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At least 649 records · Page 36Linked to original sources
PubMed2000

Arthroscopy for failed shoulder arthroplasty.

PURPOSE: It was the purpose of this study to describe the specifics of technique and results of arthroscopic evaluation and treatment of failed shoulder arthroplasties in 10 patients with early and late complications of shoulder arthroplasty. TYPE OF STUDY: Case series. MATERIALS AND METHODS: Ten patients (2 bilateral) underwent 13 arthroscopies after poor results following shoulder arthroplasty. The arthroscopic diagnoses ranged from rotator cuff tears in 5 shoulders, fibrosis and scarring of the long head of the biceps in 5 shoulders, impingement and biceps tendinitis in 1 shoulder, and capsular contracture in 1 shoulder. We performed 4 mini-open rotator cuff repairs, 1 open rotator cuff repair with revision of the humeral component, 5 arthroscopic debridements of the long head of the biceps, 2 arthroscopic decompressions with biceps tenodesis, and 1 arthroscopic capsular release. RESULTS: Before arthroscopy, the preoperative Hospital for Special Surgery (HSS) scores were 6 fair and 6 poor. At latest follow-up, there were 3 excellent, 4 good, and 5 fair results. There was a statistically significant improvement in HSS scores and range of motion for all patients in this study. All patients were satisfied with the results of the procedure. There were no infections or wound problems and neurovascular status was unaltered after arthroscopy. There was 1 intraoperative complication, a periprosthetic humerus fracture after manipulation in an osteoporotic woman with rheumatoid arthritis. CONCLUSION: Arthroscopy proved to be a reliable diagnostic and therapeutic tool in dealing with some of the postoperative complications encountered both early and late after shoulder arthroplasty. Careful attention to surgical technique, including use of blunt trocars, traction, and intraoperative prophylactic antibiotics, can minimize complications of arthroscopy in this setting.

Adult↗
PubMed2001

[Surgical treatment and rehabilitation for improving function of shoulder muscle impairment].

INTRODUCTION: The results of our integrated conservative and operative concept of therapy to compensate insufficient shoulder muscles following brachial plexus palsy or other nerve damages are presented. PATIENTS/METHODS: To improve stability and function of the shoulder in case of deltoid and supraspinatus paralysis 19 patients (3 female; 16 male; average age 37 years, range 17 to 61 years) underwent a shoulder arthrodesis. In 69 patients (12 female; 57 male; average age 31 years, range 19 to 69 years) a trapezius transfer was performed. The indication for a rotation osteotomy of the humerus to improve loss of external rotation due to paralytic infraspinatus muscle was determined in 5 male patients (average age 30 years, range 15 to 42 years). Our results are based upon an average follow-up of 21 (6-70) months after shoulder fusion, 21 (2-68) months after trapezius transfer and 28 (3-62) months after rotation osteotomy of the humerus. RESULTS: The trapezius transfer resulted in increased function of abduction of 6.6 degrees to 35.9 degrees (10 degrees-90 degrees) and forward flexion of 12.6 degrees to 30.9 degrees (5 degrees-85 degrees). A more stable condition of multidirectional shoulder instability was experienced by 64 patients (92.8%), and 65 patients (94.2%) were subjectively satisfied with the outcome of the operation. The strength and extent of functional improvement was, on average, greater following shoulder arthrodesis: abduction 10.3 degrees to 57.4 degrees (20 degrees-80 degrees), forward flexion of 12.6 degrees to 57.1 degrees (20 degrees-105 degrees). 17 patients (89.5%) were subjectively satisfied with the outcome. Patients who had undergone external rotation osteotomy showed an average deficiency of external rotation of 30 degrees before operation. After osteotomy an improvement of 29 degrees to 3 degrees external rotation was achieved. All patients were satisfied with the increase of function. CONCLUSIONS: In patients with failed shoulder muscles, particularly after brachial plexus palsy, secondary operations according to the individual pattern of muscle failure result in an improvement of shoulder function and stability, as well as patients' satisfaction. Therefore, adequate conservative treatment before and after reconstructive operations is of great importance.

Adolescent↗
PubMed1998

[Quantification of shoulder power in trained and untrained paraplegic wheelchair athletes].

