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1.
Cambios rev. méd ; 20(2): 12-18, 30 Diciembre 2021. tabs.
Article in Spanish | LILACS | ID: biblio-1368209

ABSTRACT

INTRODUCCIÓN. Según datos de la Organización Mundial de Salud los trastornos musculoesqueléticos son la principal causa de discapacidad en el mundo; retrasar su diagnóstico provocaría una discapacidad prevenible. OBJETIVO. Determinar la prevalencia de síntomas osteomusculares en galponeros de granjas avícolas asociados a condiciones del trabajo. MATERIALES Y MÉTODOS. Estudio descriptivo transversal. Muestra aleatoria estratificada de 223 trabajadores, divididos en 106 galponeros y 117 personal administrativo de granjas avícolas de la provincia de Manabí. Criterios de inclusión: trabajadores mayores de 18 años de edad con al menos un año en la misma actividad. Para el análisis de datos, se utilizó Epi Info versión 7. RESULTADOS. La prevalencia de síntomas osteomusculares en los últimos 12 meses fue mayor en los galponeros en: hombro 81,69% y columna lumbar 56,96%. Mediante un análisis a través de regresión logística se determinó que los galponeros que trabajan por más de 10 años y que realizan movimientos repetitivos en menos de un minuto, tienen mayor riesgo de presentar dolor en el hombro (IC del 95% 1,26 ­ 4,98) e (IC del 95% 1,65 ­ 5,29). CONCLUSIÓN. Se registró la prevalencia de síntomas osteomusculares en galponeros de granjas avícolas asociados a condiciones del trabajo. RECOMENDACIÓN. Es necesario contar con sistemas de vigilancia a fin de proponer estrategias públicas en la industria avícola del Ecuador


INTRODUCTION. According to data from the World Health Organization musculoskeletal disorders are the leading cause of disability in the world; delaying their diagnosis would result in preventable disability. OBJECTIVE. To determine the prevalence of musculoskeletal symptoms in poultry farm workers associated with working conditions. MATERIALS AND METHODS. Cross-sectional descriptive study. Stratified random sample of 223 workers, divided into 106 poultry sheds workers and 117 administrative personnel of poultry farms in the province of Manabí. Inclusion criteria: Workers over 18 years of age with at least 1 year in the same activity. Fort he data analysis, Epi Info version 7 was used. RESULTS. The prevalence of musculoskeletal symptoms in the last 12 months was higher in sheds workers in: shoulder 81,69% and lumbar spine 56,96%. Using logistic regression analysis, it was determined that the sheds workers who have been working for more than 10 years and who perform repetitive movements in less than one minute have a greater risk of presenting shoulder pain (95% CI 1,26 ­ 4,98) and (95% CI 1,65 ­ 5,29). CONCLUSION. The prevalence of osteomuscular symptoms in poultry farm workers associated with working conditions was recorded. RECOMMENDATION. It is necessary to have surveillance systems in order to propose public strategies in the Ecuadorian poultry industry


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Poultry , Poultry Products , Working Conditions , Occupational Exposure/adverse effects , Musculoskeletal Diseases , Muscle, Skeletal/injuries , Spine , Occupational Risks , Workload , Ankle Injuries , Neck Pain , Shoulder Pain , Hip Injuries , Knee Injuries
2.
Rev. Ciênc. Méd. Biol. (Impr.) ; 20(2): 327-332, set 29, 2021. fig
Article in English | LILACS | ID: biblio-1354629

ABSTRACT

Introduction: curved and hooked acromia play a key role in shoulder impingement syndrome. Little is known about acromial type in the Brazilian population. Aim: To describe the acromial profile of Brazilian young adults; to evaluate its correlation with gender and handedness and the occurrence of symmetry between the genders. Methodology: forty acromia in 20 Brazilian adults of both genders, aged 21-25 years, were studied. The acromial type was classified through the Bigliani/Epstein method using radiographs in supraspinatus outlet view. Results: as there was no gender difference in occurrences of acromial type, we considered the male and female groups together. Thus, among the 20 right acromia, we found 5 type I (25%), 8 type II (40%) and 7 type III (35%). Among the 20 left acromia, we found 4 type I (20%), 11 type II (55%) and 5 type III (25%). The only left-handed volunteer (100%) presented acromial type III in both the right and the left shoulder. Among the 19 right-handed volunteers, 5 (26.3%) presented right acromion type I, 8 (42.1%) had type II and 6 (31.6%) had type III; for the left acromion, 4 (21.1%) presented type I, 11 (57.9%) had type II and 4 (21.1%) had type III. Acromial symmetry occurred in 60% of females and 70% of males. Conclusion: type II acromion was predominant, in both the right and the left shoulder in Brazilian young adults. There was no correlation between acromial type and gender. It was not possible to analyze the correlation between acromial type and handedness. Acromial type tended to be symmetrical in our sample.


Introdução: o acrômio curvo e gancho desempenham um papel fundamental na Síndrome do impacto do ombro. Pouco se sabe sobre o tipo acromial na população brasileira. Objetivo: descrever o perfil do tipo acromial em adultos jovens brasileiros e avaliar sua correlação com o gênero e a lateralidade e a ocorrência de simetria entre os sexos. Metodologia: foram estudados 40 acrômios de 20 adultos brasileiros, de ambos os sexos, com idade entre 21 e 25 anos. O tipo acromial foi classificado pelo método de Bigliani/ Epstein nas radiografias de perfil de escápula. Resultados: como não houve diferença na ocorrência do tipo acromial quanto ao gênero, consideramos os grupos masculino e feminino juntos. Assim, dos 20 acrômios direitos, foram encontrados 5 (25%) do tipo I, 8 (40%) do tipo II e 7 (35%) do tipo III, enquanto que dos 20 acrômios esquerdos, foram encontrados 4 (20%) tipo I, 11 (55%) tipo II e 5 (25%) tipo III. O único voluntário canhoto (100%) apresentou para o ombro direito e esquerdo o tipo acromial III. Dos 19 voluntários destros, 5 (26,3%) apresentavam acrômio direito tipo I, 8 (42,1%) tipo II e 6 (31,6%) tipo III; para o acrômio esquerdo, 4 (21,1%) apresentavam tipo I, 11 (57,9%) tipo II e 4 (21,1%) tipo III. A simetria acromial ocorreu nos grupos feminino (60%) e masculino (70%). Conclusão: o acrômio tipo II foi o mais predominante para os ombros direito e esquerdo em adultos jovens brasileiros. Não houve correlação entre o tipo de acromial e o gênero. Não foi possível analisar a correlação entre o tipo acromial e a lateralidade. O tipo acromial tende a ser simétrico em na amostra estudada.


