Jeremy Lewis shoulder

INTRODUCTION: Lifetime prevalence of shoulder pain is 70%, and approximately 50% of people with shoulder pain will experience pain for more than a year. Rotator cuff-related shoulder pain (RCRSP) is the most common shoulder condition and the main non-surgical intervention is exercise therapy. For approximately 30% of people with RCRSP, this approach does not lead to a significant reduction in symptoms. This may be due to an inappropriate dosage or choice of exercises. The aim of this investigation is to compare the short, mid and long-term effects, in terms of symptoms, functional limitations, kinesiophobia and pain catastrophising, of three different shoulder rehabilitation approaches (education, strengthening, motor control) in adults with RCRSP...

OBJECTIVE: To evaluate the effectiveness of non-surgical interventions for rotator cuff calcific tendinopathy. DATA SOURCES: Medline, EMBASE, CINAHL, Cochrane Register of Clinical Trials, PEDro and SPORTDiscus from inception to March 2018, and accompanying reference lists. Peer-reviewed randomized clinical trials of non-surgical interventions for adults with rotator cuff calcific tendinopathy were included. DATA EXTRACTION: The same 2 reviewers independently evaluated eligibility, extracted data and evaluated risk of bias of the included randomized clinical trials...

BACKGROUND: Although posterior shoulder tightness (PST) has been associated with shoulder pathology and altered glenohumeral joint kinematics, uncertainty remains regarding its cause and definition. To understand the efficacy of treatments for PST, it must be possible to identify people with PST for the purposes of research and clinical decision-making. Clinical tests for PST must demonstrate acceptable levels of measurement reliability in order to identify the condition and to evaluate the response to intervention...

OBJECTIVE: To investigate the influence of trunk and lower limb motion on electromyography (EMG) muscle activity and recruitment patterns around the shoulder. DESIGN: Systematic review. DATA SOURCES: MEDLINE, CINAHL, PEDro, AMED, PubMed, Cochrane Central Register of Controlled trials, Cochrane Database of Systematic reviews, SportsDiscuss and PROSPERO. ELIGIBILITY CRITERIA: Studies investigating both multiregional kinetic chain (KC) shoulder exercises and localised non-kinetic chain (nKC) shoulder exercises in healthy subjects under the same experimental conditions were included in this review...

"Special tests" for rotator cuff-related shoulder pain (RCRSP) have passed their sell-by date. In this Viewpoint, we outline fundamental flaws in the validity of these tests and their proposed ability to accurately identify a pathoanatomical source of pain. The potential harm of these special tests comes in conjunction with imaging findings that are utilized to inform a structural diagnosis or recommend invasive procedures. We offer recommendations for performing a clinical interview and physical examination for people with RCRSP that does not include shoulder orthopaedic tests...

INTRODUCTION: Despite many advances in burn care, the development of extremity contracture remains a common and vexing problem. Extremity contractures have been documented in up to one third of severely burned patients at discharge. However, little is known about the long-term impact of these contractures. The purpose of this study was to examine the association of extremity contractures with employment after burn injury. METHODS: We obtained data from the Burn Model System database from 1994 to 2003...

OBJECTIVE: To update a systematic review published in 2013 that focused on evaluating the effectiveness of interventions within the scope of physical therapy, including exercise, manual therapy, electrotherapy, and combined or multimodal approaches to managing shoulder pain. DESIGN: Umbrella review. LITERATURE SEARCH: An electronic search of PubMed, Web of Science, and CINAHL was undertaken. Methodological quality was assessed using the AMSTAR (A MeaSurement Tool to Assess systematic Reviews) checklist for systematic reviews...

OBJECTIVE: To update an existing systematic review of randomized clinical trials evaluating the clinical effectiveness of non-surgical management interventions for people with primary frozen shoulder in terms of pain, movement, self-reported function and disability, quality of life, recovery time, return to work and recreation, and adverse events. DATA SOURCES: Cochrane CENTRAL, SCI and MEDLINE, CENTRAL between 1 January 2010 and June 2017, plus reference lists of included trials and trial registers...

The most common source of shoulder pain is thought to involve the tendons of the rotator cuff and associated structures around the subacromial space. A generic diagnostic term has been suggested, rotator cuff-related shoulder pain (RCRSP), which is an overarching clinical term that includes a number of conditions, such as subacromial impingement syndrome, subacromial pain syndrome, and rotator cuff tendinopathy. The management of RCRSP may include exercise, surgery, or injection therapy. Those who perform or recommend injection therapy for RCRSP have a duty of care to provide advice on the expected benefits and outcomes, as well as the potential risks and associated harms...

OBJECTIVES: To (i) identify predictors of outcome for the physiotherapy management of shoulder pain and (ii) enable clinicians to subgroup people into risk groups for persistent shoulder pain and disability. METHODS: 1030 people aged ≥18 years, referred to physiotherapy for the management of musculoskeletal shoulder pain were recruited. 810 provided data at 6 months for 4 outcomes: Shoulder Pain and Disability Index (SPADI) (total score, pain subscale, disability subscale) and Quick Disability of the Arm, Shoulder and Hand (QuickDASH)...

