Shoulder Pain And Disability Index Scores Research Articles

Shoulder pain and disability index: its effectiveness and reliability in an outpatient setting in Indian population

<p class="abstract"><strong>Background:</strong> One of the most common joints to be treated in the clinic is the shoulder joint. An orthopedic surgeon and physical therapists should be knowledgeable about the proper assessment of the shoulder joint to effectively evaluate and design a treatment program in shoulder pathologies. Shoulder pain and disability index (SPADI) is a questionnaire designed to measure pain and disability associated with shoulder pathologies in a clinical setting. SPADI’s effectiveness as a tool needed to be validated in Indian population hence this study. The objectives of this study were to measure effectiveness of SPADI in our setting and to measure the reliability and acceptability of SPADI in Indian population.</p><p class="abstract"><strong>Methods:</strong> 60 patients with shoulder pain between the age of 25-50 years who attended the orthopaedic OPD during the time period of April 2017 to April 2018 were included. The subjects were evaluated with SPADI and oxford shoulder score (OSS) questionnaires. The data was analyzed by paired sample T test and alpha coefficient level.<strong></strong></p><p class="abstract"><strong>Results:</strong> The data statistically analysed revealed that the scales are reliable as the Cronbach's alpha was high (>0.7) and was effective to measure the pain and disability of the shoulder joint in our clinical set up.</p><p class="abstract"><strong>Conclusions:</strong> It can be concluded from our statistical analysis that both SPADI and OSS are equally effective tools in measuring pain and disability in our clinical set up, the only difference being that SPADI is operationally very simple and lucid for our population.</p>

High-Intensity Shoulder Abduction Exercise in Subacromial Pain Syndrome.

This study aimed to determine if adding high-intensity aerobic interval training (HIIT) of the rotator cuff to usual care was feasible in SAPS and improved shoulder endurance more than usual care alone, as well as to examine the influence on shoulder pain and disability and the response of tendinous microcirculation after HIIT. Twenty-one subjects with chronic SAPS were randomized to two groups: experimental group (EG; n = 13) receiving HIIT in addition to treatment as usual and control group (CG; n = 8) receiving treatment as usual. Before and after 8 wk of exercise therapy, endurance performance was assessed by an incremental abduction exercise of the arm to exhaustion (TTE). Pain and disability was assessed by the shoulder pain and disability index (SPADI). Contrast-enhanced ultrasound of the musculus supraspinatus and tendon was utilized to indicate tendon blood flow. Endurance in the TTE test improved by an estimated 233 s more on average in EG than in CG (P = 0.001; 95% confidence interval, 102 to 363). The SPADI score was reduced 22 points more on average in EG (P = 0.017; 95% confidence interval, -40 to -5). The change from pretest to posttest was significant in EG for both TTE test and SPADI improvement (P < 0.001). EG also experienced less pain during exercise after the intervention compared with CG (P < 0.001). Contrast-enhanced ultrasound indicated an increase in tendinous blood flow in EG (P = 0.019). HIIT rotator cuff exercise seems to be a feasible intervention in SAPS, increasing endurance performance more than usual care alone.

Effects on shoulder pain and disability of teaching patients with shoulder pain a home-based exercise program: a randomized controlled trial

Objective: To investigate the effect on shoulder pain and disability of teaching patients with shoulder pain how to undertake a home-based exercise program. Design: A randomized controlled trial conducted from September 2015 to January 2016. Setting: Participants’ home. Participants: Sixty participants with shoulder pain who were waiting for physiotherapeutic treatment. Interventions: The control group (n = 30) received minimal education about their shoulder condition and instructions to continue their activities as normal. The intervention group (n = 30) received a two-month home exercise program with one-hour sessions delivered by a physiotherapist to begin and one month after the program for exercise instructions. Main measures: The primary outcome was change in the Shoulder Pain and Disability Index (SPADI). The secondary outcomes included change in the numeric pain rating scale and medication intake for pain relief. Results: The patients’ average age was 54.3 (13.8) years. SPADI scores at baseline were 60.9 (16.5) in the intervention and 64.7 (15.3) in the control group. After two months, the SPADI scores decreased to 18.8 (28.6) and to 61.4 (24.0), respectively, in the intervention and control groups with an estimated mean difference of 40.0, effect size: 1.61. The intervention group showed a reduced pain intensity (estimated mean difference: 3.7, effect size: 2.43) and medication intake (chi-square: 0.001). The number needed to treat was 1.2 for one patient to have a SPADI score <20. Conclusion: Teaching patients with shoulder pain how to undertake a home-based exercise program improved shoulder function and reduced pain intensity and medication intake over two months.

