Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SHOULDER”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources
PubMed2005

A new shoulder range of motion screening measurement: its reliability and application in the assessment of the prevalence of shoulder contractures in patients with impaired consciousness caused by severe brain damage.

OBJECTIVES: To determine the reliability of a new shoulder joint range of motion (ROM) measurement for unconscious patients and to assess the prevalence of shoulder joint contractures in such patients. DESIGN: Prospective cohort survey. SETTING: An early rehabilitation center for adult persons with neurologic disorders. PARTICIPANTS: Fifty patients with impaired consciousness caused by severe cerebral damage of various etiologies. In addition, reference values were measured in 60 healthy adults. INTERVENTION: Shoulder ROM was assessed by measuring the distance between the olecranon and underlay while the patient lay supine on a solid surface and the patient's hands were passively positioned behind the neck. Distances between the olecranon and underlay were measured, first, manually by the rater and, second, for control, digitally by a blinded person from a digital photo taken while a constant force was applied to the elbow. MAIN OUTCOME MEASURES: Prevalence of contractures defined as increased distance between the olecranon and underlay or impossibility of positioning the hands passively behind the neck, and intra- and interrater-reliability of the 2 shoulder ROM measurements with the interclass correlation coefficient (ICC). RESULTS: Measurement of shoulder ROM showed high intra-(ICC range, .78-.91) and interrater reliability (ICC range, .77-.90) for manual measurement, high intra- (ICC range, .91-.95) and interrater reliability (ICC range, .90-.94) for the digital analysis, and a high ICC for both methods (ICC=.87). The prevalence of shoulder contractures was 56% in the patients and 50% of all shoulder joints. CONCLUSIONS: The described method provided a reliable measurement for reduced shoulder ROM and appears to be a useful screening method to show the prevalence of shoulder joint contracture in these patients.

Adult↗
PubMed1997

Frozen shoulder: correlation between the response to physical therapy and follow-up shoulder arthrography.

OBJECTIVE: To study the correlation between improvement of shoulder motion and shoulder joint space capacity determinated by arthrography. DESIGN: Case series. SETTING: General community hospital. PATIENTS: Twelve patients with clinically diagnosed frozen shoulder without rotator cuff tear. All subjects were divided as "primary" and "secondary" according to spontaneous onset or not, and "acute" or "chronic" depending on whether duration of disease was less than 2 months or longer. INTERVENTIONS: Outpatient rehabilitation programs, including physical modalities, exercise intervention, and regular weekly outpatient clinic follow-up. MAIN OUTCOME MEASURES: Shoulder range of motion (ROM) and joint space capacity in shoulder arthrography. RESULTS: In acute patients, the joint space capacity increased significantly after treatment (t = 2.82; p < .05). Increased joint space capacity was most significantly correlated with improvement in external rotation (r = .77, p < .05), followed by abduction (r = .43, p > .05), but was poorly correlated with flexion and internal rotation. In chronic patients, both primary and secondary groups, there was no obvious joint space capacity increase despite significant shoulder motion improvement. Follow-up arthrograms showed the reappearance and/or enlargement of the axillary recess and smoother capular margins in all the patients except one chronic case (disease duration for 1 year). These findings were more obvious in acute than in chronic patients. CONCLUSIONS: For frozen shoulder, generally described as "adhesive capsulitis," the adhesion was reversible in the acute stage. The increase of joint space capacity was significant and was correlated with improvement of external rotation. In chronic patients, ROM restoration occurred independent of change in joint space capacity, which increased slightly. The stretching of other contracted soft tissues around the shoulder, in addition to the adhesive capsule, may contribute to the recovery of chronic frozen shoulder.

Acute Disease↗
PubMed2006

[Initial results of shoulder MRI in external rotation after primary shoulder dislocation and after immobilization in external rotation].

