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Analgesic gas for rehabilitation of frozen shoulder: Protocol for a randomized controlled trial / Arnaud Dupeyron in Annals of physical and rehabilitation medicine, Vol. 62, n°1 (Janvier 2019)
[article]
Titre : Analgesic gas for rehabilitation of frozen shoulder: Protocol for a randomized controlled trial Type de document : texte imprimé Auteurs : Arnaud Dupeyron ; Marie Dénarié ; Dominique Richard ; et al. Année de publication : 2019 Article en page(s) : p. 43-48 Note générale : Doi : 10.1016/j.rehab.2018.07.007 Langues : Anglais (eng) Mots-clés : Adhesive capsulitis Shoulder Physical therapy Rehabilitation Analgesia Résumé : Background
There is little evidence regarding the best way to treat adhesive capsulitis. Physical therapy can reduce pain and improve function and range of motion. However, we lack clear indications on the regimen, techniques or intensity of physical therapy to achieve better results. Intensive physical therapy seems to be confined to the later stages of adhesive capsulitis (chronic stage) given that rehabilitation-induced pain could worsen the outcomes. Here we describe a protocol for a study comparing the efficacy of a standardized program of intensive mobilization under analgesic gas to a similar program under placebo gas and questioning the impact of pain.
Method/Design
A randomized, double-blind, multicenter study — the MEOPA Trial — was designed to include adults with strictly defined clinical adhesive capsulitis for a 14-day intensive physical rehabilitation program under an equimolar mixture of oxygen and nitrous oxide or sham gas administration. Efficacy will be assessed by the Constant-Murley score. Data for secondary criteria including pain, disability, quality of life and perceived efficacy by the patient or physiotherapist will be collected over 6 months.
Discussion
This randomized controlled trial has been designed to test the effectiveness of intensive physical therapy under a simple and safe analgesic method. This study will also address the effect of pain during rehabilitation in adhesive capsulitis. Furthermore, results from the 6-month multidimensional follow-up of painful mobilization for this condition could be extrapolated to other musculoskeletal conditions.Permalink : ./index.php?lvl=notice_display&id=82638
in Annals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 43-48[article] Analgesic gas for rehabilitation of frozen shoulder: Protocol for a randomized controlled trial [texte imprimé] / Arnaud Dupeyron ; Marie Dénarié ; Dominique Richard ; et al. . - 2019 . - p. 43-48.
Doi : 10.1016/j.rehab.2018.07.007
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 43-48
Mots-clés : Adhesive capsulitis Shoulder Physical therapy Rehabilitation Analgesia Résumé : Background
There is little evidence regarding the best way to treat adhesive capsulitis. Physical therapy can reduce pain and improve function and range of motion. However, we lack clear indications on the regimen, techniques or intensity of physical therapy to achieve better results. Intensive physical therapy seems to be confined to the later stages of adhesive capsulitis (chronic stage) given that rehabilitation-induced pain could worsen the outcomes. Here we describe a protocol for a study comparing the efficacy of a standardized program of intensive mobilization under analgesic gas to a similar program under placebo gas and questioning the impact of pain.
Method/Design
A randomized, double-blind, multicenter study — the MEOPA Trial — was designed to include adults with strictly defined clinical adhesive capsulitis for a 14-day intensive physical rehabilitation program under an equimolar mixture of oxygen and nitrous oxide or sham gas administration. Efficacy will be assessed by the Constant-Murley score. Data for secondary criteria including pain, disability, quality of life and perceived efficacy by the patient or physiotherapist will be collected over 6 months.
Discussion
This randomized controlled trial has been designed to test the effectiveness of intensive physical therapy under a simple and safe analgesic method. This study will also address the effect of pain during rehabilitation in adhesive capsulitis. Furthermore, results from the 6-month multidimensional follow-up of painful mobilization for this condition could be extrapolated to other musculoskeletal conditions.Permalink : ./index.php?lvl=notice_display&id=82638 Exemplaires (1)
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Exclu du prêtKinematic patterns in normal and degenerative shoulders. Part II: Review of 3-D scapular kinematic patterns in patients with shoulder pain, and clinical implications / Marie-Martine Lefèvre-Colau in Annals of physical and rehabilitation medicine, Vol. 61, n°1 (Janvier 2018)
[article]
Titre : Kinematic patterns in normal and degenerative shoulders. Part II: Review of 3-D scapular kinematic patterns in patients with shoulder pain, and clinical implications Type de document : texte imprimé Auteurs : Marie-Martine Lefèvre-Colau ; Christelle Nguyen ; Clémence Palazzo ; Frédéric Srour ; Guillaume Paris ; V. Vuillemin ; Serge Poiraudeau ; Agnès Roby-Brami ; Alexandra Roren Année de publication : 2018 Article en page(s) : p. 46-53 Note générale : Doi : 10.1016/j.rehab.2017.09.002 Langues : Anglais (eng) Mots-clés : Shoulder Kinematics Scapula Degenerative shoulders pathology Subacromial impingement syndrome Adhesive capsulitis Osteoarthritis Rehabilitation Résumé : Background
The global range of motion of the arm is the result of a coordinated motion of the shoulder complex including glenohumeral (GH), scapulothoracic, sternoclavicular and acromioclavicular joints.