Electrical interferential current stimulation versus electrical acupuncture in management of hemiplegic shoulder pain and disability following ischemic stroke-a randomized clinical trial

BackgroundHemiplegic Shoulder Pain (HSP) is among common complications occurring after stroke leading to disability. This study was conducted to compare the effects of electrical Interferential Current stimulation (IFC) and Electrical Acupuncture (EAC) on pain intensity, range of motion, and functional ability in patients with HSP and also comparing the two modalities regarding improvement of above indices.MethodsIn this randomized clinical trial, 46 patients with HSP caused by ischemic stroke were recruited and assigned into 2 groups. Conventional exercise trainings were applied for both groups. Group A received additional IFC with medium frequency of 4000 HZ, and Group B received additional EAC two times a week for a total of 10 sessions. Pain severity, daily function, and shoulder Range of Motion (ROM) were evaluated using Visual Analogue Scale (VAS), Shoulder Pain and Disability Index (SPADI), and goniometry, respectively before and 5 weeks after the treatment.ResultsBoth groups showed relative improvement in pain severity, SPADI score, and its subscales, and also active and passive shoulder ROM after the treatment. However, IFC group compared to EAC group had higher mean changes of active ROM in abduction (28.00 ± 3.81 vs. 12.25 ± 2.39) and functional subscale of SPADI (11.45 ± 1.88 vs. 5.80 ± 1.66) after the treatment. On the contrary, EAC group showed higher percentage of VAS changes (46.14 ± 6.88 vs. 34.28 ± 5.52), indicating better pain improvement compared to IFC group. Other parameters did not show significant difference between two groups.ConclusionBoth IFC and EAC caused short term improvement in functional state, increased motion, and decreased pain in patients with HSP. Although pain control was more evident in acupuncture group, IFC resulted in better effects on function and active ROM of abduction, and seems to have higher efficacy.Trial registrationThis clinical trial was registered in the Iranian Registry of Clinical Trials at 2016-07-16 with a registry number of IRCT201602153217N10.

Ongoing Efficacy of Platelet-rich Plasma vs Corticosteroid Injection in Patients with Adhesive Capsulitis: A Prospective Randomized Assessor-blind Comparative Analysis

Introduction: The primary objective of the present study was to assess the safety and efficacy of platelet-rich plasma (PRP) injections for management of adhesive capsulitis and compare the clinical outcome with injection of corticosteroid. Materials and methods: A total of 120 patients were randomized into PRP (group I) or steroid (group II) group. Patients were assigned to receive a single injection of 1% lidocaine with either methylprednisolone (steroid) or PRP. All patients were assessed at 1, 3, and 6 months after the index procedure. The shoulder pain and disability index (SPADI) was used to evaluate the clinical results. Data were analyzed with a paired t test. The level of significance was considered as p < 0.05. Results: The efficiency of PRP injection was better and sustained than steroid. In PRP group, mean pain scale, mean disability, and total SPADI scores were almost linearly improved, while the scores increased to a higher level at the final follow-up visit compared with that post 1 and 3 months in the steroid group (p < 0.05). No major adverse complications were noted. Conclusion: In the current randomized, single-center, prospective preliminary study, results indicate that treating adhesive capsulitis with PRP injections is safe and has the potential to reduce pain and improve the functional outcome. The PRP injection had a more prolonged efficiency than steroid injections. Clinical significance: The PRP injections are safe and valuable therapeutic modality to alleviate the symptoms in subjects with adhesive capsulitis of shoulder.

Intra-articular steroid for adhesive capsulitis: does hydrodilatation give any additional benefit? A randomized control trial.

