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de Almeida LA, Pereira ND, Haik MN, Camargo PR. Linking patient reported shoulder outcomes to the international classification of functioning, disability and health. Disabil Rehabil 2024; 46:979-987. [PMID: 36803506 DOI: 10.1080/09638288.2023.2180544] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 02/05/2023] [Accepted: 02/10/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE To link the items from shoulder-specific Patient Reported Outcome Measures (PROMs) to the International Classification of Functioning, Disability and Health (ICF) domains and categories, and to determine if the items fit into the ICF framework. MATERIALS AND METHODS The Brazilian versions of the Oxford Shoulder Score (OSS), Shoulder Pain and Disability Index (SPADI), Simple Shoulder Test (SST) and Western Ontario Rotator Cuff Index (WORC) were linked to the ICF by two researchers independently. Agreement between raters was determined by calculating the Kappa Index. RESULTS Fifty-eight items from the PROMs were linked to eight domains and 27 categories of ICF. The PROMs covered components of body functions, activities, and participation. Components of body structure and environmental factors were not covered by any of the PROMs. There was substantial agreement between raters when linking the OSS (Kappa index = 0.66), SPADI (Kappa index = 0.92), SST (Kappa index = 0.72) and WORC (Kappa index = 0.71). CONCLUSIONS WORC and SST were the PROMs that covered the highest number of ICF domains (seven and six, respectively). However, SST is short and may be less time consuming in a clinical assessment. Clinicians can benefit from this study to decide which shoulder-specific PROM may be more adequate according to the clinical demand.Implications For RehabilitationWestern Ontario Rotator Cuff Index was the shoulder-specific Patient Reported Outcome Measure (PROM) that best showed a broader view of functionality through the International Classification of Functioning, Disability and Health (ICF) domains that can influence shoulder pain and disability.Simple Shoulder Test seems to be the most recommended shoulder-specific PROM considering the number of domains covered by the ICF and the clinical evaluation time consumption.Shoulder Pain and Disability Index fails to provide a broader view of functioning through other ICF domains that may influence shoulder pain and disability.
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Affiliation(s)
- Lucas Araújo de Almeida
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Natalia Duarte Pereira
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, Brazil
- Department of Physical Therapy, Functionality and Technological Innovation in Neuro Rehabilitation Group - GFIT, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Melina Nevoeiro Haik
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Paula Rezende Camargo
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, Brazil
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Ribeiro LP, Curiel-Montero F, Rodrigues-de-Souza DP, Camargo PR, Alburquerque-Sendín F. Assessment of description and implementation fidelity of clinical trials involving exercise-based treatment in individuals with rotator cuff tears: a scoping review. Braz J Phys Ther 2024; 28:101062. [PMID: 38640642 PMCID: PMC11039315 DOI: 10.1016/j.bjpt.2024.101062] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/13/2024] [Accepted: 03/27/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND For evidence-based practice, clinicians and researchers can rely on well-conducted randomized clinical trials that exhibit good methodological quality, provide adequate intervention descriptions, and implementation fidelity. OBJECTIVE To assess the description and implementation fidelity of exercise-based interventions in clinical trials for individuals with rotator cuff tears. METHODS A systematic search was conducted in PubMed, Embase, CINAHL, LILACS, Cochrane Library, Web of Science, SCOPUS and SciELO. Randomized clinical trials that assessed individuals with rotator cuff tears confirmed by imaging exam were included. All individuals must have received an exercise-based treatment. The methodological quality was scored with the Physiotherapy Evidence Database (PEDro) scale. The Template for Intervention Description and Replication (TIDieR) checklist and the National Institutes of Health Behaviour Change Consortium (NIHBCC) were used to assess intervention description and implementation fidelity, respectively. RESULTS A total of 13 studies were included. Despite their adequate methodological quality, the description of the intervention was poor with TIDieR scores ranging from 6 to 15 out of 24 total points. The TIDieR highest-scoring item was item 1 (brief name) that was reported in all studies. Considering fidelity, only one of the five domains of NIHBCC (i.e., treatment design) reached just over 50%. CONCLUSION Exercise-based interventions used in studies for individuals with rotator cuff tears are poorly reported. The description and fidelity of the intervention need to be better reported to assist clinical decision-making and support evidence-based practice.
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Affiliation(s)
- Larissa Pechincha Ribeiro
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Francisca Curiel-Montero
- Department of Nursing, Pharmacology and Physical Therapy, Universidad de Córdoba, Córdoba, Spain
| | - Daiana Priscila Rodrigues-de-Souza
- Department of Nursing, Pharmacology and Physical Therapy, Universidad de Córdoba, Córdoba, Spain; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain
| | - Paula Rezende Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil.
| | - Francisco Alburquerque-Sendín
- Department of Nursing, Pharmacology and Physical Therapy, Universidad de Córdoba, Córdoba, Spain; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain
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Araújo Almeida L, Bilterys T, Van Looveren E, Mairesse O, Cagnie B, Meeus M, Moens M, Goubert D, Munneke W, Danneels L, Ickmans K, Rezende Camargo P, Nijs J, Malfliet A, De Baets L. Do Patients with Chronic Spinal Pain and Comorbid Insomnia Have More Features of Central Sensitization? A Case-Control Study. Healthcare (Basel) 2023; 11:3152. [PMID: 38132043 PMCID: PMC10742599 DOI: 10.3390/healthcare11243152] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/26/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Chronic spinal pain (CSP) is a major public health problem worldwide, frequently related to sleep problems. Central sensitization (CS) may worsen the clinical picture of CSP patients with insomnia. The aim of this study was to compare self-reported and objectively measured clinical outcomes between insomniac CSP patients with comorbid insomnia with and without symptoms of CS. METHODS A case-control study on baseline self-reported sleep, functioning, and psychological distress through online questionnaires. Objective sleep and physical activity parameters and pressure pain thresholds (PPTs) were assessed through polysomnography, actigraphy, and digital algometry, respectively. Independent sample t-test and Mann-Whitney U tests were used to examine possible differences in the outcome measures between the groups. RESULTS Data from 123 participants were included and revealed no statistically significant group for objective sleep and physical activity parameters. The CS group, however, presented with worse self-reported sleep (quality sleep, insomnia severity, and dysfunctional beliefs about sleep), increased mental and physical fatigue, and higher psychological distress (anxiety and depressive symptoms), and reported lower PPTs. CONCLUSIONS symptoms of CS may influence perceived sleep and affect functional health and well-being perception but do not seem to affect objective sleep and physical activity.
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Affiliation(s)
- Lucas Araújo Almeida
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103—Building F, 1090 Brussel, Belgium; (L.A.A.); (T.B.); (E.V.L.); (W.M.); (K.I.); (J.N.); (A.M.)
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos 13565-905, SP, Brazil;
- Department of Physical Therapy, University of Florida, Gainesville, FL 32611, USA
| | - Thomas Bilterys
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103—Building F, 1090 Brussel, Belgium; (L.A.A.); (T.B.); (E.V.L.); (W.M.); (K.I.); (J.N.); (A.M.)
- Pain in Motion International Research Group, 1090 Brussel, Belgium; (M.M.); (M.M.); (D.G.)
- Department of Psychology, University of Warwick, Coventry CV4 7AL, UK
- Institute of Advanced Study, University of Warwick, Coventry CV4 7AL, UK
| | - Eveline Van Looveren
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103—Building F, 1090 Brussel, Belgium; (L.A.A.); (T.B.); (E.V.L.); (W.M.); (K.I.); (J.N.); (A.M.)
- Pain in Motion International Research Group, 1090 Brussel, Belgium; (M.M.); (M.M.); (D.G.)
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus Heymans—Building B3, De Pintelaan 185, 9000 Ghent, Belgium; (B.C.); (L.D.)
| | - Olivier Mairesse
- Brain, Body and Cognition (BBCO), Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1090 Brussels, Belgium;
| | - Barbara Cagnie
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus Heymans—Building B3, De Pintelaan 185, 9000 Ghent, Belgium; (B.C.); (L.D.)
| | - Mira Meeus
- Pain in Motion International Research Group, 1090 Brussel, Belgium; (M.M.); (M.M.); (D.G.)
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus Heymans—Building B3, De Pintelaan 185, 9000 Ghent, Belgium; (B.C.); (L.D.)
- Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Maarten Moens
- Pain in Motion International Research Group, 1090 Brussel, Belgium; (M.M.); (M.M.); (D.G.)
- Department of Neurosurgery and Radiology, University Hospital Brussels, 1090 Brussels, Belgium
- Stimulus Research Group, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Center of Neurosciences, Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - Dorien Goubert
- Pain in Motion International Research Group, 1090 Brussel, Belgium; (M.M.); (M.M.); (D.G.)
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus Heymans—Building B3, De Pintelaan 185, 9000 Ghent, Belgium; (B.C.); (L.D.)
| | - Wouter Munneke
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103—Building F, 1090 Brussel, Belgium; (L.A.A.); (T.B.); (E.V.L.); (W.M.); (K.I.); (J.N.); (A.M.)
- Pain in Motion International Research Group, 1090 Brussel, Belgium; (M.M.); (M.M.); (D.G.)
- Department of Sport and Rehabilitation Sciences, University of Liège, 4000 Liege, Belgium
| | - Lieven Danneels
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus Heymans—Building B3, De Pintelaan 185, 9000 Ghent, Belgium; (B.C.); (L.D.)
| | - Kelly Ickmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103—Building F, 1090 Brussel, Belgium; (L.A.A.); (T.B.); (E.V.L.); (W.M.); (K.I.); (J.N.); (A.M.)
- Pain in Motion International Research Group, 1090 Brussel, Belgium; (M.M.); (M.M.); (D.G.)
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
- Movement & Nutrition for Health & Performance Research Group (MOVE), Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium
| | - Paula Rezende Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos 13565-905, SP, Brazil;
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103—Building F, 1090 Brussel, Belgium; (L.A.A.); (T.B.); (E.V.L.); (W.M.); (K.I.); (J.N.); (A.M.)
- Pain in Motion International Research Group, 1090 Brussel, Belgium; (M.M.); (M.M.); (D.G.)
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 41390 Göterbog, Sweden
| | - Anneleen Malfliet
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103—Building F, 1090 Brussel, Belgium; (L.A.A.); (T.B.); (E.V.L.); (W.M.); (K.I.); (J.N.); (A.M.)
- Pain in Motion International Research Group, 1090 Brussel, Belgium; (M.M.); (M.M.); (D.G.)
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
- Research Foundation—Flanders (FWO), 1000 Brussels, Belgium
| | - Liesbet De Baets
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103—Building F, 1090 Brussel, Belgium; (L.A.A.); (T.B.); (E.V.L.); (W.M.); (K.I.); (J.N.); (A.M.)
- Pain in Motion International Research Group, 1090 Brussel, Belgium; (M.M.); (M.M.); (D.G.)