Methods
This study is a non-systematic review of kinematic patterns in degenerated shoulders. It is a based on our own research on the kinematics of the shoulder complex and clinical experience.
Results
For patients with subacromial impingement syndrome without rotator-cuff tears, most kinematic studies showed a small superior humeral translation relative to the glenoid and decreased scapular lateral rotation and posterior tilt. These scapular kinematic modifications could decrease the subacromial space and favor rotator-cuff tendon injury. For patients with shoulder pain and restricted mobility, the studies showed a significant increase in scapular lateral rotation generally seen as a compensation mechanism of GH decreased range of motion. For patients with multidirectional GH instability, the studies found an antero-inferior decentering of the humeral head, decreased scapular lateral rotation and increased scapular internal rotation.
Conclusion
The clinical or instrumented assessment of the shoulder complex with a degenerative pathology must include the analysis of scapula-clavicle and trunk movements complementing the GH assessment. Depending on the individual clinical case, scapular dyskinesis could be the cause or the consequence of the shoulder degenerative pathology. For most degenerative shoulder pathologies, the rehabilitation program should take into account the whole shoulder complex and include first a scapular and trunk postural-correcting strategy, then scapulothoracic muscle rehabilitation (especially serratus anterior and trapezius inferior and medium parts) and finally neuromotor techniques to recover appropriate upper-limb kinematic schemas for daily and/or sports activities.Permalink : ./index.php?lvl=notice_display&id=80439
in Annals of physical and rehabilitation medicine > Vol. 61, n°1 (Janvier 2018) . - p. 46-53[article] Kinematic patterns in normal and degenerative shoulders. Part II: Review of 3-D scapular kinematic patterns in patients with shoulder pain, and clinical implications [texte imprimé] / Marie-Martine Lefèvre-Colau ; Christelle Nguyen ; Clémence Palazzo ; Frédéric Srour ; Guillaume Paris ; V. Vuillemin ; Serge Poiraudeau ; Agnès Roby-Brami ; Alexandra Roren . - 2018 . - p. 46-53.
Doi : 10.1016/j.rehab.2017.09.002
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 61, n°1 (Janvier 2018) . - p. 46-53
Mots-clés : Shoulder Kinematics Scapula Degenerative shoulders pathology Subacromial impingement syndrome Adhesive capsulitis Osteoarthritis Rehabilitation Résumé : Background
The global range of motion of the arm is the result of a coordinated motion of the shoulder complex including glenohumeral (GH), scapulothoracic, sternoclavicular and acromioclavicular joints.
Methods
This study is a non-systematic review of kinematic patterns in degenerated shoulders. It is a based on our own research on the kinematics of the shoulder complex and clinical experience.
Results
For patients with subacromial impingement syndrome without rotator-cuff tears, most kinematic studies showed a small superior humeral translation relative to the glenoid and decreased scapular lateral rotation and posterior tilt. These scapular kinematic modifications could decrease the subacromial space and favor rotator-cuff tendon injury. For patients with shoulder pain and restricted mobility, the studies showed a significant increase in scapular lateral rotation generally seen as a compensation mechanism of GH decreased range of motion. For patients with multidirectional GH instability, the studies found an antero-inferior decentering of the humeral head, decreased scapular lateral rotation and increased scapular internal rotation.
