المؤلفون: Lakra, Celine¹ celine.lakra@nhs.net, Higgins, Rachel¹, Beare, Benjamin¹, Farrell, Rachel^1,2, Ajina, Sara¹, Burns, Sophia³, Lee, Marcus³, Swayne, Orlando^1,4

المصدر: Practical Neurology. Jun2023, Vol. 23 Issue 3, p229-238. 11p.

مصطلحات موضوعية: *SHOULDER pain treatment, *SHOULDER pain, *NEUROLOGICAL disorders, *PHYSICAL therapy, *MEDICAL protocols, *HEALTH care teams, *ORTHOPEDICS, *PAIN management, *DISEASE complications

مستخلص: Shoulder pain is common after neurological injury and can be disabling, lead to poor functional outcomes and increase care costs. Its cause is multifactoral and several pathologies contribute to the presentation. Astute diagnostic skills and a multidisciplinary approach are required to recognise what is clinically relevant and to implement appropriate stepwise management. In the absence of large clinical trial data, we aim to provide a comprehensive, practical and pragmatic overview of shoulder pain in patients with neurological conditions. We use available evidence to produce a management guideline, taking into account specialty opinions from neurology, rehabilitation medicine, orthopaedics and physiotherapy. [ABSTRACT FROM AUTHOR]

المؤلفون: Moosmayer, Stefan, Marius Ekeberg, Ole, Björnsson Hallgren, Hanna, Heier, Ingar, Kvalheim, Synnøve, Gunnar Juel, Niels, Blomquist, Jesper, Hugo Pripp, Are, Ivar Brox, Jens

المصدر: BMJ: British Medical Journal; 10/14/2023, Vol. 383 Issue 8402, p1-13, 13p

مصطلحات موضوعية: TENDINOPATHY, SHOULDER pain, SHOULDER joint, ADRENOCORTICAL hormones, CLINICAL trials, RANDOMIZED controlled trials, COMPARATIVE studies, TREATMENT effectiveness, CALCINOSIS, BLIND experiment, DESCRIPTIVE statistics, INTRA-articular injections, QUESTIONNAIRES, STATISTICAL sampling

المؤلفون: Murphy, Richard J., Bintcliffe, Fiona

المصدر: BMJ: British Medical Journal; 7/15/2023, Vol. 382 Issue 8391, pp1255-6, 6p

مصطلحات موضوعية: SHOULDER pain, RESISTANCE training, ADRENOCORTICAL hormones, FUNCTIONAL assessment, PRIMARY health care, OSTEOPOROSIS, OSTEOARTHRITIS, SECONDARY care (Medicine), BURSITIS, DISEASE complications

المؤلفون: Tun Hing Lui, Xiaohua Pan

المصدر: BMJ: British Medical Journal; 5/6/2023, Vol. 381 Issue 8381, p1-5, 5p

مصطلحات موضوعية: DIAGNOSIS of shoulder injuries, SHOULDER pain, SHOULDER injuries, JOINT instability, CARTILAGE diseases, TREATMENT effectiveness, THERAPEUTIC immobilization, ACCIDENTAL falls, FRACTURE fixation, SHOULDER dislocations

المؤلفون: Dubé, Marc-Olivier, Desmeules, François, Lewis, Jeremy S., Roy, Jean-Sébastien

المصدر: British Journal of Sports Medicine; Apr2023, Vol. 57 Issue 8, p457-463, 8p

مصطلحات موضوعية: SHOULDER exercises, SHOULDER disorders, SHOULDER pain, RANDOMIZED controlled trials, MUSCLE contraction, ROTATOR cuff

المؤلفون: Smith, Phil E. M., Fuller, Geraint N.

المصدر: Practical Neurology. Jun2023, Vol. 23 Issue 3, p189-189. 1p.

