019 and 27 patients in 2020 who underwent ATSA during the specified time frame and had a minimum 1-year follow-up. Patients in 2019 experienced improvements in forward elevation (FE) ROM (125.4° to 146.7°; p = 0.008), external rotation (ER; 33.0° to 47.7°; p < 0.001), and internal rotation (IR; S1 to L4; p = 0.019). Patients in 2020 also experienced significant improvements in FE (120.2° to 141.1°; p = 0.009), ER (32.9° to 42.0°; p = 0.037), and IR (S1 to L3; p = 0.002). Patients in 2020 terminated PT earlier (2019: 125.8 days; 2020: 91.1 days; p = 0.046) and completed fewer sessions (2019: 21.4 sessions; 2020: 13.1 sessions; p = 0.003). At the final follow-up, patients in 2020 reported an average Visual Analogue Scale (VAS) pain score of 1.67 ± 1.1. Conclusion Despite decreased PT, patients who underwent ATSA in 2020 had significant improvements in ROM and strength and were comparable to patients in 2019.


Resumo Objetivo Investigar se os pacientes submetidos à artroplastia total anatômica do ombro (ATAO) entre janeiro e março de 2020 tiveram resultados pós-operatórios diferentes dos pacientes operados em 2019. Nossa hipótese é a de que os pacientes de 2020 teriam menos acesso à fisioterapia (FT) e apresentariam desfechos pós-opera-tórios diferentes. Métodos Foram analisados os prontuários de pacientes submetidos à ATAO de 1° de janeiro de 2019 a 17 de março de 2019 e de 1° de janeiro de 2020 a 17 de março de 2020. Os dados dos pacientes, incluindo informações demográficas, amplitude de movimento (ADM), força e FT foram coletados e comparados entre os dois grupos. Os pacientes de 2020 foram contatados por telefone durante outubro de 2022, e as métricas relatadas por eles pacientes foram coletadas. Resultados Este estudo identificou 24 pacientes em 2019 e 27 pacientes em 2020 que foram submetidos à ATAO durante o período especificado e tiveram acompanhamento mínimo de 1 ano. Os pacientes em 2019 apresentaram melhoras na ADM de elevação anterior (EA; 125,4° a 146,7°; p = 0,008), rotação externa (RE; 33,0° a 47,7°; p < 0,001) e rotação interna (RI; S1 a L4; p = 0,019). Os pacientes em 2020 também apresentaram melhoras significativas de EA (120,2° a 141,1°; p = 0,009), RE (32,9° a 42,0°; p = 0,037) e RI (S1 a L3; p = 0,002). Os pacientes de 2020 terminaram a FT mais cedo (2019: 125,8 dias; 2020: 91,1 dias; p = 0,046) e fizeram menos sessões (2019: 21,4 sessões; 2020: 13,1 sessões; p = 0,003). No acompanhamento final, os pacientes de 2020 relataram uma pontuação média de dor na Escala Visual Analógica (EVA) de 1,67 ± 1,1. Conclusão Apesar da menor realização de FT, os pacientes submetidos à ATAO em 2020 apresentaram melhoras significativas na ADM e na força e foram comparáveis aos pacientes de 2019.


Subject(s)
Humans , Male , Child , Middle Aged , Postoperative Period , Shoulder/surgery , Arthroplasty, Replacement , COVID-19
7.
Article | IMSEAR | ID: sea-239705

ABSTRACT

Background: Kinesthesia, the ability to perceive movements, is diminished in individuals with type II diabetes mellitus. People with frozen shoulders also experience kinesthetic deficits. Thus, obtaining accurate information on shoulder kinesthetic function in individuals with diabetes mellitus, both with and without a frozen shoulder, will aid in developing preventive and therapeutic strategies to optimize shoulder function. Aim: The study aims to investigate kinesthetic deficits in the shoulder among individuals with diabetes mellitus, both with and without frozen shoulder. Materials and Methods: A thorough literature search was performed using PubMed, Cochrane, CINAHL, and Science Direct. Free full-text articles in English, published from 2010 to October 2020, were identified using keywords and MeSH terms. Inclusion and exclusion criteria were developed based on the PICO format. The search results were then screened to identify relevant articles for this scoping review. Results: This review included fourteen articles, encompassing systematic reviews, cross-sectional studies, and prospective studies. Six studies examined the impact of diabetes mellitus on shoulder kinesthesia. These kinesthetic deficits adversely affected basic daily activities, recreational pursuits, and occupational tasks. Conclusion: Reduced kinesthetic function in the shoulder is attributed to structural changes such as capsular tightness, alterations in the fascicle length of rotator cuff muscles, the long head of the biceps, and glenohumeral joint laxity. Factors contributing to the loss of kinesthetic function include muscular fatigue from repetitive shoulder motion, limited joint mobility, blood glucose levels, and decreased muscle strength. This study provides valuable insights for clinicians to design rehabilitation programs, enhance shoulder function, and prevent re-injury risk.

