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Brazilian Journal of Physical Therapy 2020Alterations in glenohumeral and scapulothoracic kinematics have been theorized to contribute to rotator cuff pathology by impacting the magnitude of the subacromial... (Review)
Review
BACKGROUND
Alterations in glenohumeral and scapulothoracic kinematics have been theorized to contribute to rotator cuff pathology by impacting the magnitude of the subacromial space.
OBJECTIVE
The purpose of this review is to summarize what is currently known about the relationship between shoulder kinematics and subacromial proximities.
CONCLUSIONS
A variety of methods have been used to quantify subacromial proximities including photographs, MR imaging, ultrasonography, and single- and bi-plane radiographs. Changes in glenohumeral and scapulothoracic kinematics are associated with changes in subacromial proximities. However, the magnitude and direction of a particular motion's impact on subacromial proximities often vary between studies, which likely reflects different methodologies and subject populations. Glenohumeral elevation angle has been consistently found to impact subacromial proximities. Plane of humeral elevation also impacts subacromial proximities but to a lesser degree than the elevation angle. The impact of decreased scapulothoracic upward rotation on subacromial proximities is not absolute, but instead depends on the angle of humerothoracic elevation. The effects of scapular dyskinesis and humeral and scapular axial rotations on subacromial proximities are less clear. Future research is needed to further investigate the relationship between kinematics and subacromial proximities using more homogenous groups, determine the extent to which compression and other factors contribute to rotator cuff pathology, and develop accurate and reliable clinical measures of shoulder motion.
Topics: Dyskinesias; Humans; Rotator Cuff; Scapula; Shoulder; Ultrasonography
PubMed: 31377124
DOI: 10.1016/j.bjpt.2019.07.009 -
Journal of Healthcare Engineering 2022Work-associated upper limb and neck disorders are common occupational disorders throughout the world. These disorders are usually observed more in workers who spend a... (Review)
Review
BACKGROUND
Work-associated upper limb and neck disorders are common occupational disorders throughout the world. These disorders are usually observed more in workers who spend a long time sitting, referred to as sedentary activity (SA). The immediate and distorted risk of sedentary-related problems was considered high in Europe, Australia, and the United States. Even though mediation is convenient, it is likely to reduce office workers' risks of developing cervical and upper body pain due to sedentary work. This systematic review addresses risk factors and evaluates the relationship between SA and upper body disorders in office workers (i.e., shoulder and neck/head).
METHODS
PubMed, Scopus, and Web of Science were searched for articles published between January 2010 and August 2021 in the English language. The three keywords "sedentary," "upper body elements," and "work" (and their derivatives) were searched to identify studies and carry out this systematic review. The articles were searched so that all three keywords or at least a derivation of each keyword should appear. . Of the 40 articles that met the enclosure criteria, 32 studies examined the association of SA and upper body elements during both office and computer work. However, three articles were evaluated in the sit-stand work environment, and in the remaining five studies, one was evaluated during teaching, two during hospital work, and two during mixed working conditions.
CONCLUSIONS
Research related to SA focuses mainly on extended risk factors, but there was no focus on other aspects, such as muscle and tendon contractions. As there is a convincing connection between SA and the upper body, our close examination identifies the need to institutionalize a system for collecting, analyzing, and describing the impact and short-term effects of SA on the upper body. Additionally, some suggestions were made to minimize the risk in a sedentary working environment.
Topics: Ergonomics; Head; Humans; Neck; Shoulder; Upper Extremity
PubMed: 35356625
DOI: 10.1155/2022/5178333 -
Minerva Anestesiologica 2022Regional anesthesia should be the preferred technique for analgesia in shoulder surgery, which is a frequent procedure in the daily practice of anesthesiologists. The...
Regional anesthesia should be the preferred technique for analgesia in shoulder surgery, which is a frequent procedure in the daily practice of anesthesiologists. The use of ultrasound guidance enables the visualization of the relevant nerve structures and the adjacent anatomical details. Low volumes of local anesthetics reduce the incidence of inadvertent blockade of the phrenic nerve with subsequent respiratory impairment. The additional administration of dexmedetomidine to local anesthetics prolonges the duration of analgesia with a minimal increased incidence of haemodynamic side effects. An optimal workflow is associated with economical advantages due to an improved use of operation rooms. Attention have to be paid regarding intraoperative hypotension, cerebral hypoperfusion and complications due to positioning.
