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[PMID]:28812398
[Au] Autor:Björnsson Hallgren HC; Adolfsson LE; Johansson K; Öberg B; Peterson A; Holmgren TM
[Ad] Endereço:a Institution for Clinical and Experimental Medicine, Division of Orthopaedics , Linköping University.
[Ti] Título:Specific exercises for subacromial pain.
[So] Source:Acta Orthop;88(6):600-605, 2017 Dec.
[Is] ISSN:1745-3682
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background and purpose - We have previously shown that specific exercises reduced the need for surgery in subacromial pain patients at 1-year follow-up. We have now investigated whether this result was maintained after 5 years and compared the outcomes of surgery and non-surgical treatment. Patients and methods - 97 patients were included in the previously reported randomized study of patients on a waiting list for surgery. These patients were randomized to specific or unspecific exercises. After 3 months of exercises the patients were asked if they still wanted surgery and this was also assessed at the present 5-year follow-up. The 1-year assessment included Constant-Murley score, DASH, VAS at night, rest and activity, EQ-5D, and EQ-VAS. All these outcome assessments were repeated after 5 years in 91 of the patients. Results - At the 5-year follow-up more patients in the specific exercise group had declined surgery, 33 of 47 as compared with 16 of 44 (p = 0.001) in the unspecific exercise group. The mean Constant-Murley score continued to improve between the 1- and 5-year follow-ups in both surgically and non-surgically treated groups. On a group level there was no clinically relevant change between 1 and 5 years in any of the other outcome measures regardless of treatment. Interpretation - This 5-year follow-up of a previously published randomized controlled trial found that specific exercises reduced the need for surgery in patients with subacromial pain. Patients not responding to specific exercises may achieve similar good results with surgery. These findings emphasize that a specific exercise program may serve as a selection tool for surgery.
[Mh] Termos MeSH primário: Terapia por Exercício/métodos
Síndrome de Colisão do Ombro/complicações
Dor de Ombro/terapia
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Medição da Dor
Síndrome de Colisão do Ombro/terapia
Dor de Ombro/diagnóstico
Dor de Ombro/etiologia
Método Simples-Cego
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170817
[St] Status:MEDLINE
[do] DOI:10.1080/17453674.2017.1364069


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[PMID]:28652066
[Au] Autor:Turgut E; Duzgun I; Baltaci G
[Ad] Endereço:Hacettepe University, Ankara, Turkey. Electronic address: elifcamci@hacettepe.edu.tr.
[Ti] Título:Effects of Scapular Stabilization Exercise Training on Scapular Kinematics, Disability, and Pain in Subacromial Impingement: A Randomized Controlled Trial.
[So] Source:Arch Phys Med Rehabil;98(10):1915-1923.e3, 2017 Oct.
[Is] ISSN:1532-821X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To investigate the effects of 2 different exercise programs on 3-dimensional scapular kinematics, disability, and pain in participants with subacromial impingement syndrome (SIS). DESIGN: Randomized controlled trial. SETTING: Outpatient clinic and research laboratory. PARTICIPANTS: Participants who were diagnosed with SIS and who also exhibited scapular dyskinesis (N=30). INTERVENTIONS: The participants were randomized in 2 different exercise groups: (1) shoulder girdle stretching and strengthening with additional scapular stabilization exercises based on a kinetic chain approach (intervention group), and (2) shoulder girdle stretching and strengthening exercises only (control group). MAIN OUTCOME MEASURES: Three-dimensional scapular kinematics, self-reported shoulder pain, and disability were evaluated at baseline, after 6 weeks of training, and after 12 weeks of training. RESULTS: Significant differences were observed between the control and intervention groups in external rotation and posterior tilt after 6 weeks of training and in external rotation, posterior tilt, and upward rotation after 12 weeks of training. All groups showed improvement in self-reported pain and disability scores; however, there were no significant differences between the groups. CONCLUSIONS: Progressive exercise training independent from specific scapular stabilization exercises provides decreased disability and pain severity in impingement syndrome.
