Evaluation of interventions for rotator cuff pathology: a systematic review

Grant, Heather; Arthur, Anne; Pichora, David R.

doi:10.1197/j.jht.2004.02.013

Cited by 64 publications

(40 citation statements)

References 75 publications

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“…The average  SD age of all patients in this group was 32.6  11.9 years, which is similar to that found in other studies. 7,8,33 The average  SD age of patients having a rotator cuff repair in this study was similar to findings of other investigators, 14,25,34,36 but younger than that reported by Boissonnault et al 3 (67.0  8.6 years) and others. 20,37 It is not clear why patients in this study were younger.…”

Section: Patient Outcomes Related To Disabilitysupporting

confidence: 81%

“…Overall, only 5.8% of patients attended fewer than 4 physical therapy visits, demonstrating that early dropouts are not highly prevalent in these categories. discussion n umerous investigators have demonstrated the benefits of shoulder surgeries for shoulder instabilities, 11 rotator cuff tear, 3,14,30 and subacromial impingement. 17,21,31 Treatment in outpatient physical therapy clinics is common for these conditions.…”

Section: Patient Outcomes Related To Disabilitymentioning

confidence: 99%

“…Outcome studies of patients with various surgical conditions are typically cohort designs that compare only patients' preoperative and postoperative status. 14,34 Only a few studies have documented outcomes related to the episode of care postoperatively during physical therapy. 3,28 An observed difference in clinical outcomes between men and women is another factor that has received little commentary in the literature related to shoulder surgery; yet there are reports of significant differences in ratings of pain and functional ability that may be of interest to physical therapists in managing patients following rotator cuff repair.…”

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confidence: 99%

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Description of Clinical Outcomes and Postoperative Utilization of Physical Therapy Services Within 4 Categories of Shoulder Surgery

Brennan

Parent²,

Cleland³

2010

J Orthop Sports Phys Ther

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provides homogenous categories of patients whose characteristics can be reported.The preponderance of literature that describes outcomes of surgical management for shoulder disorders relates to rotator cuff repair, 12,18 subacromial decomt he incidence of shoulder pain has been estimated at 11.2 per 1000 persons per year and ranks as the third most frequent musculoskeletal complaint of patients visiting a primary care provider. 35 The prevalence of shoulder pain in the general population ranges between 6.9% and 34%. 15The etiology and pathology of shoulder pain can be unclear, which often results in a lack of consensus regarding the appropriate classification of shoulder disorders. 15,35 However, once a patient undergoes a surgical procedure for shoulder pain, the categorization of the patient's shoulder problem is typically described on the basis of the surgical procedure itself. Grouping patients postoperatively on the basis of surgical intervention t studY dEsiGn: Retrospective cohort study. t MEthods: This study included 856 patients (43.7% female; mean  SD age, 51.8  14.2 years) who received outpatient physical therapy following shoulder surgery. Standardized methods for classification of patients to type of shoulder surgery and collection of outcome variables were used. Data were gathered from 57 therapists working in 12 clinics. Patients included had been classified into 1 of 4 surgical categories: repair of a unidirectional instability, rotator cuff repair, rotator cuff repair with a subacromial decompression, or subacromial decompression alone. Descriptive statistics were calculated for baseline characteristics of patients in each surgical category. For all patients, scores on the Disability of the Arm Shoulder and Hand (DASH) questionnaire and a numeric pain rating scale (NPRS) were obtained at the initial and final physical therapy visits, and the change between visits was calculated. Data on number of physical therapy sessions and length of stay (LOS) were collected. For each surgical category, independent-samples t tests were used to determine differences between genders for each initial and final clinical outcome of pain and disability, change scores, utilization of visits, and LOS. The percentage of patients who achieved a minimal clinically important difference (MCID) on the DASH was also determined for each surgical group. For each gender in each surgical category, paired t tests were used to determine if patients achieved significant change in pain and disability.t rEsults: Means for each clinical outcome for the initial and final pain and disability scores, change scores, and the percentage of patients that achieved an MCID are provided. Significant differences were observed between genders for clinical outcomes. In the group treated with unilateral instability repair, women reported significantly greater initial disability than men, and their DASH change scores were significantly greater. In the group that had rotator cuff repairs, women reported significantly greater disability initially a...

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Section: Patient Outcomes Related To Disabilitysupporting

confidence: 81%

Section: Patient Outcomes Related To Disabilitymentioning

confidence: 99%

mentioning

confidence: 99%

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Description of Clinical Outcomes and Postoperative Utilization of Physical Therapy Services Within 4 Categories of Shoulder Surgery

Brennan

Parent²,

Cleland³

2010

J Orthop Sports Phys Ther

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“…17 Rotator cuff repair (RCR) has been shown to be an effective procedure across a number of approaches, including open, mini-open, and arthroscopic. 25,56 Total shoulder arthroplasty (TSA) is typically offered as a reconstructive alternative for severely damaged joints and, thus, addresses a more end-stage shoulder pathology. Reasons for TSA in-T T STUDY DESIGN: Validity study.…”

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confidence: 99%

Validity of the QuickDASH in Patients With Shoulder-Related Disorders Undergoing Surgery

