Evidence-based clinical guidelines for the diagnosis, assessment and physiotherapy management of contracted (frozen) shoulder: quick reference summary

Hanchard, Nigel; Goodchild, Lorna; Thompson, Jackie; O’Brien, Tracey; Davison, Dot; Richardson, Chris

doi:10.1016/j.physio.2012.01.001

Cited by 121 publications

(152 citation statements)

References 9 publications

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“…Hawkins-Kennedy (Hawkins & Kennedy, 1980) and/or Neer (Neer, 1983) must be positive along with two of the following: external rotation resistance test (Michener et al, 2009),tendon palpation (N. Hanchard et al, 2004), horizontal (cross-body) adduction (Park et al, 2005), painful arc (Kessel & Watson, 1977), drop arm test (Park et al, 2005), Yergason test (Dalton, 1989), Speed test (Dalton, 1989;Park et al, 2005) • 'catching' or aching pain without appreciable joint stiffness (N. C. A. Hanchard & Handoll, 2008) • a painful arc elicited with pain easing on lowering the arm (N. Hanchard et al, 2004) • pain localized to the anterior or antero-lateral-superior shoulder (J. S. Lewis et al, 2001) • insidious onset of symptoms with a possible history of gradual progression over time but without history of trauma (Bigliani & Levine, 1997) • xray or ultrasound scans revealing osteophytes within the subacromial region, calcification of tendons or large rotator cuff tears .…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

“…Hanchard & Handoll, 2008) • a painful arc elicited with pain easing on lowering the arm (N. Hanchard et al, 2004) • pain localized to the anterior or antero-lateral-superior shoulder (J. S. Lewis et al, 2001) • insidious onset of symptoms with a possible history of gradual progression over time but without history of trauma (Bigliani & Levine, 1997) • xray or ultrasound scans revealing osteophytes within the subacromial region, calcification of tendons or large rotator cuff tears . Alterations in acromial shape and bursal thickening were noted but did not prevent inclusion…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

“…Pain originates from the tissues within the subacromial space including the rotator cuff (N. Hanchard, Cummins, & Jeffries, 2004; J. S. Lewis, Green, & Dekel, 2001). In people with SSI it is proposed rotator cuff muscle weakness develops secondary to inflammation and degeneration that occurs as a result of mechanical compression from a structure external to the tendon, known as extrinsic SSI (Michener, McClure, & Karduna, 2003), or as a result of overuse and tension overload affecting the tendons intrinsically, as in tendinopathy, known as intrinsic SSI (Jeremy S ).…”

Section: Introductionmentioning

confidence: 99%

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Isokinetic clinical assessment of rotator cuff strength in subacromial shoulder impingement

Land

Gordon

Watt

2017

Musculoskeletal Science and Practice

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Background: Current conservative management of subacromial shoulder impingement (SSI) includes generic strengthening exercises, especially for internal (IR) and external (ER) shoulder rotators. However, there is no evidence that the strength or the ratio of strength between these muscle groups is different between those with SSI (cases) and an asymptomatic population (controls).Objective: To identify if isokinetic rotator cuff strength or the ratio of strength is significantly different between cases and controls.Study Design: Case Control Study.Method: Fifty one cases with SSI and 51 asymptomatic controls matched for age, gender, hand dominance and physical activity level completed isokinetic peak torque glenohumeral IR and ER testing. Within the SSI group, 31 dominant limbs were symptomatic and 20 non-dominant limbs were symptomatic. IR and ER were measured separately using continuous reciprocal concentric (con) and eccentric (ecc) contraction cycles at a speed of 60 0 degrees per second and again at 120 0 degrees per second. Values of peak torque (PT), relative peak torque (RPT) and ratios were compared using independent t-tests between the SSI and asymptomatic groups.Results: Significant strength differences between the two groups were present only when the symptomatic SSI shoulder was the dominant shoulder (con ER PT at 60 0 /second, ecc ER PT at 120 0 /second, ecc ER RPT at 120 0 /second and ecc IR PT at 60 0 /second and 120 0 /second). Conclusions:Changes in rotator cuff strength in SSI may be related to limb dominance, which may have implications for strengthening regimes. Level of Evidence:Level 3a

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Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Isokinetic clinical assessment of rotator cuff strength in subacromial shoulder impingement