8.
Article | IMSEAR | ID: sea-239039

ABSTRACT

Background: The shoulder pain etiology is diverse and many disorders present with similar symptoms and signs. MRI) provides good multiplanar delineation even without contrast and absence of radiation hazards. Aim and Objectives: To evaluate the role of MRI in diagnosing causes of shoulder pain and their limitations and pitfalls, if any. Material and Methods: A descriptive cross-sectional study was undertaken in a tertiary care centre from January 2023 to December 2023 with study population of 100 patients referred to the Department of Radiology at our institute with complaints of shoulder pain. Results: Most patients in the study in our study were in the age group of 41-60 years (44%) with mean age of patients being 45.34 ± 16.10 years. In the present study, most patients were male (72%) and common pathologies observed were joint effusion (64%), rotator cuff tear (50%), tendinopathy (46%), degenerative diseases (42%), and bursitis (34%). Hill Sachs's lesion was observed in 20% of patients, while Bankart's was in 24%. A malignant tumor was present in only one patient. Conclusion: MRI showed high sensitivity and specificity for detecting rotator cuff pathologies. It is also highly sensitive for shoulder injuries arising from soft tissues particularly in cases without known trauma. These findings underscore the clinical relevance of MRI in managing shoulder pain, emphasizing its potential to enhance patient outcomes and optimize treatment strategies.

9.
Medisan ; 28(2)abr. 2024.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1558515

ABSTRACT

Introducción: La odontología holística es parte de la medicina biológica o neurofocal, dirigida a la prevención, el diagnóstico y el tratamiento relacionados con las enfermedades del sistema estomatognático en correlación con otras estructuras anatómicas, a fin de tratar al paciente de manera integral, en cuerpo, mente y alma. Objetivo: Identificar la presencia de gingivitis crónica y de otros campos de interferencia en pacientes con artritis del hombro. Métodos: Se realizó un estudio observacional, descriptivo y transversal de 24 pacientes con artritis del hombro, pertenecientes al área de salud del Policlínico Docente Carlos Juan Finlay en Santiago de Cuba, quienes fueron atendidos en la Clínica Estomatológica Provincial Docente Mártires del Moncada, desde noviembre del 2021 hasta mayo del 2022. Resultados: En la serie predominaron el sexo femenino (62,5 %) y el grupo etario de 35-59 años (75,0 %). De igual modo, la mayoría de los pacientes padecía gingivitis crónica (87,5 %), en tanto, los otros campos de interferencia mayormente hallados fueron la placa dentobacteriana (100 %) y la caries dental (58,3 %), que figuraron en todos los molares según el holograma del microsistema de dientes alemán. Conclusiones: Los campos de interferencia identificados con más frecuencia en la casuística fueron la gingivitis crónica grave, la placa dentobacteriana y la caries dental, los cuales estuvieron asociados a la artritis del hombro que aquejaba a los pacientes.


