Shoulder Joint Range Of Motion Research Articles

Calcitonin treatment for calcifying tendinitis of the shoulder

In an open, uncontrolled trial, the clinical and radiological responses to calcitonin therapy in the treatment of acute calcifying tendinitis of the shoulder were investigated. A total of 35 patients (38 shoulders) were enrolled. Each patient was injected with 10 U synthetic calcitonin intramuscularly twice a week. The mean number of injections was 6.0 (range, 1–16). At the end of the treatment period, 33 shoulders (87%) were pain-free. In 28 shoulders (74%), the localized pain disappeared within 2 weeks of the start of treatment. In 25 shoulders (66%), the clinical results were rated as good, with complete pain relief and sufficient recovery in the activities of daily living (ADL) and active range of shoulder joint motion (ROM). On the contrary, in 4 shoulders (10%) pain persisted, requiring alternative treatment. In 28 shoulders (74%), the pre-existing calcific deposits were remarkably reduced or had disappeared. Radiologically, the shoulders with fluffy-type deposits had greater pain relief and ROM recovery than those with defined-type deposits. However, there was no correlation between the clinical results and localized region or size of deposits. In 19 cases (50%) where the calcified deposits had completely disappeared, the shoulder had become pain-free, and in all of them except two cases there was complete recovery of ROM. No patient developed clinical complications. These results suggest that calcitonin treatment may be useful for calcifying tendinitis of the shoulder, and that this therapy results in both clinical and radiological improvement in this condition.

Low-Power Laser Treatment for Shoulder Pain

The objective of this study is to investigate the effect of low-power gallium-arsenide laser treatment on the patients with shoulder pain. Low-energy laser therapy has recently been popularized in the treatment of various rheumatologic, neurologic, and musculoskeletal disorders such as osteoarthritis, rheumatoid arthritis, fibromyalgia, carpal tunnel syndrome, rotator cuff tendinitis, and chronic back pain syndromes. A total of 40 patients who applied to our clinic with shoulder pain and complied with the selection criteria were included in the study. The patients were randomly assigned into Group I (n = 20, laser treatment) and Group II (n = 20, control). In Group I, patients were given laser treatment and an exercise protocol for 10 sessions during a period of 2 weeks. Laser was applied over tuberculum majus and minus, bicipital groove, and anterior and posterior faces of the capsule, regardless of the existence of sensitivity, for 1 min at each location at each session with a frequency of 2000 Hz using a GaAs diode laser instrument (Roland Serie Elettronica Pagani, wavelength 904 nm, frequency range of 5-7000 Hz, and maximum peak power of 27 W, 50 W, or 27 x 4 W). In Group II, placebo laser and the same exercise protocol was given for the same period. Patients were evaluated according to the parameters of pain, palpation sensitivity, algometric sensitivity, and shoulder joint range of motion before and after treatment. Analysis of measurement results within each group showed a significant posttreatment improvement for some active and passive movements in both groups, and also for algometric sensitivity in Group I (p < 0.05-0.01). Posttreatment palpation sensitivity values showed improvement in 17 patients (85%) for Group I and six patients (30%) for Group II. Comparison between two groups showed superior results (p < 0.01 and p < 0.001) in Group I for the parameters of passive extension and palpation sensitivity but no significant difference for other parameters. The results of our study have shown better results in palpation sensitivity and passive extension, but no significant improvement in pain, active range, and algometric sensitivity in laser treatment group compared to the control group in the patients with shoulder pain.

A 57 Years Old Diabetic and Hypertensive Female Patient with Frozen Shoulder

Frozen shoulder is a condition of adhesive shoulder or capsulitis occurs at the outset painful with later on continuing restricted for both active and passive shoulder joint range of motion, this inflammatory condition is root of fibrosis in shoulder joint capsule with pain, shoulder stiffness, restrictions in normal movements and shows absolute or nearly absolute recovery with assorted time length. This condition occurs in elderly population common in 4th to 7th decades, women are more prone to have this condition. A 57-year-old female with chief complaint of insidious onset pain often with aggravating pain and gradually decreased normal range of motion. The abundant level of evidence for Physical therapy in treatment of frozen shoulder is a specific manual treatment should be merged with advisable exercise or normal performance within the limits of pain that reached normal or simply painless self-shoulder active motion gives better results with intensive Physiotherapy. This case…

A new shoulder range of motion screening measurement: Its reliability and application in the assessment of the prevalence of shoulder contractures in patients with impaired consciousness caused by severe brain damage

