Prognostic Models in Adults Undergoing Physical Therapy for Rotator Cuff Disorders: Systematic Review

Braun, C.; Hanchard, Nigel; Batterham, Alan M.; Handoll, Helen; Betthäuser, Andreas

doi:10.2522/ptj.20150475

Cited by 12 publications

(6 citation statements)

References 51 publications

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“…As such, dextrose prolotherapy demonstrates a statistically significant improvement in pain and function when added to standard of care physical therapy, with a mean improvement of 1.6‐3.0, 9.1‐33.4, and 27.9‐point for the pain VAS, SPADI, and WORC, respectively. These all demonstrate both clinically and statistically significant improvements with minimal clinically important difference (or MCID) defined as 1.4‐points, 8‐points, and 14.3 for the VAS, SPADI, and WORC, respectively. The benefit demonstrated with the use of dextrose prolotherapy in addition to physical therapy makes prolotherapy a viable adjunct to maximize the benefit of physical therapy.…”

Section: Discussionmentioning

confidence: 80%

Effectiveness of Dextrose Prolotherapy for Rotator Cuff Tendinopathy: A Systematic Review

Catapano

Zhang

Mittal

et al. 2019

PM&R

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Objective To systematically review and evaluate the efficacy and complication profile of prolotherapy using hyperosmolar dextrose solution injection for rotator cuff tendinopathy. Literature Survey MEDLINE, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials (from inception to 1 July, 2019). Methodology A comprehensive search was completed to identify randomized controlled trials addressing prolotherapy using hyperosmolar dextrose solution for rotator cuff tendinopathy. Two reviewers independently screened the titles, abstracts, and full texts, and then extracted data from eligible studies. All reported outcome measures and complications were analyzed descriptively. Synthesis Five studies satisfied inclusion criteria. Included studies analyzed a total of 272 participants with a final follow‐up ranging from 6 weeks to 12 months. Prolotherapy differed greatly among studies. Two studies used a multisite enthesis injection protocol while the other three used ultrasound‐guided protocols. Two of the studies used an intrasubstance supraspinatus injection and three used a supraspinatus enthesis injection. Control groups consisted of nonoperative rehabilitation including physical therapy and medical management in three studies, supraspinatus saline enthesis injection in one study, and corticosteroid injection in one study. There was statistically significant improvement in pain intensity with multisite injection protocols compared to physical therapy and medical management in both studies. Ultrasound‐guided supraspinatus injection trials did not find any statistically significant difference in pain intensity, range of motion, strength, function, or ultrasound characteristics compared to controls of enthesis saline injection or corticosteroid. The complication rate was low, with only 6/272 participants experiencing adverse events consisting of transient increase in pain for 1 to 2 days postintervention. Conclusions Prolotherapy with hyperosmolar dextrose solution is a potentially effective adjuvant intervention to physical therapy for patients with rotator cuff tendinopathy ranging from tendinosis to partial‐thickness and small full‐thickness tears. Further studies are necessary to determine effects in subpopulations as well as optimal technique including dextrose concentration, volume, and location.

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Section: Discussionmentioning

confidence: 80%

Effectiveness of Dextrose Prolotherapy for Rotator Cuff Tendinopathy: A Systematic Review

Catapano

Zhang

Mittal

et al. 2019

PM&R

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“…One systematic review that examined the effectiveness of manual and exercise therapy concluded that (1) exercise was superior to manual therapy but not to surgery, (2) there were no differences in pain or function for exercise and/or manual therapy versus glucocorticoid injection or subacromial decompression, and (3) exercise was associated with greater improvement in function over advice to maintain normal activities. 159 On the basis of a systematic review of 5 studies, Braun et al 21 was unable to identify a prognostic model to predict outcomes among patients who underwent physical therapy for RC disorders (subacromial impingement and/or RC tear).…”

