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Wu M, Mo MY, Huang XD, Wei J. Implications for respiratory muscle training in patients with stroke-associated pneumonia: a meta-analysis. Disabil Rehabil 2024:1-7. [PMID: 38329457 DOI: 10.1080/09638288.2024.2314159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE To evaluate the effect of respiratory muscle training on improving lung function in patients with stroke-associated pneumonia. MATERIALS AND METHODS A systematic retrieval was conducted using the databases of the Cochrane Library, PubMed, the Web of Science, Embase, ProQuest, and others. Studies involving patients who received respiratory muscle training with/without a breathing trainer and those who adopted routine post-stroke rehabilitation training were included in the systematic review. The statistical analysis was performed using RevMan 5.3 software. RESULTS Fourteen studies were included involving 850 patients with stroke. According to the results of the meta-analysis, compared with the control group, there were statistically significant differences in forced vital capacity (FVC) measurements (mean difference (MD) = 0.93, p < 0.0001) and improvement values for FEV1/FVC (MD = 0.65, p < 0.00001) in the experimental group. The FEV1 value was higher in the experimental group than in the control group (MD = 5.89, p < 0.0001). Furthermore, respiratory muscle training was superior to routine rehabilitation training for improving the PImax of patients with stroke (MD = 9.20, p < 0.0001). The patients had better respiratory tolerance after respiratory muscle training intervention (MD = 73.40, p < 0.0001). CONCLUSIONS The implementation of respiratory muscle training can improve FVC and FEV lung function indicators, inspiratory muscle strength and the 6-min walk test results in patients with stroke.
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Affiliation(s)
- Ming Wu
- Department of Rehabilitation, Wuming Hospital of Guangxi Medical University, Nanning, China
| | - Ming-Yu Mo
- Department of Rehabilitation, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiao-Dan Huang
- Department of Rehabilitation, Wuming Hospital of Guangxi Medical University, Nanning, China
| | - Jing Wei
- Department of Rehabilitation, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Ott K, Iwanaga J, Dumont AS, Loukas M, Tubbs RS. Postprandial Referred Shoulder Pain: A Case Report. Cureus 2022; 14:e25535. [PMID: 35800831 PMCID: PMC9246054 DOI: 10.7759/cureus.25535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 11/05/2022] Open
Abstract
The precise mechanism of referred pain is not well understood; however, diaphragmatic irritation is a well-known etiology of referred pain. Left side referred pain due to diaphragmatic irritation is most commonly attributed to splenic laceration i.e. Kerr's sign. Here, we report an unusual case of left-sided referred pain that followed eating. An adult male presented vague and chronic left shoulder pain that followed eating. The pain was described as a deep boring type of discomfort that was poorly localized to the region deep to the acromion and extended superomedially along the upper fibers of the trapezius muscle. The pain was present immediately after eating heavy meals and always abated approximately 30 minutes later. There was no history of previous surgery and physical examination was unremarkable. CT examination of the abdomen and thorax did not show any pathology or anatomical variations that would result in such referred pain. Although the exact etiology of this case is unclear, the most likely cause would be left-sided diaphragmatic irritation from the stomach after eating. The current literature does not enclose reports pertaining to similar findings. Although unusual and seemingly rare, postprandial referred shoulder pain should be considered by clinicians alongside other causes of referred shoulder pain when presented with shoulder pain without an obvious musculoskeletal or neural etiology.
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Zong LZ, Ma L, Liu YY. Arthroscopic capsular release for the treatment of post-stroke frozen shoulder: A protocol for systematic review. Medicine (Baltimore) 2020; 99:e22025. [PMID: 32991405 PMCID: PMC7523792 DOI: 10.1097/md.0000000000022025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND This study will assess the efficacy and safety of arthroscopic capsular release (ACR) for the treatment of post-stroke frozen shoulder (PSFS). METHODS We will carry out a systematic study of randomized controlled trials that assess the efficacy and safety of ACR for PSFS. We will search all potential records for any eligible trials from selected electronic databases (MEDLINE, EMBASE, Cochrane Library, Web of Science, Chinese Biomedical Literature Database, WANGFANG, and China National Knowledge Infrastructure) and grey literature sources from inception to the present. Two authors will independently perform study selection, data extraction, and study quality assessment. Any disagreement will be solved by a third author via consultation. Statistical analysis will be carried out by RevMan 5.3 software. RESULTS This study will comprehensively summarize current eligible studies to systematically assess the efficacy and safety of ACR for PSFS. CONCLUSION This study will provide evidence to determine whether ACR is an effective management for patients with PSFS.
