Introduction: The most commonly recommended treatment for multidirectional instability (MDI) of the shoulder is exercise. Despite this recommendation, there is limited evidence to support the effectiveness of exercise. The aim of this paper is to describe a pilot randomised controlled trial comparing the effectiveness of 2 exercise programmes on outcomes of participants with MDI.
Methods And Analysis: Consenting participants between 12 and 35 years, with non-traumatic MDI will be randomly allocated to participate in either the Rockwood Instability programme or the Watson MDI programme. Both programmes involve 1 consultation per week for 12 weeks with a physiotherapist to prescribe and progress a home exercise programme. Outcomes will be assessed at baseline, 6, 12, 24 and 52 weeks. Primary outcome measures include the Melbourne Instability Shoulder Score and Western Ontario Shoulder Index. Secondary outcomes include scapular coordinates, scapular upward rotation angles, muscle strength, symptomatic onset, limiting factor and angle of limiting factor in abduction range, incidence of complete glenohumeral joint dislocation, global rating of change, satisfaction scores, the Orebro Musculoskeletal Pain Questionnaire, adverse events and compliance with the home exercise programme. Data will be analysed on intention-to-treat principles and a per protocol basis.
Discussion: This trial will evaluate whether there are differences in outcomes between the Rockwood and the Watson MDI programmes for participants with MDI.
Ethics And Dissemination: Participant confidentiality will be maintained with publication of results. Ethics approval: Faculty of Health Sciences (FHEC12/201).
Trial Registration Number: ACTRN12613001240730; Pre-results.
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http://dx.doi.org/10.1136/bmjopen-2016-013083 | DOI Listing |
Arthrosc Tech
November 2024
Department of Orthopedic Surgery and Traumatology, Olympia, Quirón Salud, Madrid, Spain.
Multidirectional shoulder instability represents an ongoing challenge for orthopaedic surgeons, and multiple techniques have been described to treat this condition. Posterior glenoid dysplasia is a known risk factor for posterior instability as well as persistent or recurrent instability following posterior stabilization procedures. Recurrent shoulder instability complicated by capsular insufficiency due to underlying soft tissue disorders or multiple prior failed surgical procedures poses a challenging surgical problem.
View Article and Find Full Text PDFOrthop J Sports Med
December 2024
Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Background: Anterior shoulder instability is a common pathology seen especially in young men and highly active patient populations. Subluxation is a commonly encountered clinical issue, yet little is known about the effects of first-time subluxation compared with dislocation on shoulder stability and clinical outcomes after surgical stabilization.
Purpose: To compare revision and redislocation rates as well as patient-reported outcomes (PROs) between subluxators and dislocators after a first-time anterior shoulder instability event.
J Bodyw Mov Ther
October 2024
Concordia University, St. Paul, USA.
Introduction: The purpose of this study was to investigate the effects of Kinesio® tape on scapulothoracic joint kinematics during humerothoracic elevation and lowering in asymptomatic participants.
Method: Sixteen males and 24 females participated in data collection using the Polhemus G4 3D electromagnetic motion capture system. Dominant shoulder kinematics were collected while the participant performed three repetitions of elevation in the frontal, sagittal, and scapular planes.
Expert Opin Pharmacother
December 2024
Department of Medical Oncology and Hematology, Princess Margaret Cancer Center, University Health Network, University of Toronto, Ontario, Canada.
Introduction: Despite a rising incidence, biliary tract cancers (BTCs) are still considered a rare tumor entity. The disease's subtle clinical presentation and lack of effective early detection strategies often lead to a diagnosis at an advanced or unresectable stage, where curative options are limited.
Areas Covered: This review provides an overview of current systemic therapies and emerging novel approaches for BTC.
Cureus
October 2024
Neurology, Hospital San Juan de Dios, San José, CRI.
Opsoclonus-myoclonus-ataxia syndrome (OMAS) is a rare immunological central nervous system disorder that mostly affects children, and it is extremely uncommon in adults. It usually presents idiopathically, as a parainfectious condition, or as a paraneoplastic syndrome. We present a case of a patient who developed adult-onset opsoclonus-myoclonus-ataxia syndrome (OMAS) without any associated infectious or neoplastic disease, a condition that is considered very rare in Central America.
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