The treatment of multidirectional instability of the shoulder with a rehabilitation program: Part 1

Watson, Lyndsey F.; Warby, Sarah; Balster, Simon; Lenssen, Ross; Pizzari, Tania

doi:10.1177/1758573216652086

Cited by 49 publications

(46 citation statements)

References 43 publications

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“…Both programmes have been standardised via detailed flow charts, adhering to guidelines outlined by either Burkhead and Rockwood 17 or Watson et al . 21 22 The flow charts contain guidelines for exercise prescription and progressions and algorithms for clinical decision-making. The treating physiotherapist will also be required to complete electronic clinical notes at each treatment session to document the assessment findings, clinical decision-making rationale, exercises prescribed and any adverse events attributed to the exercise programme.…”

Section: Methods and Analysesmentioning

confidence: 99%

“…The Watson programme is primarily based around maintaining good scapular control through all stages of the programme. 21 22 Most stages have a scapula phase that the participant has to master before moving on to the arc of motion phase. Stage 1 is the foundation phase and focuses on retraining faulty scapular biomechanics.…”

Section: Methods and Analysesmentioning

confidence: 99%

“…Stage 1 is the foundation phase and focuses on retraining faulty scapular biomechanics. The clinical assessment determines the exact scapular mechanics that the patient must retrain and maintain throughout the programme, 21 and most commonly incorporates scapular upward rotation. 2 21 The stages progress via an increase in load and an increase in range of glenohumeral joint elevation.…”

Section: Methods and Analysesmentioning

confidence: 99%

“…The Watson MDI programme 21 22 has been developed for the conservative treatment of MDI. The programme has been shown to significantly improve scores on the Melbourne Instability Shoulder Score (MISS) and the Western Ontario Shoulder Index (WOSI) for a group of MDI participants in a pre-post trial design.…”

Section: Introductionmentioning

confidence: 99%

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Effect of exercise-based management on multidirectional instability of the glenohumeral joint: a pilot randomised controlled trial protocol

et al. 2016

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IntroductionThe most commonly recommended treatment for multidirectional instability (MDI) of the shoulder is exercise. Despite this recommendation, there is limited evidence to support the effectiveness of exercise. The aim of this paper is to describe a pilot randomised controlled trial comparing the effectiveness of 2 exercise programmes on outcomes of participants with MDI.Methods and analysisConsenting participants between 12 and 35 years, with non-traumatic MDI will be randomly allocated to participate in either the Rockwood Instability programme or the Watson MDI programme. Both programmes involve 1 consultation per week for 12 weeks with a physiotherapist to prescribe and progress a home exercise programme. Outcomes will be assessed at baseline, 6, 12, 24 and 52 weeks. Primary outcome measures include the Melbourne Instability Shoulder Score and Western Ontario Shoulder Index. Secondary outcomes include scapular coordinates, scapular upward rotation angles, muscle strength, symptomatic onset, limiting factor and angle of limiting factor in abduction range, incidence of complete glenohumeral joint dislocation, global rating of change, satisfaction scores, the Orebro Musculoskeletal Pain Questionnaire, adverse events and compliance with the home exercise programme. Data will be analysed on intention-to-treat principles and a per protocol basis.DiscussionThis trial will evaluate whether there are differences in outcomes between the Rockwood and the Watson MDI programmes for participants with MDI.Ethics and disseminationParticipant confidentiality will be maintained with publication of results. Ethics approval: Faculty of Health Sciences (FHEC12/201).Trial registration numberACTRN12613001240730; Pre-results.

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Section: Methods and Analysesmentioning

confidence: 99%

Section: Methods and Analysesmentioning

confidence: 99%

Section: Methods and Analysesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of exercise-based management on multidirectional instability of the glenohumeral joint: a pilot randomised controlled trial protocol

et al. 2016

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“…In the latter part of rehabilitation, the patient was instructed to perform the Watson program for MDI [7,11,12] (intervention B). The Watson program is an exercise program that aims for coordination of scapular muscles with strengthening rotator cuff and deltoid muscle.…”

Section: Interventionmentioning

confidence: 99%

Structured Rehabilitation Program for Multidirectional Shoulder Instability in a Patient with Ehlers-Danlos Syndrome

Kitagawa

Matsui

Nakaizumi

2020

Case Reports in Orthopedics

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Patients with Ehlers-Danlos syndrome (EDS) present many musculoskeletal disorders. The purpose of this case report was to describe the effectiveness of a scapular motor control program for a patient with multidirectional severe shoulder instability due to EDS, with 6-month follow-up. The patient was a 14-year-old female with EDS hypermobile type who suffered recurrent shoulder dislocation. Her chief complaints were bilateral shoulder discomfort and instability during writing motion. In the early part of intervention, she was prescribed exercise therapy for multidirectional instability (MDI) with orthosis. In the latter part of intervention, she was instructed in the scapular motor control program. Active and passive range of motion (ROM), sulcus sign, and Rowe score for shoulder instability were measured at baseline and at 3, 6, and 12 months after interventions. The shoulder ROM and instability score were improved after 6-month intervention. The findings from this report indicate that the scapular motor control program for shoulder instability would be effective even for patients with EDS hypermobile type. A patient who could not increase passive ROM due to dislocation is also able to achieve fair function of the shoulder joint instead of increasing active ROM. These positive outcomes indicate the possibility of benefit from the scapular motor control program for an MDI patient with EDS as a conservative treatment.

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Exercise for multidirectional instability of the shoulder

Karasuyama,

Imai,

Gotoh

et al. 2023

Cochrane Database of Systematic Reviews

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The treatment of multidirectional instability of the shoulder with a rehabilitation program: Part 1

Cited by 49 publications

References 43 publications

Effect of exercise-based management on multidirectional instability of the glenohumeral joint: a pilot randomised controlled trial protocol

Effect of exercise-based management on multidirectional instability of the glenohumeral joint: a pilot randomised controlled trial protocol

Structured Rehabilitation Program for Multidirectional Shoulder Instability in a Patient with Ehlers-Danlos Syndrome

Exercise for multidirectional instability of the shoulder

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