Prevalence of positive modified scapular assistance test in patients with shoulder pain with and without scapular dyskinesis: a cross-sectional study.

BACKGROUND: Scapular dyskinesis (SD) is defined as an altered position of the scapula or altered motion patterns and their relationship with shoulder pain (SP) is still under debate. The modified scapular assistance test (mSAT) modifies scapular kinematics and is used to determine the impact of scapular dyskinesis in shoulder pain. However, data about the relationship between SD and the result of mSAT is scarce. PURPOSE: The aim of this study is to establish the frequency of positive mSAT in patients with SP and compare the prevalence in those with and without SD. As a secondary objective, we compare changes in pain intensity during the mSAT in patients with a positive test between those with and without SD. STUDY DESIGN: Cross-sectional study. METHODS: Adult patients with a diagnosis of SP and with pain ≥2 during anterior flexion were included. The mSAT, scapular dyskinesis test (SDT), and shoulder function were assessed. RESULTS: The study was conducted between August 2018 and May 2022 and included 70 patients. The prevalence of SDT was 54.29%. No statistically significant associations were detected when assessing the relation between the presence of mSAT and SDT (p-value 0.83). When comparing pain response during the mSAT in patients with a positive test, no differences were seen between patients with SD and patients without SD (p-value 0.26). CONCLUSIONS: The prevalence of positive mSAT results was equal between individuals with and without SD. These findings suggest that the presence or absence of SD in individuals with SP was independent of the mSAT result. The mSAT should not be used solely for the assessment of SD in clinical practice nor be influenced by the SDT result. More research is needed to determine if the result of this test could inform prognosis and guide treatment choices.

Translation, cross-cultural adaptation and validation of the Argentine version of the Pain Catastrophizing Scale in patients with chronic low back pain.

INTRODUCTION: Low back pain (LBP) is the leading cause of years lived with disability worldwide. Higher levels of catastrophizing were found in patients with LBP and this variable is associated with self-reported disability. The Pain Catastrophizing Scale (PCS) is a self-report questionnaire that assesses catastrophizing in the presence of pain. Currently, an Argentine version of the PCS is not available. OBJECTIVE: To translate and cross-culturally adapt the PCS into Argentine Spanish and test the psychometric properties of the new version with chronic LBP patients. STUDY DESIGN: Study of diagnostic accuracy/assessment scale. METHODS: The study was carried out in three consecutive phases following the COSMIN guidelines: translation, cross-cultural adaptation and validation. We included Argentine residents over 18 years with chronic LBP. We used the PCS and the Global rating of change (GROC) to assess the psychometric properties. RESULTS: No difficulties were present in the translation processes and the PCS-Arg was developed. The alfa Cronbach coefficient was 0.89. The standard error of measurement and the minimal detectable change were 5.4 and 15.1 points, respectively. In the explanatory factorial analysis 3 components were identified. For the construct validity, the correlation between the PCS-Arg and disability and pain were r = 0.35 and rho = 0.04, respectively. The mean PCS score was 29.9. The lowest and highest scores were 3 and 52 points, therefore, no roof or ceiling effects of the total score were observed. CONCLUSION: The PCS-Arg is a viable, reliable and valid tool for the assessment of catastrophizing in patients with chronic LBP.

Disability is associated with catastrophizing and not with pain intensity in patients with low back pain: A retrospective study.

