The Short-term Effect of Graded Motor Imagery on the Affective Components of Pain in Subjects with Chronic Shoulder Pain Syndrome: Open-Label Single-Arm Prospective Study

Abstract Objective To determine the short-term effect of graded motor imagery (GMI) on the affective components of pain and range of motion in subjects with chronic shoulder pain syndrome. Design Open-label single-arm prospective study. Setting The Physical Therapy Laboratory, Universidad de las Americas. Subjects One hundred seven patients with chronic shoulder pain syndrome. Methods The subjects received a six-week GMI program based on laterality training, imagined movements, and mirror therapy. We assessed pain intensity using a visual analog scale (VAS), fear of movement was assessed using the Tampa Scale of Kinesiophobia (TSK), and catastrophizing was assessed using the Pain Catastrophizing Scale (PCS). The patient’s flexion active range of motion (AROM) was also recorded. Results At the end of treatment, the VAS showed a decrease of 4.2 cm (P < 0.001, Cohen’s d = 3.3), TSK showed a decrease of 17.0 points (P < 0.001, Cohen’s d = 2.8), catastrophizing showed a decrease of 19.2 points (P < 0.001, Cohen’s d = 3.2), and shoulder flexion AROM showed an increment of 30.3º (P < 0.000, Cohen’s d = 1.6). Conclusions We conclude that a short-term GMI program improves the affective components of pain and shoulder flexion AROM in patients with chronic shoulder pain syndrome.

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Effectiveness of prolotherapy vs local anesthetic infiltration guided by ultrasound in the treatment of shoulder pain syndrome

10.1101/2020.12.22.20248223 ◽

2020 ◽

Author(s):

Juan A. Lira-Lucio ◽

Guillermo Ochoa-Gaítan ◽

Lizeth Hernández-Escobar ◽

Christian I. Padilla-Rivera ◽

Berenice C. Hernández Porras ◽

...

Keyword(s):

Shoulder Pain ◽

Local Anesthetic ◽

Corticosteroid Injection ◽

Local Treatment ◽

Pain Syndrome ◽

Interventional Therapy ◽

Initial Therapy ◽

Oncologic Patients ◽

Local Anesthetic Injection ◽

Chronic Shoulder Pain

BACKGROUNDChronic Shoulder Pain (CSP) is a health problem that affects almost 67% of the general population. Almost a third of patients with acute shoulder pain syndrome don’t respond to initial therapy with analgesics and need interventional therapy. Corticosteroid injection is the standard therapy. Prolotherapy has been demonstrated to be effective in other chronic pain syndromes, but not in CSP. The aim of this study was to determine the effectiveness of prolotherapy compared to local anesthetic injection in the treatment of chronic shoulder painMETHODSRetrospective and comparative study of 77 patients from the National Institute of Oncology in Mexico City who received treatment for Chronic Shoulder Pain guided by ultrasound between 2017-2019. 57 patients were kept in the study for further analysis. 39 received infiltration with corticosteroids and 17 prolotherapy. Effectiveness of therapies was determined based on the decrease in VAS score in next follow-up session. Statistical analysis were performed with SPSS and RStudio Software.RESULTS51% of patients with Chronic Shoulder Pain were unemployed. 84% of the patients needed 3 different types of analgesics before they received ultrasound guided local treatment. Prolotherapy was as efficient as local anesthetic injection, no matter basal pain severity or underlying shoulder diagnosis, despite prolotherapy being more used as treatment for Rotator Cuff Tendinopathy.CONCLUSIONSProlotherapy and corticosteroid injection guided by ultrasound have the same efficacy in pain relief for chronic shoulder pain in oncologic patients.

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EFFECTIVENESS OF INDIVIDUALIZED APPROACH FOR PHYSIOTHERAPY OF CHRONIC SHOULDER PAIN AND PHYSICAL FUNCTIONING IN ELITE ATHLETES WITH PHYSICAL DISABILITIES

Journal of Applied Sports Sciences ◽

10.37393/jass.2020.02.8 ◽

2020 ◽

Vol 2 (2020) ◽

pp. 91-106

Author(s):

Martin Eremiev ◽

◽

Bobi Krumov ◽

Irena Lyudmilova ◽

Nadezhda Popova ◽

...

