RESUMEN
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.
RESUMEN
Background: Lateral elbow tendinopathy (LET) is a disabling overuse injury with a significant healthcare burden. Despite the fact that exercise interventions are considered the best recommended treatment option of LET, their effectiveness in reducing pain and improving function remains debatable. The aim of our study is to evaluate the immediate effects of a new method of exercise using blood flow restriction (BFR) on pain perception and pain-free grip strength in patients with LET. Methods: This study was designed as a cross-over randomized controlled trial. We will compare an intervention using wrist extensors training with (WET-BFR) to a control intervention using WET-without-BFR in patients with LET. All measurements will be taken by a blinded assessor pre- and post-intervention. Primary outcome measures will be the changes in pressure pain thresholds at the lateral epicondyle, extensor carpi radialis brevis, C4 vertebra and tibialis anterior. Secondary outcome measure will be the changes in pain-free grip strength ratio. Conclusions: New approaches are needed to improve the treatment outcomes in LET. Although BFR training was found more effective in improving function and treatment success than conventional training, the effects on pain intensity were poor. Our hypothesis is that using the best BFR practice guidelines for wrist extensors training might be more effective to reduce pain sensitivity compared with non-BFR training in patients with LET. The trial will provide new research data to inform clinical practice regarding the effects of using BFR training in the current patient group. Trial registration: University of West Attica ethics committee: 9150/01-02-2023, ClinicalTrials.gov: NCT05919914
RESUMEN
Background: The thumb carpometacarpal osteoarthritis (CMC-OA) is a common musculoskeletal condition of the hand causing increased pain and significant disability. Although different modes of exercises are usually prescribed during the management of the condition, the evidence for their effectiveness is sparse. The aim of this protocol is to investigate through a systematic review the effectiveness of exercises compared with other non-surgical interventions in reducing pain and improving function in the management of the thumb CMC-OA. Methods: We will conduct this systematic review following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. PubMed, CINAHL, EMBASE, PEDro, ScienceDirect, Cochrane Library, Grey literature databases and clinical trial registries will be searched. Two reviewers will independently evaluate the retrieved results. Subsequently, data extraction of the eligible trials will be conducted by two independent researchers. We will use the grading of recommendations assessment, development, and evaluation (GRADE) approach to assess the certainty of evidence. Conclusions: This systematic review will provide evidence for the clinical benefits of exercises compared with other conservative interventions in the management of patients with thumb CMC-OA. Trial registration: PROSPERO registration number is CRD42023461505.