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Kamonseki DH, Haik MN, Ribeiro LP, Almeida RF, Camargo PR. Scapular movement training is not superior to standardized exercises in the treatment of individuals with chronic shoulder pain and scapular dyskinesis: randomized controlled trial. Disabil Rehabil 2023; 45:2925-2935. [PMID: 36000960 DOI: 10.1080/09638288.2022.2114552] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 08/06/2022] [Accepted: 08/13/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To investigate whether scapular movement training (SMT) is superior to standardized exercises in improving scapular biomechanics, behavioral, and clinical aspects of individuals with shoulder pain. METHODS AND METHODS A total of 64 individuals with chronic shoulder pain were randomly assigned to receive 16 sessions of SMT or SE over 8 weeks. Outcome measures included three-dimensional scapular kinematics, muscle activity of scapulothoracic muscles, pain, disability, fear-avoidance, kinesiophobia, and self-perceived changes. Kinematics and muscle activity were assessed at baseline and after treatment, and self-reported measurements at baseline, 4, 8, and 12 weeks. RESULTS SMT significantly (p < 0.05) decreased scapular internal rotation during arm elevation and lowering at sagittal and scapular planes (mean difference [MD]: ranged from 2.8 to 4.1°), and at lower angles of arm elevation and lowering at the frontal plane (MD: 3.4° and 2.4°, respectively), increased upper trapezius (UT) activity (MD: 10.3%) and decreased middle trapezius (MT) (MD: 60.4%) and serratus anterior (MD: 9.9%) activity during arm lowering compared to SE. Both groups significantly improved pain, disability, fear-avoidance, kinesiophobia, and self-perceived changes over 4 weeks, which was sustained over the remaining 8 weeks. CONCLUSIONS SMT is not superior to standardized exercises in improving scapular biomechanics, behavioral, and clinical aspects of individuals with shoulder pain. CLINICAL TRIAL REGISTRATION NUMBER NCT03528499Implications for rehabilitationScapular movement training (SMT) showed small and likely not clinically relevant changes in scapular kinematics and muscle activity compared to standardized exercises.SMT and standardized exercises presented similar improvements in pain, disability, fear-avoidance beliefs, kinesiophobia, and self-perceived change in health condition immediately following 4-weeks of treatment, which was sustained over the following 8 weeks.The changes in patient-reported outcome measures are unlikely to be associated with changes in scapular kinematics and electromyographic activity.Clinicians should consider other factors than scapular movement during the treatment of patients with shoulder pain.
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Affiliation(s)
- Danilo Harudy Kamonseki
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Melina Nevoeiro Haik
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Larissa Pechincha Ribeiro
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Rafaela Firmino Almeida
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Paula Rezende Camargo
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, Brazil
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Pereira ND, Lixandrão MC, Morris D, Michaelsen SM, Camargo PR. Shoulder complex and trunk coordination of individuals with severe hemiparesis following a constraint-induced movement therapy protocol: A case series. J Bodyw Mov Ther 2023; 35:91-98. [PMID: 37330809 DOI: 10.1016/j.jbmt.2023.04.072] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/07/2023] [Accepted: 04/15/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Constraint Induced Movement Therapy (CIMT) has been shown to be an effective rehabilitation technique in individuals with mild and moderate upper limb (UL) hemiparesis. The aim was to evaluate the effect the CIMT for improving paretic UL use and interjoint coordination with individuals in severe hemiparesis. METHODS Six individuals with severe chronic hemiparesis (mean age = 55 ± 16 years) received a UL CIMT intervention for 2 weeks. UL clinical assessments were conducted five times: two assessments at pre-intervention and then, one assessment at post-intervention and 1- and 3-month follow-up using the Graded Motor Activity Log GMAL) and the Graded Wolf Motor Function Test (GWMFT). Scapula, humerus and trunk coordination variability were assessed using the 3-D kinematics during arm elevation, combing hair, turning on the switch and grasp a washcloth. A paired t-test was used to check differences between coordination variability and a one-way ANOVA repeated measures was used to check differences between GMAL and GWMFT scores. RESULTS There were no differences in GMAL and GWMFT between the patient screening and the baseline data collection (p > 0.05). GMAL scores increased at post-intervention and at follow-ups (p < 0.02). GWMFT performance time score decreased at post-intervention and at 1-month follow-up (p < 0.04). Improvements in kinematic variability of the paretic UL at pre and post-intervention were observed in all tasks, except in the activity of turn on the light switch. CONCLUSION Following the CIMT protocol, improvements in GMAL and GWMFT scores may reflect improvements in paretic UL performance, in real-life environment. Improvements in kinematic variability may reflect an improving of UL interjoint coordination for individuals with chronic severe hemiparesis.
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Machado EDM, Haik MN, Ferreira JK, da Silva Santos JF, Camargo PR, Mendonça LDM. Association of trunk and lower limb factors with shoulder complaints and sport performance in overhead athletes: A systematic review including GRADE recommendations and meta-analysis. Phys Ther Sport 2023; 60:112-131. [PMID: 36791672 DOI: 10.1016/j.ptsp.2023.01.012] [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: 11/21/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To identify the association of trunk and lower limb factors with shoulder complaints and sport performance in overhead athletes. METHODS Search performed at PubMed/Medline, Embase, CINAHL, LILACS, Cochrane, Web of Science and SPORTDiscus for observational studies. Methodological quality and strength of the evidence was assessed with the Newcastle-Ottawa Scale and GRADE. Meta-analysis and effects sizes analysis were calculated when possible. RESULTS Sixty-five studies were included. Low to very-low evidence suggests no association of trunk/lower limb strength, endurance, power, jump or balance with shoulder complaints and/or throwing performance. Athletes with shoulder complaints performed worse in trunk stability and endurance tests (mean difference: -6.83 (95%CI: -8.78, -4.88)). Athletes with high throwing performance presented better results in CMJ, horizontal jump, power measures and knee extension strength. For swimmers, there was no association of trunk/lower limb endurance with shoulder complaints (moderate evidence) and no association of balance and swimming performance (low evidence). Better trunk/lower limb strength, power and vertical jumps measures were associated with better swimming performance. CONCLUSIONS In methodologically similar studies, some trunk/lower limb outcomes are associated with shoulder complaint or sport/swimming performance. Results should be considered with caution and future studies should use better methodologies.
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Affiliation(s)
- Eliane de Morais Machado
- Post-Graduate Program in Physical Therapy (PPGFt), Universidade Federal de Sao Carlos (UFSCar), Sao Carlos, Brazil; Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, Sao Carlos, Brazil
| | - Melina Nevoeiro Haik
- Post-Graduate Program in Physical Therapy (PPGFt), Universidade Federal de Sao Carlos (UFSCar), Sao Carlos, Brazil; Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, Sao Carlos, Brazil
| | - Julia Kortstee Ferreira
- Post-Graduate Program in Physical Therapy (PPGFt), Universidade Federal de Sao Carlos (UFSCar), Sao Carlos, Brazil; Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, Sao Carlos, Brazil
| | - Jonatas Ferreira da Silva Santos
- Physical Training and Sport Performance Research Group, Department of Physical Education, School of Biological and Health Sciences, Universidade Federal dos Vales do Jequitinhonha e do Mucuri, Diamantina, MG, Brazil
| | - Paula Rezende Camargo
- Post-Graduate Program in Physical Therapy (PPGFt), Universidade Federal de Sao Carlos (UFSCar), Sao Carlos, Brazil; Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, Sao Carlos, Brazil
| | - Luciana De Michelis Mendonça
- Post-Graduate Program in Physical Therapy (PPGFt), Universidade Federal de Sao Carlos (UFSCar), Sao Carlos, Brazil; Physical Therapy Department, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
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Machado EDM, Secchi LLB, Camargo PR, Mendonça LDM. Influence of quarantine during the coronavirus disease 2019 (COVID-19) pandemic on physical and psychosocial aspects: perceptions of 214 Brazilian athletes. Glob Health J 2023; 7:49-54. [PMID: 36643776 PMCID: PMC9831665 DOI: 10.1016/j.glohj.2023.01.001] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/25/2022] [Accepted: 12/27/2022] [Indexed: 01/12/2023] Open
Abstract
Background Social distancing may affect athletes' training, causing negative effects on mental and physical health. Objective This study therefore aimed to characterize the perception of Brazilian athletes about their physical and psychosocial aspects, sleep quality and coping strategies during the quarantine of the coronavirus disease 2019 (COVID-19) pandemic. Methods This was a cross-sectional study with online survey, performed with Brazilian athletes (amateur and professional) over 18 years. The main outcomes measures assessed were physical and psychosocial aspects, sleep quality and coping strategies. Results A total of 214 athletes were included. The average weekly hours of training during the quarantine was 4.71 ± 3.71 h, of which 64.5% athletes (138/214) were oriented by medical staff during training. For 52.8% (113/214) of athletes, training intensity during the quarantine was different/very different from the intensity before the quarantine. 79.4% athletes (170/214) reported moderate to extreme difficulties in keeping the same level of training during the quarantine. 77.1% athletes (165/214) had moderate to extreme anxiety and each of the athletes had concern about his or her athletic career future, including return to the sport. 72.9% athletes (156/214) reported change in sleep schedule during the quarantine period. Conclusion The quarantine period during COVID-19 pandemic negatively affected the athlete's perception about training routine, since athletes reported reduction in training hours and training intensity. Overall, the athletes reported that they were moderately to extremely anxious. They also had concerns about their career in the future, as well as concerns regarding return to sport.
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Affiliation(s)
- Eliane de Morais Machado
- Physical Therapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, CEP 13565-905, Brazil
| | | | - Paula Rezende Camargo
- Physical Therapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, CEP 13565-905, Brazil
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, CEP 13565-905, Brazil
| | - Luciana De Michelis Mendonça
- Physical Therapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, CEP 13565-905, Brazil
- Physical Therapy Department, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, CEP 31270-901, Brazil
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Pechincha Ribeiro L, Py Gonçalves Barreto R, Augusto Souza Fernandes R, Rezende Camargo P. What factors contribute to the Scapular Assistance Test result? A classification and regression tree approach. PLoS One 2022; 17:e0276662. [PMID: 36269769 PMCID: PMC9586338 DOI: 10.1371/journal.pone.0276662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 10/11/2022] [Indexed: 11/05/2022] Open
Abstract
The aim of this study was to determine predictive factors related to the Scapular Assistance Test in individuals with shoulder pain during arm elevation, and to analyze how these predictors interact in a nonlinear manner to discriminate the result of a positive and negative Scapular Assistance Test. Eighty-four individuals with shoulder pain with positive (n = 47, average age 38.4 years) and negative (n = 37, average age 37.8 years) Scapular Assistance Test completed the study. Demographic data, affected shoulder, pain duration, pain at rest, angular onset of pain, scapular dyskinesis, serratus anterior and lower trapezius muscle strength, Disabilities of Arm, Shoulder and Hand questionnaire and Pain Catastrophizing Scale were assessed in all participants. The Classification and Regression Tree analysis was used to determine which factors would predict the occurrence of a positive or negative Scapular Assistance Test and possible interactions among them. The resulting tree presented seven levels that combine the following variables: angular onset of pain, presence of scapular dyskinesis, pain catastrophizing, serratus anterior and lower trapezius muscle strength. The angular onset of pain during arm elevation was the main predictor of a positive Scapular Assistance Test selected by the Classification and Regression Tree. This study indicates that the Scapular Assistance Test result may be explained not only by biomechanical variables, but also by psychological factors. Disability of the upper limbs does not seem to contribute to the Scapular Assistance Test result.