Topics: Analgesia; Anesthesia, Conduction; Anesthetics, Local; Humans; Shoulder
PubMed: 35164494
DOI: 10.23736/S0375-9393.22.16295-4 -
Journal of Athletic Training Jan 2021Shoulder pain is the main cause of missed or modified training in competitive swimmers. Shoulder musculoskeletal maladaptations occur to some extent as a consequence of...
CONTEXT
Shoulder pain is the main cause of missed or modified training in competitive swimmers. Shoulder musculoskeletal maladaptations occur to some extent as a consequence of training loads during swimming that may increase the risk of shoulder injury. Further evidence is needed to understand the training intensities at which these maladaptations occur.
OBJECTIVE
To determine the acute effect of training intensity on the shoulder musculoskeletal physical qualities associated with shoulder injury in competitive swimmers.
DESIGN
Cross-sectional study.
SETTING
Indoor swimming pool.
PATIENTS OR OTHER PARTICIPANTS
Sixteen asymptomatic national- and regional-level swimmers (7 females, 9 males; age = 14.6 ± 3.9 years, height = 160.5 ± 12.7 cm, mass = 55.3 ± 12.5 kg).
MAIN OUTCOME MEASURE(S)
Bilateral active shoulder-rotation range of motion (ROM), joint position sense, latissimus dorsi length, combined elevation test, and shoulder-rotation isometric peak torque and handgrip peak force normalized to body weight were measured before and immediately after low- and high-intensity swim-training sessions. The intensity of the sessions was determined by the distance swum over or at the pace threshold and confirmed by the swimmer's rating of perceived exertion.
RESULTS
After the high-intensity training session, shoulder external-rotation ROM (dominant side: P < .001, change = -7.8°; d = 1.10; nondominant side: P = .002, change = -6.5°, d = 1.02), internal-rotator isometric peak torque (dominant side: P < .001, change = -11.4%, d = 0.42; nondominant side: P = .03, change = -6.6%, d = 0.20), and external-rotator isometric peak torque (dominant side: P = .004, change = -8.7%, d = 0.27; nondominant side: P = .02, change = -7.6%, d = 0.25) were reduced. No changes were found in any of the outcome measures after the low-intensity session.
CONCLUSIONS
Shoulder active external-rotation ROM and rotation isometric peak torque were decreased immediately after a high-intensity training session, possibly increasing the risk of injury during subsequent training. Monitoring these variables may help practitioners adjust and manage training loads to decrease the risk of shoulder injury.
Topics: Adolescent; Athletes; Child; Cross-Sectional Studies; Female; Hand Strength; Humans; Male; Muscle, Skeletal; Range of Motion, Articular; Rotation; Shoulder; Shoulder Joint; Swimming; Torque
PubMed: 33176360
DOI: 10.4085/1062-6050-0357.19 -
The Journal of Thoracic and... Aug 2020
Topics: Carcinoma, Non-Small-Cell Lung; Data Collection; Humans; Lung Neoplasms; Research Design; Shoulder
PubMed: 32037242
DOI: 10.1016/j.jtcvs.2019.12.060 -
European Review For Medical and... Mar 2022The purpose of this study was to evaluate whether there was a difference in shoulder morphology and hand dominance between a healthy shoulder and a shoulder with rotator...
OBJECTIVE
The purpose of this study was to evaluate whether there was a difference in shoulder morphology and hand dominance between a healthy shoulder and a shoulder with rotator cuff tear (RCT) in the same patient.
PATIENTS AND METHODS
Between 2015 and 2020, 120 shoulders from 60 patients with complete RCT and contralateral intact rotator cuffs were enrolled in this retrospective analysis. Physical examinations, shoulder radiographs, and magnetic resonance imaging (MRI) pictures of the patients were reviewed. On radiographs, the AT, CSA, LAA, and AI values were compared between shoulders with complete RCT and contralateral healthy shoulders from the same individuals. Additionally, the association between hand dominance and RCT was evaluated.
RESULTS
This study enrolled 60 patients. 59.17% of the participants are female, and 40.83% are male. The mean age of the patients was 54.5±7.1 years. There were statistically significant differences in AI, CSA, and LAA measurements between the study group (RCT group) and the control group. There was no significant difference in AT between the two groups.
CONCLUSIONS
There are morphological differences between a healthy shoulder and a shoulder with an RCT in the same patient, and these differences (LAA/CSA/AI/AT) may have an effect on the prevalence of RCT.