To assess the benefit offered by capsular hydrodilatation in addition to intra-articular steroid injections in cases of adhesive capsulitis, assess outcomes in diabetic patients with capsular hydrodilatation as compared to non-diabetics and correlate duration of symptoms with outcome based on the type of intervention given. This prospective double-blinded randomized control trial included patients presenting with clinical features of adhesive capsulitis with no evidence of rotator cuff pathology and randomized them into two groups-intra-articular steroid with hydrodilatation (distension group) and only intra-articular steroid (non-distension group) with intervention being performed as per the group allotted. Primary outcome measure was Shoulder Pain and Disability Index (SPADI) scores which were taken pre-intervention, at 1.5, 3 and 6months post-intervention, which were assessed by generalized linear model statistics and Pearson correlation. Although there was statistically significant drop in SPADI in both groups over time [F(1.9, 137.6) = 112.2; p < 0.001], mean difference in SPADI between the 2 groups was not statistically significant (1.53; CI:-3.7 to 6.8; p = 0.56). There was no significant difference between both groups among diabetics [F(1,38) = 0.04; p = 0.95] and no significant difference between diabetic and non-diabetic patients who received hydrodilatation [F(1.8, 60) = 2.26; p = 0.12]. There was no significant correlation between the reduction in SPADI scores and duration of symptoms in any subset of the study population. Shoulder joint hydrodilatation offered no additional benefit compared to intra-articular steroid injections for shoulder adhesive capsulitis. Outcome for diabetics and non-diabetics were similar and there was no correlation between duration of symptoms and outcome.

Faut-il synthéser les fractures de l’épine de l’omoplate après prothèse d’épaule inversée chez le patient âgé ?

PurposeScapular spine fractures sustained after reverse shoulder arthroplasty (RSA) are debilitating for elderly patients with osteoporosis. We examined the 1-year postoperative outcomes of open reduction and internal fixation (ORIF) in a small case-series, and hypothesised that patients undergoing surgical treatment for post-RSA scapular spine fractures would improve in function and pain. MethodsFive consecutive RSA patients within our shoulder arthroplasty register who sustained a scapular spine fracture underwent ORIF using a double-plating technique. Standard radiographs and clinical/patient-rated assessments of Constant-Murley (CS), Shoulder Pain And Disability Index (SPADI), Subjective Shoulder Value (SSV) and visual analogue scale (VAS) pain were made up to 12 months post-ORIF. Patients were also asked to rate their satisfaction since the surgery. Post-ORIF complications were documented. All post-RSA data were used as a baseline measure for comparison with post-fracture outcomes. ResultsMean CS, SPADI and SSV scores as well as pain were similar to pre-fracture scores. All patients improved in function and pain, and would undergo the same procedure again. Individual cases of iatrogenic pneumothorax and screw loosening were reported. ConclusionsORIF is a viable option with adequate improvements in function and pain for elderly patients with debilitating scapular spine fractures after RSA.

Chuna manual therapy combined with acupuncture and cupping for frozen shoulder (adhesive capsulitis): multicenter, randomized, patient-assessor blind, clinical trial

IntroductionFrozen shoulder is a common disease that causes pain and limited range of motion. The aim of this study was to evaluate the effectiveness, safety, and cost effectiveness of Chuna combined with integrative treatments on frozen shoulder. MethodA multicenter, randomized, patient-assessor blind, parallel clinical trial was carried out. Eligible subjects were randomly allocated to one of two groups. The experimental group received acupuncture, cupping and real Chuna manual therapy, and control group received acupuncture, cupping and sham Chuna manual therapy. During the 8-weeks period, effectiveness and safety evaluations were carried out. Evaluation of satisfaction and cost effectiveness was performed at the end of the trial (20-week). The primary outcome was shoulder pain and disability index (SPADI). The secondary outcomes were; assessment on a 100 mm pain visual analog scale, passive range of motion of shoulder, Korean shoulder scoring system score, quality of life score, use of relief medicine, evaluation of patient satisfaction, safety, and cost effectiveness. ResultsA total of 66 subjects were enrolled in the study. There were no adverse events reported as a result of any of the treatments administered. The difference of SPADI score between two groups was not statistically significant. The score of EuroQol-5 Dimension (VAS) was significantly improved in experimental group at the end of treatment and at follow up (p = 0.015, p = 0.009 respectively). With SPADI and rotator cuff and quality of life as indicators, the experimental treatment indicated that it may be cost-effective but will depend on willingness to pay. ConclusionFurther evidence is required on the effectiveness of the Chuna combined with acupuncture and cupping therapy, as well as more verification of the economic assessment.