PURPOSE: A change in the strategy for treating primary anterior traumatic dislocation of the shoulder has occurred. To date, brief fixation of internal rotation via a Gilchrist bandage has been used. Depending on the patient's age, a redislocation is seen in up to 90 % of cases. This is due to healing of the internally rotated labrum-ligament tear in an incorrect position. In the case of external rotation of the humerus, better repositioning of the labrum ligament complex is achieved. Using MRI of the shoulder in external rotation, the extent of the improved labrum-ligament adjustment can be documented, and the indication of immobilization of the shoulder in external rotation can be derived. The aim of this investigation is to describe the degree of position changing of the labrum-ligament tear in internal und external rotation. MATERIALS AND METHODS: 10 patients (9 male, 1 female, mean age 30.4 years, range 15 - 43 years) with a primary anterior dislocation of the shoulder without hyper laxity of the contra lateral side and labrum-ligament lesion substantiated by MRI were investigated using a standard shoulder MRI protocol (PD-TSE axial fs, PD-TSE coronar fs, T2-TSE sagittal, T1-TSE coronar) by an axial PD-TSE sequence in internal and external rotation. The dislocation and separation of the anterior labrum-ligament complex were measured. The shoulders were immobilized in 10 degrees external rotation for 3 weeks. After 6 weeks a shoulder MRI in internal rotation was performed. RESULTS: In all patients there was a significantly better position of the labrum-ligament complex of the inferior rim in external rotation, because of the tension of the ventral capsule and the subscapular muscle. In the initial investigation, the separation of the labrum-ligament complex in internal rotation was 0.44 +/- 0.27 mm and the dislocation was 0.45 +/- 0.33 mm. In external rotation the separation was 0.01 +/- 0.19 mm and the dislocation was - 0.08 +/- 0.28 mm. After 6 weeks of immobilization in 10 degrees external rotation, the separation of the labrum was - 0.10 +/- 0.14 mm and the dislocation was - 0.23 +/- 0.21 mm. CONCLUSION: In anterior labrum-ligament tears, the axial MRI of the shoulder in external rotation demonstrates a more physiologic position of the glenoid. This may indicate an immobilization of the shoulder in external rotation, which results in a more anatomical healing of the glenoidal tear. Thus, in the case of labrum-ligament tears, MRI in external rotation is becoming indispensable.

Adolescent↗
PubMedDate not supplied

Shoulder girdle neoplasms mimicking frozen shoulder syndrome.

Shoulder pain and immobility comprise a multifactorial disorder apparently affected by pain inhibiting joint motion. As the syndrome is very common, many patients do not undergo detailed imaging studies before treatment. This study compared a series of 7 patients in whom a neoplasm was the underlying cause for the stiff shoulder with a series of 50 patients with primary or secondary frozen shoulder. In addition to a detailed history being taken, the Disabilities of the Arm, Shoulder, and Hand (DASH) upper limb outcomes data collection questionnaire was completed and physical examination, radiography, ultrasonography, and bone scanning were performed in all cases. In the cases of tumor, the presenting symptom was a stiff shoulder without radiographic abnormality in 7 of 67 patients with shoulder girdle neoplasms who were seen at our musculoskeletal oncology clinic. The tumors included osteoid osteoma, osteoblastoma, metastatic carcinoma, chondrosarcoma, periosteal lipoma, and acute lymphoblastic lymphoma. The diagnosis was established in all cases by an area of focal isotope uptake demonstrated by a routine technetium 99 methylene diphosphonate bone scan. In a single case of metastatic colon carcinoma, the diagnosis could only be established by magnetic resonance imaging, as the radiographs were normal and the bone scan demonstrated diffuse uptake over the proximal humerus. The patients whose frozen shoulder was caused by an underlying tumor were significantly younger and had a lower fatigue/energy dimension score on the RAND Short Form-36 health survey. The most useful diagnostic test appears to be a discrete area of bony tenderness, present in 7 of 7 patients with tumor and in only 5 of 50 patients in the control group. Although an underlying tumor is a rare cause of frozen shoulder syndrome, the potential grave consequences of misdiagnosis and the possibility of performing an unnecessary and ineffective invasive procedure should prompt physicians to increased vigilance. In patients with discrete bony tenderness elicited by light tapping, a bone scan should be ordered and magnetic resonance imaging should be considered.