Keyword(s):

Shoulder Pain ◽

Rating Scale ◽

Scratch Test ◽

Shoulder Girdle ◽

Post Treatment ◽

Wheelchair Athletes ◽

Shoulder Flexion ◽

The Right ◽

Outcome Rating Scale ◽

Chronic Shoulder Pain

ABSTRACT Objective: Тo study the potential effectiveness of individual physiotherapy program for wheelchair athletes with shoulder girdle persistent pain and dysfunctions. Materials and methods: Thirteen athletes, members of the Bulgarian National Teams in wheelchair basketball and track and field athletics, with mean age 40.6 ± 10.9 participated in the study. The studied athletes had had a history of persistent pain and shoulder girdle dysfunctions for more than 6 months. Individual physiotherapy programs were applied to the participants for a period of two weeks. The selection of techniques was based on the initial assessment and evaluation. The participants were evaluated before treatment, after the first week of treatment, and at the end of the period with the use of the following specific questionnaires and tests: Goniometry of shoulder flexion and horizontal adduction, Apley’s Scratch test, Active compression test of O’Brien (ACT), Athletic shoulder outcome rating scale and Wheelchair User’s Shoulder Pain Index (WUSPI). Results: Post-treatment effects demonstrated a significant (p<0.05) increase in shoulder flexion (14.6° for the right and 12.7° for the left) and horizontal adduction (21.9° for the right and 18.8° for the left). A corresponding increase in the scores for the Athletic shoulder outcome rating scale was found with 10.92 points difference to the initial score (p<0.05). The WUSPI demonstrated a non-significant improvement of 0.69 points. The results of ACT and Apley scratch test showed a non-significant decrease of 23.1% for the right shoulder and, 15.4% decrease for the left shoulder after 7 days of treatment. Those results remained unchanged in post-treatment testing. Conclusion: This study showed that the individual physiotherapy programs are effective in the management of wheelchair athletes with chronic shoulder pain. The involvement of Mulligan’s manual therapy techniques combined with other types of exercises for the shoulder and the trunk are beneficial for wheelchair athletes with chronic shoulder pain.

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Functional Outcomes After a Physiotherapy Program in Elderly Patients With Complex Regional Pain Syndrome Type I After Distal Radius Fracture: A Prospective Observational Study

Hand ◽

10.1177/15589447211063578 ◽

2021 ◽

pp. 155894472110635

Author(s):

Héctor Gutiérrez-Espinoza ◽

Jonathan Zavala-González ◽

Rodrigo Gutiérrez-Monclus ◽

Felipe Araya-Quintanilla

Keyword(s):

Elderly Patients ◽

Grip Strength ◽

Functional Outcomes ◽

Pain Syndrome ◽

Type I ◽

Syndrome Type ◽

Cohen’S D ◽

Physiotherapy Program ◽

Cohen's D

Background: No published prospective studies have reported the clinical effects of physiotherapy at 1-year follow-up in patients with complex regional pain syndrome type I (CRPS I) after distal radius fracture (DRF). The purpose of this study was to evaluate at 1-year follow-up the functional effects of physiotherapy program in elderly patients with CRPS I after extra-articular DRF. Methods: A total of 72 patients with CRPS I after DRF were prospectively recruited. All patients were treated with a 6-week supervised physiotherapy treatment. Three evaluations were performed: at the beginning, at the end of the treatment, and at 1-year follow-up. Wrist function, upper limb function, grip strength, and pain intensity were assessed with the Patient-Rated Wrist Evaluation (PRWE), Disabilities of the Arm, Shoulder, and Hand (DASH), Jamar dynamometer, and Visual Analogue Scale (VAS), respectively. Results: At 1-year follow-up, the PRWE showed a decrease of 21.6 points (Cohen’s d = 2.8; 95% confidence interval [CI] = 18.6-24.6; P < .05); the DASH showed a decrease of 23.8 points (Cohen’s d = 2.9; 95% CI = 20.8-26.7; P < .05); grip strength showed an increase of 40.6% (Cohen’s d = 5.0; 95% CI = 43.5-37.6; P < .05); and the VAS showed a decrease of 2.6 cm (Cohen’s d = 1.9; 95% CI = 2.11-3.16; P < .05). Conclusion: At 1-year follow-up, a physiotherapy program showed clinically and statistically significant results in all functional outcomes in elderly patients with CRPS I after extra-articular DRF.

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Shoulder pain across more movements is not related to more rotator cuff tendon findings in people with chronic shoulder pain diagnosed with subacromial pain syndrome

PAIN Reports ◽

10.1097/pr9.0000000000000980 ◽

2021 ◽

Vol 6 (4) ◽

pp. e980

Author(s):

Rafael Krasic Alaiti ◽

J.P. Caneiro ◽

Juliana T. Gasparin ◽

Thais Cristina Chaves ◽

Eduardo A. Malavolta ◽

...