Hydraulic Distension with Pumping Technique for Treating Frozen Shoulder: A CaseControlled, Retrospective, Comparative Study with 6-Month Follow-Up

Background: We have applied a new method called “the pumping technique” to the capsulepreserving hydraulic distension for frozen shoulder. With this technique, the stretching effect can be directly applied to the joint capsule of the affected shoulder. Objectives: We attempted to evaluate the effect of capsule-preserving hydraulic distension using the pumping technique by comparing capsule-preserving hydraulic distension without it. Study Design: A case-controlled, retrospective, comparative study. Setting: Outpatient clinic of department of rehabilitation medicine in a single university hospital. Methods: Patients (n = 47) with frozen shoulder who were treated with hydraulic distension were assigned into the pumping group (n = 24) and the nonpumping group (n = 23). Range of motion (ROM), Shoulder Pain and Disability Index (SPADI), and Visual Analog Scale (VAS) scores were assessed. Results: Significant improvement of VAS, ROM, and SPADI scores was observed after the second injection in each group (P &lt; 0.05). There were significant differences in total passive ROM, abduction, and flexion after the fifth injection between the 2 groups (P &lt; 0.05). There was a significant difference in the disability domain of SPADI after the second injection between the 2 groups (P &lt; 0.05). However, there was no significant interaction between time and group with respect to VAS scores. There were no serious complications after procedures. Limitations: This was a retrospective study. There might be some limitations in gathering comprehensive records of outcome measurements. In addition, because the objective of this study was to determine the effect of the new pumping technique, included patients range was very narrow. This study only included patients who were treated 5 times with capsule-preserving hydraulic distensions with or without the pumping technique. Conclusions: Although the effect on pain was excellent in both groups, the superiority of the new pumping technique was demonstrated by reduction of SPADI disability subscale score and improvement of ROM of the shoulder compared with the nonpumping technique.

Arthroscopic Superior Capsular Reconstruction With Acellular Porcine Dermal Xenograft for the Treatment of Massive Irreparable Rotator Cuff Tears

PurposeTo evaluate the short-term clinical outcomes and the complications related to arthroscopic superior capsular reconstruction (SCR) with acellular porcine dermal xenograft for the treatment of irreparable massive rotator cuff tears.MethodsA prospective observational study of patients treated with arthroscopic SCR for irreparable massive rotator cuff tears in the period from 2016 to 2017 was performed. Range of motion and Shoulder Pain and Disability Index (SPADI) scores were assessed preoperatively, at 6 months postoperatively, and at 12 months postoperatively.ResultsA total of 20 shoulders in 19 patients, with an average age of 60 years, were included in the study. Twelve patients met the criterion for the minimal clinically important difference in the SPADI score. The mean SPADI score showed significant improvement from 51.3% to 10.4% at 1-year follow-up. Active abduction improved from 65.4° to 149.3° and active forward flexion improved from 68.6° to 151.4° at 1-year follow-up. The procedure had a 30% complication rate, including a 15% rate of immunologic rejection of the xenograft. Five patients underwent revision procedures, including arthroscopic debridement and removal of xenograft residuals, implantation of a balloon spacer, and revision SCR with a fascia lata autograft.ConclusionsArthroscopic SCR with an acellular porcine dermal xenograft led to a successful outcome in 60% of cases. The procedure showed a quite high complication rate; the most severe cases were related to acute immunologic rejection of the xenograft.Level of EvidenceLevel IV, case series.