Introduction: Holistic dentistry is part of the biological or neurofocal medicine, directed to the prevention, diagnosis and treatment related to the diseases of the stomatognatic system in correlation with other anatomical structures, in order to treat the patient in an integral way, in body, mind and soul. Objective: To identify the presence of chronic gingivitis and other interference fields in patients with shoulder arthritis. Methods: An observational, descriptive and cross-sectional study of 24 patients with shoulder arthritis was carried out, who belonged to the health area of Carlos Juan Finlay Teaching Polyclinic in Santiago de Cuba. They were assisted in Mártires del Moncada Teaching Provincial Stomatological Clinic, from November, 2021 to May, 2022. Results: In the series there was a prevalence of the female sex (62.5%) and the 35-59 age group (75.0%). In a same way, most of the patients suffered from chronic gingivitis (87.5%), as long as the other mostly found interference fields were the dentobacterial plaque (100%) and dental cavity (58.3%) that were in all the molars according to the hologram of the German teeth microsystem. Conclusions: Severe chronic gingivitis, dentobacterial plaque and dental cavity were the most frequently identified interference fields in the case material, which were associated to the shoulder arthritis in patients.

10.
Rev.Chil Ortop Traumatol ; 65(1): 1-8, abr.2024. graf, tab
Article in Spanish | LILACS | ID: biblio-1554748

ABSTRACT

OBJETIVO Comparar los resultados funcionales obtenidos en dos cohortes de pacientes ancianos tratados de forma quirúrgica (artroplastia reversa de hombro) versus tratamiento conservador. MATERIAL Y METODOS Estudio ambispectivo, no aleatorizado. Se incluyeron pacientes de 75 años o más, 15 tratados de forma quirúrgica y 16 siguieron tratamiento conservador. Seguimiento mínimo de 12 meses. A los 3, 6 y 12 meses de la fractura evaluamos las escalas ASES, Constant-Murley and Disabilities of the Arm, Shoulder and Hand score (DASH) y EVA. Además evaluamos los resultados radiológicos y las complicaciones. RESULTADOS No encontramos diferencias significativas para las escalas ASES, DASH, ni EVA .El grupo tratado de forma quirúrgica obtuvo a los 12 meses una puntuación media en la escala Constant mayor, diferencia estadísticamente significativa(75.1 þ/-10.3 vs. 51.9 þ/-12.4 p » 0.001). Además presentaban mayor rango de movilidad para flexión y rotación externa (128.9 þ/-17 versus 99.3 þ/-20.1 p » 0.001, and 35.7 þ/-13.9 vs. 23.4 þ/-15.5 p » 0.032). El 43% de los pacientes tratados mediante artroplastia reversa presentaban tuberosidades normoposicionadas y mejores resultados en las escalas versus pacientes con tuberosidades ausentes o malposicionadas. El grupo sometido a cirugía no presentó mayor tasa de complicaciones.CONCLUSIONES El tratamiento conservador en las fracturas de EPH en tres y cuatro fragmentos en pacientes ancianos ofrece buenos resultados en cuanto a dolor y funcionalidad en la mayoría de pacientes. Falta por definir qué pacientes por tener alta demanda funcional serían candidatos a tratamiento quirúrgico de entrada


OBJECTIVE This study compared functional results in two cohorts of older adults with three- and four-part proximal humeral fractures (PHFs) per Neer's classification treated with reverse shoulder arthroplasty (RSA) or nonoperative management. MATERIALS AND METHODS Ambispective, non-randomized study with two cohorts of patients aged 75 or older treated with RSA (n » 15) or nonoperative management (n » 16) with a minimum follow-up period of 12 months. We analyzed the American Shoulder and Elbow Surgeons (ASES), Constant-Murley, and Disabilities of the Arm, Shoulder, and Hand (DASH) scores and the visual analog scale (VAS) for pain at 3, 6, and 12 months. In addition, we recorded radiological findings and surgical complications. RESULTS The mean Constant-Murley score at 12 months was significantly higher for the RSA group (75.1 þ/- 10.3 vs. 51.9 þ/- 12.4, p » 0.001). There were no differences in ASES, DASH, and VAS scores. Statistically significant differences for flexion and external rotation in abduction favored the RSA group (128.9 þ/- 17.0 versus 99.3 þ/- 20.1, p » 0.001, and 35.7 þ/- 13.9 vs. 23.4 þ/- 15.5, p » 0.032, respectively). For the RSA group, tuberosity positioning was correct in 43% of subjects. These patients presented better scores than those with malpositioned or absent tuberosities but with no statistical significance. Complications in the surgical group were not higher. CONCLUSIONS Nonoperative treatment is a valid option regarding pain and functionality in elderly patients with three- and four-part PHFs. Characteristics of patients with high demands who may be candidates for the initial surgical treatment remain to be defined