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Affiliation(s)
- Larissa Pechincha Ribeiro
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Rodrigo Py Gonçalves Barreto
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
| | | | - Paula Rezende Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
- * E-mail:
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Policastro PO, Camargo PR. Return to Play After a Shoulder Injury: Let's Not Put the Cart Before the Horse! Int J Sports Phys Ther 2022; 17:548-550. [PMID: 35693858 PMCID: PMC9159721 DOI: 10.26603/001c.35574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/04/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Pablo Oscar Policastro
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos; KINÉ- Kinesiología Deportiva y Funcional Sports Clinic
| | - Paula Rezende Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos
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Barretti Secchi LL, Kamonseki DH, Camargo PR, Mendonça LDM. Is the isometric strength of the shoulder associated with functional performance tests in overhead athletes? Phys Ther Sport 2022; 55:131-138. [DOI: 10.1016/j.ptsp.2022.03.007] [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] [Received: 10/18/2021] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
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Gava V, Ribeiro LP, Barreto RPG, Camargo PR. Effectiveness of physical therapy given by telerehabilitation on pain and disability of individuals with shoulder pain: A systematic review. Clin Rehabil 2022; 36:715-725. [PMID: 35230167 DOI: 10.1177/02692155221083496] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To systematically review the effects of physical therapy given by telerehabilitation on pain and disability in individuals with shoulder pain. DATA SOURCES PubMed, Embase, CINAHL, LILACS, Cochrane, Web of Science, SCOPUS, SciELO and Ibecs were searched in January/2022. METHODS This systematic review followed PRISMA guidelines. Randomized controlled trials investigating the effects of physical therapy given by telerehabilitation on pain and disability in patients with shoulder pain were included. The quality and level of the evidence were assessed with the Cochrane Risk of Bias tool and GRADE, respectively. The effect sizes of the main outcomes were also calculated. RESULTS Six randomized controlled trials were included with a total sample of 368 patients with shoulder pain. Four and two randomized controlled trials were assessed as low and high risk of bias, respectively. Three randomized controlled trials assessed shoulder post-operative care, two assessed chronic shoulder pain, and one assessed frozen shoulder. Very low to low evidence suggests that there is no difference between telerehabilitation and in-person physical therapy or home-based exercises programs to improve pain and disability in patients with shoulder pain. Low evidence suggests that telerehabilitation is superior to advice only to improve shoulder pain (effect size: 2.42; 95% Confidence Interval: 1.72, 3.06) and disability (effect size: 1.61; 95% Confidence Interval: 1.01, 2.18). CONCLUSIONS Although telerehabilitation may be a promising tool to treat patients with shoulder pain and disability, the very low to low quality of evidence does not support a definite recommendation of its use in this population.
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Affiliation(s)
- Vander Gava
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, 67828Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Larissa Pechincha Ribeiro
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, 67828Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | | | - Paula Rezende Camargo
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, 67828Universidade Federal de São Carlos, São Carlos, SP, Brazil
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Requejo-Salinas N, Lewis J, Michener LA, La Touche R, Fernández-Matías R, Tercero-Lucas J, Camargo PR, Bateman M, Struyf F, Roy JS, Jaggi A, Uhl T, Bisset L, Wassinger CA, Donatelli R, Haik MN, Lluch-Girbés E. International physical therapists consensus on clinical descriptors for diagnosing rotator cuff related shoulder pain: A Delphi study. Braz J Phys Ther 2022; 26:100395. [PMID: 35366589 DOI: 10.1016/j.bjpt.2022.100395] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 01/12/2022] [Accepted: 02/08/2022] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND There is a lack of standardized criteria for diagnosing rotator cuff related shoulder pain (RCRSP). OBJECTIVE To identify the most relevant clinical descriptors for diagnosing RCRSP. METHODS A Delphi study was conducted through use of an international physical therapists expert panel. A 3-round Delphi survey involving an international panel of physical therapists experts with extensive clinical, teaching, and research experience was conducted. A search query was performed in Web of Science, along with a manual search, to find the experts. The first round was composed of items obtained from a previous pilot Delphi study along with new items proposed by the experts. Participants were asked to rate items across six clinical domains using a five-point Likert scale. An Aiken's Validity Index ≥ 0.7 was considered indicative of group consensus. RESULTS Fifteen experts participated in the Delphi survey. After the three rounds, consensus was reached on 18 clinical descriptors: 10 items were included in the "subjective examination" domain, 1 item was included in the "patient-reported outcome measures" domain, 3 items in the "diagnostic examination" domain, 2 items in the "physical examination" domain", and 2 items in the "functional tests" domain. No items reached consensus within the "special tests" domain. The reproduction of symptoms in relation to the application of load, the performance of overhead activities, and the need of active and resisted movement assessment were some of the results with greatest consensus. CONCLUSION In this Delphi study, a total of 18 clinical descriptors across six clinical domains were agreed upon for diagnosing RCRSP.
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Affiliation(s)
- Néstor Requejo-Salinas
- Department of Physical Therapy, Superior Center for University Studies La Salle, Autonomous University of Madrid, Madrid, Spain; Motion in Brains Research Group, Institute of Neuroscience and Movement Sciences (INCIMOV). Superior Center for University Studies La Salle. Autonomous University of Madrid, Madrid, Spain
| | - Jeremy Lewis
- School of Health and Social Work, University of Hertfordshire, Hertfordshire, United Kingdom; Therapy Department, Central London Community Healthcare National Health Service Trust, London, United Kingdom; Department of Physical Therapy & Rehabilitation Science, College of Health Sciences, Qatar University, Doha, Qatar
| | - Lori A Michener
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, United States
| | - Roy La Touche
- Department of Physical Therapy, Superior Center for University Studies La Salle, Autonomous University of Madrid, Madrid, Spain; Motion in Brains Research Group, Institute of Neuroscience and Movement Sciences (INCIMOV). Superior Center for University Studies La Salle. Autonomous University of Madrid, Madrid, Spain; Neuroscience and Craniofacial Pain Institute (INDCRAN), Madrid, Spain
| | - Rubén Fernández-Matías
- Research Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain; Research Institute of Physical Therapy and Pain, University of Alcala, Alcala de Henares, Madrid, Spain.
| | | | - Paula Rezende Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Marcus Bateman
- Derby Shoulder Unit, Orthopaedic Outpatient Department, Royal Derby Hospital, Derby, United Kingdom
| | - Filip Struyf
- Department Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Jean-Sébastien Roy
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada; Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec Rehabilitation Institute, Quebec City, Quebec, Canada
| | - Anju Jaggi
- Royal National Orthopaedic Hospital NHS Trust, London Borough of Harrow, London, United Kingdom
| | - Timothy Uhl
- Department of Physical Therapy, University of Kentucky, Lexington, United States
| | - Leanne Bisset
- School of Allied Health Sciences, Griffith University, South East Queensland, Australia
| | - Craig A Wassinger
- Department of Physical Therapy, East Tennessee State University, Johnson City, Tennessee, United States
| | | | - Melina Nevoeiro Haik
- Department of Physical Therapy, Center of Health and Sport Science, Universidade do Estado de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Enrique Lluch-Girbés
- Department of Physical Therapy, University of Valencia, Valencia, Spain; Pain in Motion Research Group, University of Valencia, Valencia, Spain
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Gava V, Rosa DP, Pereira ND, Phadke V, Camargo PR. Ratio between 3D glenohumeral and scapulothoracic motions in individuals without shoulder pain. J Electromyogr Kinesiol 2021; 62:102623. [PMID: 34979438 DOI: 10.1016/j.jelekin.2021.102623] [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: 02/23/2021] [Revised: 11/25/2021] [Accepted: 11/30/2021] [Indexed: 10/19/2022] Open
Abstract
This study determined the ratio between glenohumeral and three-dimensional scapular motion during arm elevation and lowering in 91 individuals without shoulder pain. Scapular kinematics were assessed using an electromagnetic tracking device. Individuals performed 3 repetitions of elevation and lowering of the arm in the sagittal plane. Two-way ANOVAs (interval: 30-60°, 60-90°, 90-120° x phase: elevation and lowering) and paired t-tests were used for data analysis. For scapular internal/external rotation, lesser scapular internal rotation contribution was found during the 60-90° interval as compared to the 90-60° interval. Lesser scapular external rotation was identified in the 60-30° interval of arm lowering. The ratio was greater during arm elevation (1.89) compared to lowering (1.74) across the entire motion arc. For scapular upward rotation, greater upward rotation contribution was observed during arm elevation at the 30-60° interval, and less scapular downward rotation contribution in the final range of arm lowering. For scapular tilt, lesser scapular posterior tilt contribution during arm elevation was observed compared to arm lowering. The ratios between glenohumeral elevation/lowering and each individual scapulothoracic motion showed either differences between intervals and/or between elevation and lowering during specific intervals in healthy individuals.
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Affiliation(s)
- Vander Gava
- Department of Physical Therapy, Universidade Federal de São Carlos, Rodovia Washington Luis km 235, São Carlos, SP 13565-905, Brazil
| | - Dayana Patricia Rosa
- Department of Physical Therapy, Universidade Federal de São Carlos, Rodovia Washington Luis km 235, São Carlos, SP 13565-905, Brazil
| | - Natalia Duarte Pereira
- Department of Physical Therapy, Universidade Federal de São Carlos, Rodovia Washington Luis km 235, São Carlos, SP 13565-905, Brazil
| | - Vandana Phadke
- Department of Clinical Research, Indian Spinal Injuries Center, Vasant Kunj, New Delhi 110070, India
| | - Paula Rezende Camargo
- Department of Physical Therapy, Universidade Federal de São Carlos, Rodovia Washington Luis km 235, São Carlos, SP 13565-905, Brazil.
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Kamonseki DH, Haik MN, Ribeiro LP, de Almeida RF, de Almeida LA, Fonseca CL, Camargo PR. Measurement properties of the Brazilian versions of Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia in individuals with shoulder pain. PLoS One 2021; 16:e0260452. [PMID: 34852000 PMCID: PMC8635377 DOI: 10.1371/journal.pone.0260452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 11/09/2021] [Indexed: 01/26/2023] Open
Abstract
PURPOSE To verify the measurement properties of the Brazilian versions of Fear-avoidance Beliefs Questionnaire (FABQ) and Tampa Scale of Kinesiophobia (TSK) in individuals with shoulder pain. METHODS Individuals with shoulder pain (>18 years) were included in this study. Structural validity was verified by exploratory factor analysis, which was used to identify dimensionality of the FABQ and TSK. Test-retest reliability was assessed with intraclass correlation coefficient(3,1) and internal consistency with Cronbach's alpha. Floor or ceiling effects were also investigated. Responsiveness was verified by effect sizes and area under the receiver operating characteristic curve (AUC). RESULTS Exploratory factor analysis identified two and one factor in the FABQ and TSK, respectively. FABQ and TSK presented moderate to good reliability and adequate internal consistency (Cronbach's alpha > 0.70). The floor effect was present in one factor of the FABQ. The FABQ and TSK showed small to moderate effect sizes and did not show adequate AUC. CONCLUSION FABQ and TSK are multidimensional and unidimensional instruments, respectively. Those instruments presented moderate to good reliability and the responsiveness was considered to be suboptimal in individuals with shoulder pain.