Subject(s)
Humans , Male , Female , Adult , Scapula , Shoulder , Shoulder Impingement Syndrome , Shoulder Pain , Rotator Cuff Injuries , Gender Identity , Functional Laterality
3.
Rev. Ciênc. Méd. Biol. (Impr.) ; 20(1): 33-39, maio 5, 2021. fig, tab
Article in Portuguese | LILACS | ID: biblio-1354793

ABSTRACT

Introdução: em 1875, Hamilton identificou o formato do acrômio como uma etiologia de dor no ombro. Neer, em 1972, descreveu a síndrome do impacto no ombro como uma relação de causa e efeito entre a morfologia do acrômio e o impacto subacromial. Em 1986, Bigliani et al. apresentaram um esquema de classificação do acrômio de acordo com o formato de sua superfície inferior: plano (tipo I), curvo (tipo II) e gancho (tipo III). Em 1993, Epstein et al. proporam que o acrômio tipo II apresentaria um declive em seu terço médio e o tipo III no seu terço anterior. Objetivo: avaliar a reprodutibilidade/confiabilidade interavaliador do método de Bigliani et al. (1986) refinado por Espstein et al. (1993) para a classificação do tipo acromial. Metodologia: casuística composta por 20 voluntários brasileiros, de ambos os gêneros, entre 21-25 anos. A incidência radiográfica utilizada para visualizar o formato do acrômio foi perfil de escápula. O tipo acromial foi classificado por três avaliadores. A reprodutibilidade e confiabilidade foram avaliadas pelo teste McNemar e pelo índice Kappa. Resultados: teste de McNemar com p > 0,05; índice Kappa entre 0,61 e 0,8; e probabilidade de significância p de Kappa < 0,05 confirmam a muito boa reprodutibilidade e confiabilidade do método para classificação do tipo acromial entre os três avaliadores. Conclusão: o método de Bigliani et al. (1986) refinado por Epstein et al. (1993) para classificação do tipo acromial mostrou concordância entre todos os avaliadores confirmando a muito boa reprodutibilidade e confiabilidade entre os avaliadores do estudo.


Introduction: in 1875, Hamilton identified that acromion shape was an etiology for shoulder pain. In 1972, Neer described shoulder impact syndrome as a cause and effect relationship between acromion morphology and subacromial impact. In 1986, Bigliani et al. presented an acromion classification scheme according to the shape of its lower surface: flat (type I), curved (type II) and hook (type III). In 1993, Epstein et al. proposed that the type II acromion would have a slope in its middle third and type III in its anterior third. Objective: to evaluate the inter-rater reproducibility and reliability of the method of Bigliani et al. (1986) for classifying acromial type, as refined by Epstein et al. (1993). Methodology: this was a case series composed of 20 Brazilian volunteers of both genders, aged 21-25 years. The shape of the acromion was visualized radiographically using the supraspinatus outlet view. Acromial type was classified by three evaluators. Reproducibility and reliability were assessed using the McNemar test and kappa index. Results: the McNemar test showed probability p > 0.05 and the kappa index was between 0.61 and 0.8 significant result: p < 0.05. These confirmed that this method had very good reproducibility and reliability for classifying acromial type among the three evaluators. Conclusion: the method of Bigliani et al. (1986) for classifying acromial type, as refined by Epstein et al. (1993) showed agreement among all the evaluators. This confirmed that there was very good reproducibility and reliability among the evaluators of this study.


Subject(s)
Humans , Male , Female , Adult , Shoulder , Acromion , Radiography , Shoulder Pain
4.
Rev. bras. ortop ; 56(3): 299-306, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1288669

ABSTRACT

Abstract Adverse reactions to vaccine injections are usually mild and incredibly rare in nature, but multiple cases of shoulder events including bursitis, generalized pain or decreased range of motion have been reported following routine vaccine administrations. These events are known as Shoulder Injury Related to Vaccine Administration or SIRVA. A systematic review of literature was performed to identify all published accounts of SIRVA. Twenty-seven papers reporting one or more accounts of SIRVA were identified. The most common vaccination involved was the Influenza vaccine. The most common symptoms were pain that began in 48 hours or less and loss of shoulder range of motion. The most common treatment modalities were physical therapy, corticosteroid injections and anti-inflammatory medication; but in some patients, surgery was required. Regardless of intervention, the vast majority of outcomes demonstrated improved pain and functional except in the occasions of nerve injury. The etiology of SIRVA injuries has multiple possibilities including needle length, mechanical injury from needle overpenetration and the possibility of an immune inflammatory response from the vaccine components, but a unique definitive test or quantifiably result does not yet exist.


Resumo As reações adversas às injeções de vacina tendem a ser brandas e são incrivelmente raras. No entanto, vários casos de eventos em ombros, como bursite, dor generalizada ou diminuição da amplitude de movimento, foram relatados após vacinações de rotina. Esses eventos são conhecidos como lesões em ombro relacionadas à administração de vacina (SIRVA, do inglês shoulder injury related to vaccine administration). Uma revisão sistemática da literatura foi realizada para identificar todos os relatos publicados de SIRVA. Vinte e sete artigos que relataram um ou mais casos de SIRVA foram encontrados. A vacina mais comumente citada foi a vacina contra influenza. Os sintomas mais comuns foram dor com início em até 48 horas e perda da amplitude de movimento do ombro. As modalidades de tratamento mais comuns foram fisioterapia, injeções de corticosteroides e administração de medicamentos anti-inflamatórios; alguns pacientes, porém, precisaram de cirurgia. Independentemente da intervenção, a grande maioria dos casos apresentou melhora da dor e da função, à exceção dos pacientes com lesão nervosa. A SIRVA tem múltiplas possíveis etiologias, inclusive comprimento da agulha, lesão mecânica por penetração excessiva da agulha e resposta inflamatória aos componentes da vacina; no entanto, ainda não há um exame definitivo ou resultado quantificável.