OBJECTIVE: Low back pain (LBP) is the leading cause of years lived with disability at a global scale. The development and chronicity of LBP are influenced by multiple factors, and among them is catastrophizing. We are unaware of the impact that catastrophizing may have on pain and disability in our population. We also lack the tools that allow us to determine in which cases catastrophizing should be assessed. The primary objective is to compare the disability and pain intensity values at baseline in low back pain patients with high and low catastrophizing. The secondary objectives are to analyse the correlation between variables and determine disability variance, and develop a prediction model to identify patients with high catastrophizing. METHOD: This is a retrospective study. We included the baseline data of patients with LBP. A PCS score ≥ 23 was classified as "high catastrophizing." RESULTS: A total 121 medical sheets were analysed. Patients with high catastrophizing showed greater disability, with no differences in pain intensity. The PCS value explained 20% of the variance of disability, and pain was 1%. A cut-off point of 11 in the RMQ allowed us to identify patients with high and low catastrophizing, with an accuracy of 76.67%. CONCLUSION: LBP patients with high catastrophizing reported greater disability than those with low catastrophizing, with no differences as to pain intensity. The PCS was the most relevant variable to explain variability in the RMQ. The RMQ allowed us to identify patients with high and low catastrophizing.

Minimal detectable change and reliability of the star excursion balance test in patients with lateral ankle sprain.

OBJECTIVE: Lateral ankle sprain (LAS) is one of the most prevalent musculoskeletal injuries in the general population and athletes. Dynamic postural control deficits and somatosensory alterations are common signs after an episode of LAS. It is important to detect these deficits to prevent a recurrent sprain and the development of chronic ankle instability. The Star Excursion Balance Test (SEBT) is a tool used to assess dynamic postural control in patients with LAS. SEBT test-retest reliability has been evaluated in several populations. However, no data on patients with LAS are available and we do not know the minimal detectable change (MDC). The primary objective of our study was to obtain the MDC for normalized reach distances of the eight SEBT directions in patients with LAS. The secondary objective was to determine test-retest reliability. METHODS: Cross-sectional study. Thirty-one patients (between 18 and 40 years old) diagnosed with a Grade I or II LAS. Participants were evaluated by two raters at two time-points separated by an interval of 24-72 hrs. In each assessment, four practice trials were allowed, then three test trials were performed in a randomized order. Normalized reaching distances were analyzed. RESULTS: From the initial 31 patients, two were eliminated, so 29 patients were considered for the final analysis. The MDC values obtained were 6.73-13.36%, and the medial and posteromedial directions showed the lowest and highest values, respectively. A statistically significant increase was found in lateral direction between T0 and T1. Intraclass correlation coefficients ranged from 0.72 to 0.93. CONCLUSION: The SEBT is an accurate and reliable tool to assess dynamic postural control in patients with LAS.

Postoperative rehabilitation of simultaneous rupture of anterior cruciate ligament and patellar ligament: A case report.

INTRODUCTION: The simultaneous rupture of anterior cruciate ligament (ACL) and patellar ligament (PL) is an infrequent condition. Each isolated injury has surgical techniques and rehabilitation protocols that differ widely among each other. Nonetheless, there is no established physical rehabilitation approach when both injuries are associated. OBJECTIVE: The aim of this report is to describe the rehabilitation and the outcomes obtained in the postoperative period of simultaneous rupture of ACL and PL and the follow-up period. CASE REPORT: A 21-year-old male patient suffered the rupture of ACL and PL after landing from a jump while playing soccer. The knee was immediately immobilized, and 10 weeks later, he was operated in a one-stage surgery. He initiated his rehabilitation 3 weeks after the surgical resolution. A three-times a week rehabilitation was implemented to restore range of motion and improve functional status. An extensive evaluation was carried out monthly using dynamic neuromuscular tests and self-reported questionnaires. RESULTS: At the end of the rehabilitation, he presented a complete extension and 130° of knee flexion in passive open kinetic chain. The Single Leg Squat and Landing Error Scoring System showed a good performance, while the Star Excursion Balance Test and the single hops assessments were symmetrical. The International Knee Documentation Committee and Lower Extremity Functional Scale questionnaires yielded values of 90.8% and 77 points, respectively. CONCLUSION: An approach based on mobility exercises and strengthening of the lower limbs and the core muscles, considering the biological healing times of each particular structure, made it possible to obtain satisfactory results in mobility, functional tests, self-reported questionnaires, and patient's satisfaction.