مصطلحات موضوعية: *MIGRAINE prevention, *SHOULDER pain treatment, *NEUROLOGISTS, *MIGRAINE, *MULTIPLE system atrophy, *EXPERIENCE, *DELIRIUM, *MYOSITIS, *VITAMIN B12 deficiency

المؤلفون: Cederqvist, Sanna, Flinkkilä, Tapio, Sormaala, Markus, Ylinen, Jari, Kautiainen, Hannu, Irmola, Tero, Lehtokangas, Heidi, Liukkonen, Juho, Pamilo, Konsta, Ridanpää, Tero, Sirniö, Kai, Leppilahti, Juhana, Kiviranta, Ilkka, Paloneva, Juha

المصدر: Annals of the Rheumatic Diseases; Jun2021, Vol. 80 Issue 6, p796-802, 7p

مصطلحات موضوعية: SHOULDER pain, RESEARCH, ARTHROSCOPY, EVALUATION research, TREATMENT effectiveness, COMPARATIVE studies, RANDOMIZED controlled trials, ROTATOR cuff, LONGITUDINAL method

مستخلص: Background: Rotator cuff disease (RCD) causes prolonged shoulder pain and disability in adults. RCD is a continuum ranging from tendinopathy to full-thickness tendon tear. Recent studies have shown that subacromial decompression and non-surgical treatments provide equivalent results in RCD without a full-thickness tendon lesion. However, the importance of surgery for full-thickness tendon tears remains unclear.Methods: In a pragmatic, randomised, controlled trial, 417 patients with subacromial pain underwent 3-month initial rehabilitation and MRI arthrography (MRA) for the diagnosis of RCD. Of these, 190 shoulders remained symptomatic and were randomised to non-surgical or surgical treatments. The primary outcomes were the mean changes in the Visual Analogue Scale for pain and the Constant Murley Score for shoulder function at the 2-year follow-up.Results: At the 2-year follow-up, both non-surgical and surgical treatments for RCD reduced pain and improved shoulder function. The scores differed between groups by 4 (95% CI -3 to 10, p=0.25) for pain and 3.4 (95% CI -0.4 to 7.1, p=0.077) for function. Among patients with full-thickness ruptures, the reduction in pain (13, 95% CI 5 to 22, p=0.002) and improvement in function (7.0, 95% CI 1.8 to 12.2, p=0.008) favoured surgery.Conclusions: Non-surgical and surgical treatments for RCD provided equivalent improvements in pain and function. Therefore, we recommend non-surgical treatment as the primary choice for patients with RCD. However, surgery yielded superior improvement in pain and function for full-thickness rotator cuff rupture. Therefore, rotator cuff repair may be suggested after failed non-surgical treatment.Trial Registration Details: ClinicalTrials.gov, NCT00695981 and NCT00637013. [ABSTRACT FROM AUTHOR]

: Copyright of Annals of the Rheumatic Diseases is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Paavola, Mika, Kanto, Kari, Ranstam, Jonas, Malmivaara, Antti, Inkinen, Jari, Kalske, Juha, Savolainen, Vesa, Sinisaari, Ilkka, Taimela, Simo, Järvinen, Teppo L., Finnish Shoulder Impingement Arthroscopy Controlled Trial (FIMPACT) Investigators

المصدر: British Journal of Sports Medicine; 1/15/2021, Vol. 55 Issue 2, p99-107, 9p

مصطلحات موضوعية: SHOULDER exercises, ARTHROSCOPY, SHOULDER disorders, EXERCISE therapy, PLACEBOS, CLINICAL trials, SHOULDER pain, RESEARCH, ANALYSIS of variance, PAIN measurement, SHOULDER injuries, TIME, RESEARCH methodology, SELF-evaluation, SURGICAL decompression, MEDICAL cooperation, EVALUATION research, TREATMENT effectiveness, COMPARATIVE studies, RANDOMIZED controlled trials, BLIND experiment, LONGITUDINAL method, HEALTH self-care