Subject(s)
Humans , Bursitis , Influenza Vaccines , Shoulder Impingement Syndrome , Shoulder Pain , Shoulder Injuries , Anti-Inflammatory Agents
5.
Rev. Assoc. Med. Bras. (1992) ; 67(2): 282-286, Feb. 2021. tab
Article in English | LILACS | ID: biblio-1287821

ABSTRACT

SUMMARY OBJECTIVE: The aim of this study was to compare the effect of transcutaneous electrical nerve stimulation (TENS), ultrasound (US), and pulsed electromagnetic field (PEMF) combination with TENS and US therapy alone in patients with supraspinatus tear. METHODS: Forty patients were included in this study. The patients were randomly divided into two groups as follows: PEMF (n=20) and Sham (n=20) groups. PEMF was applied to the first group at a frequency of 50 Hz, 25 G intensity, and 20 min/session. The device was turned off while PEMF was applied to the second group. Diathermy (US) and electrotherapy (TENS) were applied to both groups for 10 sessions. Numerical Rating Scale (NRS), University of California-Los Angeles (UCLA) Shoulder Scale, and Shoulder Pain and Disability Index (SPADI) were used as outcome measures. RESULTS: In both groups, there was a significant improvement in the NRS, UCLA Shoulder Scale, and SPADI scores after treatment compared with pretreatment (p<0.05). In the comparison of the difference between the pretreatment and posttreatment measurement values between the groups, no significant difference was found between PEMF and Sham groups according to the NRS (p=0.165), UCLA Shoulder Scale (p=0.141), and SPADI (p=0.839) scores. CONCLUSIONS: In our study, a combination of PEMF therapy with conventional physical therapy modalities was not found to be superior to the conventional therapy alone, and adding it to the routine treatment of symptomatic supraspinatus tear would not provide any additional benefit.


Subject(s)
Humans , Electric Stimulation Therapy , Magnetic Field Therapy , Treatment Outcome , Rotator Cuff , Shoulder Pain/therapy , Electromagnetic Fields
6.
Artrosc. (B. Aires) ; 28(2): 192-196, 2021.
Article in Spanish | LILACS, BINACIS | ID: biblio-1282688

ABSTRACT

La capsulitis adhesiva de hombro se caracteriza por la inflamación crónica de la capa subsinovial de la cápsula articular que produce fibrosis, contractura y adherencia de la cápsula a sí misma y al cuello anatómico del húmero. La rehabilitación enfocada en optimizar el rango de movilidad en forma activa y pasiva es la base del tratamiento, independientemente de la etapa. Sobre la base de la historia natural de la enfermedad, la inyección con corticoides en forma precoz tiene utilidad en acortar la duración general de los síntomas, y permite a los pacientes trabajar el rango de movilidad en las etapas de rehabilitación y así volver a sus actividades cotidianas más rápidamente. La mayoría de los pacientes tratados con terapia física logran la resolución completa de síntomas. En casos con rigidez refractaria, puede estar indicada la manipulación bajo anestesia o la liberación capsular artroscópica; debido a varios riesgos potenciales de complicaciones con las manipulaciones, se prefiere esta última. Existen escasos estudios con alto nivel de evidencia que comparen diferentes técnicas para la liberación capsular: tanto la liberación circunferencial como la capsular anteroinferior han demostrado ser efectivas como técnica quirúrgica. La cirugía debe ser seguida de forma temprana por una terapia física diligente y dirigida a prevenir la rigidez recurrente


Adhesive capsulitis is characterized by chronic inflammation of the capsular subsynovial layer, which produces capsular fibrosis, contracture, and adherence of the capsule to itself and to the anatomic neck of the humerus. Physical therapy is the mainstay of treatment, regardless of stage. Based on the natural history of the disease, early corticosteroid injection has a role in shortening the overall duration of symptoms allowing patients to move faster in the stages of rehabilitation and thus return to their daily life activities more rapidly. Most patients will see complete resolution of symptoms with nonsurgical management. In cases with refractory stiffness, manipulation under anesthesia or arthroscopic capsular release may be indicated. Because of various potential risks of complications with manipulations, arthroscopic capsular release is preferred. There is a lack of high-level studies comparing different techniques for capsular release. Both circumferential and anteroinferior release have proven to be effective. Surgery should be followed by early, diligent and directed therapy to prevent recurrent stiffness


Subject(s)
Shoulder Joint , Bursitis/surgery , Bursitis/diagnosis , Bursitis/physiopathology , Bursitis/therapy , Shoulder Pain
7.
Article in Spanish | LILACS, BINACIS | ID: biblio-1353995

ABSTRACT

Las lesiones de hombro atribuibles a la vacunación son aquellos efectos adversos secundarios a una inoculación. Su causa más frecuente ha sido la vacunación contra la gripe, pero la actual campaña masiva por la pandemia de SARS-CoV-2 determina que los especialistas conozcan este cuadro para un mejor diagnóstico y tratamiento. Estas lesiones tienen una evolución tórpida y prolongada. Deben notificarse a las agencias de control sanitario. Su tratamiento se basa en la administración temprana de corticoides y la rehabilitación. Nivel de Evidencia: IV


Shoulder injury attributable to vaccination (SIRVA) is an adverse ev ent secondary to inoculation. Its most frequent cause has been vaccination against influenza, but the current massive campaign against the SARS-CoV-2 pandemic makes it an injury whose knowledge is of importance for specialists. It includes different structural lesions and has a torpid and prolonged evolution. SIRVAs must be reported to the sanitary control agencies. Their treatment is based on the use of corticosteroids and rehabilitation. Level of Evidence: V


Subject(s)
Bursitis , Shoulder Pain , COVID-19 Vaccines
8.
Rev. bras. ortop ; 55(6): 804-807, Nov.-Dec. 2020. graf
Article in English | LILACS | ID: biblio-1156184

ABSTRACT

Abstract Neurothekeomas, also known as neural sheath myxomas, are rare benign tumors of the neural sheath affecting most commonly the head, arms and shoulder of women in their 2nd and 3rd decades of life. Due to the low prevalence and undefined clinical picture, they are hardly considered in the initial differential diagnosis of skin tumors. We report the case of a 24 year-old woman who was seen in 2016 reporting > 1 year of moderate pain and limited mobility of her left shoulder. Clinical evaluation revealed restricted mobility of the affected shoulder and nuclear magnetic resonance imaging showed a T2-weighted contrast-enhanced multilobular mass in the quadrilateral area apparently invading the adjacent humeral cortical region. Histopathology of a needle sample material revealed loose fibroconnective tissue with no signs of invasion, mitosis or atypical figures. Successful surgical excision was performed and the diagnosis of neurothekeoma was confirmed after detailed histopathology, including immunohistochemistry. The patient was asymptomatic at 18 months of follow-up, with full recovery of shoulder movement and no signs of relapse.