Adolescent↗
PubMed2002

Risk of shoulder tendinitis in relation to shoulder loads in monotonous repetitive work.

BACKGROUND: Few studies relate the occurrence of shoulder disorders to quantified ergonomic exposures. This study evaluates the hypothesis that shoulder loads in repetitive work might contribute to the occurrence of shoulder tendinitis. METHODS: This is a cross-sectional study of 1961 workers in repetitive work and 782 referents. Shoulder loads were quantified at task level and measures of exposures were assigned based on task distribution. Symptoms in combination with clinical criteria defined shoulder tendinitis. RESULTS: The prevalence of shoulder tendinitis was higher among exposed workers (adjusted OR 3.1, 95% CI 1.3-3). Neither frequency of movements (ranging 1-36/min) nor lack of micro-pauses in shoulder flexion (ranging 0-100% of cyclus time) was related to disease prevalence. Increasing force requirements (categorized as light = 1, somewhat hard = 2, hard = 3 or very hard = 4) increased risk slightly (OR 1.6, 95% CI 1.0-2.6 per unit). CONCLUSIONS: The results indicate that workers with repetitive tasks have increased risk of shoulder tendinitis, which partially can be attributed to force requirements.

Adult↗
PubMed1997

A comparison of patients with late-stage rheumatoid arthritis and osteoarthritis of the shoulder using self-assessed shoulder function and health status.

OBJECTIVE: To compare the function and health status of individuals with advanced rheumatoid arthritis (RA) and osteoarthritis (OA) of the shoulder using standardized patient self-assessment tools. METHODS: A group of patients with late-stage arthritic involvement of the shoulder was evaluated at the time of initial presentation using 2 questionnaires, one focusing on shoulder function and other on overall health status. RESULTS: There was substantial variability in the shoulder function and health status within each diagnostic group; however, both groups demonstrated significant deficits in their Simple Shoulder Test responses and in many of their Health Status Questionnaire-Short Form 36 scores. While the patients with RA tended to have somewhat greater impairment of shoulder function, many of the differences were not statistically significant. By contrast, most health status parameters were significantly more impaired in the patients with RA. CONCLUSIONS: Among patients with late-stage shoulder arthritis, the overall health status of those with RA is significantly worse than those with OA. Differences in health status may be important in selecting the optimal management for individual patients with late-stage shoulder arthritis. Self-assessment questionnaires are effective in characterizing these differences.

Activities of Daily Living↗
PubMed1999

Bone mineral density of the shoulder joint in frozen shoulder.

The purpose of this study was to evaluate the osteopenia in several parts of the shoulder joint in a series of individuals suffering from frozen shoulder and to elucidate the pathogenesis. The bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DEXA). In 30 cases of frozen shoulder, 16 men and 14 women, BMD of the head of the humerus, greater tubercle of the humerus, surgical neck of the humerus, and neck of the scapula was evaluated. The average age of the male patients was 58.4 years and of the women, 59.5 years. At the neck of the scapula, there were no significant differences in any of the cases. However, there was a marked decrease in BMD at the proximal end of the humerus on the affected side of women. In contrast, men showed no significant difference between the affected and unaffected shoulders, suggesting that the degree of osteopenia remains low compared with women. Although frozen shoulder is a disease which may occur in both men and women, the loss of bone was conspicuous only in women. This may be due to the involvement of female hormones in alterations of bone in frozen shoulder, as in cases of osteoporosis, in addition to the originally low bone density in women. The degree of osteopenia of the proximal humerus with frozen shoulder was not correlated with the duration of the disease, range of motion of the shoulder joint, or patient's age.

Absorptiometry, Photon↗
PubMed2002

Measurement of three dimensional shoulder movement patterns with an electromagnetic tracking device in patients with a frozen shoulder.