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Affiliation(s)
- Danilo Harudy Kamonseki
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, (SP), Brazil
| | - Melina Nevoeiro Haik
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, (SP), Brazil
| | - Larissa Pechincha Ribeiro
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, (SP), Brazil
| | - Rafaela Firmino de Almeida
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, (SP), Brazil
| | - Lucas Araújo de Almeida
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, (SP), Brazil
| | | | - Paula Rezende Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, (SP), Brazil
- * E-mail:
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Kamonseki DH, Pott-Junior H, Haik MN, Almeida LAD, Camargo PR. Pain-related fear phenotypes are associated with function of the upper limbs in individuals with shoulder pain. Musculoskelet Sci Pract 2021; 55:102416. [PMID: 34175789 DOI: 10.1016/j.msksp.2021.102416] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/30/2021] [Accepted: 06/09/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To identify and describe phenotypes related to kinesiophobia, fear-avoidance, and pain catastrophizing, and determine clinical and demographic characteristics related to each phenotype as a function of self-reported function of the upper limbs in individuals with shoulder pain. METHODS One hundred and seventy-seven individuals with shoulder pain participated in this study. Tampa Scale of Kinesiophobia, Fear-Avoidance Beliefs Questionnaire, Pain Catastrophizing Scale, Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH), Numerical Pain of Rating Scale, and the angular onset of pain during the elevation of the arm were measured in all participants. A cluster analysis was performed considering kinesiophobia, fear-avoidance, and pain catastrophizing, then clinical and demographic characteristics of clusters were used to model individual's chance to belong to one of the clusters as a function of DASH. RESULTS Two clusters were identified based on kinesiophobia, fear-avoidance, and pain catastrophizing. The cluster with worse pain-related fear profile presented (p < 0.05) higher age, worse function, and higher pain intensity. This same cluster was also associated with involvement of the dominant side (OR = 2.10, 95% CI = 1.03, 4.41) and worse function (OR = 0.96, 95% CI = 0.94, 0.98). CONCLUSION This study identified that individuals with worse pain-related fear profile were older, with worse function, and higher pain intensity. Worse function and involvement of the dominant side were associated with the phenotype with a worse pain-related fear condition.
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Affiliation(s)
- Danilo Harudy Kamonseki
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos (SP), Brazil
| | - Henrique Pott-Junior
- Department of Medicine, Universidade Federal de São Carlos (UFSCar), São Carlos (SP), Brazil
| | - Melina Nevoeiro Haik
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos (SP), Brazil
| | - Lucas Araújo de Almeida
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos (SP), Brazil
| | - Paula Rezende Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos (SP), Brazil.
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Mazuquin B, Trede RG, Camargo PR. An online survey of clinical practice of Brazilian physical therapists on rehabilitation following rotator cuff repair. J Clin Orthop Trauma 2021; 17:143-148. [PMID: 33791190 PMCID: PMC7994437 DOI: 10.1016/j.jcot.2021.03.008] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Physical therapy is essential to help patients to recover their movements and function following a rotator cuff repair. However, there are uncertainties regarding how long a sling should be used for and when exercises should be started. OBJECTIVE To investigate the current clinical practice of Brazilian physical therapists treating patients who had a rotator cuff repair. We also explored differences between shoulder specialists and non-specialists. METHODS An online survey with 38 questions, including a clinical case, regarding the physical therapy clinical practice for patients having a rotator cuff repair. RESULTS We analyzed 194 responses. Majority of participants were from the Southeast of Brazil (57.5%), had up to 10 years of clinical experience (61.4%) and were not shoulder-specialists (69.8%). Majority of the respondents stated that patients have their first post-operative physical therapy session within the first three weeks (51%). Patients usually use a sling for four to six weeks (60.6%). Passive mobilization is often started in the first-week post-surgery. Fifteen percent of shoulder specialists compared to only six percent of non-shoulder specialists would allow strengthening exercises to start between the first and third weeks post-surgery. CONCLUSION Physical therapists in Brazil seems to follow similar postoperative programs to other countries. Shoulder specialists allow a faster return to activities and start of strengthening exercises.
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Affiliation(s)
- Bruno Mazuquin
- Faculty of Health, Psychology and Social Care, Department of Health Professions, Manchester Metropolitan University, United Kingdom,Corresponding author. Faculty of Health, Psychology and Social Care, Brooks Building, 53 Bonsall street, Manchester, M15 6GX, UK.
| | - Renato Guilherme Trede
- Movement Analysis Laboratory, Physical Therapy Department, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brazil
| | - Paula Rezende Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Physical Therapy Department, Universidade Federal de São Carlos, Brazil
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Kamonseki DH, Haik MN, Camargo PR. Scapular movement training versus standardized exercises for individuals with chronic shoulder pain: protocol for a randomized controlled trial. Braz J Phys Ther 2021; 25:221-229. [PMID: 32855073 PMCID: PMC7990736 DOI: 10.1016/j.bjpt.2020.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 07/31/2020] [Accepted: 08/05/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Scapular focused exercise interventions are frequently used to treat individuals with shoulder pain. However, evidence for changes in scapular motion after intervention is limited. OBJECTIVE To compare the effects of scapular movement training versus standardized exercises for individuals with shoulder pain. METHODS This will be a single-blinded randomized controlled trial. Sixty-four individuals with shoulder pain for at least 3 months, scapular dyskinesis, and a positive scapular assistance test will be randomly allocated to one of two groups: Scapular Movement Training (group 1) and Standardized Exercises (group 2). Group 1 will receive education about scapular position and movement, and be trained to modify the scapular movement pattern. Group 2 will perform stretching and strengthening exercises. Both groups will be treated twice a week for eight weeks. Three-dimensional scapular kinematics and muscle activity of the serratus anterior and upper, middle, and lower trapezius during elevation and lowering of the arm will be assessed at baseline and after 8 weeks of treatment. Pain intensity, function, fear avoidance beliefs, and kinesiophobia will be assessed at baseline and after 4 and 8 weeks of treatment, and 4 weeks after the end of treatment. CONCLUSIONS The results of this study may contribute to a better understanding of the efficacy of scapular focused treatments for individuals with shoulder pain. CLINICAL TRIAL REGISTRATION NCT03528499.
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Affiliation(s)
- Danilo Harudy Kamonseki
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Melina Nevoeiro Haik
- Department of Physical Therapy, Center of Health and Sport Science, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | - Paula Rezende Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil.
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Kamonseki DH, Calixtre LB, Barreto RPG, Camargo PR. Effects of electromyographic biofeedback interventions for shoulder pain and function: Systematic review and meta-analysis. Clin Rehabil 2021; 35:952-963. [PMID: 33517777 DOI: 10.1177/0269215521990950] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To systematically review the effectiveness of electromyographic biofeedback interventions to improve pain and function of patients with shoulder pain. DESIGN Systematic review of controlled clinical trials. LITERATURE SEARCH Databases (Medline, EMBASE, CINAHL, PEDro, CENTRAL, Web of Science, and SCOPUS) were searched in December 2020. STUDY SELECTION CRITERIA Randomized clinical trials that investigated the effects of electromyographic biofeedback for individuals with shoulder pain. Patient-reported pain and functional outcomes were collected and synthesized. DATA SYNTHESIS The level of evidence was synthesized using GRADE and Standardized Mean Differences and 95% confidence interval were calculated using a random-effects inverse variance model for meta-analysis. RESULTS Five studies were included with a total sample of 272 individuals with shoulder pain. Very-low quality of evidence indicated that electromyographic biofeedback was not superior to control for reducing shoulder pain (standardized mean differences = -0.21, 95% confidence interval: -0.67 to 0.24, P = 0.36). Very-low quality of evidence indicated that electromyographic biofeedback interventions were not superior to control for improving shoulder function (standardized mean differences = -0.11, 95% confidence interval: -0.41 to 0.19, P = 0.48). CONCLUSION Electromyographic biofeedback may be not effective for improving shoulder pain and function. However, the limited number of included studies and very low quality of evidence does not support a definitive recommendation about the effectiveness of electromyographic biofeedback to treat individuals with shoulder pain.
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Affiliation(s)
- Danilo Harudy Kamonseki
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Letícia Bojikian Calixtre
- Department of Dental Materials and Prosthodontics, Araraquara Dental School, Universidade Estadual Paulista (UNESP), Araraquara, São Paulo, Brazil
| | - Rodrigo Py Gonçalves Barreto
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Paula Rezende Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, Brazil
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Ribeiro LP, Cools A, Camargo PR. Rotator cuff unloading versus loading exercise program in the conservative treatment of patients with rotator cuff tear: protocol of a randomised controlled trial. BMJ Open 2020; 10:e040820. [PMID: 33310803 PMCID: PMC7735118 DOI: 10.1136/bmjopen-2020-040820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Atraumatic and degenerative rotator cuff tears are common in individuals over 55 years of age. This condition can have a high impact on social life and is associated with chronic pain, weakness and dysfunction of the upper limb. There is evidence that conservative approaches should be the first treatment option. Conservative treatment usually addresses a variety of therapeutic behaviours without providing scientific arguments for the choice and progression of exercises. OBJECTIVE To compare the effects of two different exercise programmes based on the load of the rotator cuff on a population with shoulder pain and rotator cuff tears. METHODS AND ANALYSIS This is a controlled, randomised, blinded clinical trial. Seventy-eight individuals with shoulder pain and presence of atraumatic and degenerative rotator cuff tear will participate and will be randomly distributed between two groups. The primary outcome will be quality of life (The Western Ontario Rotator Cuff Index), and secondary outcomes will include pain, function (Disabilities of the Arm, Shoulder and Hand), fear avoidance beliefs (Fear Avoidance Beliefs Questionnaire-Brazil), kinesiophobia (Tampa Scale), Pain Catastrophizing Scale, muscle strength of abductors, external and internal rotators of the shoulder, range of motion of arm elevation and patient satisfaction. The treatment will be performed for 12 weeks (2 x/week) acording to the selected group (Rotator Cuff Unloading x Rotator Cuff Loading Exercise Programme). ETHICS AND DISSEMINATION The study protocol was approved by the Institutional Review Board. The findings of the trial will be disseminated through peer-reviewed journals and scientific conferences. TRIAL REGISTRATION NUMBER NCT03962231.
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Affiliation(s)
- Larissa Pechincha Ribeiro
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Ann Cools
- Department of Rehabilitation Sciences and Physical Therapy, Ghent University, Ghent, Belgium
| | - Paula Rezende Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
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Ribeiro LP, Barreto RPG, Pereira ND, Camargo PR. Comparison of scapular kinematics and muscle strength between those with a positive and a negative Scapular Assistance Test. Clin Biomech (Bristol, Avon) 2020; 73:166-171. [PMID: 32000046 DOI: 10.1016/j.clinbiomech.2019.12.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 11/21/2019] [Accepted: 12/31/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND The Scapular Assistance Test was suggested to directly assess the influence of scapular motion on pain and indirectly measure the function of the scapular rotators. However, it is still not clear if individuals with a positive Scapular Assistance Test actually present changes in scapular motion and muscle strength. This study compared scapular kinematics and muscle strength between those with a positive Scapular Assistance Test and those with a negative Scapular Assistance Test. METHODS Fifty individuals with shoulder pain were randomly allocated to: positive (n = 25) or negative Scapular Assistance Test (n = 25) group. Scapular kinematics was measured during elevation and lowering of the arm. Strength of the serratus anterior and lower trapezius was also measured. Two-way analysis of variance was used to compare kinematics between groups. Unpaired Student's t-test and Mann-Whitney test were used to compare strength of serratus anterior and lower trapezius, respectively. FINDINGS There were no differences (P > 0.05) in scapular internal rotation and upward rotation between both groups. For scapular tilt, there was group main effect (P < 0.05) during elevation and lowering of the arm, whereas the positive Scapular Assistance Test group presented greater scapular anterior tilt. There was no difference (P > 0.05) in strength between groups. INTERPRETATION Individuals with a positive Scapular Assistance Test are more likely to present decreased scapular posterior tilt in those with shoulder pain. Strength of the scapular muscles seems to be same in those with a positive and a negative Scapular Assistance Test.