Resumo Neurotecomas, também conhecidos como mixomas da bainha neural, são tumores benignos raros da bainha neural afetando mais comumente a cabeça, braços e ombros de mulheres entre 20 e 40 anos de idade. Devido à baixa prevalência e quadro clínico mal definido, essas lesões são raramente consideradas no diagnóstico diferencial de tumores cutâneos. Relatamos o caso de uma mulher de 24 anos de idade que procurou atendimento em 2016 relatando dor moderada por mais de um ano e limitação dos movimentos do ombro esquerdo. Ao exame, foi constatada restrição da mobilidade dessa articulação e uma ressonância magnética revelou imagem multilobular com aumento de sinal em T2 na região quadrilateral, aparentando invasão da região cortical do úmero subjacente. A histopatologia de uma biópsia incisional mostrou lesão composta por tecido conjuntivo frouxo, sem sinais de invasão, figuras de mitose ou atipias. Foi realizada excisão completa da lesão e o diagnóstico de neurotecoma foi confirmado após análise histopatológica que incluiu painel imunohistoquímico. À revisão de 18 meses, a paciente estava assintomática com recuperação completa do movimento e sem evidência de recidiva da lesão.


Subject(s)
Humans , Female , Adult , Arm , Recurrence , Skin Neoplasms , Axilla , Biopsy , Magnetic Resonance Spectroscopy , Neurothekeoma , Connective Tissue , Shoulder Pain , Diagnosis, Differential , Head , Joints , Mitosis , Myxoma , Neoplasms
9.
Rev. chil. ortop. traumatol ; 61(2): 47-52, oct. 2020. tab, ilus
Article in Spanish | LILACS | ID: biblio-1342410

ABSTRACT

OBJETIVO: Evaluar la concordancia diagnóstica durante la evaluación inicial de pacientes con dolor de hombro entre: (1) Traumatólogos especialistas en hombro realizando una evaluación convencional y (2) un médico general utilizando una nueva aplicación móvil. MATERIALES Y MÉTODO: Se diseñó una aplicación móvil para asistir a médicos generales a realizar una evaluación del dolor de hombro entregando una hipótesis diagnóstica. Se diseñó un estudio de concordancia diagnóstica. Se evaluó un grupo de 60 pacientes, quienes consultaron por primera vez con un especialista en hombro. Primero, todos fueron evaluados por un médico general utilizando la aplicación. Se registró la hipótesis diagnóstica entregada por la aplicación. Luego, el especialista realizó una evaluación con anamnesis y examen físico, registrando su hipótesis diagnóstica. Se realizó una prueba Kappa para determinar la concordancia entre ambos evaluadores. RESULTADOS: La concordancia global entre los especialistas y la aplicación móvil utilizada por el médico general fue sustancial (k » 0,74; p < 0,001). La concordancia fue casi perfecta para el Pinzamiento subacromial, dolor cervical, lesión acromioclavicular, inestabilidad de hombro, y el pinzamiento interno. CONCLUSIÓN: La concordancia diagnóstica durante la evaluación inicial de pacientes con dolor de hombro entre traumatólogos especialistas y un médico general utilizando una aplicación móvil fue sustancial. NIVEL DE EVIDENCIA: Tipo III.


OBJECTIVE: To evaluate the diagnostic concordance during the initial evaluation of patients with shoulder pain between: (1) Shoulder orthopedic surgeons performing a conventional evaluation and (2) a general practitioner using a new mobile application. MATERIALS AND METHOD: A mobile application was designed to assist general practitioners to perform an evaluation of shoulder pain by providing a diagnostic hypothesis. A diagnostic concordance study was designed. A group of 60 patients were evaluated, who consulted for the first time with a shoulder specialist. First, they were all evaluated by a general practitioner using the application. The diagnostic hypothesis delivered by the application was recorded. Then, the specialist made an evaluation with anamnesis and physical examination, recording his diagnostic hypothesis. A Kappa test was performed to determine the agreement between both evaluators. RESULTS: The overall agreement between the specialists and the mobile application used by the general practitioner was substantial (k » 0.74, p < 0.001). The agreement was almost perfect for subacromial impingement, cervical pain, acromioclavicular injuries, shoulder instability, and internal impingement. CONCLUSION: The diagnostic agreement during the initial evaluation of patients with shoulder pain between shoulder specialist and a general practitioner using a mobile application was substantial. LEVEL OF EVIDENCE: Type III.


Subject(s)
Humans , Shoulder Pain/diagnosis , Mobile Applications
10.
Rev. Ciênc. Méd. Biol. (Impr.) ; 19(2): 335-341, set 24, 2020. fig, tab
Article in Portuguese | LILACS | ID: biblio-1358399

ABSTRACT

Introdução: a dor no ombro leva a limitações e incapacidades entre adultos e idosos, merecendo atenção do fisioterapeuta. Objetivo: Avaliar o efeito imediato da técnica de Mulligan em pacientes com dor no ombro. Metodologia: trata-se de resultados preliminares de um ensaio clínico realizado entre julho de 2018 a julho de 2019. Pacientes com dor no ombro (n=44), de ambos os sexos, foram randomizados e submetidos a dois protocolos de tratamento: exercícios terapêuticos (n=22) e MWM de Mulligan (n=22), atendidos na Clínica Escola de Fisioterapia da UFBA. Todos os participantes responderam a um questionário clínico e sociodemográfico e realizaram avaliação da dor pela escala visual analógica (EVA) e algometria. Os pacientes foram tratados por dois fisioterapeutas experientes na área e, depois, foram reavaliados imediatamente. Resultados: mulheres predominaram, a média de idade foi de 56 anos no grupo Mulligan e 57 no grupo exercícios terapêuticos. Síndrome do manguito rotador predominou: 19 (86,4%) no grupo Mulligan e 15 (68%) no grupo exercícios. O ombro mais acometido foi o direito no Grupo Mulligan, (17 (77,3%); já no grupo exercícios, foi o esquerdo com 12 (55%). A cor negra foi a mais autorrelatada pelos pacientes, e poucos tinham o ensino superior completo. No grupo Mulligan, as ocupações mais informadas foram dona de casa, seguida de aposentados e autônomos. No grupo exercícios, não houve dona de casa, e sim mais aposentados e autônomos. Os dois grupos mostraram ser mais sedentários. Não houve diferença da dor pela EVA entre os grupos, antes e após o tratamento (p=0.79, p=0.56, respectivamente). Já a intensidade da dor mensurada pela algometria, tanto antes do tratamento (p=0.008) quanto depois do tratamento (p=0.04), foi diferente entre os grupos, com predomínio de melhora no grupo Exercícios. Conclusão: a MWM não foi mais eficaz que os exercícios terapêuticos na redução da dor do ombro, sendo que o exercício apresentou mais eficácia quando medido através da EVA e sem melhora significativa ao ser mensurada pela algometria após aplicação de uma única sessão de tratamento.