Conclusion
The clinical or instrumented assessment of the shoulder complex with a degenerative pathology must include the analysis of scapula-clavicle and trunk movements complementing the GH assessment. Depending on the individual clinical case, scapular dyskinesis could be the cause or the consequence of the shoulder degenerative pathology. For most degenerative shoulder pathologies, the rehabilitation program should take into account the whole shoulder complex and include first a scapular and trunk postural-correcting strategy, then scapulothoracic muscle rehabilitation (especially serratus anterior and trapezius inferior and medium parts) and finally neuromotor techniques to recover appropriate upper-limb kinematic schemas for daily and/or sports activities.Permalink : ./index.php?lvl=notice_display&id=80439 Exemplaires (1)
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Exclu du prêtIs systematic long-term sonographic follow-up after arthroscopic rotator cuff repair useful in asymptomatic patients? / Emilie DESPORTES in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)
[article]
Titre : Is systematic long-term sonographic follow-up after arthroscopic rotator cuff repair useful in asymptomatic patients? Type de document : texte imprimé Auteurs : Emilie DESPORTES, Auteur ; Mathieu LEFERE, Auteur ; Pierre-Henri Flurin, Auteur Année de publication : 2015 Article en page(s) : p.478-484 Langues : Anglais (eng) Mots-clés : Ultrasound shoulder cuff arthroscopic postoperative Constant’s Shoulder Score repair asymptomatic Résumé : Objective: To establish whether ultrasonographic (US) appearance is correlated to functional outcome in asymptomatic patients 12 months after rotator cuff repair.
Materials and methods: 26 asymptomatic patients at twelve months after arthroscopic cuff repair and 26 controls were retrospectively included. A clinical score (Constant’s Shoulder Score, CSS) was compared with a US score (the modified Sugaya Score, mSS). The minimal thickness of the anterior and posterior parts of the cuff was also measured.
Results: CSS improved significantly from preoperatively to postoperatively (mean increased from 41 to 82.6, p <.001). Correlation between the postoperative CSS and the minimal thickness of the cuff at its anterior and posterior part (p = 0.55 and p = 0.13) was not significant. There was also no significant correlation between the postoperative CSS and mSS (p = 0.34).
Conclusion: The sonographic appearance of the cuff repair is not correlated to the functional outcome at 12 months after arthroscopic surgery in asymptomatic patients.Permalink : ./index.php?lvl=notice_display&id=40924
in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.478-484[article] Is systematic long-term sonographic follow-up after arthroscopic rotator cuff repair useful in asymptomatic patients? [texte imprimé] / Emilie DESPORTES, Auteur ; Mathieu LEFERE, Auteur ; Pierre-Henri Flurin, Auteur . - 2015 . - p.478-484.
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.478-484
Mots-clés : Ultrasound shoulder cuff arthroscopic postoperative Constant’s Shoulder Score repair asymptomatic Résumé : Objective: To establish whether ultrasonographic (US) appearance is correlated to functional outcome in asymptomatic patients 12 months after rotator cuff repair.
Materials and methods: 26 asymptomatic patients at twelve months after arthroscopic cuff repair and 26 controls were retrospectively included. A clinical score (Constant’s Shoulder Score, CSS) was compared with a US score (the modified Sugaya Score, mSS). The minimal thickness of the anterior and posterior parts of the cuff was also measured.
Results: CSS improved significantly from preoperatively to postoperatively (mean increased from 41 to 82.6, p <.001). Correlation between the postoperative CSS and the minimal thickness of the cuff at its anterior and posterior part (p = 0.55 and p = 0.13) was not significant. There was also no significant correlation between the postoperative CSS and mSS (p = 0.34).
Conclusion: The sonographic appearance of the cuff repair is not correlated to the functional outcome at 12 months after arthroscopic surgery in asymptomatic patients.Permalink : ./index.php?lvl=notice_display&id=40924 Exemplaires (1)
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Exclu du prêtPassive mobilization after arthroscopic rotator cuff repair is not detrimental in the early postoperative period / Pieter-Jan DE ROO in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)
[article]
Titre : Passive mobilization after arthroscopic rotator cuff repair is not detrimental in the early postoperative period Type de document : texte imprimé Auteurs : Pieter-Jan DE ROO, Auteur ; Stijn MUERMANS, Auteur ; Mathieu MAROY, Auteur Année de publication : 2015 Article en page(s) : p.485-492 Langues : Anglais (eng) Mots-clés : Arthroscopy rehabilitation shoulder rotator cuff repair Résumé : This prospective randomized study compares the clinical results of immediate passive mobilization versus delayed mobilization in the rehabilitation of rotator cuff repair during the early postoperative period.
The mobilization group (79 patients) received immediate daily passive mobilization. The immobilization group (51 patients) was immobilized for 4 weeks until physiotherapy was started. Passive range of motion was noted preoperatively, at 6 weeks and 4 months.
