Showing 11 results for Shoulder
Talebian S, Bahrami Sh, Olyaei Gr, Bagheri H, Hadian Mr,
Volume 64, Issue 7 (8-2006)
Abstract
Background: The purpose of this study was to measure isokinetic maximum and average peak torque of internal and external rotators of glenohumeral joint in volley ball and tennis players
Methods: This study was performed on 17 professional female athletes
(7 tennis players &10 volleyball players) with age ranged 18-28 years. The subjects had played in a skilled team for more than 3 years. They were free from injury to their dominant shoulder in the past year. Subjects performed a five minute warm up by shoulder wheel and Maximum average Peak Torque (APT) were obtained unilaterally by a Biodex System 3 with the arm of players in 90 degree abduction at 120,180 & 210 o/s. Players performed five trails of concentric movements with 30 second rest between them.
Results: Maximum and average of maximum torques of shoulder rotator, in both groups, expect for internal rotators of tennis players, reduced by increase of movement speed (P<0.05). There are not significant difference between two groups in maximum, average of maximum torques and normalized data (ratio of maximum torque to weight). There is significant difference between two groups in percentage of APT of External rotator / Internal rotator ratio at 210 o/s (P<0.05).
Conclusion: Volleyball and tennis have no effect on isokinetic strength of shoulder rotators. In high speed, ratio of External rotator / Internal rotator is reduced. This indicates that increase in movement speed increase internal rotator in comparison to external rotator in these professional female athletes.
Guity Mr, Ghaznavi Ar,
Volume 65, Issue 6 (9-2007)
Abstract
Background: Frozen shoulder is a debilitating disease characterized by pain and progressive loss of motion in shoulder secondary to fibrotic inflammation of the joint capsule. The incidence is 2% in the general population, mostly affecting women 40 to 70 years of age. Therapeutic measures include physiotherapy, shoulder manipulation, corticosteroid injection and arthroscopic release. The purpose of this study was to compare the results of manipulation under anesthesia with or without concomitant intra-articular injection of corticosteroid.
Methods: Twenty-six patients (21 females, 5 males) with the clinical diagnosis of idiopathic frozen shoulder were evaluated in a randomized clinical trial. The average age of the patients was 55.7 years. Twelve cases had diabetes mellitus, which is considered a strong predisposing factor and has a poor prognosis. Thirteen patients received intra-articular corticosteroid injection just before manipulation. The outcome was assessed by evaluating functional score (Constant scoring system) at the six-month follow-up.
Results: The average score before manipulation was 28.7 out of 100, which significantly improved to 84.8 at six months after the procedure (p<0.05). The results were slightly better in the group who received corticosteroid injection, but the difference was not statistically significant (p=0.1). The outcome in the diabetic group was less favorable than in the non-diabetic patients (p<0.05).
Conclusions: Manipulation under anesthesia is a very effective method of treatment for idiopathic frozen shoulder. Concomitant intra-articular injection of corticosteroid does not seem to improve significantly the final outcome. Diabetes mellitus can negatively affect the results of this treatment method.
Guity Mr, Yousef Sibdari S, Espandar R,
Volume 68, Issue 4 (7-2010)
Abstract
Background: Shoulder hemiarthroplasty is one of the established methods for management of proximal humerus fractures particularly in the types with more displacement so that fixation is not possible. Successful treatment is a challenge for shoulder surgeons especially in elderly patients. The aim of this study is to investigate the functional results and prognostic factors on shoulder hemiarthroplasty.
Methods: Thirty nine patients operated by one shoulder surgeon in Imam Khomeini and Shariati Hospital in Tehran, Iran, from October 2005 to February 2009 were included in this study and followed postoperatively for at least one year. Mean (±SD) age was 49.7±14.3 years. Functional results were measured by constant score and pain was scored using visual analogue score. The relationship between factors such as age, injury to surgery interval, radiographic parameters and functional results were assessed. Results: Mean (±SD) constant score was 61.9±20.2. The age and injury to surgery interval showed a reverse correlation with constant score (p<0.05). There was a significant correlation between constant score and acromiohumeral interval (r=0.53) and head to tuberusity distance (-0.59). Median VAS score was 4.5 (interquartile range: 2- 5.2) that had a direct correlation with age (r=0.38) and injury to surgery interval (r=0.55) (p<0.05).
Conclusions: Shoulder hemiarthroplasty should be performed in minimal delay from injury and this operation should be performed by an experienced shoulder surgeon to create the best anatomic position of prostheses. Careful rehabilitation particularly in older patients is very important to improve results.
Guity Mr, Sianati S,
Volume 68, Issue 7 (10-2010)
Abstract
Background: Anterior glenohumeral instabilities can be corrected with open and arthroscopic surgery. The purpose of this study was to evaluate retrospectively the surgical outcomes of arthroscopic repair of anterior glenohumeral instabilities with use of suture anchors in a series of patients who were followed for twenty to fifty months.