Introduction: shoulder pain leads to limitations and disabilities among adults and the elderly deserving attention from the physiotherapist. Objective: to evaluate the immediate effect of the Mulligan technique in patients with shoulder pain. Methodology: these are preliminary results of a clinical trial conducted from July 2018 to July 2019. Patients (n=44) with shoulder pain of both sexes were randomized and submitted to two treatment protocols: therapeutic exercises (n = 22) and Mulligan's MWM (n = 22) attended at the UFBA School of Physiotherapy Clinic. All participants answered a clinical and sociodemographic questionnaire and underwent pain assessment by visual analog scale (VAS) and algometry. The patients were treated by two experienced physiotherapists and then reassessed immediately. Results: women predominated, the average age was 56 years in the Mulligan group and 57 in the therapeutic exercises group. Rotator cuff syndrome predominated, 19 (86.4%) in the Mulligan group and 15 (68%) in the exercise group. The most affected shoulder was the right shoulder in the Mulligan Group (17 (77.3%), while in the exercise group was the left shoulder with 12 (55%).The black color was the most self-reported by the patients and few patients had higher education. In the Mulligan group the most informed occupations were housewife followed by retirees and self-employed. In the exercise group we had no housewife but more retired and self-employed. The two groups were more sedentary. There was no difference in VAS pain between the groups before and after treatment (p = 0.79, p = 0.56, respectively), while pain intensity measured by algometry both before treatment (p = 0.008) and after treatment (p = 0.04) was different between Conclusion: Mulligan's MWM was not more effective than exercise in reducing shoulder pain, and exercise was more effective when measured by VAS and without significant improvement when measured by algometry after applying a single treatment session.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Kinesiology, Applied , Shoulder Impingement Syndrome , Shoulder Pain , Exercise Therapy , Clinical Trial
11.
Rev. Assoc. Med. Bras. (1992) ; 66(2): 166-173, Feb. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1136180

ABSTRACT

SUMMARY OBJECTIVE We investigated the associations between adhesive capsulitis (AC) and a specific psychological profile. METHODS We assessed 72 patients with phase-II AC. In our study, 36 patients were affected by primary disease and 36 by secondary disease. The inclusion criteria were as follows: unilateral AC and pain in the shoulder for at least two months. The exclusion criteria were: psychiatric and neurological manifestations with a previous diagnosis and inability to comprehend the instruments. Outcomes were determined at 52 weeks. Shoulder pain severity was assessed with the Visual Analog Scale. We also measured the range of motion with a universal goniometer and the strength with the Medical Research Council. We assessed the personality traits of our patients with the Cloninger's Temperament and Character Inventory and the Multidimensional Perfectionism Scale. RESULTS Patients with primary AC needed more time to improve the symptomatology compared to the group with the secondary disease (p<0.01). Patients with primary AC complained of severe and lasting pain more frequently than patients with the secondary disease (p< 0.01). In patients with primary disease, the prevalence of perfectionism, low levels of novelty seeking, and high levels of harm avoidance were 88.2 and 86.2%, and 80.4, respectively, and below 20 percent in patients with secondary AC disease. CONCLUSION We found a significant correlation between primary AC and particular personality traits, indicating an interaction between psychological and somatic factors.


RESUMO OBJETIVO Investigar as associações entre a capsulite adesiva (CA) e um perfil psicológico específico. METODOLOGIA Foram avaliados 72 pacientes com CA fase II. Em nosso estudo, 36 pacientes foram afetados pela doença primária e 36 pela secundária. Os critérios de inclusão foram os seguintes: CA unilateral e dor no ombro durante por pelo menos dois meses. Os critérios de exclusão foram: manifestações neurológicas e psiquiátricas com um diagnóstico prévio e incapacidade de compreender os instrumentos de medição utilizados. Os resultados foram determinados após 52 semanas. A intensidade da dor no ombro foi avaliada usando a Escala Visual Analógica. Também medimos a amplitude de movimento com um goniômetro universal e a força com a escala do Conselho de Pesquisa Médica. Avaliamos os traços da personalidade dos nossos pacientes através do Inventário de Temperamento e Caráter de Cloninger e da Escala Multidimensional de Perfeccionismo. RESULTADOS Pacientes com CA primária precisaram de mais tempo para melhorar a sintomatologia quando comparados ao grupo secundário (p<0,01). Pacientes com CA primária apresentaram mais queixas de dor intensa e duradoura do que pacientes secundários (p< 0,01). Em pacientes com a doença primária, a prevalência de perfeccionismo, baixos níveis de procura por novidade, e altos níveis de prevenção de danos foram 88,2, 86,2% e 80,4, respectivamente, e abaixo de 20% em pacientes secundários. CONCLUSÃO Encontramos uma correlação significativa entre CA primária e traços de personalidade específicos, indicando uma interação entre fatores psicológicos e somáticos.


Subject(s)
Humans , Male , Female , Adult , Aged , Personality , Psychophysiologic Disorders/psychology , Bursitis/psychology , Personality Inventory , Time Factors , Pain Measurement , Bursitis/physiopathology , Bursitis/rehabilitation , Retrospective Studies , Range of Motion, Articular , Treatment Outcome , Shoulder Pain/physiopathology , Shoulder Pain/psychology , Shoulder Pain/rehabilitation , Middle Aged
12.
Rev. bras. anestesiol ; 70(1): 15-21, Jan.-Feb. 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1137141

ABSTRACT

Abstract Introduction: Painful shoulder syndrome is a frequent condition among the elderly and an important cause of functional disability. As the conservative treatment is not always effective, ultrasound guided suprascapular nerve blockade presents as an important alternative treatment. Objective: To evaluate the efficacy and safety of the use of 0.25% levobupivacaine and 40 mg of triamcinolone in the suprascapular nerve blockade in patients with chronic pain in the shoulder. Methods: A retrospective, descriptive and analytical study of 71 patients submitted to suprascapular nerve infiltration between August 2014 and March 2017. Surveys were carried out to patients before the technique was performed, after 72 hours and at 1, 3 and 6 months. Pain intensity was assessed using a numeric pain scale (NPS). Results: Out of the 71 patients who underwent a blockade of the suprascapular nerve, 81.2% reported a decrease in pain at 72 hours. In the first, third and sixth month, respectively, 89.8%, 76.1% and 61.8% of the patients presented pain relief. A statistically significant difference (p < 0.001) was verified between NPS and the 4 moments assessed after the technique. 43.7% had total pain remission (NPS = 0) at six months. Global effectiveness of suprascapular nerve blockade was 60.6% and for the subgroup of patients with rotators' cuff patology was 62.2%. No complications were reported regarding the suprascapular nerve block. Conclusion: The results show that ultrasound-guided blockade of the suprascapular nerve using 0.25% levobupivacaine and 40 mg of triamcinolone is a safe and effective treatment in patients with chronic shoulder pain.