STUDY DESIGN: Multicentre, double-blind, placebo-controlled randomised clinical trial. OBJECTIVES: To compare the effectiveness of long chain omega-3 polyunsaturated fatty acids (PUFAs) as part of the management for people diagnosed with rotator cuff related shoulder pain (RCRSP). SUMMARY OF BACKGROUND: Although there is no robust evidence to support their use, omega-3 PUFAs have been recommended for those with tendinopathy due to their potential to moderate inflammation...

In 1972, American orthopaedic surgeon Charles Neer published his seminal paper, "Anterior Acromioplasty for the Chronic Impingement Syndrome in the Shoulder: A Preliminary Report." It wasn't a robust scientific paper; however, it changed the direction of orthopaedic practice for the next half century. Neer argued that a primary cause of shoulder pain was attrition of the supraspinatus tendon and related structures from the overlying acromion, especially when the arm was elevated. Neer recommended surgical removal to stop the impingement, and over the last half century, it could be argued that millions of people around the globe would have undergone acromioplasty surgery to stop this portion of the bone impinging onto the soft tissues located in the subacromial space...

OBJECTIVE: To compare the effectiveness of corticosteroid injections to local anaesthetic injections in the management of rotator cuff-related shoulder pain (RCRSP). DESIGN: Systematic review with best evidence synthesis. DATA SOURCES: The Cochrane, PubMed, CINAHL Plus, PEDro and EMBASE electronic databases were searched (inception until 8 June 2017). Reference lists of included articles were also hand searched. ELIGIBILITY CRITERIA: Two reviewers independently evaluated eligibility...

STUDY DESIGN: A case series was carried out. INTRODUCTION: There is a lack of evidence exploring the effectiveness of group exercise classes for people with nonspecific shoulder pain (NSSP). Also, there is a lack of research that measures potential reductions in thoracic kyphosis after exercise interventions in people with NSSP. PURPOSE OF THE STUDY: To observe changes in shoulder pain, disability, and thoracic kyphosis in 2 groups of people with NSSP, after 2 different types of group exercise classes...

Study Design Prospective multicenter longitudinal cohort study. Background A key component of assessing clinical effectiveness is to compare instruments measuring similar outcomes and to select one that is sufficiently responsive. Despite their widespread use in reporting outcomes, the responsiveness of the Shoulder Pain and Disability Index (SPADI) and the shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) has not been compared and reported within the same population...

BACKGROUND: Musculoskeletal conditions involving the shoulder are common and, because of the importance of the upper limb and hand in daily function, symptoms in this region are commonly associated with functional impairment in athletic and non-athletic populations. Deriving a definitive diagnosis as to the cause of shoulder symptoms is fraught with difficulty. Limitations have been recognised for imaging and for orthopaedic special tests. 1 solution is to partially base management on the response to tests aimed at reducing the severity of the patient's perception of symptoms...

BACKGROUND: Frozen shoulder is a common yet poorly understood musculoskeletal condition, which for many, is associated with substantial and protracted morbidity. Understanding the pathology associated with this condition may help to improve management. To date this has not been presented in a systematic fashion. As such, the aim of this review was to summarise the pathological changes associated with this primary frozen shoulder. DATABASES: Medline, Embase, CINAHL, AMED, BNI and the Cochrane Library, were searched from inception to 2nd May, 2014...

INTRODUCTION: Excessive thoracic kyphosis is considered a predisposing factor for shoulder pain, though there is uncertainty about the nature of the relationship between shoulder pain and thoracic spine posture. The aim of this systematic review was to investigate the relationship between thoracic kyphosis and shoulder pain, shoulder range of motion (ROM) and function. METHODS: Two reviewers independently searched eight electronic databases and identified relevant studies by applying eligibility criteria...

BACKGROUND/AIM: Shoulder pain is a major musculoskeletal problem. We aimed to identify which baseline patient and clinical characteristics are associated with a better outcome, 6 weeks and 6 months after starting a course of physiotherapy for shoulder pain. METHODS: 1030 patients aged ≥18 years referred to physiotherapy for the management of musculoskeletal shoulder pain were recruited and provided baseline data. 840 (82%) provided outcome data at 6 weeks and 811 (79%) at 6 months...

INTRODUCTION: Rotator cuff related shoulder pain (RCRSP) is an over-arching term that encompasses a spectrum of shoulder conditions including; subacromial pain (impingement) syndrome, rotator cuff tendinopathy, and symptomatic partial and full thickness rotator cuff tears. For those diagnosed with RCRSP one aim of treatment is to achieve symptom free shoulder movement and function. Findings from published high quality research investigations suggest that a graduated and well-constructed exercise approach confers at least equivalent benefit as that derived from surgery for; subacromial pain (impingement) syndrome, rotator cuff tendinopathy, partial thickness rotator cuff (RC) tears and atraumatic full thickness rotator cuff tears...