Methods: The results of arthroscopic Bankart repair with use of suture anchors in 30 patients with traumatic recurrent anterior instability of the shoulder were evaluated. At the time of follow-up (mean of thirty-three months), the patients were assessed with two outcome measurement tools (the Rowe score, the Constant score). The recurrence rate, range of motion, and risk factors for postoperative recurrence were evaluated.
Results: According to the Rowe scale, 12 patients (40%) had an excellent score 13 (43%), a good score 4 (13%), a fair score and 1 (4%), a poor score. The mean ROWE score was 81.8 and the mean CONSTANT score was 85.5. Overall, the rate of postoperative recurrence of instability was 10% (two dislocations, one subluxation). The mean delay to recurrence was 20 months. Loss of external rotation in regard to uninvolved extremity was less than 10 degrees in 30% and more than 10 degrees in 10% of patients. The average number of anchors used was 3.2 which follow-up radiographs showed all of them in the osseous glenoid without pullout. In preoperative studies, shoulder 3D CT scan was not performed routinely. Radiographic signs of degenerative changes were noted in one shoulder.
Conclusion: Arthroscopic capsulolabral repair with use of suture anchors can provide satisfactory outcomes in terms of recurrence rate, activity, and range of motion.
Saadat Niaki A, Momenzadeh S, Mohammadinasab H, Ghahramani M, Nayebaghaie H, Ommi D,
Volume 69, Issue 6 (9-2011)
Abstract
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Background: Shoulder pain is a common complication of cerebrovascular accidents. This study was conducted to assess the effects
of local injections of bupivacaine and triamcinolone acetate on shoulder joint pain
and on restricted range of motion following brain events.
Methods: This single-blind clinical trial study included 35 patients
with chronic shoulder pain (the controls) and 35 patients
with chronic shoulder pain due to brain events (the case group). The study was
done at Imam Hossein Hospital & Gandhi Day Clinic
during the year 2008-2010. The patients in the
two groups received bupivacaine and triamcinolone acetate for subacromial bursa
injection and suprascapular nerve block by following the protocol described by
Dangoisse et al. The patients were followed up for 12
weeks and they were evaluated for pain and range of motion 1,
6, and 12 weeks after the
injections.
Results: The mean age of the patients was 60.9±9.07
years. Statistically significant improvements in pain score (P=0.001)
and shoulder joint range of motion (P=0.001)
were observed in patients with chronic shoulder pain versus patients with brain
events 12 weeks after
suprascapulare nerve block and subacromial bours injections by bupivacaine and triamcinolone acetate.
Conclusion: Suprascapular
nerve block and subacromial bursa injections of bupivacaine and triamcinolone
acetate is a safe and efficacious treatment for the treatment of chronic shoulder
pain and restricted range of motion but it is not efficacious or of significant
value for the treatment of shoulder pain in patients with brain events.
Ali Zahedian, Mohsen Shoja , Hadi Mollazade, Masoomeh Taiebi ,
Volume 72, Issue 2 (5-2014)
Abstract
Background: Laparoscopic cholecystectomy is a way of removing the gallbladder. But like other surgeries, this procedure has some side effects such as postoperative shoulder pain. This study evaluates the effect of different gas flow rates into the abdominal cavity on postoperative shoulder pain in laparoscopic cholecystectomy patients.
Methods: The study as a randomized clinical trial was conducted on laparoscopic chol-ecystectomy patients in Imam Khomeini Hospital- Esfarayen 2011-2012. One hun-dred participants were selected by available sampling, and were divided randomly into two groups of 50 patients. In group I flow rate of CO2 gas was two liters per minute and in group II flow rate of CO2 gas was five liters per minute. After reversing anesthe-sia, six, 12 and 24 hours post operative, shoulder pain was evaluated by Visual Ana-logue Scale (VAS) pain questionnaire. The study findings analyzed by independent t-test.
Results: The mean age of participants was 48.8±7.5 years and mean surgery duration was 36.5±13.1 minutes, and there was no significant differences between two groups (P>0/05). However, the mean shoulder pain scores in group I (blowing with low pres-sure) was differed significantly with group II (blowing with high pressure) (P<0.05). In group I, pain was lower than group II.
Conclusion: Results showed if CO2 gas flow rate is two liters per minute (blowing with low pressure), the patients complain less shoulder pain. Therefore low pressure gas in-sufflation for laparoscopic surgery is recommended. Further studies in this field should be considered.