Strength was measured preoperatively and at 4 months. Constant-Murley, Simple Shoulder Test, SPADI and UCLA scores were noted at baseline and at 4 months. Ultrasonography was performed at 6 weeks to exclude early failures of repair.
We noted no significant difference between the two groups regarding range of motion at 6 weeks and range of motion, strength and functional outcome scores at 4 months. Ultrasound didn’t show a difference in healing at 6 w in either of both groups.
Both rehabilitation protocols seem applicable as well as safe in the early post-operative phase.
Level of evidence: Level 1, randomized prospective trial.Permalink : ./index.php?lvl=notice_display&id=40925
in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.485-492[article] Passive mobilization after arthroscopic rotator cuff repair is not detrimental in the early postoperative period [texte imprimé] / Pieter-Jan DE ROO, Auteur ; Stijn MUERMANS, Auteur ; Mathieu MAROY, Auteur . - 2015 . - p.485-492.
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.485-492
Mots-clés : Arthroscopy rehabilitation shoulder rotator cuff repair Résumé : This prospective randomized study compares the clinical results of immediate passive mobilization versus delayed mobilization in the rehabilitation of rotator cuff repair during the early postoperative period.
The mobilization group (79 patients) received immediate daily passive mobilization. The immobilization group (51 patients) was immobilized for 4 weeks until physiotherapy was started. Passive range of motion was noted preoperatively, at 6 weeks and 4 months.
Strength was measured preoperatively and at 4 months. Constant-Murley, Simple Shoulder Test, SPADI and UCLA scores were noted at baseline and at 4 months. Ultrasonography was performed at 6 weeks to exclude early failures of repair.
We noted no significant difference between the two groups regarding range of motion at 6 weeks and range of motion, strength and functional outcome scores at 4 months. Ultrasound didn’t show a difference in healing at 6 w in either of both groups.
Both rehabilitation protocols seem applicable as well as safe in the early post-operative phase.
Level of evidence: Level 1, randomized prospective trial.Permalink : ./index.php?lvl=notice_display&id=40925 Exemplaires (1)
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Exclu du prêtSynergic regenerative effects of polydeoxyribonucleotide and microcurrent on full-thickness rotator cuff healing in a rabbit model / Dong Rak Kwon in Annals of physical and rehabilitation medicine, Vol. 63, n°6 (November 20)
[article]
Titre : Synergic regenerative effects of polydeoxyribonucleotide and microcurrent on full-thickness rotator cuff healing in a rabbit model Type de document : texte imprimé Auteurs : Dong Rak Kwon ; Yong Suk Moon Année de publication : 2020 Article en page(s) : p. 474-482 Note générale : doi.org/10.1016/j.rehab.2019.09.010 Langues : Anglais (eng) Mots-clés : Shoulder Rotator cuff Microcurrent Polydeoxyribonucleotide Injections Ultrasonography Résumé : Background
Rotator cuff tendon tears (RCTTs) are common adult injuries. We hypothesized that a local injection of polydeoxyribonucleotide (PDRN) and microcurrent therapy (MIC) would be more effective in regenerating a tendon tear than PDRN administration alone.
Objectives
To evaluate the effect of PDRN combined with MIC on the regeneration of RCTTs in a rabbit subscapularis tendon chronic RCTT model.
Methods
Rabbits (n = 24) were allocated to 3 groups at 6 weeks after full-thickness RCTT (FTRCTT): 0.2 mL normal saline (G1-SAL); 0.2 mL PDRN with Sham MIC (G2-PDRN + Sham MIC); and 0.2 mL PDRN with MIC (G3-PDRN + MIC). All treatments were performed under ultrasound guidance. PDRN was injected weekly for 4 weeks and sham MIC or MIC was applied daily for 4 weeks after the first PDRN injection.