Resumo Introdução: A síndrome do ombro doloroso é uma condição frequente entre os idosos e uma causa importante de incapacidade funcional na população em geral. O tratamento conservador nem sempre é eficaz, pelo que o bloqueio do nervo supraescapular guiado por ecografia apresenta-se como uma opção de tratamento válida. Objetivo: Avaliação da eficácia e segurança do uso de levobupivacaína a 0,25% e 40 mg de triancinolona no bloqueio do nervo supraescapular ecoguiado em doentes com dor crônica no ombro. Métodos: Realizou-se um estudo retrospectivo observacional, descritivo e analítico com 71 doentes submetidos à infiltração do nervo supraescapular entre agosto de 2014 e março de 2017. Foram aplicados questionários antes da realização da técnica, após 72 horas; 1, 2 e 6 meses. A intensidade da dor foi avaliada usando a Escala de Avaliação Numérica (EAN). Resultados: Dos 71 doentes submetidos ao bloqueio do nervo supraescapular; 81,2% referiram diminuição da dor às 72 horas. Aos primeiro, terceiro e sexto mês, respectivamente 89,8%; 76,1% e 61,8% apresentaram melhoria da dor. Verificou-se uma diferença estatisticamente significativa (p < 0,001), entre a EAN inicial e os 4 momentos após a realização da técnica. 43,7% dos doentes tiveram remissão total da dor (EAN = 0) aos seis meses. A eficácia global do bloqueio do nervo supraescapular foi de 60,6% e, para o subgrupo com patologia da coifa dos rotadores, de 62,2%. Nenhuma complicação do bloqueio do NSE foi registrada. Conclusão: Este estudo mostra que o bloqueio eco-guiado do NSE usando levobupivacaína a 0,25% e 40 mg de triancinolona é um procedimento seguro e eficaz em doentes com dor crônica no ombro.


Subject(s)
Humans , Male , Female , Triamcinolone/administration & dosage , Ultrasonography, Interventional , Shoulder Pain/therapy , Chronic Pain/therapy , Levobupivacaine/administration & dosage , Glucocorticoids/administration & dosage , Nerve Block/methods , Shoulder/innervation , Retrospective Studies , Treatment Outcome , Anesthetics, Local , Middle Aged
13.
ABCS health sci ; 44(3): 167-171, 20 dez 2019. tab
Article in English, Portuguese | LILACS | ID: biblio-1047667

ABSTRACT

INTRODUÇÃO: A Tendinopatia do Manguito Rotador (TMR) acarreta dor e prejuízo na função do ombro, porém não se sabe se ambas na mesma proporção. OBJETIVO: Verificar se a intensidade dolorosa se correlaciona com a função do membro superior em sujeitos com TMR. MÉTODOS: Estudo observacional transversal, com 60 indivíduos com TMR. Utilizou-se a Escala Visual Analógica (EVA) para avaliar a dor e o questionário Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) para função do ombro. Para análise dos dados foi realizada estatística descritiva (médias e desvio-padrão, apresentação numérica e percentual) e aplicada a correlação de Spearman utilizando nível de significância de 5%. RESULTADOS: A dor média pela EVA foi de 5,02 (moderada). Verificou-se limitação leve (pontuação média de 34,43) nas 30 questões do questionário DASH. Em relação aos módulos opcionais, no módulo destinado a atletas/músicos, não houve limitação dos sujeitos que praticavam este (média de pontuação de 11,82). No módulo referente ao trabalho houve limitação leve (média de pontuação de 35,38). Houve correlação baixa entre dor e a função do ombro (rs=0,2949; p=0,0222). CONCLUSÃO: Embora os sujeitos com TMR apresentassem dor moderada, a correlação foi fraca entre dor e função do ombro.


INTRODUCTION: Rotator Cuff Tendinopathy (RMR) causes pain and impairment in shoulder function, but it is not known if both in the same proportion. OBJECTIVE: Verify whether pain intensity correlates with upper limb function in subjects with RMR. METHODS: Cross-sectional observational study of 60 individuals with RMR. The Visual Analogue Scale (VAS) was used to assess pain and the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) for shoulder function. For data analysis, descriptive statistics (means and standard deviation, numerical and percentage presentation) were performed and Spearman correlation was applied using a significance level of 5%. RESULTS: The average pain by VAS was 5.02 (moderate). Mild limitation (mean score 34.43) was found in the 30 questions of the DASH questionnaire. Regarding the optional modules, in the module intended for athletes/musicians, there was no limitation of the subjects who practiced this (average score of 11.82). In the work module there was a slight limitation (average score 35.38). There was a low correlation between pain and shoulder function (rs=0.2949; p=0.0222). CONCLUSION: Although subjects with RMR had moderate pain, the correlation was weak between pain and shoulder function.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Rotator Cuff/pathology , Shoulder Pain , Tendinopathy , Rotator Cuff Injuries , Shoulder Injuries , Activities of Daily Living
14.
Säo Paulo med. j ; 137(6): 543-549, Nov.-Dec. 2019. tab
Article in English | LILACS | ID: biblio-1094517

ABSTRACT

ABSTRACT BACKGROUND: Shoulder pain is considered to be the third largest cause of musculoskeletal functional alterations in individuals presenting pain during movement. OBJECTIVE: The purpose of this synthesis of evidence was to identify the clinical effectiveness of conservative and surgical treatments reported in Cochrane systematic reviews among individuals diagnosed with rotator cuff disease. DESIGNAND SETTING: Review of systematic reviews, conducted in the Federal University of São Paulo (Universidade Federal de São Paulo, UNIFESP). METHODS: This synthesis of evidence included systematic reviews that had been published in the Cochrane database. The inclusion criteria were that these systematic reviews should involve individuals aged ≥ 16 years with rotator cuff disease, comparing surgical procedures with or without associated nonsurgical procedures versus placebo, no treatment or other nonsurgical interventions. RESULTS: Thirty-one systematic reviews were included, involving comparisons between surgical procedures and conservative treatment; procedures either combined or not combined with drugs, versus other procedures; and procedures involving exercises, manual therapy and electrothermal or phototherapeutic resources. CONCLUSIONS: The findings suggest that strengthening exercises, with or without associated manual therapy techniques and other resources, were the interventions with greatest power of treatment over the medium and long terms, for individuals with shoulder pain. These had greater therapeutic power than surgical procedures, electrotherapy or photobiomodulation. Protocol registration number in the PROSPERO database: ID - CRD42018096578.