Tayebeh Mirhashemi , Mehri Ghasemi , Frideh Dehghan-Manshadi , Alireza Akbarzadeh-Baghban , Alimohammad Faizi , Alireza Sabbaghian ,
Volume 76, Issue 5 (8-2018)
Abstract
Background: Some studies show that frozen shoulder is due to the pathologic changes in the muscles around the shoulder. Measurement of the ultrasonic thickness of a muscle is a method for measuring the muscle changes. There is no study about the reliability of measurement of the muscle’s ultrasonic thickness around the shoulder in patients with frozen shoulder. The present study aims to investigate the intra-rater reliability of the ultrasonic thickness measurement of the supraspinatus, deltoid and upper trapezius muscles in women with frozen shoulder and healthy women.
Methods: This study was carried out during 4 months (June to October 2017). Twenty women consisted of 10 patients with frozen shoulder (mean age: 51.6±9.41 years) and 10 healthy subjects (mean age: 35.5±8.22 years) participated in this study. The patients from some clinics and hospitals in Tehran, and healthy subjects consisted of some personals and students in the School of Rehabilitation of Shahid Beheshti university of Medical Sciences participated in the present study. Measurements of ultrasonic thickness of the upper trapezius, supraspinatus and deltoid muscles in rest position carried out by the same rater two times in 48 hours. Ultrasonography instrument with linear probe (frequency: 7.5 MHz) were used for measurement of muscle thickness in millimeter.
Results: Reliability of the ultrasonic measurements of the muscle thickness in patients and healthy subjects was respectively as follow: The upper trapezius muscle (0.81, 0.81), the supraspinatus muscle (0.90, 0.92) and the middle deltoid muscle (0.93, 0.96). The reliability of the ultrasonic measurements of the muscle thickness for the upper trapezius muscle and the supraspinatus muscle was higher in healthy subjects compared to the patients with frozen shoulder. The reliability of the ultrasonic measurements of the middle deltoid thickness for the patients and healthy subjects was similar.
Conclusion: It seems that ultrasonography is a reliable method for measuring the thickness of the muscles around the shoulder in patients with frozen shoulder and healthy subjects.
Seyedeh-Saeideh Hoseini, Noureddin Nakhostin Ansari, Soofia Naghdi ,
Volume 78, Issue 6 (9-2020)
Abstract
Background: Oxford Shoulder Score (OSS) is a specific questionnaire for the assessment of pain and function in subjects with shoulder pain. The reliability and validity of the Persian version of this questionnaire have been shown previously. But its responsiveness has not been investigated yet. This study aimed to determine the Persian OSS responsiveness in subjects with shoulder pain.
Methods: This was a prospective cohort study design conducted in the Physiotherapy Clinic, School of Rehabilitation, Tehran University of Medical Sciences in 2018. Thirty-one subjects with shoulder pain (20 females and 11 males) with a mean age of 50±15.3 participated in this study. They completed the Persian OSS, Disability of Arm, Shoulder & Hand (DASH) questionnaire, and Visual Analog Scale (VAS) before and after 10 physiotherapy sessions. After the 10th session, the Global Rating of Change (GRC) was also completed. The statistical analysis included the Effect Size (ES), Standardized Response Mean (SRM), and the Spearman or Pearson correlation coefficients.
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Results: The results showed that the ES and SRM of the Persian OSS were 1.73 and 1.79, respectively. The correlation between the Persian OSS and the VAS scores was 0.69 and between the Persian OSS and the DASH scores was 0.89. The correlation between the Persian OSS changes and GRC was not statistically significant (r=0.25, P=0.18). However, a significant moderate correlation was identified between the VAS and DASH with the GRC scores (r=0.43, r=0.42, respectively).
Conclusion: The Persian OSS has internal and external responsiveness for the assessment of subjects with shoulder pain. The Persian OSS, as a responsive instrument, can be used to investigate the effectiveness of interventions in the clinical settings and research to detect the changes in patients with shoulder pain. Further study with larger sample of patients with shoulder pain is warranted to confirm the findings and to estimate the minimally clinically important change.