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Affiliation(s)
- Long-ze Zong
- Department of Joint Surgery, Yanan University Affiliated Hospital, Yan’an, China
| | - Li Ma
- Department of Neurology, Yanan University Affiliated Hospital, Yan’an, China
| | - Ying-ying Liu
- Third Ward of Neurology Department, Cardiology and Cerebrovascular Specialty Section, Yanan University Affiliated Hospital, Yan’an, China
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Abstract
RATIONALE Information on referred pain can be helpful for diagnosing diseases of the visceral organs. Here, the authors report a patient with cervical spinal cord injury (SCI) who had referred pain at the right side from the neck to shoulder, as a presentation of pulmonary embolism (PE). PATIENT CONCERNS A 55-year-old man with complete tetraplegia, due to cervical SCI after C5 and C6 vertebral body fracture, complained of right neck-to-shoulder pain (numerical scale rating: 6). Despite pain medication (meloxicam 15 mg, gabapentin 400 mg, and propacetamol HCl 1 g), the pain was not reduced. Along with right neck-to-shoulder pain, he presented mild fever (37.8°C) and mildly elevated respiratory rate (20 breaths/min). D-dimer level was also mildly elevated to 6.09 mg/mL (normal value: < 0.5 mg/mL). DIAGNOSES Computed tomography pulmonary angiography revealed PE in the right lower lobe pulmonary artery. INTERVENTIONS For managing PE, rivaroxaban was administered for three days. OUTCOMES After the administration of rivaroxaban, the patient's pain completely disappeared. LESSONS This study shows that pain at the neck-to-shoulder area can occur following unexpected causes such as PE. Not limited to PE, the evaluation of diseases in the thoracic or abdominal organs is recommended if patients with cervical SCI present refractory pain in the dermatomes innervated by high cervical nerve roots.
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Dee SW, Kao MJ, Hong CZ, Chou LW, Lew HL. Chronic shoulder pain referred from thymic carcinoma: a case report and review of literature. Neuropsychiatr Dis Treat 2012; 8:399-403. [PMID: 22969299 PMCID: PMC3435118 DOI: 10.2147/ndt.s36476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Indexed: 11/23/2022] Open
Abstract
We report a case of thymic carcinoma presenting as unilateral shoulder pain for 13 months. Before an accurate diagnosis was made, the patient received conservative treatment, cervical discectomies, and myofascial trigger point injection, none of which relieved his pain. When thymic carcinoma was eventually diagnosed, he received total resection of the tumor and the shoulder pain subsided completely. Thymic carcinoma is a rare carcinoma, and our review of the literature did not show shoulder pain as its initial presentation except for one case report. The purpose of this report is to document our clinical experience so that other physiatrists can include thymic carcinoma in their differential diagnosis of shoulder pain.
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Affiliation(s)
- Shu-Wei Dee
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung
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Abstract
Children with pneumonia presenting with extrathoracic pain, such as abdominal pain, have been previously described. In this report, we describe a 3-year-old girl with fever and right arm pain who was found to have an apical lobar pneumonia.