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Shoulder Fractures/surgery , Shoulder Fractures/therapy , Shoulder Fractures/diagnostic imaging , Treatment Outcome , Aftercare , Conservative Treatment/methods , Arthroplasty, Replacement, Shoulder/methods
11.
Article | IMSEAR | ID: sea-228811

ABSTRACT

Background: Anterior shoulder instability (ASI) is highly prevalent in the general population causing a significant functional decline and increased healthcare burden. Among the surgical stabilization options, the Latarjet procedure is commonly preferred to treat traumatic ASI in young active individuals. Despite the advances in surgical procedures, the research evidence regarding the content of post-operative rehabilitation programmes following a Latarjet procedure for ASI is inconclusive. Methods: This protocol will adhere on the preferred reporting items for systemic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) and the Joanna Briggs Institute guidelines. MEDLINE, OvidSP, Embase, Cochrane Library, CINAHL, PubMed, SPORTS Discus and Scopus databases will be searched for relevant studies. Two reviewers will independently screen the results against the eligibility criteria defined by the population concept and context of this scoping review. A PRISMA-ScR flow diagram will be used to present the number of sources of evidence identified. The two reviewers will extract the data aiming to synthesize the results in appropriate tables. The most relevant details of the post-operative rehabilitation programmes will be presented based on consensus on exercise reporting template checklist. Conclusions: This scoping review can provide critical information regarding the content of the post-operative rehabilitation programmes after shoulder stabilization with a Latarjet procedure in patients with ASI.

12.
Article | IMSEAR | ID: sea-228804

ABSTRACT

Background: Many prior studies have utilized thoracic or lumbar spinal anesthesia with isobaric/hyperbaric bupivacaine or Ropivacaine and opioids for laparoscopic cholecystectomy and have reported variable results. our study is centered around addressing the occurrence of intraoperative right shoulder pain and its potential impact on the need for conversion to general anesthesia.Methods: This is a prospective comparative case series study in which 70 patients scheduled for elective laparoscopic cholecystectomy were. Patients in Group R received 1 ml (1 mg) of Hypobaric Ropivacaine 0.1% at T10-11 followed by 25 mcg fentanyl, and 5 mg Isobaric Ropivacaine 0.5% whereas patients in Group B received 1.5 ml (7.5 mg) Isobaric levo Bupivacaine 0.5% and 25 mcg fentanyl at T8-T10. Patients in both the groups were compared for incidence of shoulder tip pain and Hemodynamic stability.Results: Both techniques achieved satisfactory anaesthesia quality, with similar results in surgical anaesthesia onset. Average surgical duration was 45-75 minutes with average of 60 mins with longer durations in two cases common to both the groups. In group R there was there was no bradycardia or hypotension recorded more than 10% of preinduction vitals. Whereas in group B 2 patients had bradycardia and hypotension more than 10% of preinduction vitals. Conclusions: The T10-11 technique using low-dose (6 mg) hypobaric ropivacaine and isobaric Ropivacaine appears to be superior in terms of shoulder tip pain, and hemodynamic stability compared to the T8-T10 technique using isobaric levo-Bupivacaine alone in higher dose.

13.
Rev. Pesqui. Fisioter ; 14(1)mar., 2024. tab, ilus
Article in English, Portuguese | LILACS | ID: biblio-1555417

ABSTRACT

INTRODUCTION: Shoulder pain after stroke, a complication with a prevalence of up to 16­84% usually occurs after 2­3 months and leads to patients withdrawing from rehabilitation programs, staying in the hospital longer, having less limb function and having a great negative impact on their quality of life. The aim of the present study was to determine the effect of PEMF and NMES in reducing shoulder pain in patients with stroke. MATERIAL AND METHODS: A prospective, randomized controlled trial included 51 patients with shoulder pain following stroke. The patients were randomly assigned to three groups (17 people in each group): Pulsed Electromagnetic Field (PEMF), Neuromuscular Electrical Stimulation (NMES) and Control group. The outcome measures were Visual Analogue Scale (VAS), Modified Ashworth Scale (MAS) and Fugl Meyer Assessment­Upper Extremity (FMA-UE), Active and Passive Range of Motion (AROM/PROM) assessed at the baseline, six weeks into the intervention, and one week into the follow-up. RESULTS: VAS score for pain showed a mean change of 1.60, 1.60 and 4.94 in PEMF, NMES, and control respectively after 20 sessions. It showed pain was significantly improved in all the groups (p<0.001), but the effectiveness of the PEMF and NMES groups was superior to the control group. CONCLUSION: The current literature showed that PEMF & NMES are effective in improving post-stroke shoulder pain, spasticity, range of motion and motor function and a novel method for stroke patients undergoing rehabilitation.