Does ORIF of rare scapular spine fractures sustained after reverse shoulder arthroplasty benefit elderly patients? A case-series appraisal

PurposeScapular spine fractures sustained after reverse shoulder arthroplasty (RSA) are debilitating for elderly patients with osteoporosis. We examined the 1-year postoperative outcomes of open reduction and internal fixation (ORIF) in a small case-series, and hypothesised that patients undergoing surgical treatment for post-RSA scapular spine fractures would improve in function and pain. MethodsFive consecutive RSA patients within our shoulder arthroplasty register who sustained a scapular spine fracture underwent ORIF using a double plating technique. Standard radiographs and clinical/patient-rated assessments of Constant–Murley (CS), Shoulder Pain And Disability Index (SPADI), Subjective Shoulder Value (SSV) and visual analogue scale (VAS) pain were made up to 12months post-ORIF. Patients were also asked to rate their satisfaction since the surgery. Post-ORIF complications were documented. All post-RSA data were used as a baseline measure for comparison with post-fracture outcomes. ResultsMean CS, SPADI and SSV scores as well as pain were similar to pre-fracture scores. All patients improved in function and pain, and would undergo the same procedure again. Individual cases of iatrogenic pneumothorax and screw loosening were reported. ConclusionsORIF is a viable option with adequate improvements in function and pain for elderly patients with debilitating scapular spine fractures after RSA.

Ultrasound-guided pulsed radiofrequency neuromodulation of the suprascapular nerve in partial rotator cuff tears

Background/AimPulsed radiofrequency (PRF) of the suprascapular nerve has been shown to be effective in the treatment of chronic shoulder pain. Ultrasound (US) guidance has gained popularity in regional blocks recently. This study aims to investigate the efficacy of suprascapular nerve pulsed radiofrequency under the guidance of ultrasonography.Materials and methodsThis retrospective study included patients treated with PRF of the suprascapular nerve with a diagnosis of partial rotator cuff tears. The patients were assessed with a numeric rating scale (NRS), the Shoulder Pain and Disability Index (SPADI), and a Likert patient satisfaction score before the treatment and 3 weeks and 6 months following the treatment.ResultsA total of 31 patients was included in the study. The patients’ mean age was 66.8 ± 13.3 years. The mean scores of the NRS, SPADI, and Likert scale before the procedure (7.32 ± 1.1, 69.0 ± 8.5, 1.6 ± 0.6) and at 3 weeks (2.9 ± 2.1, 32.1 ± 17.20, 4 ± 1.2) and 6 months (3.2 ± 2.6, 33.9 ± 20.8, 3.8 ± 1.2) after the procedure were evaluated. We observed significant improvement in NRS, SPADI, and Likert scores at 3 weeks and 6 months following the treatment (P < 0.001).ConclusionThe study demonstrated that US-guided suprascapular nerve PRF achieves good pain relief and functional improvement in patients with partial rotator cuff tears for at least 6 months.

Feasibility of Ultrasound-Guided Trigger Point Injection in Patients with Myofascial Pain Syndrome.

We compared the feasibility of ultrasound (US)-guided myofascial trigger point (MTrP) injection with that of a blind injection technique following the use of shear wave elastography (SWE) for the measurement of stiffness at the MTrPs in patients with trapezius myofascial pain syndrome (MPS). A total of 41 patients (n = 41) were randomized to either the trial group (n = 21, SWE combined with US-guided injection) or the control group (n = 20, SWE combined with blind injection). At baseline and four weeks, they were evaluated for the manual muscle test (MMT), the range of motion (ROM), pain visual analogue scale (VAS) scores, Shoulder Pain and Disability Index (SPADI) scores and Neck Disability Index (NDI) scores during the abduction, adduction, flexion, extension, external rotation and internal rotation of the shoulder joint. Differences in changes in pain VAS scores, NDI scores and SPADI scores at four weeks from baseline between the two groups reached statistical significance (p = 0.003, 0.012, and 0.018, respectively). US-guided MTrP injection is a more useful modality as compared with a blind injection in patients with MPS.