Keyword(s):

Rotator Cuff ◽

Shoulder Pain ◽

Pain Syndrome ◽

Rotator Cuff Tendon ◽

Subacromial Pain Syndrome ◽

Chronic Shoulder Pain

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Effectiveness of non-pharmacological interventions on sleep characteristics among adults with musculoskeletal pain and a comorbid sleep problem: a systematic review

Chiropractic & Manual Therapies ◽

10.1186/s12998-021-00381-6 ◽

2021 ◽

Vol 29 (1) ◽

Author(s):

Efrosini Papaconstantinou ◽

Carol Cancelliere ◽

Leslie Verville ◽

Jessica J. Wong ◽

Gaelan Connell ◽

...

Keyword(s):

Systematic Review ◽

Sleep Problems ◽

Sleep Efficiency ◽

Pharmacological Interventions ◽

Short Term ◽

Cohen’S D ◽

Pain Subscale ◽

Wrist Actigraphy ◽

Pain Outcomes ◽

Cohen's D

AbstractSleep problems are common and may be associated with persistent pain. It is unclear whether non-pharmacological interventions improve sleep and pain in adults with comorbid sleep problems and musculoskeletal (MSK) pain. We conducted a systematic review on the effectiveness of non-pharmacological interventions on sleep characteristics among adults with MSK pain and comorbid sleep problems. We searched MEDLINE, EMBASE, CINAHL, Cochrane Central and PsycINFO from inception to April 2, 2021 for randomized controlled trials (RCTs), cohort, and case-control studies. Pairs of independent reviewers critically appraised and extracted data from eligible studies. We synthesized the findings qualitatively. We screened 8459 records and identified two RCTs (six articles, 467 participants). At 9 months, in adults with insomnia and osteoarthritis pain, cognitive behavioral therapy for pain and insomnia (CBT-PI) was effective at improving sleep (Insomnia Severity Index, ISI) when compared to education (OR 2.20, 95% CI 1.25, 3.90) or CBT for pain (CBT-P) (OR 3.21, 95% CI 1.22, 8.43). CBP-P vs. education was effective at increasing sleep efficiency (wrist actigraphy) in a subgroup of participants with severe pain at baseline (mean difference 5.45, 95% CI 1.56, 9.33). At 18 months, CBT-PI, CBT-P and education had similar effectiveness on sleep and pain or health outcomes. In adults with insomnia and knee osteoarthritis, CBT-I improved some sleep outcomes including sleep efficiency (diary) at 3 months (Cohen’s d 0.39, 95% CI 0.24, 1.18), and self-reported sleep quality (ISI) at 6 months (Cohen’s d − 0.62, 95% CI -1.01, − 0.07). The intervention was no better than placebo (behavioural desensitization) for improving other sleep outcomes related to sleep onset or pain outcomes. Short-term improvement in sleep was associated with pain reduction at 6 months (WOMAC pain subscale) (sensitivity 54.8%, specificity 81.4%). Overall, in two acceptable quality RCTs of adults with OA and comorbid insomnia, CBT-PI/I may improve some sleep outcomes in the short term, but not pain outcomes in the short or long-term. Clinically significant improvements in sleep in the short term may improve longer term pain outcomes. Further high-quality research is needed to evaluate other non-pharmacological interventions for people with comorbid sleep problems and a range of MSK conditions.

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Treatment of Postmastectomy Pain Syndrome with Spinal Cord Stimulation: A Case Series

Pain Management Case Reports ◽

10.36076/pmcr.2021/5/73 ◽

2021 ◽

pp. 73-78

Author(s):

Matthew Chung

Keyword(s):