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Flanagin BA, Mitchell MT, Thistlethwaite WA, Alverdy JC. Diagnosis and treatment of atypical presentations of hiatal hernia following bariatric surgery. Obes Surg 2010; 20:386-92. [PMID: 19856036 DOI: 10.1007/s11695-009-0013-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2009] [Accepted: 10/07/2009] [Indexed: 10/20/2022]
Abstract
Bariatric surgery dramatically alters the normal stomach anatomy resulting in a significant incidence of hiatal hernia and gastroesophageal reflux disease. Although the majority of patients remain asymptomatic, many complain of severe heartburn refractory to medical management and additional highly atypical symptoms. Here, we describe the diagnosis and treatment regarding four cases of symptomatic hiatal hernia following bariatric surgery presenting with atypical symptoms in the University Hospital, USA. Four patients presented following laparoscopic Roux-en-Y gastric bypass or duodenal switch/pancreaticobiliary bypass (DS) with disabling and intractable midepigastric abdominal pain characterized as severe and radiating to the jaw, left shoulder, and midscapular area. The pain in all cases was described as paroxysmal and not necessarily associated with eating. All four patients also experienced nausea, vomiting, and failure to thrive at various intervals following laparoscopic bariatric surgery. Routine workup failed to produce any clear mechanical cause of these symptoms. However, complimentary use of multidetector CT and upper gastrointestinal contrast studies eventually revealed the diagnosis of hiatal hernia. Exploration identified the presence of a type I hiatal hernia in all four patients, with the stomach staple lines densely adherent to the diaphragm and parietal peritoneum. Operative intervention led to immediate and complete resolution of symptoms. The presence of a hiatal hernia following bariatric surgery can present with highly atypical symptoms that do not resolve without operative intervention. Recognition of this problem should lead to the consideration of surgery in cases where patients are dependent on artificial nutritional support and whose symptoms are poorly controlled with medication alone.
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Kim HT, Jang IS, Han SJ, Lee JH, Kwon YE. Pulsed Radiofrequency Lesioning of the Suprascapular Nerve for Referred Shoulder Pain due to Metastatic Liver Cancer - A case report -. Korean J Pain 2007. [DOI: 10.3344/kjp.2007.20.2.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Hyung Tae Kim
- Department of Anesthesiology and Pain Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - In Su Jang
- Department of Anesthesiology and Pain Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Sang Ji Han
- Department of Anesthesiology and Pain Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Jun Hak Lee
- Department of Anesthesiology and Pain Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Young Eun Kwon
- Department of Anesthesiology and Pain Medicine, Presbyterian Medical Center, Jeonju, Korea
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Affiliation(s)
- Sang Hyun Park
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Pyung Bok Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Myung Sin Seo
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yun Hee Lim
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yong Seok Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Natsis K, Paraskevas G, Papaziogas B, Agiabasis A. "Pes anserinus" of the right phrenic nerve innervating the serous membrane of the liver: a case report (anatomical study). Morphologie 2004; 88:203-5. [PMID: 15693425 DOI: 10.1016/s1286-0115(04)98150-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
During the preparations of cadavers for educational purposes we followed the course of the right phrenic nerve. On one of them and especially a female cadaver aged 72-year-old we found a branch arising from the thoracic portion of the right phrenic and passing through the two layers of the falciform ligament distributed to the upper surface of the serous layer of the liver in the form of "pes anserinus". As it is known, pain referred from the diaphragmatic peritoneum is classically felt in the shoulder tip but pain from thoracic surfaces supplied by the phrenic nerve is usually located there albeit vaguely. We believe that the above anatomical finding is the explanation of distinct radiating pain from the hepatic region to the right shoulder in some patients. The stimulations is carried through the phrenic nerve to the fourth cervical neurotome from were arise the supraclavicular nerves which are distributed to the shoulder region.
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Affiliation(s)
- K Natsis
- Department of Anatomy, Medical School of the Aristotle University of Thessaloniki, Greece
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Abstract
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.
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Affiliation(s)
- Dror Robinson
- Department of Othopedics, Assaf Harofe Medical Center, Zeriffin, Israel.
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Foye PM. Finding the etiology of shoulder pain. Arch Phys Med Rehabil 2000; 81:1256. [PMID: 10987175 DOI: 10.1053/apmr.2000.18577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Petchkrua W, Harris SA. The authors reply. Arch Phys Med Rehabil 2000; 81:1256. [DOI: 10.1016/s0003-9993(00)70071-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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