Section: Resultsmentioning

confidence: 99%

A Systematic Summary of Systematic Reviews on the Topic of the Rotator Cuff

Jancuska

Matthews

Miller

et al. 2018

Orthopaedic Journal of Sports Medicine

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Background:The number of systematic reviews and meta-analyses published on the rotator cuff (RC) has increased markedly.Purpose:To quantify the number of systematic reviews and meta-analyses published on the RC and to provide a qualitative summary of the literature.Study Design:Systematic review; Level of evidence, 4.Methods:A systematic search for all systematic reviews and meta-analyses pertaining to the RC published between January 2007 and September 2017 was performed with PubMed, MEDLINE, and the Cochrane Database of Systematic Reviews. Narrative reviews and non–English language articles were excluded.Results:A total of 1078 articles were found, of which 196 met the inclusion criteria. Included articles were summarized and divided into 15 topics: anatomy and function, histology and genetics, diagnosis, epidemiology, athletes, nonoperative versus operative treatment, surgical repair methods, concomitant conditions and surgical procedures, RC tears after total shoulder arthroplasty, biological augmentation, postoperative rehabilitation, outcomes and complications, patient-reported outcome measures, cost-effectiveness of RC repair, and quality of randomized controlled trials.Conclusion:A qualitative summary of the systematic reviews and meta-analyses published on the RC can provide surgeons with a single source of the most current literature.

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“…However, recent systematic reviews and meta-analyses have indicated that the TUG has only moderate predictive validity in identifying older people who fall, although the predictive validity varies according to the population and health care setting [ 47 – 49 ]. The lack of prognostic models and the evidence of (sufficient) prognostic validity of many MI has been described for various populations and health-related problems managed by physiotherapists [ 50 – 52 ]. We expect that the assessment and communication of prognostic information in physiotherapy will increase if more evidence on prognostic factors and prognostic validity of MI is available for the physiotherapy profession.…”

Section: Discussionmentioning

confidence: 99%

Current use of measurement instruments by physiotherapists working in Germany: a cross-sectional online survey

Braun

Rieckmann

Weber

et al. 2018

BMC Health Serv Res

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BackgroundThe use of measurement instruments in physiotherapy has been recommended in clinical practice guidelines to improve evidence-based practice. The aims of the study were (a) to describe the current use of measurement instruments by physiotherapists working in Germany and (b) to investigate the facilitators and barriers to use measurement instruments.MethodsThis cross-sectional study used a nationwide online survey, which was accessible to all physiotherapists working in Germany.ResultsIn total, 522 adult physiotherapists working in Germany completed the questionnaire. The mean age of the respondents was 38 years, 63% were female, and 53% had >10 years of work experience.Thirty-one percent of the respondents used measurement instruments in ≥80% of their patients, and 26% used measurement instruments in ≤20%. Measurement instruments were used for diagnostic and prognostic purposes by 69% and 22% of respondents, respectively. The three most frequently reported measurement instruments were “goniometer” (n = 254), some kind of a “visual/numeric analogue scale” (n = 139), and the “manual examination of muscle-strength” (n = 54). Seven of the 13 most stated measurement instruments measure activities or participation.The most important facilitator was physiotherapists’ positive attitudes towards measurement instruments. Two out of three respondents reported having sufficient knowledge and skills to apply measurement instruments in clinical practice. The most pronounced barriers were insufficient additional financial compensations and requiring extra time to document test scores. Seventy-eight percent of the respondents could imagine using an electronic device for a user-friendly patient health record system in clinical practice.ConclusionsThe limited use of measurement instruments reported by physiotherapists working in Germany appears to be due to organisational issues, in combination with a lack of knowledge and skills needed to apply the measurement instruments, rather than due to individual or managerial reasons. To support the use of measurement instruments, sufficient time resources and adequate financial compensation are required. Educational approaches should focus on imparting patient-centred and patient-reported outcomes to quantify activities and participation. Electronic patient health record systems have potential to facilitate the application of standardised measurement instruments if the barriers identified in this survey are addressed properly.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3563-2) contains supplementary material, which is available to authorized users.

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Prognostic Models in Adults Undergoing Physical Therapy for Rotator Cuff Disorders: Systematic Review

Cited by 12 publications

References 51 publications

Effectiveness of Dextrose Prolotherapy for Rotator Cuff Tendinopathy: A Systematic Review

Effectiveness of Dextrose Prolotherapy for Rotator Cuff Tendinopathy: A Systematic Review

A Systematic Summary of Systematic Reviews on the Topic of the Rotator Cuff

Current use of measurement instruments by physiotherapists working in Germany: a cross-sectional online survey

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