Shoulder complaints are frequently observed to result from the increased stress to the upper extremities of wheelchair users. The cause may be muscle dysbalances of the stressed musculature, whereby the changed situation in the wheelchair during everyday and athletic exercise is important. To demonstrate the different importance of altered shoulder stress in the wheelchair situation and in additional athletic stress, maximum strength in the dominant shoulder was recorded in 14 trained and 13 untrained paraplegics. The goal was to examine the differences between the groups during concentric (60 degrees/s) and eccentric (60 degrees/s) shoulder exercise. Based on the strength/velocity curve, differentiation was also made between the shoulder movements in dependence on various movement velocities. Finally, a comparison was to be made with the test results of untrained and trained, non-paralyzed subjects examined by the same test methods in earlier studies. The results show higher maximum torques in both groups under eccentric stress (p < 0.001), more expressed in trained paraplegics (p < 0.001). In group comparison, there are only slight differences in concentric exercise. The comparison between untrained paraplegics and untrained normal persons (non-paralyzed) show hardly any differences. Trained paraplegics attain values comparable to those of non-paralyzed athletes in eccentric and isometric shoulder exercise. It is concluded, that objective data for determination of the strength situation in the shoulder musculature can be obtained by isokinetic strength measurements in paraplegics. Obviously, eccentric forms of exercise are particularly important. Valuable information can be obtained by determining shoulder strength in dependence on work mode and comparison with non-paralyzed subjects; the information must be interpreted according to the movement.

Adult↗
PubMedDate not supplied

Open surgical release for frozen shoulder: surgical findings and results of the release.

Over a 5-year period, 75 shoulders that met Codman's criteria for primary frozen shoulder were treated. Nine patients improved with nonoperative treatment, and the remaining 66 patients underwent manipulation under anesthesia. The shoulders in 41 patients successfully released with manipulation. Those in 25 failed to release with manipulation, and therefore, these patients underwent open surgical release of the contracted shoulder. We reviewed the cases of all of the surgically treated patients at 19.52 months' average follow-up, using the history and clinical examination technique recommended by the American Shoulder and Elbow Surgeons. The surgical findings in this group of 25 patients showed a consistent alteration in the rotator interval and coracohumeral ligament. The rotator interval was obliterated, and the coracohumeral ligament was transformed into a tough contracted band. The histology of this contracture was examined in 12 patients and consisted of a dense matrix of type III collagen populated with fibroblasts and myofibroblasts. The contracted coracohumeral ligament was excised with immediate release of the external rotation deficit. Pain scores on visual analogue scale improved from 8.28 to 2.0. The average score for function, with a maximum score of 30, improved from 6.08 to 18.9. Twenty patients had excellent or good results, and 3 had fair results. The shoulders of 2 patients failed to improve: 1 was an insulin-dependent patient with diabetes, and 1 had severe bilateral Dupuytren's contractures. The results in the patients without diabetes were very satisfactory, with visual analogue scale scores of pain decreasing from 8.4 to 1.1, function increasing from 6.4 to 20.1, flexion increasing from an average of 96 degrees to an average of 131 degrees, and external rotation increasing from an average of 10.0 degrees to an average of 46.7 degrees. Surgical release of frozen shoulder is a useful option in those few patients with severe disease whose shoulders fail to release with manipulation under anesthesia. Caution should be used in insulin-dependent patients with diabetes.

Adult↗
PubMedDate not supplied

The magnitude and durability of functional improvement after total shoulder arthroplasty for degenerative joint disease.

So that patients with degenerative glenohumeral joint disease who wish to consider total shoulder arthroplasty will be better informed, we sought to document the magnitude and durability of the improvement in shoulder function after this procedure. The function of 124 shoulders with primary degenerative joint disease was documented by patient self-assessment with the Simple Shoulder Test before and sequentially after total shoulder arthroplasty performed with a standardized technique. Patients reported that they could perform 3.8 +/- 0.3 (SEM) of the 12 Simple Shoulder Test functions before surgery. The total number of performable functions was consistent at different follow-up intervals: 8.0 +/- 0.4 at 6 months, 9.5 +/- 0.4 at 1 year, 10.0 +/- 0.3 at 2 years, 9.2 +/- 0.4 at 3 years, 9.6 +/- 0.4 at 4 years, and 10.0 +/- 0.4 at 5 years. We conclude that total shoulder arthroplasty can provide substantial and durable improvement in shoulder function.

Aged↗
PubMedDate not supplied

Shoulder proprioception in baseball pitchers.