OBJECTIVE: To compare three dimensional movement patterns of the affected and non-affected shoulder in patients with a frozen shoulder before and after physical therapy. METHODS: Patients with a unilateral frozen shoulder were assessed before and after three months of treatment. Three dimensional movement analysis was performed with the "Flock of Birds" electromagnetic tracking device while the patient raised their arms in three directions. Slopes of the regression lines of glenohumeral joint rotation versus scapular rotation, reflecting the scapulohumeral rhythm, were calculated. All assessments were made for both the affected and the unaffected side. Additional assessments included conventional range of motion (ROM) measurements and visual analogue scales (VAS) (0-100 mm) for shoulder pain at rest, during movement, and at night. RESULTS: Ten patients with a unilateral frozen shoulder were included. The slopes of the curves of the forward flexion, scapular abduction, and abduction in the frontal plane of the affected and the unaffected side were significantly different in all three movement directions. Mean differences were 0.267, 0.215, and 0.464 (all p values <0.005), respectively. Mean changes of the slopes of the affected side after treatment were 0.063 (p=0.202), 0.048 (p=0.169), and 0.264 (p=0.008) in forward flexion, scapular abduction, and abduction in the frontal plane, respectively. All patients showed significant improvement in active ROM (all p<0.005), and the VAS for pain during movement and pain at night (p<0.05). CONCLUSIONS: With a three dimensional electromagnetic tracking system the abnormal movement pattern of a frozen shoulder, characterised by the relatively early laterorotation of the scapula in relation to glenohumeral rotation during shoulder elevation, can be described and quantified. Moreover, the system is sufficiently sensitive to detect clinical improvements. Its value in other shoulder disorders remains to be established.

Adult↗
PubMed1989

Frozen shoulder and other shoulder disturbances in Parkinson's disease.

The frequency of shoulder disturbances, particularly frozen shoulder, has not been assessed previously in Parkinson's disease. In a survey of 150 patients compared with 60 matched control subjects a significantly higher incidence of both a history of shoulder complaints (43% vs. 23%) and frozen shoulder (12.7% vs. 1.7%) was found in the Parkinson's disease population. Those developing a frozen shoulder had initial disease symptoms indicative of akinesia twice as frequently as tremor while the ratio was reversed in those without frozen shoulder. In at least 8% of the patients frozen shoulder was the first symptom of disease, occurring 0-2 years prior to the onset of more commonly recognised features. Parkinson's disease should be added to the list of causes of frozen shoulder, and clinicians must be aware that the latter is often the presenting symptom of Parkinson's disease.

Activities of Daily Living↗
PubMed1999

The inferior capsular shift operation for instability of the shoulder. Long-term results in 34 shoulders.

We reviewed 26 patients with 34 shoulders treated by the inferior capsular shift operation for inferior and multidirectional instability. The mean follow-up was 8.3 years. In total, 12 shoulders showed voluntary subluxation. Eight operations used an anterior and posterior approach, 11 were by the posterior route, and 15 shoulders had an anterior approach. In 30 shoulders (85%) the outcome was satisfactory and 20 (59%) scored good or excellent results on the Rowe system. Instability had recurred in nine shoulders (26%) from three months to three years after the operation. Six of the 12 shoulders with voluntary subluxation (50%) had recurrence, as against three of the other 22 (14%), a statistically significant difference. The operation is therefore not indicated for voluntary subluxation. The 19 shoulders which had been assessed in 1987 at a mean of 3.5 years after surgery, were also reviewed in 1995 and found to have no significant changes in instability or Rowe score. This shows that the capsular shift appeared to have maintained its tension over an eight-year period. After the use of a posterior approach, 64% of the shoulders showed a posterolateral defect on radiographs of the humerus.

Adolescent↗
PubMedDate not supplied

Simple home program for frozen shoulder to improve patients' assessment of shoulder function and health status.

BACKGROUND: The purpose of this investigation was to test the hypothesis that a simple home program can improve the self-assessed shoulder function and health status of a group of patients with frozen shoulders. METHODS: A case series using a one-group pretest, posttest design analyzing 41 patients from a single orthopedic practice who had a frozen shoulder were included in this study. The patients completed the Simple Shoulder Test (SST) and the Medical Outcomes Study Short-Form Health Survey (SF-36) questionnaire at the time of initial consultation, had treatment consisting of education regarding frozen shoulder and home stretching instructions, and were asked to complete the same questionnaires mailed every 6 months. Initial results were compared with previously published control values to establish level of impairment, and follow-up results were compared with the initial results to determine the extent of improvement. RESULTS: Patients initially had serious deficits in the 12 shoulder functions inventoried by the SST and were also compromised in their general health status as reflected by the SF-36 scores. At follow-up, 4 of 10 SST functions were improved (P < 0.001). The SF-36 health status scores of physical function, comfort, and physical role function were also improved (P < 0.001). CONCLUSION: These data suggest that this home program for frozen shoulder can lead to improved self-assessed shoulder function and health status in patients similar to those in the study population.