INTRODUÇÃO: Dor no ombro após acidente vascular cerebral com prevalência de 16­84% geralmente ocorre após 2­3 meses e pode resultar na suspensão de programas de reabilitação, internações hospitalares mais longas e redução da função dos membros, prejudicando qualidade de vida dos pacientes com AVC. O objetivo do presente estudo foi determinar o efeito da PEMF e da EENM na redução da dor no ombro em pacientes com acidente vascular cerebral. MATERIAL E MÉTODOS: Um estudo prospectivo, randomizado e controlado incluiu 51 pacientes com dor no ombro pós-AVC. Os pacientes foram divididos aleatoriamente em três grupos (17 pessoas em cada grupo): grupo Campo Eletromagnético Pulsado (PEMF), grupo Estimulação Elétrica Neuromuscular (EENM) e grupo Controle. As medidas de resultados foram na Escala Visual Analógica (VAS), Escala de Ashworth Modificada (MAS) e Avaliação de Fugl Meyer ­ Extremidade Superior (FMA-UE), Amplitude de Movimento (AROM/PROM) foram avaliadas no início do estudo, após seis semanas de tratamento, e após um acompanhamento semanal. RESULTADOS: A pontuação VAS para dor mostrada uma alteração média de 1,60, 1,60 e 4,94 na PEMF, EENM e Controle, respectivamente, após 20 sessões. Mostrou melhora significativa entre os três grupos (p<0,001), mas a eficácia do grupo PEMF e EENM foi superior ao grupo Controle. CONCLUSÃO: O presente estudo mostrou que PEMF e EENM são eficazes na melhora da dor no ombro pós-AVC, espasticidade, amplitude de movimento e função motora e um novo método para pacientes com AVC em reabilitação. Nossas descobertas indicam que a eficácia da EENM é claramente superior à do PEMF na manutenção da analgesia a longo prazo.


Subject(s)
Stroke , Shoulder Pain , Electric Stimulation
14.
Article | IMSEAR | ID: sea-231321

ABSTRACT

Background: The scapula provides stability and mobility for efficient upper-limb movement. Optimal scapular kinematics are essential for efficient force generation and injury prevention. Sports trainees, particularly those involved in sports requiring repetitive or high-intensity shoulder movements, are susceptible to injuries and performance limitations if associated with aberrant scapular mechanics. Understanding the intricacies of scapular dynamics is essential for designing tailored training interventions that enhance athletic performance.Rationale and objectives: Previous research has emphasized the need for sports-specific training protocols. The measurement of scapular rotation has gained significant attention. Evaluating asymmetries in scapular dynamics across various sports trainee populations is a step forward for the need for tailored interventions and injury prevention strategies in preventing injury and planning better exercise programs. The study uses a PALM meter for the measurement of scapular rotation.Methodology: 40 Subjects 19 to 24 years old from the sports authority of Andhra Pradesh, India, were studied after obtaining written informed consent. Scapular rotation measured in a neutral and with hands on the hip position. Root of the scapula (RSS), inferior angle of the scapula (IAS), and spinous processes (Sp) of C7 to T8 are taken as the anatomical landmarks. Measurements of scapular position taken in two arm positions: shoulder neutral, hands on hip. A right-angle triangle created by dropping a perpendicular line from the scapula’s root to intersect the horizontal line between the scapula’s inferior angle and the thoracic spine’s closest spinous process (IAS-Sp). The hypotenuse represents the distance IAS to RSS, while the side opposite the angle ? is the distance IAS-Sp minus RSS-Sp. A positive result indicates upward scapular rotation, while a negative result indicates downward scapular rotation.Results and Conclusion: This cross-sectional study revealed variations in scapular rotation and the distances from spinous processes in the scapular position in neutral and hands-on Hip positions from right to left and male to female. Further studies are required to understand scapular rotation variations concerning various sports involving overhead activity, heavy weight lifting, endurance sports and anatomical variations, muscle activation patterns, or task demands.