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Affiliation(s)
- Larissa Pechincha Ribeiro
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Rodrigo Py Gonçalves Barreto
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Natalia Duarte Pereira
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Paula Rezende Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil.
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21
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Ribeiro IL, Moreira RFC, Ferrari AV, Alburquerque-Sendín F, Camargo PR, Salvini TF. Effectiveness of early rehabilitation on range of motion, muscle strength and arm function after breast cancer surgery: a systematic review of randomized controlled trials. Clin Rehabil 2019; 33:1876-1886. [PMID: 31480855 DOI: 10.1177/0269215519873026] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The objective was to evaluate the effectiveness of early rehabilitation on arm range of motion (ROM), strength and function after breast cancer surgery (BCS). Data sources: PubMed, MEDLINE, Bireme, Embase, LILACS and CINAHL databases were searched. METHODS Two independent reviewers selected randomized controlled trials evaluating women who underwent early rehabilitation to restore arm ROM, strength or function after BCS. Cochrane Collaboration recommendations and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Methodological quality was assessed by the PEDro scale. The International Classification of Functioning, Disability and Health was considered to analyze results. Effect size (ES) was calculated for clinical relevance interpretation of the outcomes of interest, and the evidence was summarized through the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. RESULTS Up to June 2019, a total of 1658 references were identified and 15 studies were included. Twelve of them presented adequate methodological quality. A total of 1710 patients were evaluated. Few studies performed the simultaneous assessment of variables related to body structure and function and patient-reported outcomes. A moderate level of evidence was synthesized regarding the effectiveness of ROM exercises for improving arm flexion, abduction and external rotation (ES: 0.45-2.5). A low level of evidence was synthesized regarding the effectiveness of isolated strengthening exercises for patient-reported arm function. ROM exercises associated with muscle strengthening exhibited a moderate level of evidence for improving shoulder flexion (ES: 1.4-2.4). CONCLUSION Both ROM and strengthening exercises associated with ROM exercises improved shoulder flexion, abduction and external rotation ROM after BCS. Shoulder abduction and external rotation showed less recovery, irrespective of the intervention applied.
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Affiliation(s)
- Ivana Leão Ribeiro
- Department of Kinesiology, Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile.,Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
| | | | | | - Francisco Alburquerque-Sendín
- Department of Socio-Sanitary Sciences, Radiology and Physical Medicine, Universidad de Córdoba, Córdoba, Spain.,Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Paula Rezende Camargo
- Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Tania Fátima Salvini
- Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
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Barreto RPG, Braman JP, Ludewig PM, Ribeiro LP, Camargo PR. Bilateral magnetic resonance imaging findings in individuals with unilateral shoulder pain. J Shoulder Elbow Surg 2019; 28:1699-1706. [PMID: 31279721 DOI: 10.1016/j.jse.2019.04.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 04/01/2019] [Accepted: 04/04/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) is commonly used to diagnose structural abnormalities in the shoulder. However, subsequent findings may not be the source of symptoms. The aim of this study was to determine comparative MRI findings across both shoulders of individuals with unilateral shoulder symptoms. MATERIALS AND METHODS We prospectively evaluated 123 individuals from the community who had self-reported unilateral shoulder pain with no signs of adhesive capsulitis, no substantial range-of-motion deficit, no history of upper-limb fractures, no repeated shoulder dislocations, and no neck-related pain. Images in the coronal, sagittal, and axial planes with T1, T2, and proton density sequences were generated and independently and randomly interpreted by 2 examiners: a board-certified, fellowship-trained orthopedic shoulder surgeon and a musculoskeletal radiologist. Absolute and relative frequencies for each MRI finding were calculated and compared between symptomatic and asymptomatic shoulders. Agreement between the shoulder surgeon and the radiologist was also determined. RESULTS Abnormal MRI findings were highly prevalent in both shoulders. Only the frequencies of full-thickness tears in the supraspinatus tendon and glenohumeral osteoarthritis were higher (approximately 10%) in the symptomatic shoulder according to the surgeon's findings. Agreement between the musculoskeletal radiologist and shoulder surgeon ranged from slight to moderate (0.00-0.51). CONCLUSION Most abnormal MRI findings were not different in frequency between symptomatic and asymptomatic shoulders. Clinicians should be aware of the common anatomic findings on MRI when considering diagnostic and treatment planning.
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Affiliation(s)
- Rodrigo Py Gonçalves Barreto
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Jonathan P Braman
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Paula M Ludewig
- Division of Physical Therapy, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, USA; Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Larissa Pechincha Ribeiro
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Paula Rezende Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil.
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Rosa DP, Borstad JD, Pogetti LS, Camargo PR. In response to the letter to the editor regarding: Resting pectoralis minor muscle length: An accurate way to determine if the muscle is shortened? J Hand Ther 2019; 30:e7-e8. [PMID: 28801198 DOI: 10.1016/j.jht.2017.06.007] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 06/11/2017] [Indexed: 02/03/2023]
Affiliation(s)
- Dayana P Rosa
- Federal University of São Carlos, São Carlos, Brazil
| | - John D Borstad
- Department of Physical Therapist, The College of St. Scholastica, Duluth, MN, USA
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Pires ED, Camargo PR. Analysis of the kinetic chain in asymptomatic individuals with and without scapular dyskinesis. Clin Biomech (Bristol, Avon) 2018; 54:8-15. [PMID: 29501915 DOI: 10.1016/j.clinbiomech.2018.02.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 02/24/2018] [Accepted: 02/26/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study measured strength of the trunk and hip, and compared Y Balance Test and Upper Quarter Y Balance Test in individuals without and with scapular dyskinesis. Strength and endurance of the scapulothoracic muscles were also assessed. METHODS Forty-four individuals without shoulder pain were divided in 2 groups: without scapular dyskinesis (age 26.00, SD 4.10 years) and scapular dyskinesis (age 23.68, SD 4.20 years). Scapular dyskinesis was assessed by clinical observation of the scapular motion during arm elevation, and was classified as present or absent. A handheld dynamometer was used to measure the isometric strength of the trunk flexors and lateral flexors, hip extensors and abductors, lower trapezius, serratus anterior, and latissimus dorsi. Y and Upper Quarter Y Balance Tests were performed with the individual in single-limb and 3-point plank position, respectively. Endurance of the scapulothoracic muscles was assessed with the individuals in prone with the arm at 135° abduction. Independent t-test and Mann-Witney test were used for comparison between groups. A P < 0.05 was considered significant. Effect sizes between groups were also calculated. FINDINGS No differences (P > 0.05) were demonstrated between groups for all variables. Moderate effect size (d ~ 0.40) was found for the trunk flexors and hip extensors, and endurance of the scapulothoracic muscles, whereas the scapular dyskinesis group showed less strength and endurance in relation to the group without dyskinesis. INTERPRETATION Strength of the trunk flexors and hip extensors, and endurance of the scapulothoracic muscles seem to have influence in scapular dyskinesis in non-athletes without shoulder pain.
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Affiliation(s)
- Elisa Doria Pires
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, Brazil
| | - Paula Rezende Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, Brazil.
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Silva ESM, Pereira ND, Gianlorenço ACL, Camargo PR. The evaluation of non-use of the upper limb in chronic hemiparesis is influenced by the level of motor impairment and difficulty of the activities–proposal of a new version of the Motor Activity Log. Physiother Theory Pract 2018; 35:964-974. [DOI: 10.1080/09593985.2018.1460430] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Erika Shirley Moreira Silva
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Natalia Duarte Pereira
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | | | - Paula Rezende Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
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Alburquerque-Sendín F, Madeleine P, Fernández-de-Las-Peñas C, Camargo PR, Salvini TF. Spotlight on topographical pressure pain sensitivity maps: a review. J Pain Res 2018; 11:215-225. [PMID: 29403305 PMCID: PMC5779713 DOI: 10.2147/jpr.s135769] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Mechanical hyperalgesia defined as decreased pressure pain thresholds (PPTs) is commonly associated with pain. In this narrative review, we report the current state of the art within topographical pressure sensitivity maps. Such maps are based on multiple PPT assessments. The PPTs are assessed by an a priori defined grid with special focus on both spatial and temporal summation issues. The grid covers the muscle or the body region of interest using absolute or relative values determined from anatomical landmarks or anthropometric values. The collected PPTs are interpolated by Shepard or Franke and Nielson interpolation methods to create topographical pressure sensitivity maps. This new imaging technique has proven to be valuable in various disciplines including exercise physiology, neurology, physical therapy, occupational medicine, oncology, orthopedics, and sport sciences. The reviewed papers have targeted different body regions like the scalp, low back, neck-shoulder, and upper and lower extremities. The maps have delineated spatial heterogeneity in the pressure pain sensitivity underlining the different extents of pressure pain hyperalgesia in both experimentally induced and disease-associated pain conditions. Furthermore, various intervention studies have proven the utility of topographical pressure pain sensitivity maps. Topographical pressure pain sensitivity maps have contributed to revealing the efficacy of therapeutic, ergonomic, or training interventions that aim at reducing pain.
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Affiliation(s)
| | - Pascal Madeleine
- Physical Activity and Human Performance Group, SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Madrid, Spain
| | - Paula Rezende Camargo
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Tania Fátima Salvini
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
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Avila MA, Camargo PR, Ribeiro IL, Alburquerque-Sendín F, Zamunér AR, Salvini TF. Effects of a 16-week hydrotherapy program on three-dimensional scapular motion and pain of women with fibromyalgia: A single-arm study. Clin Biomech (Bristol, Avon) 2017; 49:145-154. [PMID: 28950237 DOI: 10.1016/j.clinbiomech.2017.09.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 09/14/2017] [Accepted: 09/19/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although hydrotherapy is widely used to treat women with fibromyalgia, no studies have investigated the effects of this intervention on scapular kinematics in this population. This study verified the effectiveness of a hydrotherapy program on scapular kinematics, pain and quality of life in women with fibromyalgia. METHODS Twenty women completed the study and performed three evaluations before treatment (to establish a baseline), and two other evaluations (after 8 and 16weeks of hydrotherapy) at the end of treatment. Three-dimensional kinematics of the scapula was evaluated during arm elevation in two different planes with the Flock of Birds® system. Patients also answered quality of life and Fibromyalgia Impact Questionnaires and had pain assessed with a digital algometer. Treatment consisted of 2 weekly hydrotherapy sessions, lasting 45min each, for 16weeks. Data were analyzed with a two-way ANOVA (for kinematics results) and one-way ANOVA (for the other variables). Effect size was assessed with Cohen's d coefficient for all quantitative variables. RESULTS Although an important improvement was achieved in terms of pain and quality of life (P<0.05, effect sizes varied from -1.93 to 1.61 depending on the variable), scapular kinematics did not change after treatment (P>0.05, effect sizes from -0.40 to 0.46 for all kinematic variables). INTERPRETATION The proposed program of hydrotherapy was effective to improve quality of life, pain intensity and fibromyalgia impact in women with fibromyalgia. However, scapular kinematics did not change after the period of treatment. Although symptoms improved after the treatment, the lack of changes in scapular kinematics may indicate these women have an adaptive movement pattern due to their chronic painful condition.