Adult↗
PubMed2000

[Newborn shoulder width: physiological variations and predictive value for shoulder dystocia].

OBJECTIVES: The purpose of this study was to determine maternal and infant characteristics affecting newborn shoulder width (NSW) and to evaluate the predictive value of NSW measurement in cases of shoulder dystocia. DESIGN: NSW was systematically measured at birth during a period of 18 months. SETTING: Department of Obstetrics and Gynaecology of Saint-Antoine University Hospital (Paris-France). POPULATION: A total of 2.222 NSW measurements were performed and 22 cases of true shoulder dystocia occurred during the study period. METHODS: NSW measurements were reviewed and correlated with maternal age, parity, nonpregnant weight, weight gain during pregnancy, height, race, fasting glucose and one hour glucose levels, gestational age, birthweight and sex of the neonate. A Receiver Operating Characteristics (ROC) curve was constructed to evaluate NSW as a test for predicting shoulder dystocia. RESULTS: The mean NSW was 122.06 mm +/-0.50 SD. Stepwise multiple regression showed that NSW was significantly associated with birthweight (p<0.001), parity (p = 0.04), and nonpregnant weight (p = 0.04). We estimated that the best cut-off for shoulder dystocia prediction was a NSW measurement with a low false positive rate (<10%) in association with a high sensitivity rate. Therefore, NSW measurement above or equal to 140 mm was selected. This measurement should have a low sensitivity of 27.27%, a specificity of 91.82%, a positive predictive value of 4.02%, and a predictive negative value of 99.01% for shoulder dystocia prediction. Nevertheless, birthweight above or equal to 4000 g should retrospectively have a better predictive value for shoulder dystocia. CONCLUSIONS: NSW measurement, which is strongly correlated with birth weight, still remains a poor predictor for shoulder dystocia, even when this evaluation is correct antenatally.

Anthropometry↗
PubMed2002

A capsular dilatation facilitated shoulder manipulation for treating patients with frozen shoulder.

Forty patients with a diagnosis of frozen shoulder who had symptom for an average of 8 months and failed conservative treatment of at least 6 weeks of physical therapy were treated with capsular dilatation facilitated shoulder manipulation. Post-manipulation, the patient underwent arthroscopy for visualization, fibrin debridement and bleeding point coagulation. All the essential intra-articular structures ie, glenohumeral ligament, rotator cuff were intact. Post-operatively, all patients revealed substantial gain in shoulder range of motion as well as diminished shoulder pain. The average flexion, abduction, and internal rotation gain were 76.9+/-8.9, 18.1+/-5.7, 9.6+/-7.1 degrees respectively. External rotation gain in the position of 90 degrees shoulder abduction and shoulder adduction were 53.0+/-9.97 and 31.4+/-7.2 degrees respectively. The average pain score by visual analogue scale pre and 6-month post-manipulation were 80.6+/-8.6 and 7.6+/-7.3 respectively with the average of pain score of 73.0+/-10.4. The authors proposed an effective and safe technique employing intra-articular pressure to facilitate shoulder manipulation in order to treat frozen shoulder.

Adult↗
PubMed1994

Voluntary subluxation of the shoulder in children. A long-term follow-up study of 36 shoulders.