[Mh] Termos MeSH primário: Avaliação da Deficiência
Terapia por Exercício/métodos
Escápula/fisiopatologia
Síndrome de Colisão do Ombro/reabilitação
Dor de Ombro/reabilitação
[Mh] Termos MeSH secundário: Adulto
Fenômenos Biomecânicos/fisiologia
Feminino
Seres Humanos
Masculino
Síndrome de Colisão do Ombro/fisiopatologia
Dor de Ombro/fisiopatologia
Escala Visual Analógica
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170628
[St] Status:MEDLINE


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[PMID]:28630217
[Au] Autor:Steuri R; Sattelmayer M; Elsig S; Kolly C; Tal A; Taeymans J; Hilfiker R
[Ad] Endereço:Department of Health, Bern University of Applied Sciences, Berne, Switzerland.
[Ti] Título:Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement: a systematic review and meta-analysis of RCTs.
[So] Source:Br J Sports Med;51(18):1340-1347, 2017 Sep.
[Is] ISSN:1473-0480
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To investigate the effectiveness of conservative interventions for pain, function and range of motion in adults with shoulder impingement. DESIGN: Systematic review and meta-analysis of randomised trials. DATA SOURCES: Medline, CENTRAL, CINAHL, Embase and PEDro were searched from inception to January 2017. STUDY SELECTION CRITERIA: Randomised controlled trials including participants with shoulder impingement and evaluating at least one conservative intervention against sham or other treatments. RESULTS: For pain, exercise was superior to non-exercise control interventions (standardised mean difference (SMD) -0.94, 95% CI -1.69 to -0.19). Specific exercises were superior to generic exercises (SMD -0.65, 95% CI -0.99 to -0.32). Corticosteroid injections were superior to no treatment (SMD -0.65, 95% CI -1.04 to -0.26), and ultrasound guided injections were superior to non-guided injections (SMD -0.51, 95% CI -0.89 to -0.13). Nonsteroidal anti-inflammatory drugs (NSAIDS) had a small to moderate SMD of -0.29 (95% CI -0.53 to -0.05) compared with placebo. Manual therapy was superior to placebo (SMD -0.35, 95% CI -0.69 to -0.01). When combined with exercise, manual therapy was superior to exercise alone, but only at the shortest follow-up (SMD -0.32, 95% CI -0.62 to -0.01). Laser was superior to sham laser (SMD -0.88, 95% CI -1.48 to -0.27). Extracorporeal shockwave therapy (ECSWT) was superior to sham (-0.39, 95% CI -0.78 to -0.01) and tape was superior to sham (-0.64, 95% CI -1.16 to -0.12), with small to moderate SMDs. CONCLUSION: Although there was only very low quality evidence, exercise should be considered for patients with shoulder impingement symptoms and tape, ECSWT, laser or manual therapy might be added. NSAIDS and corticosteroids are superior to placebo, but it is unclear how these treatments compare to exercise.
[Mh] Termos MeSH primário: Terapia por Exercício
Manipulações Musculoesqueléticas
Síndrome de Colisão do Ombro/terapia
[Mh] Termos MeSH secundário: Pesquisa Comparativa da Efetividade
Seres Humanos
Terapia a Laser
Ensaios Clínicos Controlados Aleatórios como Assunto
Amplitude de Movimento Articular
Dor de Ombro/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170921
[Lr] Data última revisão:
170921
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170621
[St] Status:MEDLINE
[do] DOI:10.1136/bjsports-2016-096515


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[PMID]:28490661
[Au] Autor:Dalbøge A; Frost P; Andersen JH; Svendsen SW
[Ad] Endereço:Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark.
[Ti] Título:Surgery for subacromial impingement syndrome in relation to occupational exposures, lifestyle factors and diabetes mellitus: a nationwide nested case-control study.
[So] Source:Occup Environ Med;74(10):728-736, 2017 Oct.