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Affiliation(s)
| | | | - Ivana Leão Ribeiro
- Physical Therapy Department, Federal University of Sao Carlos, SP, Brazil
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Abstract
Table tennis requires rapid and extreme movements that may result in shoulder adaptations, such as glenohumeral internal rotation deficit, which is a risk factor for several injuries. This study compared range of motion of internal and external rotation and total rotation motion of glenohumeral joint between dominant and non-dominant shoulders of table tennis players. This is a cross-sectional observational study. Twenty healthy male table tennis players that were enrolled in an official table tennis league took part in this study (mean age: 22.9 ± 12.9 years, time of sports practice: 6.2 ± 7.12 years). Measurements of passive glenohumeral external rotation and internal rotation were taken with the individuals in the supine and sidelying positions. Total rotation motion was calculated by summing external and internal rotations. The dominant side showed decreased internal rotation when compared to non-dominant side in both supine (mean difference: 14.9°, p = 0.02) and sidelying positions (mean difference: 16.3°, p = 0.01). No significant difference (p > 0.05) was found for external rotation and total rotation motion between dominant and non-dominant shoulders. The findings indicate that table tennis players exhibit glenohumeral internal rotation deficit of dominant shoulder.
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Affiliation(s)
- Danilo Harudy Kamonseki
- a Health Sciences Institute , Universidade Paulista , Sorocaba , SP , Brasil.,b Laboratory of Analysis and Intervention of the Shoulder Complex , Universidade Federal de São Carlos (UFSCar) , São Carlos , SP , Brasil
| | - Luísa Cedin
- a Health Sciences Institute , Universidade Paulista , Sorocaba , SP , Brasil
| | - Fernanda Assis Paes Habechian
- b Laboratory of Analysis and Intervention of the Shoulder Complex , Universidade Federal de São Carlos (UFSCar) , São Carlos , SP , Brasil.,c Department of Kinesiology, Faculty of Health Sciences , Catholic University of Maule , Talca , Chile
| | | | - Paula Rezende Camargo
- b Laboratory of Analysis and Intervention of the Shoulder Complex , Universidade Federal de São Carlos (UFSCar) , São Carlos , SP , Brasil
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30
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Guimarães JF, Salvini TF, Siqueira AL, Ribeiro IL, Camargo PR, Alburquerque-Sendín F. Immediate Effects of Mobilization With Movement vs Sham Technique on Range of Motion, Strength, and Function in Patients With Shoulder Impingement Syndrome: Randomized Clinical Trial. J Manipulative Physiol Ther 2016; 39:605-615. [DOI: 10.1016/j.jmpt.2016.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 08/02/2016] [Accepted: 08/04/2016] [Indexed: 10/20/2022]
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Serra MVGB, Camargo PR, Zaia JE, Tonello MGM, Quemelo PRV. Effects of physical exercise on musculoskeletal disorders, stress and quality of life in workers. International Journal of Occupational Safety and Ergonomics 2016; 24:62-67. [DOI: 10.1080/10803548.2016.1234132] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Santos GL, García-Salazar LF, Souza MB, Oliveira AB, Camargo PR, Russo TL. Torque steadiness and muscle activation are bilaterally impaired during shoulder abduction and flexion in chronic post-stroke subjects. J Electromyogr Kinesiol 2016; 30:151-60. [PMID: 27451360 DOI: 10.1016/j.jelekin.2016.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 03/30/2016] [Revised: 06/30/2016] [Accepted: 07/05/2016] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To characterize sensorimotor control and muscle activation in the shoulder of chronic hemiparetic during abduction and flexion in maximal and submaximal isometric contractions. Furthermore, to correlate submaximal sensorimotor control with motor impairment and degree of shoulder subluxation. METHODS Thirteen chronic hemiparetic post-stroke age-gender matched with healthy were included. Isometric torques were assessed using a dynamometer. Electromyographic activity of the anterior and middle deltoid, upper trapezius, pectoralis major and serratus anterior muscles were collected. Variables were calculated for torque: peak, time to target, standard deviation (SD), coefficient of variation (CV), and standard error (RMSE); for muscle activity: maximum and minimum values, range and coefficient of activation. Motor impairment was determined by Fugl-Meyer and shoulder subluxation was measured with a caliper. RESULTS Paretic and non-paretic limbs reduced peak and muscle activation during maximal isometric contraction. Paretic limb generated lower force when compared with non-paretic and control. Paretic and non-paretic presented higher values of SD, CV, RMSE, and CV for prime mover muscles and minimum values for all muscles during steadiness. No correlation was found between sensorimotor control, motor impairment and shoulder subluxation. CONCLUSION Chronic hemiparetic presented bilateral deficits in sensorimotor and muscle control during maximal and submaximal shoulder abduction and flexion.
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Affiliation(s)
- Gabriela Lopes Santos
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
| | - Luisa Fernanda García-Salazar
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil; Physical Therapy Program, School of Medicine and Health Science, University of Rosario, Bogotá, D.C., Colombia
| | - Matheus Bragança Souza
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Ana Beatriz Oliveira
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Paula Rezende Camargo
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Thiago Luiz Russo
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
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Rodrigues-de-Souza DP, Palacios-Ceña D, Moro-Gutiérrez L, Camargo PR, Salvini TF, Alburquerque-Sendín F. Socio-Cultural Factors and Experience of Chronic Low Back Pain: a Spanish and Brazilian Patients' Perspective. A Qualitative Study. PLoS One 2016; 11:e0159554. [PMID: 27434594 PMCID: PMC4951039 DOI: 10.1371/journal.pone.0159554] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 07/04/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Low back pain (LBP) could be influenced by socio-cultural factors. Pain narratives are important to understand the influence of environment on patients with chronic LBP. There are few studies that have explored the experience of patients with chronic LBP in different socio-cultural environments. The aim of this study was to describe the experience of patients with chronic LBP in Spain and Brazil. METHODS A qualitative phenomenology approach was implemented. Chronic LBP patients from the University Hospital of Salamanca (Spain), and/or Federal University of São Carlos (Brazil) were included, using purposeful sampling. Data were collected from 22 Spanish and 26 Brazilian patients during in-depth interviews and using researchers' field notes and patients' personal diaries and letters. A thematic analysis was performed and the guidelines for reporting qualitative research were applied. RESULTS Forty-eight patients with a mean age of 50.7 years (SD: ± 13.1 years) were included in the study. The themes identified included: a) ways of perceiving and expressing pain-the participants focused constantly on their pain and anything outside it was considered secondary; b) the socio-familial environment as a modulator of pain-most participants stated that no one was able to understand the pain they were experiencing; c) religion as a modulator of pain-all Brazilian patients stated that religious belief affected the experience of pain; and d) socio-economic and educational status as a modulator of pain-the study reported that economic factors influenced the experience of pain. CONCLUSIONS The influences of LBP can be determined based on the how a patient defines pain. Religion can be considered as a possible mechanism for patients to manage pain and as a form of solace.
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Affiliation(s)
| | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Lourdes Moro-Gutiérrez
- Department of Social Psychology and Anthropology, University of Salamanca, Salamanca, Spain
| | | | - Tania Fátima Salvini
- Department of Physical Therapy, Federal University of Sao Carlos, São Paulo, Brazil
| | - Francisco Alburquerque-Sendín
- Biomedical Research Institute of Salamanca (IBSAL), Department of Nursing and Physical Therapy, University of Salamanca, Salamanca, Spain
- * E-mail:
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Haik MN, Alburquerque-Sendín F, Moreira RFC, Pires ED, Camargo PR. Effectiveness of physical therapy treatment of clearly defined subacromial pain: a systematic review of randomised controlled trials. Br J Sports Med 2016; 50:1124-34. [DOI: 10.1136/bjsports-2015-095771] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2016] [Indexed: 12/13/2022]
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Ribeiro IL, Camargo PR, Alburquerque-Sendín F, Madeleine P, Fernández-de-Las-Peñas C, Salvini TF. Topographical pressure pain sensitivity maps of the shoulder region in individuals with sub-acromial pain syndrome. ACTA ACUST UNITED AC 2015; 20:e20-1. [PMID: 26453505 DOI: 10.1016/j.math.2015.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 09/07/2015] [Indexed: 10/23/2022]
Affiliation(s)
- I L Ribeiro
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - P R Camargo
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | | | - P Madeleine
- Laboratory for Ergonomics and Work-Related Disorders, Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - C Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - T F Salvini
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil.
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Avila MA, Camargo PR, Ribeiro IL, Zamunér AR, Salvini TF. Three-dimensional scapular motion during arm elevation is altered in women with fibromyalgia. Clin Biomech (Bristol, Avon) 2014; 29:815-21. [PMID: 24923738 DOI: 10.1016/j.clinbiomech.2014.05.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 05/20/2014] [Accepted: 05/21/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND The core feature of fibromyalgia is pain, which may play a role in various mechanisms that might lead to alterations in shoulder kinematics. Alterations in muscle activity and presence of tender points in the shoulder girdle have already been described in this population; however there is lack of evidence on three-dimensional scapular motion in women with fibromyalgia. METHODS Forty women with fibromyalgia and 25 healthy women (control group) matched in terms of age, weight and height, took part in this study. Three-dimensional scapular kinematics of the dominant arm were collected during elevation and lowering of the arm in the sagittal and scapular planes. Pain was evaluated by the Visual Analogue Scale and the Numerical Pain Rating Scale. Group comparisons were performed with one-way ANOVA for pain and two-way ANOVA for the kinematic variables (scapular internal/external rotation, upward/downward rotation and anterior/posterior tilt), with group and humeral elevation angle as categorical factors. Significance level was set at P<0.05. FINDINGS Fibromyalgia women presented higher pain scores (P<0.001) than the control group. Fibromyalgia women also presented greater scapular upward rotation (P<0.001, both planes) and greater scapular posterior tilt (P<0.001, both planes) than the control group. INTERPRETATION Women with fibromyalgia present greater scapular upward rotation and posterior tilt in the resting position and during arm elevation and lowering of the arm in sagittal and scapular planes. These alterations may be a compensatory mechanism to reduce pain during arm movement.
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Affiliation(s)
- Mariana Arias Avila
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Paula Rezende Camargo
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Ivana Leão Ribeiro
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | | | - Tania Fátima Salvini
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil.