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Nima Bagheri, Mahdieh Ghiasi, Khalil Pestehei,
Volume 82, Issue 4 (7-2024)
Abstract
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Tendon ruptures may occur as a result of acute injuries or degenerative changes in the tendons caused by aging, excessive and long-term use of the shoulders, and sudden wear and tear. This tear may be partial or completely separate the tendon from its attachment to the bone. Rotator cuff tendinopathy of the shoulder is one of the common causes in patients that affect the daily performance and quality of life. Tendinopathy problems are one of the most common problems of people who refer to medical centers, and in some people, improvement is very important because of their job position. Platelet-rich plasma has received attention due to having growth factors involved in tissue repair in tendinopathy patients. This review study examined the clinical effect of platelet-rich plasma injection in rotator cuff tendinopathy, as well as other studies comparing it with corticosteroids. A literature search was conducted in various scientific databases to obtain articles up to 2022 examining the clinical effects of PRP injection on tendinopathy. Platelet-rich plasma (PRP) is one of the products derived from blood that contains a greater number of physiological platelets. PRP contains a large amount of growth factors such as TGF-β, platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF) and epidermal growth factor (EGF), which play an important role in cell proliferation, cell differentiation, chemotaxis and angiogenesis. These growth factors are significantly upregulated following tendon injury and are active at different stages of the healing process. Platelet-rich plasma is an autologous source of growth factors and has been shown to be beneficial in the treatment of tendinopathy and osteoarthritis. PRP injection can be recommended as a suitable and desirable method in tendinopathy and rotator cuff tear patients, especially in adults, and can be substituted for corticosteroids. PRP is a minimally invasive treatment method that is used to treat muscle diseases and tendon injuries. In this method, blood is taken from the person, and after that, the components of the blood are separated during a process, and the platelet-enriched plasma is re-injected into the muscles and tendons of the shoulder.
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Seyed Mohammad Reza Hadavi , Maryam Zahedi, Navid Kalani, Naeimeh Ossadat Asmarian , Reza Sahraei ,
Volume 82, Issue 9 (12-2024)
Abstract
Background: Shoulder labral repair surgery is associated with significant postoperative pain and restricted mobility. Inadequate pain management may lead to delayed rehabilitation, increased risk of chronic pain development, and higher opioid consumption. This study aimed to compare postoperative pain intensity during the first two weeks following shoulder labral repair between patients receiving interscalene block alone versus those receiving interscalene block combined with intravenous morphine.
Methods: In this randomized, double-blind, parallel-group clinical trial, 120 patients undergoing open rotator cuff repair at Chamran Hospital, Shiraz (June-December 2024) were allocated using balanced block randomization. Group 1 received preoperative interscalene block with 30 mL of 0.5% ropivacaine, while Group 2 received the same block plus intravenous morphine (1% mg/kg). Data analysis was performed using descriptive statistics such as mean and percentage and appropriate statistical tests such as Repeated measurement and Anova using SPSS software, version 21 (SPSS Inc., Chicago, IL, USA). The significance level was considered to be (P<0.05).
Results: Demographic characteristics (age, sex, weight, ASA class) showed no significant intergroup differences (p>0.05). Pain scores were significantly lower at all time points in the combination therapy group compared to the block-only group (p<0.05).
Conclusion: The results of the present study showed that the combination of interscalene block with morphine was significantly more effective in reducing pain after rotator cuff surgery than interscalene block alone. This finding suggests that the use of morphine as an additional analgesic can enhance the analgesic effects of interscalene block and provide better pain relief. The combination of these two methods may cause a positive interaction in pain relief and reduce the need for other medications, which consequently prevents the side effects caused by additional analgesic drugs, and patients who receive the combination of these two treatment methods experience greater comfort and better functional improvement. However, it is recommended that further studies focusing on the precise dosage and timing of drug combinations be conducted to obtain more precise results regarding the optimization of pain management after rotator cuff surgery. Also, examining the long-term effects of this treatment method could help to better understand its advantages and disadvantages.
Naseh Yousefi, Katayoun Moradi, Korosh Mansouri , Simin Sajadi , Masoud Torabi ,
Volume 82, Issue 12 (3-2025)
Abstract
Background: The most common cause of Shoulder pain is inflammation in the subacromial bursa. Intra-bursal corticosteroid injections are one of the most common methods in cases of bursitis. Recently, botulinum toxin A injection has also been used as a safe treatment in these patients. This injection does not have many of corticosteroid disadvantages. The most important disadvantages of this method are its cost. This study was performed to compare corticosteroids with botulinum toxin A in the treatment of subacromial bursitis by single injection.
Methods: This study is a prospective randomized clinical trial performed on patients with rotator cuff tendinopathy who were referred to the physical medicine and rehabilitation clinic of Iran University of Medical Sciences from November 2020 to October 2021. 54 patients with signs and symptoms of rotator cuff tendinopathy, were randomly assigned to one of the two groups of botulinum toxin A or corticosteroid injection. Routine treatment included exercise training for all patients. Patient's symptoms were assessed using VAS, Constant Score and SPADI criteria before treatment, two weeks and two months after injection.
Results: In the VAS study, both groups showed an improvement over baseline (P=0.000), which was significantly greater in the corticosteroid group. VAS between the first and second follow-up showed a decrease in the botulinum toxin A group and an increase in the corticosteroid group. In the Constant Score and SPADI study, both groups showed an improvement over baseline.
Conclusion: This study showed that a single-session injection of botulinum toxin A is less effective than corticosteroid in controlling symptoms of these patients. However, the therapeutic effect of botulinum toxin A, remains 2 months and unlike corticosteroid, has more reliability and durability.