15.
Article | IMSEAR | ID: sea-227710

ABSTRACT

Background: The hemiplegic shoulder, characterized by pain, weakness, and limited range of motion, is a common complication affecting individuals who have experienced hemiplegia due to stroke or other neurological conditions. It significantly impacts the quality of life of patients and hampers their rehabilitation progress. In the context of healthcare, nurses play a pivotal role in the holistic care of patients with hemiplegia. Their knowledge, assessment skills, and interventions contribute to the prevention and management of hemiplegic shoulder, thereby aiding in the overall recovery of patients, awareness of this condition is crucial because early identification and timely interventions can prevent its progression and associated complications. Furthermore, comprehensive knowledge of hemiplegic shoulder management can contribute to patient comfort, better rehabilitation outcomes, and improved patient satisfaction. Methods: A self-made questionnaire was validated and circulated via Google Forms to hospital nurses of all age groups. 60 participants who fit the inclusion criteria and gave consent to participate in the study were selected. Their responses were recorded, data analysis was done and results were obtained. Results: 60 responses were recorded via Google Forms. The average age of the population was 32 years. Out of the entire population, only 30.77% of the entire population were aware of the hemiplegic shoulder condition. Conclusions: According to this study there is a lack of awareness about the hemiplegic shoulder in the population of nurses in India, they need to be made more aware of the safe practices of handling stroke patients.

16.
Article | IMSEAR | ID: sea-237009

ABSTRACT

Introduction: Frozen shoulder is a disabling and painful condition that is commonly managed in the primary care setting. Frozen shoulder has a protracted natural history that usually ends in resolution. It is a condition characterised by functional restriction of both active and passive shoulder motion for which radiographs of the glenohumeral joint are essentially unremarkable except for the possible presence of osteopenia or calcific tendonitis. Aims and Objectives: To evaluate the functional outcome of arthroscopic release of capsule in adhesive capsulitis (frozen shoulder). Materials and Methods: A prospective study conducted on patients diagnosed as having frozen shoulder. A total of 25 patients were taken who underwent Arthroscopic capsular release. Results: The mean forward elevation improved from 100.52 to 156.60 at final follow up. Mean abduction improved from 97.12 to 156.36 at final follow up. Mean external rotation 32.76 to 38.96 at final follow up. Mean internal rotation 18.88 to 37.0 at final follow up. The mean UCLA score improved from 13.16 to 32.16 at final follow. Excellent results were seen in 12 patients (48%), Good in 8 patients (32%), Fair in 4 patients (16%) and Poor in 1 patient (4%). Conclusion: Arthroscopic release of capsule in frozen shoulder (adhesive capsulitis) is a safe and effective procedure with very few complications. It gives further advantage of evaluating any glenohumeral joint and subacromial pathology & rapid rehabilitation is possible in comparison to open procedures.

17.
Article | IMSEAR | ID: sea-228178

ABSTRACT

Periarthritis is a chronic, inflammatory disorder of the shoulder and surrounding soft tissues, caused by injury, leading to pain and lack of use. Various therapeutic methods and surgical treatments have been introduced for shoulder periarthritis. This observational study was carried out on 16 patients clinically and radiologically diagnosed with periarthritis of shoulder to assess the efficacy of SSNB in the treatment of periarthritis of the shoulder. In this study the mean abduction increased and reached from 72.3° ± 3.10° to 116.3°± 4.8° at the follow-up of 12-weeks. Mean flexion, mean internal rotation and mean external rotation shows an improvement of 41.50, 19.8° and 23.50 respectively at 12-weeks follow-up. The mean VAS score was 7.25 ± 0.9, which shows a significant reduction at different time intervals. In this study we conclude that supra-scapular nerve block (SSNB) is an effective method for controlling pain and accelerating recovery of shoulder motion in patients with periarthritis of shoulder.