Subject(s)
Humans , Evidence-Based Medicine , Rotator Cuff Injuries/therapy , Phototherapy/methods , Exercise , Treatment Outcome , Shoulder Pain/therapy , Pain Management/methods , Rotator Cuff Injuries/surgery , Rotator Cuff Injuries/drug therapy , Conservative Treatment/methods , Systematic Reviews as Topic
15.
Ocotal, Nueva Segovia; s.n; s.n; dic. 2019. 74 p. ilus, tab, graf.
Thesis in Spanish | LILACS | ID: biblio-1119539

ABSTRACT

Objetivo. Determinar riesgos laborales presentes en trabajadores con síndrome de hombro doloroso. Empresa de alimentos. San Pedro Sula, Cortes, Honduras, enero ­ junio 2019. Diseño Metodológico: Estudio descriptivo, transversal. Como muestra se estudiaron 30 trabajadores con diagnóstico de síndrome de hombro doloroso captados en la consulta médica, con el propósito de identificar los riesgos laborales presentes en los trabajadores en el desarrollo de síndrome de hombro doloroso en los operadores de empaque, determinar las características sociodemográficas, determinar antecedentes patológicos personales, traumáticos, laborales, determinar los riesgos disergonómicos que se relacionan al síndrome de hombro doloroso, establecer el género que predomina los casos. La recolección de los datos y tabulación fueron realizados por el investigador en el mes de diciembre 2019. Resultados: Se identifica que la frecuencia del SHD en el área de empaque predomina en un 60 % el sexo femenino e identificó que los riesgos presentes para el desarrollo del SHD predominan en aquellos pacientes con IMC elevado, actividades extra laborales, movimientos repetitivos, posturas forzadas, el trabajar > 8 horas laborales, el reposo inadecuado. Conclusiones: De los 30 trabajadores en la investigación se demostró que los riesgos Disergonomicos posturas forzadas y movimientos repetitivos están presentes en el área de empaque, el cual se asocia al síndrome de hombro doloroso en los trabajadores de la empresa de alimentos, Honduras 2019


Subject(s)
Humans , Occupational Risks , Shoulder Pain , Epidemiology, Descriptive , Cross-Sectional Studies , Occupational Health
16.
Fisioter. Pesqui. (Online) ; 26(1): 78-84, Jan.-Mar. 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1002018

ABSTRACT

RESUMO A dor no ombro representa a terceira principal queixa musculoesquelética da população. Afeta fatores físicos, psicológicos e econômicos do indivíduo. A atenção primária à saúde é essencial para a eficácia do cuidado dos pacientes acometidos. Este estudo é observacional transversal e obteve um perfil dos usuários e das consultas médicas com relato de dor no ombro durante um ano na atenção primária do município de Ribeirão Preto (SP). Foram analisados em prontuários os registros das consultas médicas agendadas e sem agendamento prévio. Nestes registros foram coletados dados dos pacientes que apresentaram queixas de dor musculoesquelética no ombro (dados sociodemográficos e características das consultas), que foram analisados de forma descritiva e pelos testes qui-quadrado de Pearson, razão de chance e regressão logística múltipla. A frequência de consultas médicas por queixa de dor no ombro foi de 9,2%. O perfil dos indivíduos que se queixaram de dor no ombro se caracterizava por mulheres, com idade avançada, casadas, alfabetizadas e que apresentavam alguma ocupação. As consultas em sua maioria tiveram retornos agendados, oferecimento de orientações terapêuticas e poucos encaminhamentos.


RESUMEN El dolor en el hombro representa la tercera principal queja musculoesquelética de la población. Acomete los factores físicos, psicológicos y económicos del individuo. La atención primaria a la salud es esencial para la eficacia del cuidado de los pacientes afectados. Este estudio de tipo observacional transversal obtuvo un perfil de los usuarios y de las consultas médicas en que había relato de dolor en el hombro durante un año en la atención primaria del municipio de Ribeirão Preto (SP). Se analizaron los registros de las consultas médicas programadas y sin programación previa. En estos registros se recolectaron los datos de los pacientes que se quejaban de dolor musculoesquelético en el hombro (sus datos sociodemográficos y las características de las consultas), los cuales fueron analizados de forma descriptiva y por la prueba chi-cuadrado de Pearson, por las razones de prevalencia y por la regresión logística múltiple. La frecuencia de consultas médicas por queja de dolor en el hombro fue del 9,2%. El perfil de los individuos que se quejaron de dolor en el hombro fue de mujeres, con edad avanzada, casadas, alfabetizadas y que se dedicaban a alguna actividad. Las consultas en su mayoría tuvieron retornos programados, ofrecimiento de orientaciones terapéuticas y pocos encaminamientos.


ABSTRACT Shoulder pain is the third most common musculoskeletal complaint of the world population. It affects the physical, psychological and financial situation of the individual. Primary care is essential to an effective health care for affected patients. This cross-sectional and observational study has the purpose of characterizing the profile of users of the primary health care service, and analyzing the medical records with shoulder pain reports over an one-year period in the primary care service of Ribeirão Preto - SP. Medical records of patients with scheduled and unscheduled medical consultations were analyzed. Data from patients with musculoskeletal shoulder pain - sociodemographic data and the consultation characteristics - were collected and analyzed descriptively and by Pearson's Chi-squared test, Odds Ratio and Multiple Logistic Regression. The frequency of shoulder pain in the primary care was 9.2%. The profile of individuals who complained about shoulder pain was advanced age, married, literate and working women. Most consultations had scheduled follow-up consultations, therapeutic guidance and few referrals.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Primary Health Care , Shoulder Pain/therapy , Musculoskeletal Pain/therapy , Physicians' Offices , Medical Records , Epidemiology, Descriptive , Cross-Sectional Studies , Shoulder Pain/diagnosis , Musculoskeletal Pain/diagnosis
17.
Article in Korean | WPRIM | ID: wpr-741532