We examined proprioceptive differences between the dominant and nondominant shoulders of 21 collegiate baseball pitchers without a history of shoulder instability or surgery. A proprioceptive testing device was used to measure kinesthesia and joint position sense. Joint position sense was significantly (P =.05) more accurate in the nondominant shoulder than in the dominant shoulder when starting at 75% of maximal external rotation and moving into internal rotation. There were no significant differences for proprioception in the other measured positions or with kinesthesia testing. Six pitchers with recent shoulder pain had a significant (P =.04) kinesthetic deficit in the symptomatic dominant shoulder compared with the asymptomatic shoulder, as measured in neutral rotation moving into internal rotation. The net effect of training, exercise-induced laxity, and increased external rotation in baseball pitchers does not affect proprioception, although shoulder pain, possibly due to rotator cuff inflammation or tendinitis, is associated with reduced kinesthetic sensation.

Adolescent↗
PubMedDate not supplied

Operative management of the frozen shoulder in patients with diabetes.

Forty-three patients with diabetes (47 shoulders) who had a manipulation under anesthesia only (24 shoulders), a manipulation under anesthesia followed by an arthroscopy (12 shoulders), or an arthroscopic release (11 shoulders) for a frozen shoulder were followed-up for a mean period of 35 months. The mean Constant score improved from 20.3 to 63.7 points (P <.001). The mean improvement in forward flexion was 71.7 degrees, in abduction 78.5 degrees, in external rotation with the arm at the side 36.3 degrees, and in internal rotation from the buttock to the first lumbar vertebra (P <.001 for all). When gentle manipulation with the patient under anesthesia was possible, the outcome was satisfactory in 13 of 15 shoulders (86.7%) in patients with non-insulin-dependent diabetes and in 17 of 21 shoulders (81%) in patients with insulin-dependent diabetes (P >.5). Insulin-dependent patients with diabetes were more likely to require an arthroscopic release than patients with non-insulin-dependent diabetes (P <.05). Most of our patients obtained their maximum relief of pain and functional recovery within 3 months of surgery. We recommend manipulation under anesthesia for the resistant frozen shoulder in patients with diabetes. Arthroscopic release is required when mobilization under anesthesia is not possible.

Adult↗
PubMed2006

Maternal and anthropomorphic risk factors for shoulder dystocia.

OBJECTIVE: To study maternal and anthropomorphic parameters as potential risk factors for shoulder dystocia. MATERIAL AND METHOD: From a series of 9667 vaginal deliveries between January 1998 and December 2003, a total of 138 cases complicated by shoulder dystocia were retrospectively identified and compared with a control group of 138 uncomplicated vaginal deliveries. In addition to maternal age, parity, diabetes, body mass index (BMI), and ethnicity, anthropometric factors including maternal height-to-infant weight ratio, characteristics of labor, management techniques, and outcome were evaluated as possible risk factors for shoulder dystocia. RESULTS: The overall incidence of shoulder dystocia in this retrospective series of vaginal deliveries was 1.4%. In univariate analysis, maternal obesity (OR; 95% CI: 3.6; 2.1-6.3), diabetes (OR: 19.4; 2.5-145.7), parity greater than 2 (OR: 2.5; 1.4-4.4), maternal height-to-infant weight ratio (OR: 1.02; 1.01-1.04; P < 0.001), and infant weight-to-maternal BMI ratio (OR: 1.02; 1.01-1.03; P < 0.001) were predictive of shoulder dystocia. In multiple regression analysis, obesity and multiparity were the most significant maternal risk factors for shoulder dystocia. The only anthropometric factors associated with shoulder dystocia in multiple regression analysis were maternal height <1.55 m (OR: 6.6; 1.3-34.9) and maternal height-to-infant weight ratio (OR: 1.02; 1.01-1.05). CONCLUSION: Shoulder dystocia may be anticipated in cases involving short women and discrepancy between maternal height or weight and infant weight.

Adult↗
PubMed1991

Shoulder pain and reflex sympathetic dystrophy.

Shoulder pain has become one of the commonest clinical problems in modern North American society. The pathogenetic mechanisms vary widely, and often times, speculations about the underlying pathology have not been substantiated by investigative studies. In the past year, progress in our knowledge about shoulder pain has not been significant. We discuss the topic by dividing shoulder pain into four categories: 1) shoulder pain of local origin; 2) pain referred to the shoulder; 3) shoulder and neck pain; and 4) shoulder pain and reflex sympathetic dystrophy. It appears that a thorough history taking, an understanding of the psychosocial background of the patient, and a complete physical are equally important in the clinical evaluation of painful shoulders.

Humans↗
PubMed2006

Prevalence and risk factors for symptomatic thromboembolic events after shoulder arthroplasty.