Pohl M, Mehrholz J. A new shoulder range of motion screening measurement: its reliability and application in the assessment of the prevalence of shoulder contractures in patients with impaired consciousness caused by severe brain damage. Objectives To determine the reliability of a new shoulder joint range of motion (ROM) measurement for unconscious patients and to assess the prevalence of shoulder joint contractures in such patients. Design Prospective cohort survey. Setting An early rehabilitation center for adult persons with neurologic disorders. Participants Fifty patients with impaired consciousness caused by severe cerebral damage of various etiologies. In addition, reference values were measured in 60 healthy adults. Intervention Shoulder ROM was assessed by measuring the distance between the olecranon and underlay while the patient lay supine on a solid surface and the patient’s hands were passively positioned behind the neck. Distances between the olecranon and underlay were measured, first, manually by the rater and, second, for control, digitally by a blinded person from a digital photo taken while a constant force was applied to the elbow. Main outcome measures Prevalence of contractures defined as increased distance between the olecranon and underlay or impossibility of positioning the hands passively behind the neck, and intra- and interrater-reliability of the 2 shoulder ROM measurements with the interclass correlation coefficient (ICC). Results Measurement of shoulder ROM showed high intra-(ICC range, .78–.91) and interrater reliability (ICC range, .77–.90) for manual measurement, high intra- (ICC range, .91–.95) and interrater reliability (ICC range, .90–.94) for the digital analysis, and a high ICC for both methods (ICC=.87). The prevalence of shoulder contractures was 56% in the patients and 50% of all shoulder joints. Conclusions The described method provided a reliable measurement for reduced shoulder ROM and appears to be a useful screening method to show the prevalence of shoulder joint contracture in these patients.

Shoulder function after accessory nerve-sparing neck dissections.

This study was designed to observe the effect of preserving the spinal accessory nerve (SAN) during neck dissection (ND) and adjuvant radiotherapy (ART) after ND on shoulder function. Fifty-seven patients with head and neck cancer who had undergone primary tumor resection and various types of NDs were enrolled in this prospective study. Postoperative shoulder joint range of motion was evaluated by goniometry, and muscle strength was measured manually. SAN function was evaluated with electromyography (EMG) with respect to percentage of denervation and presence of neurogenic involvement. Patients were grouped by treatment as follows: radical ND (RND) versus modified radical ND (MRND)/selective ND (SND) and ART versus no ART. Shoulder joint range of motion and shoulder muscle strength were significantly better in the MRND/SND group than in the RND group. However, EMG findings were similar in the RND and MRND/SND groups. When all patients who underwent ND, RND, or MRND/SND were compared with the control group, statistically significant changes in shoulder joint range of motion and shoulder muscle strength were found. Also, denervation and neurogenic involvement of the SAN were significantly higher after all NDs than in the control group. ART did not affect range of motion of the shoulder joint, shoulder muscle strength, or the degree of denervation and neurogenic involvement in any of the ND groups. ART does not have a negative effect on shoulder function after ND. SAN is always functionally impaired even if we preserve it macroscopically during ND.

Reliability of five methods for assessing shoulder range of motion

In symptomatic subjects, the reliability of tests for shoulder joint range of motion has yet to be determined. For this reason, inter-rater and intra-rater agreement trials were undertaken to ascertain the reliability of visual estimation, goniometry, still photography, "stand and reach" and hand behind back reach for six different shoulder movements. Intra-class correlation coefficients (Rho) were derived by using a random effects model. For flexion, abduction and external rotation fair to good reliability was demonstrated for both trials using visual estimation (Inter-rater Rho = 0.57-0.70; Intra-rater Rho = 0.59-0.67), goniometry (Inter-rater Rho = 0.64-0.69; Intra-rater Rho = 0.53-0.65) and still photography (Inter-rater Rho = 0.62-0.73; Intra-rater Rho = 0.56-0.61). The tests had standard errors of measurement of between 14 and 25 degrees (inter-rater trial) and 11 and 23 degrees (intra-rater trial).

Shoulder Pain in Middle Age

Studies on 574 subjects demonstrated the prevalence of shoulder pain and its relationship to occupational work load and psychosocial factors. The prevalence of shoulder pain was 14% (13% men, 15% women). Women had more often myalgias with a tenderness on palpation of the shoulder muscles and rhizopathia-brachialgia type of pain, whereas men had mainly intraarticular pain. Three percent had been on sick leave because of shoulder pain in the year preceding the examination and 5% had a reduced range of shoulder joint motion. The subjects with shoulder pain were less satisfied with their jobs and had been less successful in a childhood intelligence test. No difference could be demonstrated between subjects with or without shoulder pain in estimated overall work load, but women with signs of supraspinatus tendinitis more often had jobs with physical demands.