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Dervey E, Marshall S, Rouse S, Bernhardsson S, Camargo PR, McVeigh JG. Eccentric exercise therapy in the treatment of subacromial impingement syndrome: A critical review. International Journal of Therapy and Rehabilitation 2014. [DOI: 10.12968/ijtr.2014.21.7.338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Aim: This critical review explores the current evidence underpinning eccentric exercise therapy in the treatment of subacromial impingement syndrome (SAIS). Method: A critical review method was used. Four large databases, CINAHL, MEDLINE, SportDiscus and Pubmed, as well as the PEDro and Cochrane electronic libraries were searched. The search terms ‘subacromial impingement’ or ‘SAI’ or ‘shoulder impingement’ and ‘eccentric exercises’ or ‘eccentric loading’ or ‘eccentrics’ were used. All available studies were marked against predetermined inclusion and exclusion criteria. Results: Five studies met the inclusion criteria, two of which were RCTs, one a case series, one a single subject A–B experimental design and one a pilot study. Similarities in the nature of the eccentric exercise programmes in these five studies included the exercise regime. Commonly, these studies’ exercise regimes followed three sets of 15 repetitions, twice each day for 2 months, and the resistance was either hand weights or resistance bands, and used the pain monitoring model as a measure of readiness to progress resistance. Main differences in the programmes were the arm position chosen for performance of the exercises and the shoulder muscle groups targeted. Conclusions: Although there is a clinical consensus, which would appear to support the above regime, there is limited empirical evidence. Therefore, more research on such areas as the best arm position and exercise regime is required. In addition, while the pain-monitoring model appears to be supported clinically; again, further empirical evidence is needed before it can be recommended as a means of monitoring readiness for exercise progression. More research is needed to determine the best arm position and exercise regime for optimum results.
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Affiliation(s)
- Emily Dervey
- Senior Physiotherapist at York Teaching Hospital NHS Foundation Trust
| | - Sophia Marshall
- Senior Lecturer at the Faculty of Health and Life Sciences, York St John University
| | - Simon Rouse
- Associate Professor at the Faculty of Health and Life Sciences, York St John University, UK
| | | | - Paula Rezende Camargo
- Department of Physical Therapy Federal University of São Carlos São Carlos, SP, Brazil
| | - Joseph G McVeigh
- Centre for Health and Rehabilitation Technologies (CHaRT), University of Ulster, Northern Ireland, UK
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Santos HH, Hanashiro DN, Ávila MA, Camargo PR, Oliveira AB, Salvini TF. Efeito do treino isocinético excêntrico sobre a razão I/Q do torque e EMGs em sujeitos saudáveis. REV BRAS MED ESPORTE 2014. [DOI: 10.1590/1517-86922014200301210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Avaliar os efeitos do treino isocinético excêntrico dos extensores do joelho sobre a razão Isquiotibiais/Quadríceps (I/Q) do torque e do eletromiograma de superfície (EMGs), em sujeitos saudáveis.MÉTODOS: Vinte homens ativos e saudáveis com idade média 22,5±2,1 anos; massa corporal 67,8±9,5 kg; estatura 1,72±0,10 m; e índice de massa corporal (IMC) de 22,5±2,0 kg/m2 foram avaliados quanto ao torque (isométrico e excêntrico a 30 e 120o/s) e EMGs dos extensores e flexores do joelho, antes e após 6 semanas de treino isocinético excêntrico (30o/s) dos extensores do joelho.RESULTADOS: O torque extensor do joelho aumentou em todos os modos e velocidades avaliados (P<0,01); a razão I/Q do torque declinou em todas as medidas realizadas (P<0,01), porém a razão I/Q do EMGs manteve-se nos valores pré-treino (P>0,05). As correlações torque/EMGs mostraram-se fracas (r<0.3; P>0,05) para todos os modos de contração, no pré- e pós-treino, porém, houve diferença (P>0,01) na comparação entre o modo excêntrico (30º e 120º/s) e isométrico, pré e pós-treino.CONCLUSÕES: O treino isocinético excêntrico dos extensores do joelho aumentou a diferença na razão I/Q do torque, porém, não alterou a razão I/Q do EMGs, sugerindo que a adaptação pelo aumento do torque associado ao treino excêntrico não alterou o recrutamento das unidades motoras avaliadas pelo EMGs.
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Sousa CDO, Camargo PR, Ribeiro IL, Reiff RBDM, Michener LA, Salvini TF. Motion of the shoulder complex in individuals with isolated acromioclavicular osteoarthritis and associated with rotator cuff dysfunction: part 1 - Three-dimensional shoulder kinematics. J Electromyogr Kinesiol 2014; 24:520-30. [PMID: 24877751 DOI: 10.1016/j.jelekin.2014.04.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 04/21/2014] [Accepted: 04/24/2014] [Indexed: 11/18/2022] Open
Abstract
This study described the three-dimensional shoulder motion during the arm elevation in individuals with isolated acromioclavicular osteoarthritis (ACO) and ACO associated with rotator cuff disease (RCD), as compared to controls. Seventy-four participants (ACO=23, ACO+RCD=25, Controls=26) took part of this study. Disability was assessed with the DASH, three-dimensional kinematics were collected during arm elevation in the sagittal and scapular planes, and pain was assessed with the 11-point numeric pain rating scale. For each kinematic variable and demographic variables, separate linear mixed-model 2-way ANOVAs were performed to compare groups. Both ACO groups had higher DASH and pain scores. At the scapulothoracic joint, the isolated ACO group had greater internal rotation than control, and the ACO+RCD group had greater upward rotation than both other groups. At the sternoclavicular joint, both groups with ACO had less retraction, and the isolated ACO group had less elevation and posterior rotation. At the acromioclavicular joint, the isolated ACO group had greater upward rotation, and both ACO groups had greater posterior tilting. Patients with ACO had altered shoulder kinematics, which may represent compensatory responses to reduce pain and facilitate arm motion during arm elevation and lowering.
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Affiliation(s)
- Catarina de Oliveira Sousa
- Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil; Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Paula Rezende Camargo
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil.
| | - Ivana Leão Ribeiro
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | | | - Lori Ann Michener
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA, USA
| | - Tania Fátima Salvini
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
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Sousa CDO, Michener LA, Ribeiro IL, Reiff RBDM, Camargo PR, Salvini TF. Motion of the shoulder complex in individuals with isolated acromioclavicular osteoarthritis and associated with rotator cuff dysfunction: part 2 - muscle activity. J Electromyogr Kinesiol 2014; 25:77-83. [PMID: 24928470 DOI: 10.1016/j.jelekin.2014.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 05/13/2014] [Accepted: 05/13/2014] [Indexed: 11/18/2022] Open
Abstract
This study aimed to compare muscle activity in individuals with isolated acromioclavicular osteoarthritis (ACO), ACO associated with rotator cuff disease (ACO+RCD), and controls. Seventy-four participants (23 isolated ACO, 25 ACO+RCD, 26 controls) took part in this study. Disability was assessed with the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Muscle activity of the upper trapezius (UT), lower trapezius (LT), serratus anterior (SA), and anterior deltoid (AD) was collected during arm elevation in the sagittal and scapular planes. Pain during motion was assessed with the numerical pain rating scale. Analysis of the DASH, pain and kinematics were reported in part 1 of this study. For each muscle, separate 2-way linear mixed-model ANOVAs were performed to compare groups. ACO+RCD group had more UT and AD activity than the the isolated ACO and control other groups, more AD activity than the isolated ACO group during the ascending phase, and more AD activity than the ACO and control groups during the descending phase in both planes. Isolated ACO group had less SA activity than the control group only in the sagittal plane. Alterations in shoulder muscle activity are present in individuals with isolated ACO and with ACO+RCD and should be considered in rehabilitation.
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Affiliation(s)
- Catarina de Oliveira Sousa
- Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil; Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Lori Ann Michener
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA, USA
| | - Ivana Leão Ribeiro
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | | | - Paula Rezende Camargo
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil.
| | - Tania Fátima Salvini
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
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Avila MA, Romaguera F, Oliveira AB, Camargo PR, Salvini TF. Bilateral impairments of shoulder abduction in chronic hemiparesis: Electromyographic patterns and isokinetic muscle performance. J Electromyogr Kinesiol 2013; 23:712-20. [DOI: 10.1016/j.jelekin.2012.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 12/07/2012] [Accepted: 12/14/2012] [Indexed: 11/27/2022] Open
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Santos MVC, Paiva MG, Macedo CRDP, Petrilli AS, Azeka E, Jatene IB, Castro Junior CG, Seber A, Miachon AS, Tanaka ACS, Castro MAS, Carvalho AC, Nars CCF, Terzian CN, Santos CCL, Guerra CCS, Silva DCB, Bassi DU, Feitosa FA, Hamamoto F, Szarf G, Lederman HM, Rigon Junior HJ, Mota ICF, Perrud JÁ, Soares Junior J, Gutierrez JA, Perin JPM, Catani LH, Tsai LY, Vianna LC, Santos MJ, Ishigai MMS, Diógenes MSB, Alves MTS, Piedade MTC, Parreiras M, Cypriano M, Negrini NS, Campos Filho O, Figueiredo PA, Novaes PE, Camargo PR, Maia OS, Petrilli R, Arduini RG, Gouveia RV, Teruya SBM, Moisés VA, Morais VLL. I Diretriz Brasileira de Cardio-Oncologia Pediátrica da Sociedade Brasileira de Cardiologia. Arq Bras Cardiol 2013; 100:1-68. [DOI: 10.5935/abc.2013s005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Camargo PR, Avila MA, de Oliveira AB, Asso NA, Benze BG, de Fátima Salvini T. Shoulder abduction torque steadiness is preserved in subacromial impingement syndrome. Eur J Appl Physiol 2009; 106:381-7. [PMID: 19294409 DOI: 10.1007/s00421-009-1030-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2009] [Indexed: 10/21/2022]
Abstract
This study compared peak torque and torque steadiness during isometric abduction in subjects with subacromial impingement syndrome (SIS) and those with no upper limb disorders. The SIS group consisted of 27 subjects (33.48 +/- 9.94 years) with unilateral SIS. The control group consisted of 23 healthy and active subjects (32.26 +/- 9.04 years). Peak torque and torque steadiness were measured during isometric abduction (80 masculine in the scapular plane) of the shoulder. Standard deviation, coefficient of variation, stability time, median frequency, and relative power were measured from the steadiness trials. There were neither significant interactions between group and side (P > 0.05), nor were there significant main effects of group and side (P > 0.05) for all variables analyzed. The results of this study showed that steadiness is preserved by SIS during isometric abduction of the shoulder.
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Affiliation(s)
- Paula Rezende Camargo
- Department of Physical Therapy, Federal University of São Carlos, Rodovia Washington Luís, km 235, São Carlos, SP, 13565-905, Brazil
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Guimarães GV, Bellotti G, Mocelin AO, Camargo PR, Bocchi EA. Cardiopulmonary exercise testing in children with heart failure secondary to idiopathic dilated cardiomyopathy. Chest 2001; 120:816-24. [PMID: 11555515 DOI: 10.1378/chest.120.3.816] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [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: 11/01/2022] Open
Abstract
STUDY OBJECTIVE To determine and compare the cardiopulmonary responses of healthy children and children with heart failure due to idiopathic dilated cardiomyopathy (IC) to progressive treadmill exercise testing. SETTING University teaching hospital specializing in cardiology. PATIENTS OR PARTICIPANTS Twenty-six children with stable, chronic heart failure (left ventricular ejection fraction < 45%) caused by IC (IC group) and 12 healthy children (control group). INTERVENTIONS After 12-lead resting ECG, all children underwent progressive treadmill exercise testing using a modified Naughton protocol. Tests were performed in a controlled-temperature exercise facility, at least 2 h after a light meal. MEASUREMENTS AND RESULTS Cardiopulmonary parameters were assessed at rest, at anaerobic threshold (AT), and at peak exercise. At rest, the tidal volume (VT) and O(2) consumption (VO(2)) for heart rate (O(2) pulse) were lower, while the heart rate, respiratory rate, and ventilatory equivalent for O(2) (minute ventilation [VE]/VO(2)) were higher in the IC group compared with the control group. At AT, the systolic BP, O(2) pulse, VT, exercise duration, VO(2), CO(2) production (VCO(2)), and VE were lower, while the VE/VO(2) and ventilatory equivalent for CO(2) (E/CO(2)) were higher in the IC group (p < 0.05). At peak exercise, the IC group had a significantly lower systolic BP, O(2) pulse, VE, VT, exercise duration, VO(2), and VCO(2), but higher VE/VO(2) and VE/VCO(2) than the control group (p < 0.05). The VE/VCO(2) slope was significantly higher for the IC group. No correlation existed between variables evaluated at rest vs during exercise. CONCLUSIONS Gas exchange analysis performed during exercise successfully differentiated children with heart failure from healthy children.