Comparative Effectiveness of Operative Versus Nonoperative Treatment for Rotator Cuff Tears: A Propensity Score Analysis From the ROW Cohort

Background: The evidence to support operative versus nonoperative treatment for rotator cuff tears is sparse and inconclusive. Purpose: To assess pain and functional outcomes in patients undergoing operative and nonoperative treatments for rotator cuff tears. Study Design: Cohort study; Level of evidence, 3. Methods: From March 2011 to February 2015, a multicenter cohort of patients with rotator cuff tears undergoing operative and nonoperative treatments was recruited. Patients completed a detailed history questionnaire, the Shoulder Pain and Disability Index (SPADI), and the American Shoulder and Elbow Surgeons (ASES) standardized form and underwent magnetic resonance imaging. In addition to baseline assessments, patients received follow-up questionnaires at 3, 6, 12, and 18 months. Propensity score weighting was used to balance differences in characteristics of the operative and nonoperative groups. Results: Adjusted for propensity scores, the operative (n = 50) and nonoperative (n = 77) groups had similar characteristics, as evidenced by the small standardized mean differences between the groups. Adjusted mean differences in the SPADI and ASES scores between the operative and nonoperative groups were –22.0 points (95% CI, –32.1 to –11.8) and –22.2 points (95% CI, –32.8 to –11.6) at 18 months, respectively. The operative group had a significantly higher proportion of patients who showed ≥30% (P = .002) and ≥50% (P < .0001) improvement in SPADI and ASES scores as compared with the nonoperative group. Conclusion: In this prospective cohort study, patients undergoing operative treatment had significantly better pain and functional outcomes as compared with patients undergoing nonoperative treatment for rotator cuff tears. Differences between the 2 groups in SPADI and ASES scores at the 6- to 18-month time points met the minimal clinically important difference (depending on the threshold used). A large randomized controlled trial is needed to answer this question more definitively.

A comparison of the effectiveness of lateral versus posterior approach to shoulder injection in patients with subacromial impingement syndrome: A pragmatic randomized controlled trial.

The aim of the study was to determine the effectiveness of the lateral approach to subacromial injection, compared with the posterior approach, for the treatment of subacromial impingement syndrome. A pragmatic randomized controlled trial was carried out in an outpatient community musculoskeletal service. The sample comprised 80 adults, aged 18 years or over, with subacromial impingement syndrome. The intervention group received a single subacromial injection, using a 21-gauge green needle, of 40 mg/ml triamcinolone acetonide (Kenalog) and 4 ml 1% lignocaine using a lateral approach. The control group received identical treatment, with the exception that the injection was given using a posterior approach. The outcome measures were pain measured using 0-10 numerical pain scale and shoulder pain and disability index (SPADI) scores at 8 and 12 weeks' follow-up. A moderate but statistically and clinically significant difference in improvement in daytime pain (mean change in score) occurred in favour of the lateral group (mean = 4.0) compared with the posterior group (mean = 2.0) between weeks 0 and 8 (1.4 points [95% confidence interval 0.3, 2.6; p = 0.018]). However, there were no statistically significant differences between the groups in night-time pain, shoulder function and SPADI scores. There was a statistically and clinically significant difference (p = 0.001) within the groups for all clinical outcomes between weeks 0 and 8, and between weeks 0 and 12. There were no significant differences in the treatments; however, both forms of treatment were associated with a significant improvement in shoulder pain, function and disability.

Does Combining a Suprascapular Nerve Block With an Intra-articular Corticosteroid Injection Have an Additive Effect in the Treatment of Adhesive Capsulitis? A Comparison of Functional Outcomes After Short-term and Minimum 1-Year Follow-up.