[Is] ISSN:1470-7926
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To estimate the risk of surgery for subacromial impingement syndrome (SIS) in relation to occupational exposures, lifestyle factors and diabetes mellitus. METHODS: We conducted a case-control study nested in a register-based cohort study of the Danish working population. For each of 3000 first-time cases of surgery for SIS, two age-matched and sex-matched controls were drawn. Cases and controls received a questionnaire on job history and other factors. Job histories were combined with a psychosocial job exposure matrix (JEM) and the updated Shoulder JEM, which provided exposure intensities on measurement scales. Ten-year cumulative exposures to upper arm elevation >90°, repetitive shoulder movements, forceful shoulder exertions and hand-arm vibrations (HAVs) were estimated. We used conditional logistic regression. RESULTS: There were 5396 persons (60%) who answered the questionnaire. For occupational mechanical exposures, the adjusted OR (OR ) ranged from 1.9 (95% CI 1.5 to 2.5 for HAVs) to 2.5 (95% CI 1.9 to 3.5 for force) among men and 1.7 (95% CI 1.2 to 2.5 for HAVs) to 2.0 (95% CI 1.3 to 2.9 for force) among women. No statistically significant associations were found for occupational psychosocial factors. Body mass index (BMI) and pack-years of smoking showed OR up to 2.0. Diabetes mellitus showed OR of 1.5 (95% CI 1.1 to 2.2) for men and 2.2 (95% CI 1.4 to 3.4) for women. CONCLUSIONS: Our findings add to the evidence of an increased risk of surgery for SIS in relation to occupational cumulative mechanical exposures, even when an increased risk in relation to BMI, smoking and diabetes mellitus is taken into account.
[Mh] Termos MeSH primário: Índice de Massa Corporal
Diabetes Mellitus
Estilo de Vida
Doenças Profissionais/etiologia
Exposição Ocupacional/efeitos adversos
Síndrome de Colisão do Ombro/etiologia
Fumar
[Mh] Termos MeSH secundário: Adulto
Idoso
Estudos de Casos e Controles
Estudos de Coortes
Transtornos Traumáticos Cumulativos/complicações
Dinamarca
Feminino
Seres Humanos
Masculino
Meia-Idade
Movimento
Fatores de Risco
Ombro
Síndrome de Colisão do Ombro/cirurgia
Articulação do Ombro
Inquéritos e Questionários
Vibração
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170512
[St] Status:MEDLINE
[do] DOI:10.1136/oemed-2016-104272


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[PMID]:28488536
[Au] Autor:Marx C; Tamborrini G
[Ad] Endereço:1 Ultraschall Zentrum Rheumatolgoie Basel.
[Ti] Título:CME-Rheumatologie 12/Auflösung: Osteonekrose des Humeruskopfes..
[So] Source:Praxis (Bern 1994);106(10):551-552, 2017.
[Is] ISSN:1661-8157
[Cp] País de publicação:Switzerland
[La] Idioma:ger
[Mh] Termos MeSH primário: Bursite/diagnóstico por imagem
Cabeça do Úmero/diagnóstico por imagem
Cabeça do Úmero/lesões
Traumatismos Ocupacionais/diagnóstico por imagem
Osteonecrose/diagnóstico por imagem
Periartrite/diagnóstico por imagem
Síndrome de Colisão do Ombro/diagnóstico por imagem
[Mh] Termos MeSH secundário: Diagnóstico Diferencial
Seres Humanos
Cápsula Articular/diagnóstico por imagem
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Pasteurização
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170707
[Lr] Data última revisão:
170707
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170511
[St] Status:MEDLINE
[do] DOI:10.1024/1661-8157/a002665


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[PMID]:28441418
[Au] Autor:Li X; Xu W; Hu N; Liang X; Huang W; Jiang D; Chen H
[Ad] Endereço:Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
[Ti] Título:Relationship between acromial morphological variation and subacromial impingement: A three-dimensional analysis.