Topics: Acromion; Female; Humans; Male; Middle Aged; Risk Factors; Rotator Cuff Injuries; Shoulder; Shoulder Joint
PubMed: 35302201
DOI: 10.26355/eurrev_202203_28222 -
BMC Musculoskeletal Disorders Jun 2022The aim of this study is to evaluate both the utility of MRI scans and reports used in the current practice routine of shoulder surgeons and their surgical...
BACKGROUND
The aim of this study is to evaluate both the utility of MRI scans and reports used in the current practice routine of shoulder surgeons and their surgical decision-making process.
METHODS
Ninety-three shoulder-specialised orthopaedic surgeons of the Canadian Shoulder and Elbow Society (CSES) Orthopaedic Association were surveyed in 2020 anonymously online to help identify the use of MR-imaging and reports in managing shoulder disorders and surgical decision process.
RESULTS
Thirty out of 93 (32.25%) CSES fellowship-trained orthopaedic surgeons participated. Respondents request MRI scans in about 55% of rotator cuff (RC) pathology and 48% of shoulder instability cases. Fifty percent of patients with potential RC pathology arrive with a completed MRI scan prior first orthopaedic consult. Their surgical decision is primarily based on patient history (45-55%) and physical examination (23-42%) followed by MRI scan review (2.6-18%), reading MRI reports (0-1.6%) or viewing other imaging (3-23%) depending on the shoulder disease. Ninety percent of surgeons would not decide on surgery in ambiguous cases unless the MR-images were personally reviewed. Respondents stated that shoulder MRI scans are ordered too frequently prior specialist visit as identified in more than 50% of cases depending on pathology.
CONCLUSIONS
The decision-making process for shoulder surgery depends on the underlying pathology and patient history. The results demonstrate that orthopaedic surgeons are comfortable reviewing shoulder MRI scans without necessarily reading the MRI report prior to a surgical decision. MRI scans are becoming an increasingly important part of surgical management in shoulder pathologies but should not be used without assessment of patient history and or physical examination.
Topics: Canada; Decision Making; Humans; Joint Instability; Magnetic Resonance Imaging; Rotator Cuff Injuries; Shoulder; Shoulder Joint
PubMed: 35717178
DOI: 10.1186/s12891-022-05541-0 -
Acta Orthopaedica Et Traumatologica... Nov 2019The present study aimed to compare the isometric strength and endurance of shoulder abduction and internal and external rotation between operated shoulders and... (Comparative Study)
Comparative Study
OBJECTIVE
The present study aimed to compare the isometric strength and endurance of shoulder abduction and internal and external rotation between operated shoulders and nonoperated, contralateral shoulders of patients who underwent reverse shoulder replacement due to unilateral rotator cuff tear arthropathy.
PATIENTS AND METHODS
With a diagnosis of cuff tear arthropathy, 41 consecutive patients (mean age of 70.8 years; age range, 57 to 84; 36 females, 5 males) who underwent unilateral reverse shoulder arthroplasty were reviewed based on functional and radiological data. In all cases, cuff tear arthropathy was unilateral and contralateral shoulder was asymptomatic, with normal shoulder function. The average length of follow-up was 34 months (range of 12-67). To assess patients' functional level, the Constant score and the Disabilities of the Arm, Shoulder, and Hand (the Quick-DASH) outcome measure were used preoperatively and at the final examination. The primary outcomes of the present study were measurement of isokinetic strength and endurance of shoulder abduction and internal and external rotation using an isokinetic evaluator.
RESULTS
Patients exhibited marked improvement in functional level as reflected by a significant increase in the mean Constant score from 38 preoperatively to 65 at the final follow-up (p = 0.03). The functional improvement was supported by a decrease in the mean Quick-DASH from 64 preoperatively to 26 at the final follow-up (p = 0.018). In the comparison of the isokinetic strength and endurance of shoulder abduction, no statistical difference was observed between operated shoulders and contralateral shoulders (p > 0.05). However; the strength and endurance of internal and external rotation were lower in operated shoulders than in contralateral shoulders (p < 0.05). Similarly, there was no statistically significant difference in comparisons of the durability of abduction (p > 0.05); however, the durability of internal and external rotation were significantly lower in operated shoulders (p < 0.05).
CONCLUSION
In terms of durability and strength of abduction, similar results with the unaffected shoulder may be accomplished; nonetheless, the surgeon should be aware that durability and strength of rotation would be weak.