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Affiliation(s)
- G V Guimarães
- Heart Institute, University of São Paulo, Medical School, São Paulo, Brazil.
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Azeka E, Barbero-Marcial M, Jatene M, Camargo PR, Auler JO, Atik E, Ramires JA, Ebaid M. Heart transplantation in neonates and children. Intermediate-term results. Arq Bras Cardiol 2000; 74:197-208. [PMID: 10951823 DOI: 10.1590/s0066-782x2000000300002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 11/21/2022] Open
Abstract
OBJECTIVE To assess intermediate-term outcome in children who have undergone orthotopic heart transplantation. METHODS We carried out a longitudinal and prospective study between October '92 and June '99 comprising 20 patients with ages ranging from 12 days to 7 years (mean of 2.8 years). We employed a double immunosuppression protocol with cyclosporine and azathioprine and induction therapy with polyclonal antithymocyte serum. Survival and complications resulting from the immunosuppression protocol were analyzed. RESULTS The double immunosuppression protocol and the induction therapy with polyclonal antithymocyte serum resulted in an actuarial survival curve of 90% and 78.2% at 1 and 6 years, respectively, with a mean follow-up period of 3.6 years. One patient died due to acute rejection 40 days after transplantation; another patient died 2 years after transplantation due to lymphoproliferative disorder; a third patient died because of primary failure of the graft; and a fourth patient died due to bronchopneumonia. The major complications were as follows: acute rejection, infection, nephrotoxicity, and systemic hypertension. The means of rejection and infection episodes per patient were 2.9 and 3.4, respectively. After one year of transplantation, a slight reduction in the creatinine clearance and systemic hypertension were observed in 7 (38.9%) patients. CONCLUSION Heart transplantation made life possible for those patients with complex congenital heart diseases and cardiomyopathies in refractory congestive heart failure constituting a therapeutical option for this group of patients in the terminal phase.
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Affiliation(s)
- E Azeka
- Instituto do Coração do Hospital das Clínicas-FMUSP and Hospital Sírio Libanês-São Paulo, Brazil
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Azeka E, Marcial MB, Camargo PR, Kajita L, Aliman AC, Auler JO, Atik E, Ebaid M. [Hemodynamic evaluation and clinical outcome of children with severe dilated cardiomyopathy eligible for heart transplantation]. Arq Bras Cardiol 1998; 71:661-6. [PMID: 10347948 DOI: 10.1590/s0066-782x1998001100004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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: 11/21/2022] Open
Abstract
PURPOSE To evaluate hemodynamic parameters and clinical outcome of children with severe cardiomyopathy who are candidates for heart transplantation. METHODS Twenty four children aged from 4 months to 10 years and 8 months (mean 3.7 +/- 2.5 years) from February 1992 to May 1996, were submitted to hemodynamic study and the following parameters were measured: cardiac output, mean pulmonary artery pressure (MPAP) and capillary wedge pressure. The pulmonary vascular resistance index (PVRI) and transpulmonary pressure gradient (TGP) were calculated. RESULTS Ten (41.6%) children were transplanted (group A), 5 (20.8%) are still waiting heart transplantation (group B) and 9 (37.6%) died (group C). The mean age of the B and C group were significantly different. The PVRI, MPAP and TPG were significant lower in group A than group C (p = 0.01; p = 0.044 and p = 0.023 respectively). CONCLUSION The profile of the hemodynamic parameters of children with severe dilated cardiomyopathy was compatible with the clinical findings. The age was the only difference comparing groups B and C. PVRI, MPAP and TPG were significant factors between group A and C. The older the patient, the worse was the prognosis.
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Affiliation(s)
- E Azeka
- Instituto do Coração do Hospital das Clínicas, FMUSP
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Barbero-Marcial M, Azeka E, Camargo PR, Riso A, Jatene M, Soares J, Snitcowsky R, Auler Júnior JO, Camargo L, Santos S, Coelho V, Atik E, Ebaid M, Jatene A. [Neonate and infant heart transplantation]. Arq Bras Cardiol 1996; 67:165-70. [PMID: 9181709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Heart transplantation has offered children with complex congenital heart diseases and severe cardiomyopathies a chance for survival. The present article was written to show the three year experience of this procedure at the Instituto do Coração-HCFMUSP. METHODS The methodology used was based on heart transplant indication criteria, inclusion criteria for donors, postoperative management, immunosuppression and prophylaxis as well as treatment of potential complications. RESULTS From November 1992 to November 1995, 11 children, aged 12 days old to six years (mean 2.5 years) underwent transplantation. Sixty percent of recipients were male; weight ranged from 3.5 to 17.8 kg (mean 10.3 kg). The mean age of donors was 4.4 years (a range of three weeks to ten years), 80% male, weight ranging from 3.8 to 20 kg (median 14.3 kg). The survival rate was 91% and the remaining 10 children are doing well. The most important complications were systemic hypertension, acute rejection and infection. The number of rejections and infections per patient were 3.5 and 4.7 episodes, respectively. The follow-up was between one month to three years (average 16 months). CONCLUSION In this experience, heart transplantation has given an additional opportunity for children with complex congenital heart diseases and cardiomyopathies, with a survival rate of 91% in three years.
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Camargo PR, Snitcowsky R, da Luz PL, Mazzieri R, Higuchi ML, Rati M, Stolf N, Ebaid M, Pileggi F. Favorable effects of immunosuppressive therapy in children with dilated cardiomyopathy and active myocarditis. Pediatr Cardiol 1995; 16:61-8. [PMID: 7784236 DOI: 10.1007/bf00796819] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Among 68 children with severe dilated cardiomyopathy, 43 (aged 10 months to 15 years) presented with active myocarditis, diagnosed by endomyocardial biopsy. They were divided into four treatment groups: I, controls: 9 patients submitted to conventional treatment (digitalis, diuretics, and vasodilators) for 8.1 +/- 0.7 (SD) months; II, prednisone: 12 patients received conventional therapy plus prednisone; III, azathioprine: 16 patients submitted to conventional therapy plus prednisone and azathioprine; IV, cyclosporine: 13 patients treated with conventional therapy plus prednisone and cyclosporine. Immunosuppressive therapy was maintained for a mean of 8.4 +/- 1.2 months. They were submitted to noninvasive (electrocardiogram, chest radiograph, Doppler echocardiogram, and radioisotopic scintigraphy) and invasive (hemodynamic) studies. In the control group only 2 of 9 patients showed clinical and hemodynamic improvement and 1 of 4, histologic regression of the myocarditis. Among patients submitted to conventional therapy plus prednisone, 3 of 12 presented clinical and hemodynamic improvement; 2 of 5 also showed histologic regression of inflammatory process. By contrast, patients treated with azathioprine or cyclosporine associated with prednisone had significantly better results: 13 of 16 and 10 of 13 patients, respectively, had clinical and hemodynamic improvement; all 6 patients in the azathioprine group and all 4 patients in the cyclosporine group had histologic regression of the myocarditis. Two patients in the prednisone group, one in the azathioprine group, and one in the cyclosporine group died during treatment, in cardiogenic shock. In our experience immunosuppressive therapy with azathioprine or cyclosporine associated with prednisone improves the prognosis of children with active myocarditis and severe ventricular dysfunction.
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Affiliation(s)
- P R Camargo
- Instituto do Coraçao, Divisao Clínica, Sao Paulo, Brazil
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Camargo PR, Mazzieri R, Snitcowsky R, Ratti M, Costa R, Higuchi ML, Albuquerque AM, Meneghetti C, Ebaid M, Pileggi F. [Immunosuppressive drugs for the treatment of active myocarditis in children. Hemodynamic evaluation]. Arq Bras Cardiol 1990; 55:295-9. [PMID: 2090072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To analyse hemodynamic parameters (left ventricles ejection fraction, cardiac index, mean pulmonary wedge pressure and left ventricle diastolic diameter, in a group of children with active myocarditis (diagnosed by endomyocardial biopsy) pre and post treatment with conventional therapy and immunosuppressive drugs (isolated prednisone or prednisone associated with azathioprine or cyclosporine). PATIENTS AND METHODS Forty-four pediatric patients with active myocarditis were studied. Twenty males and 24 females from 10 months to 15 years old (median = 1.3 years). All patients were submitted to hemodynamic study and endomyocardial biopsy. The hemodynamic parameters mentioned above were analysed before and after the proposed therapy. The patients were distributed in group according to the admission in the protocol, group I (9 pts)--conventional therapy (CT); group II (12 pts)--CT plus prednisone; group III (16 pts)--CT plus prednisone plus azathioprine; group IV (13 pts)--CT plus prednisone plus cyclosporine. RESULTS Forty-four patients were submitted to four different groups of therapeutic protocol. The hemodynamic parameters were analysed in each of them. Left ventricle ejection fraction were no significantly different in the pre and post therapeutic scheme in group I and II, they were significantly higher (p less than 0.05) in group III and IV. The same happened with cardiac index. The mean pulmonary wedge pressure no presented statistical differences in group I and II before and after treatment but significantly lower lends were observed in group III and IV. The same behavior were noted in the left ventricle end diastolic diameter. CONCLUSION The association of azathioprine or cyclosporine to prednisone presented better results in the left ventricle function, when compared with conventional drugs or isolated use of prednisone, based in the analysis of same hemodynamic parameters.
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Affiliation(s)
- P R Camargo
- Instituto do Coração do Hospital das Clínicas, FMUSP
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Camargo PR, Mazzieri R, Snitcowsky R, Higuchi ML, Meneghetti JC, Soares Júnior J, Fiorelli A, Ebaid M, Pileggi F. Correlation between gallium-67 imaging and endomyocardial biopsy in children with severe dilated cardiomyopathy. Int J Cardiol 1990; 28:293-7. [PMID: 2210893 DOI: 10.1016/0167-5273(90)90311-r] [Citation(s) in RCA: 14] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Fourty-four patients (aged 10 months to 15 years) were assessed in a double-blind study to observe the correlation between myocardial uptake of 67-gallium and endomyocardial biopsy in the detection of moderate to severe myocardial inflammation. The sensitivity and specificity of gallium-67 imaging were 87 and 81%, respectively. Based on these findings, immunosuppressive therapy can be assigned to children with dilated cardiomyopathy and positive myocardial uptake, since moderate and severe myocardial inflammation may be detected by this non-invasive method.
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Affiliation(s)
- P R Camargo
- Heart Institute, University of São Paulo Medical School, Brazil
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