مصطلحات جغرافية: FINLAND

مستخلص: Objectives: To assess the long-term efficacy of arthroscopic subacromial decompression (ASD) by comparing it with diagnostic arthroscopy (primary comparison), a placebo surgical intervention, and with a non-operative alternative, exercise therapy (secondary comparison).Methods: We conducted a multicentre, three group, randomised, controlled superiority trial. We included 210 patients aged 35-65 years, who had symptoms consistent with shoulder impingement syndrome for more than 3 months. 175 participants (83%) completed the 5 years follow-up. Patient enrolment began on 1 February 2005 and the 5-year follow-up was completed by 10 October 2018. The two primary outcomes were shoulder pain at rest and on arm activity measured with Visual Analogue Scale (VAS). Minimally important difference (MID) was set at 15. We used a mixed-model repeated measurements analysis of variance with participant as a random factor, the baseline value as a covariate and assuming a covariance structure with compound symmetry.Results: In the primary intention to treat analysis (ASD vs diagnostic arthroscopy), there were no between-group differences that exceeded the MID for the primary outcomes at 5 years: the mean difference between groups (ASD minus diagnostic arthroscopy) in pain VAS were -2.0 (95% CI -8.5 to 4.6; p=0.56) at rest and -8.0 (-17.3 to 1.3; p=0.093) on arm activity. There were no between-group differences in the secondary outcomes or adverse events that exceeded the MID. In our secondary comparison (ASD vs exercise therapy), the mean differences between groups (ASD minus exercise therapy) in pain VAS were 1.0 (-5.6 to 7.6; p=0.77) at rest and -3.9 (-12.8 to 5.1; p=0.40) on arm activity. There were no significant between-group differences for the secondary outcomes or adverse events.Conclusions: ASD provided no benefit over diagnostic arthroscopy (or exercise therapy) at 5 years for patients with shoulder impingement syndrome. [ABSTRACT FROM AUTHOR]

: Copyright of British Journal of Sports Medicine is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Joshi, Vanya, Osborne, Thomas, Tzias, Demitrios

المصدر: BMJ: British Medical Journal; 1/8/2022, Vol. 376 Issue 8320, p1-3, 3p

مصطلحات موضوعية: SHOULDER pain, TENDINOPATHY, IRRIGATION (Medicine), SHOULDER joint, ULTRASONIC imaging, INJECTIONS, PHYSICAL therapy, STEROIDS, NONSTEROIDAL anti-inflammatory agents, DIFFERENTIAL diagnosis, TREATMENT effectiveness, CALCINOSIS, QUALITY of life, ROTATOR cuff

المؤلفون: Björnsson Hallgren, Hanna C.¹ hanna.bjornsson.hallgren@lio.se, Holmgren, Theresa², Öberg, Birgitta², Johansson, Kajsa², Adolfsson, Lars E.¹

المصدر: British Journal of Sports Medicine. Oct2014, Vol. 48 Issue 19, p1-7. 7p. 1 Diagram, 6 Charts, 1 Graph.

مصطلحات موضوعية: *EXERCISE, *SHOULDER pain, *SHOULDER surgery, *SURGICAL decompression, *SPORTS medicine, *PATIENTS

مستخلص: Background and purpose A programme based on eccentric exercises for treating subacromial pain was in a previous study found effective at 3-month follow-up. The purposes of the present study were to investigate whether the results were maintained after 1 year and whether the baseline Constant-Murley score, rotator cuff status and radiological findings influenced the outcome. Patients and methods 97 patients on the waiting list for arthroscopic subacromial decompression had been randomised to a specific exercise programme or unspecific exercises (controls). After 3 months of exercises, the patients were asked whether they still wanted surgery and this option was available until a 1-year follow-up. 1 year after inclusion or 1 year after surgery, the number of patients who decided to have surgery in each group was compared. The choice of surgery was related to the baseline Constant-Murley score, ultrasound and radiographs taken at inclusion. Results All patients had improved significantly (p<0.0001) in the Constant-Murley score at the 1-year follow-up. Significantly more patients in the control group decided to have surgery (63%) than those in the specific exercise group (24%; p<0.0001). Patients who decided to have surgery had a significantly lower baseline Constant-Murley score and more often a full-thickness tear. Patients with partial tears did not differ from those with intact tendons. Interpretation The positive short-term results of specific exercises were maintained after 1 year, and this exercise strategy reduces the need for surgery. Full-thickness tear and a low baseline Constant-Murley score appear to be a predictive marker for a less good outcome. [ABSTRACT FROM AUTHOR]