Land

Gordon

Watt

2017

Musculoskeletal Science and Practice

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“…1,2 The term SIS is a description of the painful signs found on assessment which include no history of trauma, a localised catching or aching pain without appreciable joint stiffness and/or a painful arc through glenohumeral elevation. 3,4 Current literature varies widely regarding the classification, diagnosis and terminology of SIS. However it is agreed that the mechanisms include extrinsic or intrinsic factors or a combination of both, with the aetiology being poorly understood.…”

Section: Introductionmentioning

confidence: 99%

“…13 While these tests are commonly used to reproduce SIS pain by increasing compression or tension within the subacromial space they do not identify the specific painful structure or the degree of injury to that structure. 7,14,15 Further they do not differentiate between extrinsic and intrinsic mechanisms purported to be associated with SIS which include restriction of the posterior shoulder 1,4 , altered cervical and/or thoracic posture 1,2,4 , altered scapula movement 16,17,18 and dysfunctional or weak rotator cuff musculature. 1, 4, 19 -22 Several literature reviews have presented the evidence for use of special orthopaedic tests in the diagnosis of SIS 7,15 but no previous reviews have identified the clinical tests used to assess external factors in those with SIS.…”

Section: Introductionmentioning

confidence: 99%

Clinical assessment of factors associated with subacromial shoulder impingement: a systematic review

Land

Gordon

2016

Physical Therapy Reviews

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Background Physiotherapists commonly use orthopaedic special tests to reproduce subacromial shoulder impingement (SIS) pain by increasing compression or tension within the subacromial space. However, these tests do not differentiate between purported extrinsic and intrinsic mechanisms associated with SIS.Objective To identify, and determine the reliability and validity of clinical tests used to assess extrinsic factors associated with SIS.Method A scoping review identified tests for extrinsic SIS. A systematic approach was then used to search six electronic databases in July 2016 to identify clinical tests used to measure (1) posterior shoulder range (2) cervical and/or thoracic posture (3) 2D scapula movement (4) rotator cuff strength. The 14 articles included in the review were assessed using a modified Downs and Black quality assessment tool.Results Moderate quality studies investigated 2D scapula measurements (N=2), resting pectoralis minor length (N=2) and rotator cuff strength (N=5). High quality studies measured forward head position and/or thoracic posture (N=2) and rotator cuff strength (N=1).Conclusion A good level of assessment reliability and significantly less range and strength was identified in those with SIS for: posterior shoulder range (passive shoulder adduction and internal rotation and passive internal rotation in supine); isokinetic peak torque values for internal and external shoulder rotation (isokinetic testing); forward head position (lateral photograph) and; thoracic range of motion (tape measure or ultrasound tomography). Good to excellent reliability was reported for lateral scapular slide test positions and resting pectoralis minor muscle length. These clinical tests should be considered for use in SIS assessment.

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Surgical Referral Criteria for Degenerative Rotator Cuff Tears: A Delphi Questionnaire Study

Griffiths

Yohannes

2013

Musculoskelet. Care

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Selecting the most appropriate patients to refer for surgery is crucial for high-quality and efficient clinical care. However, there are no specific referral criteria to guide the referral of appropriate patients for rotator cuff repair surgery. The aim of the present study was to design robust surgical referral criteria for patients with degenerative rotator cuff tears using consensus methodology. A two-round Delphi questionnaire was undertaken with a nationally representative sample of 41 specialist shoulder surgeons experienced in rotator cuff repair. Surgical referral criteria for degenerative rotator cuff tear were developed where consensus of at least 70% agreement was achieved. The initial questionnaire consisted of 24 items. Consensus was reached on 14 items, including: severity of pain, functional limitation, the identification of fat atrophy, agreement that a course of physiotherapy should be attempted before surgical referral, and exclusion for those with an active frozen shoulder. However, there was no consensus with regard to the dimensions of the tear. The surgical referral criteria developed were novel and promising for patients with degenerative rotator cuff tears, and further research is required to examine their efficacy.

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Evidence-based clinical guidelines for the diagnosis, assessment and physiotherapy management of contracted (frozen) shoulder: quick reference summary

Cited by 121 publications

References 9 publications

Isokinetic clinical assessment of rotator cuff strength in subacromial shoulder impingement

Isokinetic clinical assessment of rotator cuff strength in subacromial shoulder impingement

Clinical assessment of factors associated with subacromial shoulder impingement: a systematic review

Surgical Referral Criteria for Degenerative Rotator Cuff Tears: A Delphi Questionnaire Study

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