MacDermid

Khadilkar²,

Birmingham³

et al. 2015

Journal of Orthopaedic & Sports Physical Therapy

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Study Design Validity study. Objective To determine the validity of the shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) in comparison to the full DASH in patients undergoing total shoulder arthroplasty (TSA) and rotator cuff repair (RCR). Background The QuickDASH is a shorter version of the DASH that may reduce respondent burden while retaining similar measurement properties. Methods One hundred thirty-two patients undergoing TSA or RCR were assessed at baseline and at 3 and 6 months postoperatively. The patients completed the DASH, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form self-report section, and the Western Ontario Rotator Cuff index, and were tested to determine their shoulder range of motion and isometric strength. The differences between scores on the DASH and QuickDASH across the scale range were evaluated using the Bland-Altman technique. Item difficulty, correlations with other patient-reported outcome measures, and physical impairments were used to assess validity. Known group validity was assessed by examining differentiation of work status. Responsiveness was assessed through standardized response means. Results QuickDASH scores were slightly higher than DASH scores, with a mean difference of 1 to 1.3 points for the TSA group and 1 to 3 points for the RCR group tested preoperatively, and at 3 months and 6 months postoperatively, although limits of agreement were wide (ranging from −10 to 13 across all estimates). The QuickDASH items were distributed across the full DASH, when ranked by item difficulty, for both patient groups. The correlation between the QuickDASH and DASH was almost perfect (r>0.92). Correlations between the DASH/QuickDASH and other patient-reported outcome measures ranged from moderate to very large (American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form self-report section, r = 0.47–0.85; Western Ontario Rotator Cuff index, r = 0.83–0.91), whereas correlations to impairments were small to moderate. Correlation estimates varied by less than 0.07, depending on whether the DASH or QuickDASH was used, suggesting equivalent construct validity. Both the DASH and QuickDASH discriminated between working and nonworking patients, with similar group differences and statistical significance (P<.01). The QuickDASH and DASH showed similar responsiveness between presurgery and 6-month follow-up (standardized response mean, 1.1 following TSA and 0.8 following RCR). Conclusion When substituting the QuickDASH for the full DASH, similar score estimates, discrimination of clinically relevant subgroups, and responsiveness can be expected across patients following TSA and RCR. J Orthop Sports Phys Ther 2015;45(1):25–36. Epub 13 Nov 2014. doi:10.2519/jospt.2015.5033

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“…Because corticosteroid injection may lead to temporary weakening of the tendon, 38 participants were given instructions to avoid heavy work or exercise on the shoulders for the first 2 weeks after the injection. Although systematic reviews of interventions for rotator cuff disorders and shoulder pain suggested that exercise can be an effective treatment, 39,40 there is no consensus about an ideal exercise program to treat patients with rotator cuff disorders. In this study, we adopted the exercise program of a systematic review that synthesized features of exercise protocols from clinical studies with the highest levels of evidence.…”

Section: Interventionmentioning

confidence: 99%

Comparison of High- and Low-Dose Corticosteroid in Subacromial Injection for Periarticular Shoulder Disorder: A Randomized, Triple-Blind, Placebo-Controlled Trial

Hong

Moon

et al. 2011

Archives of Physical Medicine and Rehabilitation

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Shoulder pain accounts for 33.2% of physician office visits for musculoskeletal pain in the United States. The prevalence of shoulder pain is 7% to 27% for adults and is increasing for women and older individuals. The most frequent cause of shoulder pain is subacromial impingement syndrome (SIS), which includes a number of pathological entities: rotator cuff syndrome, tendonitis and bursitis in the shoulder. SIS occurs when the soft tissues of the glenohumeral joint between the coracoacromial arch and the humeral tuberosity are compressed, disturbing the normal slidingmechanism when elevating the arm. Current approaches to treat SIS include conservative management comprising rest (but not immobilization), ice packs, physiotherapy, or NSAIDS, or any combination of these approaches. In some cases, surgical treatment may be considered an option. Accreditation StatementThis journal-based activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the sponsorship of the Elsevier Office of Continuing Medical Education (EOCME). The EOCME is accredited by the ACCME to provide continuing medical education (CME) for physicians. Credit Designation StatementThe EOCME designates this journal-based activity for a maximum of 3.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity. All other health care professionals completing continuing education credit for this activity will be issued a certificate of participation. Educational ObjectivesTo support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objective:1. Describe the evidence-base supporting the effectiveness of corticosteroid injections for subacromial impingement syndrome 2. Demonstrate their ability to develop a treatment plan based on current evidence Planning CommitteeJi Yeon Hong, MD, Seung-Hyun Yoon, MD, PhD, Do Jun Moon, MD, Kyu-Sung Kwack, MD, PhD, Bohyun Joen, MD, Hyun Young Lee, MS, Tania Dickson, PhD. Faculty Profiles & Disclosure InformationAs a sponsor accredited by the ACCME, it is the policy of the EOCME to require the disclosure of anyone who is in a position to control the content of an educational activity. All relevant financial relationships with any commercial interests and/or manufacturers must be disclosed to participants at the beginning of each activity. The faculty of this educational activity discloses the following: JI YEON HONG, MD Department of Physical Medicine and RehabilitationAjou University School of Medicine and Ajou University Hospital, Suwon Republic of Korea Disclosures: Has nothing to disclose. SEUNG-HYUN YOON, MD, PhD Department of Physical Medicine and Rehabilitation Ajou University School of Medicine and Ajou University Hospital, SuwonRepublic of Korea Disclosures: Has nothing to disclose. DO JUN MOON, MDDepartment of Physical Medicine and Rehabilitation Goyang Healings Hospi...

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Evaluation of interventions for rotator cuff pathology: a systematic review

Cited by 64 publications

References 75 publications

Description of Clinical Outcomes and Postoperative Utilization of Physical Therapy Services Within 4 Categories of Shoulder Surgery

Description of Clinical Outcomes and Postoperative Utilization of Physical Therapy Services Within 4 Categories of Shoulder Surgery

Validity of the QuickDASH in Patients With Shoulder-Related Disorders Undergoing Surgery

Comparison of High- and Low-Dose Corticosteroid in Subacromial Injection for Periarticular Shoulder Disorder: A Randomized, Triple-Blind, Placebo-Controlled Trial

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