Background:No therapeutic intervention is universally accepted as the most effective treatment for adhesive capsulitis. An intra-articular corticosteroid injection (IAI) with a suprascapular nerve block (SSNB), a common treatment for this disease, is a safe and effective method for the resolution of pain and restoration of shoulder range of motion (ROM).Purpose:To compare the efficacy of combined SSNB and IAI with that of IAI alone in the treatment of adhesive capsulitis.Study Design:Cohort study; Level of evidence, 3.Methods:We performed a retrospective review of 102 patients with adhesive capsulitis who were treated at an outpatient clinic from July 2016 to January 2017. A combined SSNB with IAI was performed in 48 patients (SSNB + IAI group), and an IAI alone was performed in 54 patients (IAI group). Patients were assessed before the intervention and at 2 weeks and 2 months after the intervention. ROM and pain and function visual analog scales (PVAS and FVAS, respectively), the American Shoulder and Elbow Surgeons (ASES) score, the Korean Shoulder Scoring System (KSS), the Constant score, the Simple Shoulder Test (SST), and the Shoulder Pain and Disability Index (SPADI) were used for clinical assessments. PVAS, FVAS, and ASES scores at a minimum of 1 year after the intervention were assessed for 82 patients.Results:At the 2-month assessment, all parameters significantly improved in both the SSNB + IAI and IAI groups (P < .05), however, improvements in forward flexion (FF) and abduction (ABD) between the 2-week and 2-month assessments were better in the SSNB + IAI group. At the 2-month assessment, improvements in the FVAS, ASES, SST, and SPADI scores and FF and ABD values were statistically significantly greater in the SSNB + IAI group compared with the IAI group. Improvements in FVAS and ASES scores were significantly greater in the SSNB + IAI group at a minimum of 1 year.Conclusion:Both a combined SSNB and IAI and an IAI alone significantly improved pain and functional outcomes in patients with adhesive capsulitis. The use of an SSNB with an IAI further increased treatment efficacy, as per the FVAS, ASES, SST, and SPADI scores and FF and ABD values. Patients who underwent SSNB combined with an IAI showed better improvements in the FVAS and ASES scores compared with IAI alone at a minimum of 1 year after the intervention. Therefore, an SSNB combined with an IAI may be a good treatment choice for adhesive capsulitis.

Functional outcome of latarjet’s procedure for recurrent shoulder dislocation

Background: Recurrence of anterior shoulder instability is disabling condition for which treatment options have been insufficiently studied. Our patients don’t seek definitive treatment initially, hence they tend to have engaging hill sacks with or without bony bank arts defect. Coracoid transfer as described by Latar jet and modified by Joe De Beer is one surgery which is suited for recurrent shoulder dislocations. There are various papers mentioning different results. Hence the purpose of this study was to know the functional outcome at two years duration in our set of patients with variable age and occupation.Methods: A cohort formed the basis of retrospective series study was done in tertiary care medical college hospital in Mangalore, Karnataka, India involving twenty-seven patients who underwent Latar jet procedure with congruent ark modification for recurrent anterior glen humeral instability by a single Orthopaedic surgeon in our Institute during July 2015 and Jan 2018. Twenty-four patients were available for follow-up. Clinical outcomes at a mean of three, twelve and twenty-four months postoperatively assessed by the Rowe and SPADI (Shoulder Pain and Disability Index) scores. Standardized anteroposterior and axial radiographs were used to assess the graft position and union.Results: No shoulder dislocations or subluxations observed post-surgery. Unspecified shoulder symptoms of pain were present in two patients. We noticed that there was significant increase in the functional outcome between the 3rd, 12th and the 24th month follow up. At the end of 24months follow up sixteen patients had excellent and remaining eight had good results in terms of Rowe scoring.Conclusions: Later jet procedure with congruent arc modification and adequate rehab can effectively restore anterior glen humeral shoulder stability with good functional results.

Functional improvement is sustained following anatomical and reverse shoulder arthroplasty for fracture sequelae: a registry-based analysis.