[So] Source:PLoS One;12(4):e0176193, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To evaluate the association of acromial morphology and subacromial impingement. METHODS: Bilateral shoulder computed tomography was performed in 138 patients who received shoulder arthroscopy. Measured parameters included: acromial tilt (AT), modified acromial tilt (mAT), acromial slope (AS), acromiohumeral interval (AHI), lateral acromial angle (LAA), acromial index (AI), critical shoulder angle (CSA), acromial anterior protrusion (AAP), and acromial inferior protrusion (AIP). Acromial morphological characteristics were compared between groups. Side-to-side differences were assessed between affected and non-affected shoulders. Intra- and inter-observer agreements for each parameter were calculated. RESULTS: AT (25.90 vs. 29.41°), mAT (18.88 vs. 22.64°), and AHI (5.46 vs. 6.47 mm) were significantly smaller in impinged patients. The impingement group demonstrated significantly larger AI (63.50 vs. 59.84%), CSA (31.78 vs. 28.74°), AAP (7.13 vs. 5.32 mm), and AIP (5.51 vs. 4.04 mm). Regarding side-to-side comparison, the acromial morphology was significantly different between the affected and non-affected shoulders in impinged patients, while the difference was slight and insignificant in control patients. All, except AS and LAA, measured parameters demonstrated good intra- and inter-observer agreements. CONCLUSIONS: Three-dimensional reconstructed CT scan is a reliable method to measure shoulder morphology. The acromial morphological variation is related with sub acromial impingement, however, the causal relationship of them should be further explored.
[Mh] Termos MeSH primário: Acrômio/diagnóstico por imagem
Síndrome de Colisão do Ombro/diagnóstico por imagem
Articulação do Ombro/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Feminino
Seres Humanos
Imagem Tridimensional
Masculino
Meia-Idade
Tomografia Computadorizada por Raios X
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170426
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0176193


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[PMID]:28416022
[Au] Autor:Shire AR; Stæhr TAB; Overby JB; Bastholm Dahl M; Sandell Jacobsen J; Høyrup Christiansen D
[Ad] Endereço:Department of Physiotherapy, VIA University College, Hedeager 2, Aarhus N, Denmark. a.shire@live.com.au.
[Ti] Título:Specific or general exercise strategy for subacromial impingement syndrome-does it matter? A systematic literature review and meta analysis.
[So] Source:BMC Musculoskelet Disord;18(1):158, 2017 Apr 17.
[Is] ISSN:1471-2474
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Exercise is frequently suggested as a treatment option for patients presenting with symptoms of subacromial impingement syndrome. Some would argue implementing a specific exercise strategy with special focus on correction of kinematic deficits would be superior to general exercise strategy. There is however a lack of evidence comparing such exercise strategies to determine which is the most effective in the treatment of subacromial impingement syndrome. The aim of this review is to evaluate whether implementing specific exercise strategies involving resistive exercises are more effective than a general exercise strategy for the treatment of patients with subacromial impingement syndrome. METHODS: Randomized controlled trials were identified through an electronic search on PubMed/MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science and PEDro. In addition, article reference lists and Clinicaltrials.gov were searched. Studies were considered eligible if they included interventions with resistive specific exercises as compared to general resistance exercise. Four reviewers assessed risk of bias and methodological quality guided by Cochrane recommendations. Results were synthesised qualitatively or quantitatively, where appropriate. RESULTS: Six randomized controlled trials were included with 231 participants who experienced symptoms of subacromial impingement syndrome. Four studies evaluated the effectiveness of specific scapular exercise strategy and two studies evaluated the effectiveness of specific proprioceptive strategy. Five studies were of moderate quality and one study was of low quality. No consistent statistical significant differences in outcomes between treatment groups were reported in the studies. Standardized mean difference (SMD) for pain was SMD -0.19 (95% CI -0.61, 0.22) and SMD 0.30 (95% CI -0.16, 0.76) for function. CONCLUSIONS: There is insufficient evidence to support or refute the effectiveness of specific resistive exercise strategies in the rehabilitation of subacromial impingement syndrome. More high quality research is needed to accurately assess this. This review provides suggestions on how to improve the methodological design of future studies in this area.