LEVEL OF EVIDENCE
Level III, Therapeutic Study.
Topics: Aged; Aged, 80 and over; Arthroplasty, Replacement, Shoulder; Female; Humans; Male; Middle Aged; Radiography; Range of Motion, Articular; Rotator Cuff Tear Arthropathy; Shoulder; Shoulder Joint
PubMed: 31439480
DOI: 10.1016/j.aott.2019.08.001 -
The Iowa Orthopaedic Journal Jun 2022Research has shown that postoperative shoulder imbalance is a common problem after spinal fusion in adolescent idiopathic scoliosis (AIS). The best radiographic...
BACKGROUND
Research has shown that postoperative shoulder imbalance is a common problem after spinal fusion in adolescent idiopathic scoliosis (AIS). The best radiographic predictor has not yet been determined and results are inconsistent. This study was to investigate whether using medial and lateral shoulder parameters can effectively achieve postoperative shoulder balance.
METHODS
A prospective database of AIS undergoing posterior spinal fusion were reviewed. Patient demographics and radiological parameters including radiographic shoulder height (RSH), clavicle angle, T1-tilt and first-rib angle at baseline, 6 weeks and last minimal follow up of 2 years were recorded. Correlations between radiological parameters were assessed using Pearson's correlation coefficients. Multivariable linear models identified predictors associated with increased RSH.
RESULTS
219 patients (mean age:13.7 years; 81.7% female) were included. The mean follow-up time was 2.8 years (range:2.0-7.0). The mean RSH at baseline, 6 weeks and last follow up was improved significantly at 95.8%. Preoperative (r=0.8; p<0.001) and post-operative measurements of RSH at 6-week (r=0.9; p<0.001) and last follow up (r=0.9; p<0.001) correlated strongly with clavicle angle measured at respective time-points. In a multivariable linear model, we noted marginal increase in clavicle angle (+4.3°; p<0.001) to be associated with increased RSH. On the contrary, first rib angle and T1-tilt demonstrated moderate to weak correlation with RSH.
CONCLUSION
Clavicle angle is strongly consistent with RSH. First rib angle and T1-tilt as demonstrate medial shoulder balance are moderate to weak correlation. Leveling T1 tilt and first rib angle do not guarantee the postoperative shoulder balance. .
Topics: Adolescent; Female; Humans; Kyphosis; Male; Radiography; Scoliosis; Shoulder; Thoracic Vertebrae
PubMed: 35821947
DOI: No ID Found -
Einstein (Sao Paulo, Brazil) 2022Adhesive capsulitis is an inflammatory disease of the joint capsule, clinically manifested as pain, stiffness, and dysfunction of the shoulder. We subjectively observed...
OBJECTIVE
Adhesive capsulitis is an inflammatory disease of the joint capsule, clinically manifested as pain, stiffness, and dysfunction of the shoulder. We subjectively observed an increased incidence of adhesive capsulitis, and raised the hypothesis that adhesive capsulitis was more frequent in magnetic resonance imaging examinations performed during the COVID-19 pandemic as compared with examinations prior to this period.
METHODS
Data from medical records and magnetic resonance imaging of the shoulder presenting typical imaging findings of adhesive capsulitis, performed in our organization from March to June 2020, were evaluated and compared with data and imaging from the same period of the previous year. To this end, an organizational business intelligence tool called "search reports" was used, searching for the term "adhesive capsulitis" in the radiological report, results were tabulated, and corresponding magnetic resonance imaging exams were analyzed.
RESULTS
Our search found a total of 240 and 1,373 cases of adhesive capsulitis in the 2020 and 2019 periods, respectively. The mean age of patients was 53.9 years in the 2020 group and 49.9 years in 2019 (p<0.001). Magnetic resonance imaging findings were positive for adhesive capsulitis in 40 out of 240 shoulders (16.7%) in the 2020 group versus 127 out of 1,373 shoulders (9.2%) in the 2019 group. This difference was statistically significant (p=0.001).
CONCLUSION
Our study findings suggest a relative increase in the proportion of magnetic resonance imaging findings suggestive of adhesive capsulitis cases during COVID-19 pandemics based on data from our organization.
Topics: Humans; Middle Aged; Bursitis; COVID-19; Pandemics; Shoulder
PubMed: 36477521
DOI: 10.31744/einstein_journal/2022AE0163