UNLABELLED: Deep venous thrombosis and pulmonary embolism after shoulder arthroplasty are not well described. We sought to identify the frequency of deep venous thrombosis and pulmonary embolisms in patients after shoulder arthroplasties to compare these rates with the frequency of deep venous thrombosis and pulmonary embolisms among patients who had total hip and total knee arthroplasties, and to identify associated risk factors. The New York State Department of Health Statewide Planning and Research Cooperative System database was used to identify hospital admissions of patients having shoulder, hip, or knee arthroplasties between 1985 and 2003 with or without an associated diagnostic code for deep venous thrombosis or pulmonary embolism. This resulted in a retrospective cohort of 328,301 procedures. The frequency of deep venous thrombosis was 5.0 per 1000 procedures for shoulder arthroplasties compared with 15.7 for hip arthroplasties and 26.9 for knee arthroplasties. The frequency of pulmonary embolisms was 2.3 for shoulder arthroplasties, 4.2 for hip arthroplasties, and 4.4 for knee arthroplasties. Increasing age, trauma, and cancer were risk factors for thromboembolic events after shoulder arthroplasties. Although the absolute rates of thromboembolic complications were less in patients who had shoulder arthroplasties compared with those of patients who had lower extremity procedures, a larger percentage of these complications were pulmonary embolisms. Perioperative antithrombotic prophylaxis may be beneficial to reduce the frequency of deep venous thrombosis and pulmonary embolisms among patients having shoulder arthroplasties, particularly in higher-risk groups. LEVEL OF EVIDENCE: Prognostic study, Level II (retrospective study). See the Guidelines for Authors for a complete description of levels of evidence.

Aged↗
PubMed1996

Measurement of isometric elbow and shoulder moments: position-dependent strength of posterior deltoid-to-triceps muscle tendon transfer in tetraplegia.

This report describes an apparatus which has been developed to measure several isometric elbow and shoulder forces and moments simultaneously and also allows this characterization to be performed across a range of shoulder and elbow joint angles in a horizontal plane. This apparatus was used to characterize the elbow extension strength in individuals with tetraplegia resulting from cervical level spinal cord injury. In all of these individuals, voluntary elbow extension was provided exclusively by the posterior deltoid muscle, which had previously been surgically transferred to the tendon of the paralyzed triceps muscle. Elbow extension is essential for many daily activities, such as reaching above shoulder level and pushing objects away from the body; the widely used posterior deltoid-to-triceps muscle tendon transfer surgery restores some degree of voluntary control to this important function. The apparatus contained a six-axis force-moment transducer to which the arm of each subject was attached. The six outputs of the transducer were transformed to correspond to physiological elbow and shoulder moments and forces. A customized table allowed the shoulder and elbow angles of the subject to be varied over a wide range in a horizontal plane so that the effects of posterior deltoid muscle length could be characterized over the likely functional range of the subject within this plane. It was found that elbow extension strength varied widely across subjects with C5 or C6 tetraplegia, from quite weak to strong enough to propel a manual wheelchair. Furthermore, the elbow extension strength of most subjects showed a strong dependence on both elbow and shoulder angles. Elbow extension was typically weak when the upper arm was elevated to shoulder level at the side, which unfortunately corresponds to the position often adopted by these individuals due to shoulder weakness.

Elbow Joint↗
PubMed1986

The painful diabetic shoulder.

Different types of shoulder affection were studied in 62 diabetic patients with shoulder pain. Three groups of shoulder joint disorder were found: painful shoulder with restricted mobility (62%), tendinitis without mobility restriction (27%), and a small group with mixed diagnoses. Sixty per cent had hand symptoms and 38% had restricted mobility of their hip joints. High frequencies of retinopathy and neuropathy were found. Affection of the shoulder joint was seen with almost the same frequency in insulin-dependent as in non-insulin-dependent patients, but after a shorter duration of diabetes in the latter. A group of patients with the triad shoulder pain, hand symptoms and restricted mobility of the hip joints had a significantly higher frequency of proliferative retinopathy than patients with shoulder pain only. The long duration of diabetes, the high frequency of insulin treatment and classical late complications indicate that diabetic patients with painful shoulder and restricted mobility are suffering from clinically advanced diabetes mellitus.

Adult↗
PubMedDate not supplied

Ultrasonographic evaluation of the canine shoulder.