ABSTRACT

PURPOSE: The purpose of this study was to investigate the effects of thermotherapy on gas pain, post-operative resilience, and body temperature discomfort among patients who received laparoscopic myomectomies. METHODS: The experimental group consisted of 62 patients with thermotherapy and the control group consisted of 60 patients. Thermotherapy was applied individually to the experimental group four hours after surgery. The collected data was analyzed using descriptive statistics, t-tests, χ²-tests, and repeated measures of analysis of variance, using IBM SPSS Statistics version 18. RESULTS: The results showed no significant interaction effect between the group and time of measurement in gas-related pain in the experimental group. For gas-related pain, there was significant difference in right shoulder pain at 24 hours (t=-4.222, p=.000), 48 hours (t=-3.688, p=.000), 72 hours (t=-2.250, p=.028), and left at 24 hours (t=-3.727, p=.000), 48 hours (t=-4.150, p=.000), and 72 hours (t=-2.482, p=.016) and both shoulders at 24 hours (t=-2.722, p=.009) and 48 hours (t=-2.525, p=.014). There was no significant difference in epigastric pain, excluding both epigastric pain at 48 hours (t=2.908, p=.005), 72 hours (t=3.010, p=.004), but there was a significant difference in objective body temperature discomfort (t=2.895, p=.008). CONCLUSION: Thermotherapy relieved shoulder gas-related pain and objective body temperature discomfort. It needs to be developed and applied to improve post-operative discomfort in patients with laparoscopic hysterectomies.


Subject(s)
Body Temperature , Humans , Hyperthermia, Induced , Hysterectomy , Shoulder , Shoulder Pain
18.
Article in Korean | WPRIM | ID: wpr-786170

ABSTRACT

The shoulder is the third most common region in which musculoskeletal pain occurs, involving symptoms that cause a decrease in quality of life and a reduced ability to perform activities of daily life if untreated. Many lesions cause shoulder pain; therefore, we included those commonly encountered in primary care clinics. We aimed to describe the diagnosis and non-operative or conservative treatment modalities of rotator cuff tendinopathy, impingement syndrome, rotator cuff tear, adhesive capsulitis, biceps tendonitis, and acromioclavicular arthritis. Exercise has been reported to be effective for the treatment of impingement syndrome, and the effect of exercise has been shown to reduce pain. Both home-based self-exercise and exercise supervised by professionals are equally effective. Types of exercise should include stretching, active, active-assistive, and resistive exercise. Ten repetitions per set for 3 sets of each exercise should be prescribed initially post-injury. Repetition and resistance should be increased as strength grows. The use of ultrasonography for the diagnosis of shoulder pain has increased recently. Corticosteroid injection under ultrasonographic guidance is effective in reducing pain.


Subject(s)
Arthritis , Bursitis , Diagnosis , Muscle Stretching Exercises , Musculoskeletal Pain , Primary Health Care , Quality of Life , Rotator Cuff , Shoulder Pain , Shoulder , Tears , Tendinopathy , Tendons , Ultrasonography
19.
Article in English | WPRIM | ID: wpr-762628

ABSTRACT

OBJECTIVE: To describe scapular upward rotation during passive humeral abduction in individuals with hemiplegia post-stroke compared to normal subjects. METHODS: Twenty-five individuals with hemiplegia post-stroke and 25 age- and gender-matched normal subjects voluntarily participated in this study. Scapular upward rotation during resting and passive humeral abduction at 30°, 60°, 90°, 120°, and 150° were measured using a digital inclinometer. RESULTS: In both groups, scapular upward rotation significantly increased as humeral abduction increased (p<0.001). Scapular upward rotation was significantly less in the hemiplegic group compared to that in the control at 90° (p=0.002), 120° (p<0.001), and 150° of humeral abduction (p<0.001). The mean difference in scapular upward rotation between these two groups ranged from 6.3° to 11.38°. CONCLUSION: Passive humeral abductions ranging from 90° to 150° can significantly alter scapular upward rotation in individuals with hemiplegia post-stroke compared to those of matched normal subjects. The magnitude of reduction of the scapular upward rotation may potentially lead to the development of hemiplegic shoulder pain after prolonged repetitive passive movement. Scapular upward rotation should be incorporated during passive humeral abduction in individuals with hemiplegia post-stroke, especially when the humeral is moved beyond 90° of humeral abduction. Combined movements of scapular and humeral will help maintain the relative movement between the scapula and humerus. However, further longitudinal study in patients with shoulder pain post-stroke is needed to confirm these findings.


Subject(s)
Hemiplegia , Humans , Humerus , Longitudinal Studies , Range of Motion, Articular , Scapula , Shoulder , Shoulder Pain , Stroke
20.
Article in English | WPRIM | ID: wpr-739754

ABSTRACT

BACKGROUND: Latissimus dorsi (LD) tendon transfer is used as a treatment option for massive irreparable posterosuperior rotator cuff tears, and recently, an arthroscopic-assisted technique was introduced. This study was undertaken to evaluate the clinical and radiological outcomes of arthroscopic-assisted LD tendon transfer for the management of irreparable rotator cuff tears in active middle-aged patients. METHODS: The records of five patients (two males) with irreparable tears involving the supraspinatus and infraspinatus tendons managed by arthroscopic-assisted LD tendon transfer were retrospectively reviewed. Clinical outcomes were assessed using the visual analogue scale (VAS) pain scale, American Shoulder and Elbow Surgeon's (ASES) scores, the University of California Los Angeles (UCLA) scale, and ranges of motion. Postoperative integrities of transferred tendon were evaluated by magnetic resonance imaging in 4 patients and by ultrasound in one. RESULTS: Mean patient age was 55 years (range, 48–61 years), and mean follow-up period was 20 months (range, 12.0–27.2 months). Mean VAS score significantly improved from 6.6 ± 2.6 preoperatively to 1.8 ± 2.5 postoperatively (p=0.009), mean ASES score increased from 67.6 ± 9.2 to 84.6 ± 15.1, and mean UCLA score from 18.0 ± 1.4 to 28.8 ± 8.5 (all p<0.001). Postoperative imaging of the transferred LD tendon showed intact repair in 4 patients. The remaining patient experienced LD transfer rupture and a poor outcome. CONCLUSIONS: Arthroscopic-assisted LD tendon transfer improved shoulder pain and function in patients with massive, irreparable rotator cuff tears, and may be an option for this condition, especially in physically active patients.


Subject(s)
California , Elbow , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Retrospective Studies , Rotator Cuff , Rupture , Shoulder , Shoulder Pain , Superficial Back Muscles , Tears , Tendon Transfer , Tendons , Ultrasonography
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