Spinal Cord ◽

Spinal Cord Stimulation ◽

Pain Syndrome ◽

Cancer Center ◽

University Of Texas ◽

Cohen’S D ◽

The Mean ◽

Md Anderson ◽

The University ◽

Cohen's D

Background: Postmastectomy pain syndrome (PMPS) is a chronic pain syndrome that can be refractory to treatment by pain specialists. Spinal cord stimulation is a technique that has been approved for neuropathic pain and shown promise as a modality for targeted treatment. In this study, we report the outcomes of spinal cord stimulation in patients with refractory PMPS. Case Report: A retrospective chart review was performed at The University of Texas MD Anderson Cancer Center to identify patients who underwent spinal cord stimulation during a 3-year period. Relevant outcomes for efficacy and safety were evaluated. The protocol was reviewed and approved by The University of Texas MD Anderson Cancer Center Institutional Review Board. Seven patients with refractory PMPS were treated with spinal cord stimulation at our institution. All patients initially underwent trial spinal cord stimulation, with a mean preoperative Numeric Rating Scale (0-10) (NRS-11) score of 8.29 ± 1.70. Six of 7 (85.7%) patients reported a successful trial stimulation (> 50% pain reduction); however, only 5 received permanent implantation. Following implantation, the reported one-month postoperative NRS-11 score was 4.20 ± 1.79. The mean change in the pain score between pre- and postoperative intervention was 4.40 ± 1.34 (Cohen’s d = 3.28, P = .002). The mean decrease in the morphine equivalent daily dose (MEDD) following implantation was 55.80 (SD 82.21, Cohen’s d = 0.68, P = .125). Conclusion: Spinal cord stimulation may be an effective therapy for patients experiencing chronic PMPS and should be considered in medically refractory cases. Future prospective studies are warranted to confirm the positive outcomes we demonstrated pertaining to pain scores and opioid medication changes. Key words: Cancer pain, postmastectomy pain syndrome, neuromodulation, opioids

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Hemiparetic Shoulder Pain Syndrome Treated with Deep Dry Needling During Early Rehabilitation: A Prospective, Open-Label, Randomized Investigation

Journal of Musculoskeletal Pain ◽

10.1300/j094v12n02_04 ◽

2004 ◽

Vol 12 (2) ◽

pp. 25-34 ◽

Cited By ~ 54

Author(s):

L. DiLorenzo ◽

M. Traballesi ◽

D. Morelli ◽

A. Pompa ◽

S. Brunelli ◽

...

Keyword(s):

Shoulder Pain ◽

Pain Syndrome ◽

Early Rehabilitation ◽

Dry Needling ◽

Open Label

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Phonologische Verarbeitung bei Grundschulkindern mit schwacher Lesefähigkeit

Lernen und Lernstörungen ◽

10.1024/2235-0977/a000045 ◽

2013 ◽

Vol 2 (4) ◽

pp. 199-215 ◽

Cited By ~ 9

Author(s):

Maria Klatte ◽

Claudia Steinbrink ◽

Kirstin Bergström ◽

Thomas Lachmann

Keyword(s):

Cohen’S D ◽

Phonologische Verarbeitung ◽

Cohen's D

Defizite in der phonologischen Informationsverarbeitung werden heute als Kernsymptom der Lese-Rechtschreibstörung betrachtet. In Trainingsstudien mit betroffenen Kindern erwiesen sich Phonemwahrnehmungsfähigkeiten als trainierbar, und Programme, in denen Aufgaben zur phonologischen Bewusstheit mit der systematischen Vermittlung von Phonem-Graphem-Zuordnungen kombiniert wurden, zeigten Transfereffekte auf Lese- und Rechtschreibleistungen. Ausgehend von diesen Erkenntnissen wurde ein computerbasiertes Trainingsprogramm zur Förderung der Phonemwahrnehmung, der phonologischen Bewusstheit und der Graphem-Phonem-Zuordnungen für deutschsprachige Grundschulkinder mit Lese-Rechtschreibstörung entwickelt. Aufgrund der besonderen Relevanz der Vokallänge für die deutsche Orthographie enthält das Programm neben Aufgaben, die auf Konsonanten fokussieren, auch Vokallängenaufgaben. Bei der Konzipierung des Programms wurden etablierte, ursprünglich für andere Sprachen entwickelte Aufgaben an die deutsche Phonologie angepasst und in ein computerbasiertes Format übersetzt. Im Rahmen der vorliegenden Studie sollte überprüft werden, ob die konstruierten Trainingsaufgaben die spezifischen Defizite von Kindern mit Lese-Rechtschreibstörung wie intendiert abbilden. Hierzu wurden leseschwache Dritt- und Viertklässler (n = 35) mit mindestens durchschnittlichen Lesern derselben Klassenstufen (n = 75; Kontrollgruppe) hinsichtlich ihrer Leistungen in den Aufgaben verglichen. Die leseschwachen Kinder zeigten in allen Aufgaben schlechtere Leistungen als die Kontrollgruppe. Die Effektstärken der Gruppenunterschiede (Cohen's d) lagen im mittleren bis hohen Bereich (0.50 – 2.19). Die Ergebnisse bestätigen, dass die Aufgaben des Trainingsprogramms die spezifischen Defizite leseschwacher Kinder abbilden. Ein Training mit diesen Aufgaben erscheint daher grundsätzlich sinnvoll. Die Wirkungen eines solchen Trainings auf die schriftsprachlichen Leistungen von Kindern mit Lese-Rechtschreibstörung werden in zukünftigen Studien überprüft.

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