Results
In the G3-PDRN + MIC group, the mean (SD) subscapularis tendon tear size was continuously reduced from 1 week post-treatment to 4 weeks and was significantly decreased as compared with the other 2 groups [6.0 (1.5) vs. G1: 11.5 (1.8) and G2: 9.1 (1.6) mm2; G3 vs. G1, P < 0.001; G3 vs. G2, P = 0.018]. The gross morphologic mean tendon tear size was significantly smaller in the G3-PDRN + MIC group than G1-SAL and G2-PDRN+ Sham MIC groups [8.8 (3.5) vs. 15.9 (2.3) and 12.4 (1.6) mm2; G3 vs. G1, P < 0.001; G3 vs. G2, P = 0.03]. Mean values for regenerated collagen type 1 fibers, angiogenesis, and walking parameters were all greater for the G3-PDRN + MIC group than the other 2 groups based on histological examination and motion analysis [collagen type 1, G3: 1.60 (0.80) vs. G1: 0.45 (0.60), G2: 1.10 (0.74), G3 vs. G1, P < 0.001; G3 vs. G2, P = 0.002] [angiogenesis, G3: 2.44 (0.73) vs. G1: 0.80 (0.82) and G2: 2.06 (0.81), G3 vs. G1, P < 0.001; G3 vs. G2, P = 0.006] [walking distance, G3: 6391.4 (196.9) vs. G1: 4852.8 (137.3) and G2: 5514.4 (257.3) cm; G3 vs. G1, P < 0.001; G3 vs. G2, P < 0.001].
Conclusions
On gross morphologic, histological, and motion analysis, combined PDRN with MIC therapy was more effective than PDRN alone treating a rabbit model of chronic traumatic FTRCTT.Permalink : ./index.php?lvl=notice_display&id=91323
in Annals of physical and rehabilitation medicine > Vol. 63, n°6 (November 20) . - p. 474-482[article] Synergic regenerative effects of polydeoxyribonucleotide and microcurrent on full-thickness rotator cuff healing in a rabbit model [texte imprimé] / Dong Rak Kwon ; Yong Suk Moon . - 2020 . - p. 474-482.
doi.org/10.1016/j.rehab.2019.09.010
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 63, n°6 (November 20) . - p. 474-482
Mots-clés : Shoulder Rotator cuff Microcurrent Polydeoxyribonucleotide Injections Ultrasonography Résumé : Background
Rotator cuff tendon tears (RCTTs) are common adult injuries. We hypothesized that a local injection of polydeoxyribonucleotide (PDRN) and microcurrent therapy (MIC) would be more effective in regenerating a tendon tear than PDRN administration alone.
Objectives
To evaluate the effect of PDRN combined with MIC on the regeneration of RCTTs in a rabbit subscapularis tendon chronic RCTT model.
Methods
Rabbits (n = 24) were allocated to 3 groups at 6 weeks after full-thickness RCTT (FTRCTT): 0.2 mL normal saline (G1-SAL); 0.2 mL PDRN with Sham MIC (G2-PDRN + Sham MIC); and 0.2 mL PDRN with MIC (G3-PDRN + MIC). All treatments were performed under ultrasound guidance. PDRN was injected weekly for 4 weeks and sham MIC or MIC was applied daily for 4 weeks after the first PDRN injection.
Results
In the G3-PDRN + MIC group, the mean (SD) subscapularis tendon tear size was continuously reduced from 1 week post-treatment to 4 weeks and was significantly decreased as compared with the other 2 groups [6.0 (1.5) vs. G1: 11.5 (1.8) and G2: 9.1 (1.6) mm2; G3 vs. G1, P < 0.001; G3 vs. G2, P = 0.018]. The gross morphologic mean tendon tear size was significantly smaller in the G3-PDRN + MIC group than G1-SAL and G2-PDRN+ Sham MIC groups [8.8 (3.5) vs. 15.9 (2.3) and 12.4 (1.6) mm2; G3 vs. G1, P < 0.001; G3 vs. G2, P = 0.03]. Mean values for regenerated collagen type 1 fibers, angiogenesis, and walking parameters were all greater for the G3-PDRN + MIC group than the other 2 groups based on histological examination and motion analysis [collagen type 1, G3: 1.60 (0.80) vs. G1: 0.45 (0.60), G2: 1.10 (0.74), G3 vs. G1, P < 0.001; G3 vs. G2, P = 0.002] [angiogenesis, G3: 2.44 (0.73) vs. G1: 0.80 (0.82) and G2: 2.06 (0.81), G3 vs. G1, P < 0.001; G3 vs. G2, P = 0.006] [walking distance, G3: 6391.4 (196.9) vs. G1: 4852.8 (137.3) and G2: 5514.4 (257.3) cm; G3 vs. G1, P < 0.001; G3 vs. G2, P < 0.001].
Conclusions
On gross morphologic, histological, and motion analysis, combined PDRN with MIC therapy was more effective than PDRN alone treating a rabbit model of chronic traumatic FTRCTT.Permalink : ./index.php?lvl=notice_display&id=91323 Exemplaires (1)
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