[Mh] Termos MeSH primário: Terapia por Exercício/métodos
Síndrome de Colisão do Ombro/reabilitação
Dor de Ombro/reabilitação
[Mh] Termos MeSH secundário: Fenômenos Biomecânicos
Estudos de Avaliação como Assunto
Retroalimentação Sensorial
Seres Humanos
Guias de Prática Clínica como Assunto
Ensaios Clínicos Controlados Aleatórios como Assunto
Treinamento de Resistência
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170419
[St] Status:MEDLINE
[do] DOI:10.1186/s12891-017-1518-0


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[PMID]:28352939
[Au] Autor:Apeldoorn AT; Kamper SJ; Kalter J; Knol DL; van Tulder MW; Ostelo RW
[Ad] Endereço:Rehabilitation department, Noordwest Ziekenhuisgroep, NL-1815 JD Alkmaar, The Netherlands. a.t.apeldoorn@nwz.nl.
[Ti] Título:Rigid shoulder taping with physiotherapy in patients with subacromial pain syndrome: A randomized controlled trial.
[So] Source:J Rehabil Med;49(4):347-353, 2017 Apr 06.
[Is] ISSN:1651-2081
[Cp] País de publicação:Sweden
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess the effectiveness of individualized physiotherapy in combination with rigid taping compared with individualized physiotherapy alone in patients with subacromial pain syndrome. DESIGN: A prospective randomized trial with concealed allocation. PATIENTS: A total of 140 patients between 18 and 65 years of age from primary physiotherapy settings. METHODS: The intervention group received individualized physiotherapy and shoulder taping. The control group received individualized physiotherapy only. Primary outcomes were: pain intensit (numerical rating scale) and functioning (Simple Shoulder Test). Secondary outcomes were: global perceived effect and patient-specific complaints. Data were collected at baseline, and at 4, 12 and 26 weeks' follow-up. RESULTS: During the 6-month follow-up period multilevel analysis showed a significant difference between groups favouring the control group on pain intensity (p = 0.02), but not on functioning. Regarding secondary outcomes, a significant difference between groups was found favouring the intervention group for global perceived effect (p = 0.02), but not for patient-specific complaints. CONCLUSION: Rigid shoulder taping, as used in this study, cannot be recommended for improving physiotherapy outcomes in people with subacromial pain syndrome.
[Mh] Termos MeSH primário: Rigidez Muscular/terapia
Síndrome de Colisão do Ombro/terapia
Dor de Ombro/reabilitação
Ombro/patologia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
Meia-Idade
Modalidades de Fisioterapia
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170516
[Lr] Data última revisão:
170516
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170330
[St] Status:MEDLINE
[do] DOI:10.2340/16501977-2214


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[PMID]:28259517
[Au] Autor:Haik MN; Alburquerque-Sendín F; Camargo PR
[Ad] Endereço:Federal University of São Carlos, São Carlos, SP, Brazil.
[Ti] Título:Short-Term Effects of Thoracic Spine Manipulation on Shoulder Impingement Syndrome: A Randomized Controlled Trial.
[So] Source:Arch Phys Med Rehabil;98(8):1594-1605, 2017 Aug.
[Is] ISSN:1532-821X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To investigate the short-term effects of thoracic spine manipulation (TSM) on pain, function, scapular kinematics, and scapular muscle activity in individuals with shoulder impingement syndrome. DESIGN: Randomized controlled trial with blinded assessor and patient. SETTING: Laboratory. PARTICIPANTS: Patients with shoulder impingement syndrome (N=61). INTERVENTIONS: Participants were randomly allocated to TSM group (n=30) or sham-TSM group (n=31) and attended 2 intervention sessions over a 1-week period. MAIN OUTCOME MEASURES: Scapular kinematics and muscle activity were measured at day 1 (baseline, before the first intervention), day 2 preintervention (before second intervention), day 2 postintervention (after the second intervention), and day 3 (follow-up). Shoulder pain and function were assessed by the Disability of the Arm, Shoulder and Hand questionnaire and Western Ontario Rotator Cuff Index at baseline, day 2 preintervention, and follow-up. An assessor blinded to group assignment measured all outcomes. RESULTS: Pain decreased by 0.7 points (95% confidence interval, 1.3-0.1 points) at day 2 preintervention and 0.9 points (95% confidence interval, 1.5-0.3 points) at day 2 postintervention in the TSM group. The Disability of the Arm, Shoulder and Hand questionnaire (P=.01) and Western Ontario Rotator Cuff Index (P=.02) scores improved in both groups. Scapular upward rotation increased during arm lowering (P<.01) at day 2 postintervention (5.3°) and follow-up (3.5°) in the TSM group. Upper trapezius activity increased (P<.05) in the sham-TSM group. Middle trapezius, lower trapezius, and serratus anterior decreased activities in both groups during elevation and lowering of the arm. CONCLUSIONS: TSM may increase scapular upward rotation during arm lowering. TSM does not seem to influence activity of the scapular muscles. The results concerning shoulder pain, function, scapular tilt, and internal rotation are not conclusive.