The aim of this study was to determine the normal ultrasonographic anatomy of the canine shoulder. Fourteen shoulders from 7 clinically normal mid-sized dogs were radiographed and imaged using high frequency ultrasound. Each shoulder was isolated postmortem, and the ultrasonographic and gross anatomy was studied during dissection. The ultrasonographic appearance of the shoulder specimens was similar to that found in the live dogs. Twenty-four shoulders isolated postmortem from 12 variably sized dogs were also used to characterize the normal ultrasound anatomy over a range of sizes. Important anatomic structures that could be consistently evaluated were the biceps tendon and bursa, the bicipital groove surface, the supraspinatous tendon, the infraspinatous tendon, the teres minor tendon, and the caudal aspect of the humeral head. Results of ultrasonographic examination of 4 dogs with shoulder lameness are described to illustrate some applications of canine shoulder ultrasonography in the evaluation of the canine shoulder. In these dogs, ultrasound was a valuable tool to evaluate effusion and synovial proliferation within the bicipital bursa, supraspinatous and biceps tendinitis, biceps tendon strain, and dystrophic calcification.

Animals↗
PubMed2005

Two pragmatic trials of treatment for shoulder disorders in primary care: generalisability, course, and prognostic indicators.

OBJECTIVE: To investigate predictors of long term prognosis in patients treated for shoulder pain in primary care. METHODS: Data were taken from two pragmatic randomised clinical trials investigating the effectiveness of conservative treatments for shoulder pain presenting to primary care. Shoulder pain severity, disability, and perceived recovery measured in the long term (UK, 18 months; Netherlands, 12 months) were considered as outcome measures. Prognostic indicators measured before randomisation were determined by linear regression (pain severity and disability) and logistic regression (perceived recovery). RESULTS: 316 adults with a new episode of shoulder pain were recruited (UK, n = 207; Netherlands, n = 109). In multivariate analysis, greater shoulder disability at follow up was associated with higher baseline disability score, concomitant neck pain, and a gradual onset and longer duration of shoulder symptoms. Pain scores at follow up were higher in women and in those with longer baseline duration of symptoms and higher baseline pain or disability scores. Being female, reporting gradual onset of symptoms, and a higher baseline disability score each independently reduced the likelihood of perceived recovery. CONCLUSIONS: The results suggest that there is no long term difference in outcome between patients with shoulder pain treated with different clinical interventions in different clinical settings, or having different clinical diagnoses. Baseline clinical characteristics of this consulting population, rather than the randomised treatments which they received, were the most powerful predictors of outcome. Whether this highlights the need for earlier intervention or reflects different natural histories of shoulder pain is a topic for further research.

Anti-Inflammatory Agents↗
PubMed1987

Shoulder disorders in the elderly (a hospital study).

One hundred acute geriatric inpatients were assessed to investigate the prevalence of shoulder disorders; 21 had symptoms due to shoulder disease. Conditions included supraspinatus tendinitis (five), chronic rotator cuff rupture (seven), frozen shoulder (two), glenohumeral osteoarthritis (two), apatite related shoulder arthritis (one), stroke related shoulder disease (six). (Some patients had more than one shoulder condition.) The last group included painful stiff shoulders (three), glenohumeral subluxation (two), and acute shoulder-hand syndrome (one). Patients with rotator cuff rupture had bilateral disease. Only three patients had sought medical attention for their symptoms. The common occurrence of these conditions has possible implications for rehabilitation, and medical awareness is required as few may volunteer symptoms. A community based study is needed to assess the prevalence in the elderly population.

Aged↗
PubMed1996

Shoulder capsulitis in type I and II diabetic patients: association with diabetic complications and related diseases.