Shoulder arthroplasty for proximal humerus fracture sequelae is known to provide significant patient improvement, yet this outcome varies with time, prosthesis type, and fracture sequelae. We outline the expected course of postoperative shoulder pain and function in patients with anatomical (ASA) or reverse (RSA) shoulder arthroplasty following different fracture sequelae. Of 111 consecutive patients from our local shoulder arthroplasty registry, 32 underwent ASA for Boileau type 1 sequelae and 77 RSA patients were identified with Boileau types I, III, and IV. By 5year post-surgery, there were 72 patients available. All patients underwent standardised ASA or RSA procedures with anatomical (Promos Standard; Lima SMR™; Arthrex Eclipse™; Univers™ II) or reverse prostheses (Promos Reverse®; Lima SMR™ Reverse; Univers Revers™; Aequalis® Reversed). Range of motion, Constant-Murley, Disability of the Arm, Shoulder and Hand (DASH), and Shoulder Pain and Disability Index (SPADI) scores were compared at 6, 12, 24, and 60months postoperatively. We used generalised linear mixed models or random-effects ordered logistic regression to investigate postoperative changes of outcome parameters from baseline to follow-up time points for each group as well as for group comparisons. Range of motion and clinical scores improved until 24months postoperatively and did not deteriorate thereafter, except for internal rotation of Boileau type III and IV patients and external rotation of RSA patients with type I and IV sequelae. At all follow-ups, ASA patients with Boileau type I sequelae had significantly better internal and external rotation versus patients with RSA and/or other Boileau types (p < 0.001), while Constant, DASH, and SPADI scores were not significantly different between groups. In humeral fracture sequelae, ASA and RSA lead to sustained clinical improvements. Surgeons may primarily consider implantation of ASA in type I sequelae.

Dynamic scapular recognition exercise improves scapular upward rotation and shoulder pain and disability in patients with adhesive capsulitis: a randomized controlled trial

ABSTRACT Background Examine the ability of a dynamic scapular recognition exercise to improve scapular upward rotation and decrease shoulder pain and disability in patients with adhesive capsulitis of the shoulder. Methods A test-retest randomized controlled study design was used. A total of sixty-six patients with unilateral adhesive capsulitis were equally divided into two groups. The study group received a dynamic scapular recognition exercise using a wireless biofeedback system, while the control group received placebo treatment in the form of active range-of-motion (ROM) exercises of the sound upper limb. A digital inclinometer was used to measure the scapular upward rotation and ROM of the shoulder joint, and the Shoulder Pain and Disability Index (SPADI) was used to measure the shoulder pain and disability. Results Study results showed that after two weeks, there were statistically significant differences between the study and control groups in scapular upward rotation and shoulder flexion and abduction (P < .05) and nonsignificant differences in shoulder external rotation and SPADI (P > .05). After two and six months, there were statistically significant differences between study and control groups in scapular upward rotation; shoulder flexion, abduction and external rotation; and SPADI scores (P < .05). Conclusion This study showed that a dynamic scapular recognition exercise significantly improves scapular upward rotation and the ROM of shoulder flexion and abduction after two weeks. At two and six months, this exercise improves scapular upward rotation; ROM of shoulder flexion, abduction, and external rotation; and SPADI scores. These improvements persisted for six months after the performance of this exercise

Efficacy of acetaminophen versus ibuprofen for the management of rotator cuff-related shoulder pain: Randomized open-label study

BackgroundShoulder pain related to the rotator cuff (RC) is one of the most common and bothersome musculoskeletal complaints. Pharmacologic treatment most often includes acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. However, data allowing comparison of the efficacy of these two drugs are very limited. We compared the therapeutic outcomes of acetaminophen and ibuprofen in the management of RC-related pain. MethodsThis was an open-label, two-center, active-control, prospective randomized clinical trial. Participants were assigned randomly to acetaminophen or ibuprofen treatment groups. The acetaminophen dose was 500 mg every 6–8 h, and it was 400–800 mg every 6–8 h for ibuprofen. The impact of the treatment was measured by Shoulder Pain and Disability Index (SPADI), Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) and World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaires at baseline and after 6 weeks of therapy. ResultsThirty-three patients completed the study; 20 treated with ibuprofen and 13 with acetaminophen. Patients in both groups were comparable at baseline with regard to SPADI, Quick-DASH, and WHOQOL-BREF scores. After 6 weeks of treatment, patients receiving ibuprofen, but not acetaminophen, reported an improvement in pain severity and functional activity (as measured by SPADI and Quick-DASH). Patients taking acetaminophen, but not ibuprofen, reported improvement in the physical and environmental domains of WHOQOL-BREF scores. ConclusionsIbuprofen and acetaminophen provide benefits to patients suffering from RC-related pain. However, the type of improvement perceived by patients differed between these two medications.