[Mh] Termos MeSH primário: Manipulações Musculoesqueléticas/métodos
Síndrome de Colisão do Ombro/reabilitação
Vértebras Torácicas
[Mh] Termos MeSH secundário: Adulto
Fenômenos Biomecânicos
Método Duplo-Cego
Feminino
Seres Humanos
Masculino
Meia-Idade
Força Muscular/fisiologia
Músculo Esquelético/fisiopatologia
Amplitude de Movimento Articular
Ombro/fisiopatologia
Dor de Ombro/reabilitação
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170816
[Lr] Data última revisão:
170816
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170306
[St] Status:MEDLINE


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[PMID]:28245972
[Au] Autor:Chang KV; Wu WT; Han DS; Özçakar L
[Ad] Endereço:Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, BeiHu Branch and National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: pattap@pchome.com.tw.
[Ti] Título:Static and Dynamic Shoulder Imaging to Predict Initial Effectiveness and Recurrence After Ultrasound-Guided Subacromial Corticosteroid Injections.
[So] Source:Arch Phys Med Rehabil;98(10):1984-1994, 2017 Oct.
[Is] ISSN:1532-821X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To explore factors contributing to initial effectiveness and recurrence after ultrasound (US)-guided subacromial corticosteroid injections by assessing clinical measurements and static and dynamic shoulder US images. DESIGN: Retrospective cohort study. SETTING: Rehabilitation outpatient clinic. PARTICIPANTS: Adults with shoulder pain referred for injection therapy (N=164). INTERVENTION: US-guided subacromial corticosteroid injection. MAIN OUTCOME MEASURES: The association of initial effectiveness (defined as >50% decrease in any of the 3 pain subdomains after the first injection) and recurrent shoulder pain that required repeated intervention with record-based clinical measurements and static/dynamic shoulder US. RESULTS: This study included 164 patients, 106 of whom were responsive to a first injection. Among the 106 participants, 42 received a second injection because of recurrent shoulder pain. By using the multivariate logistic regression analysis, initial effectiveness was positively associated with right handedness, grade 2 subacromial impingement during the dynamic US examination, and bicipital groove tenderness. However, these patients had a negative association with subdeltoid bursitis, grade 3 subacromial impingement, and shoulder stiffness. Subdeltoid bursitis and a positive painful arc test were predictors of recurrent shoulder pain that necessitated a repeated injection in the Cox proportional hazards model. CONCLUSIONS: The initial effectiveness and recurrence after US-guided subacromial corticosteroid injection were associated with certain clinical measurements and static and dynamic shoulder US, which should be carefully evaluated (and can be used) to guide the best treatment outcomes.
[Mh] Termos MeSH primário: Glucocorticoides/administração & dosagem
Articulação do Ombro/diagnóstico por imagem
Dor de Ombro/tratamento farmacológico
[Mh] Termos MeSH secundário: Bursite/complicações
Bursite/tratamento farmacológico
Estudos de Coortes
Feminino
Lateralidade Funcional
Seres Humanos
Injeções Intra-Articulares
Masculino
Meia-Idade
Análise Multivariada
Recidiva
Retratamento
Estudos Retrospectivos
Síndrome de Colisão do Ombro/complicações
Síndrome de Colisão do Ombro/diagnóstico por imagem
Síndrome de Colisão do Ombro/tratamento farmacológico
Dor de Ombro/etiologia
Ultrassonografia de Intervenção
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glucocorticoids)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170302
[St] Status:MEDLINE



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