OBJECTIVE: To examine the association between shoulder capsulitis and chronic diabetic complications and diseases closely related to diabetes. METHODS: A cross sectional study in 291 type I [mean (SD) age 33.2 (9.9) years] and 134 type II [61.1 (12.4) years] diabetic patients. The presence of shoulder capsulitis, Dupuytren disease, and limited joint mobility was sought. The patients were assessed for background and proliferative retinopathy, nephropathy, autonomic neuropathy, and peripheral symmetrical somatic polyneuropathy. Diseases closely related to diabetes (hypertension, history of myocardial infarction, coronary heart disease, and peripheral vascular disease) were also recorded. RESULTS: Prevalence of shoulder capsulitis was 10.3% in type I and 22.4% in type II diabetic subjects. Shoulder capsulitis was associated with the age in types I (P < 0.01) and II (P < 0.05) diabetic patients, and with the duration of diabetes in type I patients (P < 0.01). Odds ratios for autonomic neuropathy in type I and type II diabetic subjects with shoulder capsulitis were 4.1 (95% confidence interval, 1.6 to 10.9) and 2.7 (95% CI, 1.1 to 7.0), respectively, after controlling for age and duration of diabetes. Odds ratio for history of myocardial infarction in type I diabetic subjects with shoulder capsulitis was 13.7 (95% CI, 1.3 to 139.5) after controlling for age, duration of diabetes, hypertension, and smoking habits. Other associations between shoulder capsulitis and diabetic complications, related diseases, and other hand abnormalities were fully explained by age and the duration of diabetes. CONCLUSIONS: Shoulder capsulitis is common in type I and type II diabetic patients. It is associated with age in type I and II diabetic patients and with the duration of diabetes in type I patients. It is associated with autonomic neuropathy in type I and II diabetic patients and with history of myocardial infarction in type I diabetic patients, independently of time related variables.

Adolescent↗
PubMed2002

Chronic shoulder pain in the community: a syndrome of disability or distress?

OBJECTIVES: To investigate two questions in a community based population of people with chronic shoulder pain. Firstly, does chronic pain lead to impaired psychological health over time? Secondly, how does restriction of daily activity influence pain perception and psychological health? METHODS: Two postal surveys, two years apart, were carried out to identify a group of subjects with chronic shoulder pain. The first survey was sent to a random sample of adults (n=40026) registered with a primary care practice, and included a pain manikin, demographic information, and the Hospital Anxiety and Depression scale (HAD). The second survey was sent to those subjects who reported unilateral shoulder region pain in the first survey and it included a shoulder-specific disability scale, pain severity score, and the HAD. RESULTS: 2606 (65.1%) people responded to the initial survey. Of these, 304 (11.7%) reported unilateral shoulder region pain at baseline. In the subsequent survey, there were 234 responders (83.3% adjusted response): 142 of these reported shoulder pain and formed our study group of "subjects with chronic shoulder pain". Within this group there was no significant change in psychological distress scores between baseline and follow up. Both the disability score and psychological distress scores correlated significantly with pain severity (disability v pain r=0.536, p<0.001; psychological distress v pain r=0.269, p=0.002). When the correlation between disability and pain severity was corrected for possible confounders, it remained significant (r=0.490, p<0.001). This was not the case for the correlation between psychological distress and pain (p>0.05). Disability was significantly correlated with psychological distress on univariate (r=0.445, p<0.001) and multivariate analysis (r=0.341, p=0.002). CONCLUSION: In those with chronic shoulder pain the relation between pain and psychological health seems to be linked to disability. Psychological distress was not explained by persistent pain itself.

Adult↗
PubMed2006

Physical capacity in relation to low back, neck, or shoulder pain in a working population.

AIMS: To investigate the longitudinal relation between physical capacity (isokinetic lifting strength, static endurance of the back, neck, and shoulder muscles, and mobility of the spine) and low back, neck, and shoulder pain. METHODS: In this prospective cohort study, 1789 Dutch workers participated. At baseline, isokinetic lifting strength, static endurance of the back, neck, and shoulder muscles, and mobility of the spine were measured in the pain free workers, as well as potential confounders, including physical workload. Low back, neck, and shoulder pain were self-reported annually at baseline and three times during follow up. RESULTS: After adjustment for confounders, Poisson generalised estimation equations showed an increased risk of low back pain among workers in the lowest sex specific tertile of performance in the static back endurance tests compared to workers in the reference category (RR = 1.42; 95% CI 1.19 to 1.71), but this was not found for isokinetic trunk lifting strength or mobility of the spine. An increased risk of neck pain was shown for workers with low performance in tests of isokinetic neck/shoulder lifting strength (RR = 1.31; 95% CI 1.03 to 1.67) and static neck endurance (RR = 1.22; 95% CI 1.00 to 1.49). Among workers in the lowest tertiles of isokinetic neck/shoulder lifting strength or endurance of the shoulder muscles, no increased risk of shoulder pain was found. CONCLUSIONS: The findings of this study suggest that low back or neck endurance were independent predictors of low back or neck pain, respectively, and that low lifting neck/shoulder strength was an independent predictor of neck pain. No association was found between lifting trunk strength, or mobility of the spine and the risk of low back pain, nor between lifting neck/shoulder strength or endurance of the shoulder muscles and the risk of shoulder pain.

Adult↗