We reviewed 25 children who presented consecutively with voluntary (habitual) subluxation of the shoulder. Thirty-six shoulders were involved and symptoms had been present for an average period of 12 years. Eighteen children were managed by 'skillful neglect': all these had become fully active in the profession of their choice and were satisfied with the outcome. Two of them had required shoulder surgery in adult life but only after trauma. Seven children (ten shoulders) had undergone stabilising operations during childhood with the aim of preventing later degenerative arthritis. These patients were also active in their selected professions, but only three (five of the ten shoulders) had good results: two shoulders had recurrent instability, two were painful and one was stiff. None of the shoulders in either group had developed osteoarthritic changes. There was no association with emotional or psychiatric problems. We conclude that voluntary subluxation of the shoulder in children has a favourable prognosis and that there is no indication for surgical intervention during childhood.

Adolescent↗
PubMed1996

Influence of anthropometric and psychological variables pain and disability on isometric endurance of shoulder abduction in patients with rotator tendinosis of the shoulder.

Predictors of isometric endurance of shoulder abduction were investigated in 18- to 75-year-old women (n = 59, mean age 48 years) and men (n = 53, mean age 46 years) with unilateral rotator tendinosis of the shoulder (median duration 1-2 years). They were asked to keep both shoulders abducted at 45 degrees, both wrists loaded with 2 kg, for as long as possible. The average force exerted to keep the required position was 17% higher in men compared to women. Mean times to exhaustion were: 103 seconds (SD 109) for the involved shoulder and 160 seconds (SD 81) for the uninvolved shoulder in women; compared to 159 seconds (SD 109) and 289 seconds (SD 109) in men. Increased pain, emotional distress and disability were associated with decreased endurance in the involved shoulder. Gender and emotional distress were the most powerful predictors of time to exhaustion in the uninvolved shoulder, and accounted for 41.7% of the total variance (R2). Age, body weight, self-efficacy for pain and active coping were poor predictors. This study indicates that isometric endurance is a psychophysiological measure in patients with shoulder pain. Reported pain, emotional distress and disability should be taken into account for interpretation of results.

Adult↗
PubMed2006

Effect of shoulder tightness on glenohumeral translation, scapular kinematics, and scapulohumeral rhythm in subjects with stiff shoulders.

Shoulder tightness may cause altered kinematics and lead to development of subacromial impingement, tendinitis, and degenerative changes. In this investigation, the humeral head translations, scapular kinematics, and scapulohumeral rhythm were determined with a three-dimensional electromagnetic tracking device during arm elevations in six subjects with anterior shoulder tightness and in six subjects with posterior shoulder tightness to study the effects of anterior/posterior tightness on shoulder kinematics. Subjects with anterior tightness showed lower slopes in curves of glenohumeral elevation plotted against scapular upward rotation (scapulohumeral rhythm, 0.11 to 0.32; p = 0.021) and less posterior scapular tilt (2.9 to 7.5 degrees; p = 0.002) during arm elevations when compared to the group with posterior tightness. The humeral head was positioned less posteriorly (2.2 to 3.4 mm; p = 0.004) and more superiorly (3.8 to 7.0 mm; p < 0.0005) during arm elevation in subjects with posterior tightness. The alternations in shoulder kinematics between subjects with anterior and posterior shoulder tightness may be relevant to the development of subacromial impingement, tendinitis, and degenerative changes as seen in subjects with stiff shoulders.

Adult↗
PubMedDate not supplied

Why is the humeral retroversion of throwing athletes greater in dominant shoulders than in nondominant shoulders?

A rotation angle of the proximal humerus relative to the elbow (bicipital-forearm angle) was measured by use of ultrasonography to determine the relationship between humeral retroversion and growth in dominant and nondominant shoulders of 66 elementary and junior high school baseball players. The subjects were aged 12 years on average. The bicipital-forearm angle was significantly smaller in dominant shoulders than in nondominant shoulders. This indicated that the retroversion angle was greater in dominant shoulders than in nondominant shoulders. Furthermore, there was a moderately positive correlation between age and the bicipital-forearm angle in both dominant and nondominant shoulders. From these data, we conclude that the humeral retroversion angle decreases with age, and the decrease is much smaller in dominant shoulders. We assume that the repetitive throwing motion does not increase the retroversion of the humeral head but rather restricts the physiologic derotation process of the humeral head during growth.

Adaptation, Physiological↗