18.
Article | IMSEAR | ID: sea-241048

ABSTRACT

Background: COVID-19 vaccines are key to restoring normalcy after the global pandemic. However, improper injection techniques due to lack of clear instructions and inexperienced personnel can lead to issues like shoulder injury related to vaccine administration (SIRVA), causing shoulder pain and limited mobility. Ensuring correct administration is crucial for vaccine efficacy and patient well-being. The aim of this study was to determine the incidence of shoulder pain following COVID-19 vaccination on public health. Material & Methods: This was an observational study and was conducted in the Department of � Anaesthesia, Analgesia and Intensive care medicine of Bangabandhu Sheikh Mujib Medical University (BSSMU, Dhaka, Bangladesh during the period from February 2023 to January 2024. The study included 120 patients, male and female, focusing on Shoulder Injury Related to Vaccine Administration (SIRVA) after COVID-19 vaccination. Physician-evaluated cases were analyzed to minimize diagnostic errors, using a checklist for data extraction. Results: Patients (29.2% aged 63-72 years) predominantly received Pfizer and Moderna vaccines (80%). Common symptoms were bursitis (36%) and adhesive capsulitis (44%). Onset varied, with 35.2% reporting immediate symptoms, 40.8% within 24 hours. Pain was predominant (92%). X-ray (63.2%) and MRI (36.8%) used for diagnosis. Treatment included oral steroids (56%), physical therapy (16%), and NSAIDs (24%). Conclusions: The significance of accurate vaccine administration to avoid complications like SIRVA. Clear guidelines and trained personnel are essential for the success of the COVID-19 vaccination campaign, ensuring both efficacy and the well-being of individuals.

19.
Chongqing Medicine ; (36): 204-208,213, 2024.
Article in Chinese | WPRIM | ID: wpr-1017465

ABSTRACT

Objective To explore the effect of massage therapy guided by"corresponding compensa-tion"theory on the rehabilitation of shoulder joint function after radical resection in the patients with breast cancer.Methods Forty female patients with breast cancer after radical resection in Chongqing Municipal Hos-pital of Traditional Chinese Medicine during 2020-2022 were selected and divided into the group A and B ac-cording to the random number table method,20 cases in each group.The group A conducted the progressive functional exercise,and the group B received"corresponding compensation"massage combined with progres-sive functional exercise.Both of the two groups were treated for 20 d.Before treatment,on 20 d of treatment and after 3 months follow-up,the peak torque and total work of elbow joint flexor and extensor on the affected side were measured for evaluating the muscle force and endurance of the affected limb;the initiative joint mob-ility of anterior flexion,posterior extension,abduction and adduction of the affected shoulder joint was meas-ured to evaluate the shoulder joint mobility;the disabilities of the arm,shoulder and hand scale(DASH)was used to evaluate the degree of upper limb dysfunction;the swelling recovery of the upper limb was evaluated by measuring the difference of the circumference of the upper arm.The comparative analysis was conducted.Results On 20 d of treatment and after 3 months follow-up,the elbow flexion,extensor peak torque and total work on the affected side,and shoulder mobility in all directions on the affected side were improved in both groups,moreover these indicators in the group B were higher than those in the group A with statistically sig-nificant differences(P<0.05);the DASH score and the circumference difference of the upper arm on the af-fected side all were decreased,moreover these indicators in the group B were lower than those in the group A with statistically significant differences(P<0.05).Conclusion"Corresponding compensation"massage com-bined with progressive functional exercise could promote the rehabilitation of shoulder joint function after rad-ical resection in the patients with breast cancer.

20.
International Journal of Surgery ; (12): 153-159, 2024.
Article in Chinese | WPRIM | ID: wpr-1018106

ABSTRACT

Rotator cuff tears are very common in middle-aged and older adults and are the leading cause of shoulder surgery in the population. Some patients have rotator cuff tears that are classified as irreparable tears due to the large size of the tear and severe muscle atrophy. The treatment of irreparable rotator cuff tears presents great challenges. How to reconstruct the function of the shoulder joint is the key point. In this review article, authors will focus on partial repair of irreparable rotator cuff tears and tendon transfer for rotator cuff reconstruction, paying attention to its scope of application, efficacy, advantages and disadvantages, and providing reference for clinical diagnosis and treatment.

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