scholarly journals Return-to-Sport Criteria After Upper Extremity Surgery in Athletes—A Scoping Review, Part 1: Rotator Cuff and Shoulder Stabilization Procedures

2021 ◽  
Vol 9 (8) ◽  
pp. 232596712110218
Author(s):  
Rebecca Griffith ◽  
Nickolas Fretes ◽  
Ioanna K. Bolia ◽  
Iain R. Murray ◽  
John Meyer ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Muscle Strength ◽  
Range Of Motion ◽  
Scoping Review ◽  
Return To Sport ◽  
Radiographic Evaluation ◽  
Shoulder Stabilization ◽  
Level Of Evidence ◽  
Specific Test ◽  
Definition Of

Background: Standardized criteria are lacking to guide patient return to sport (RTS) after rotator cuff surgery (RCS) or shoulder stabilization surgery (SSS). Purpose: To describe RTS criteria used after RCS and SSS in athletic populations. Study Design: Scoping review; Level of evidence, 4. Methods: This scoping review was based on the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses–Scoping Review) guidelines. A total of 5 electronic databases (MEDLINE, Scopus, SPORTDiscus, Embase, Google Scholar Advanced search) and the gray literature were searched for English-language studies that reported at least 1 RTS criterion in athletes after shoulder surgery. Studies were assigned to the RCS or SSS subgroup based on the primary procedure performed. Data were extracted and summarized as frequencies or arithmetic mean and standard deviation. Results: Included were 52 studies and 2706 athletes (2206 male, 500 female, with a mean age of 28.8 ± 1.8 years). The RCS group consisted of 14 studies and the SSS group consisted of 38 studies. Time from surgery was the most common RTS criterion reported overall (37/52 studies; 71%) as well as within the RCS (93%) and SSS (63%) subgroups. Muscle strength (25/52 studies; 48%) and range of motion (23/52; 44%) were used by almost half of the included articles. RTS criteria reported less often were absence of pain, successful completion of sport-specific or position-specific test, proprioception, radiographic evaluation, patient-surgeon agreement, minimum time required to participate in pain-free throwing, and satisfactory scapulothoracic mechanics. All studies used 1 to 3 of the above RTS criteria; however, the definition of each criterion differed among the included articles. Conclusion: Time from surgery was the most commonly reported RTS criterion after RCS or SSS in athletes, whereas muscle strength and range of motion were used by almost half of the articles. There was high heterogeneity in the definition of each RTS criterion used among the included studies, which also used different combinations of 1 to 3 RTS criteria. These results suggest the need to better define quantitative and qualitative RTS criteria in athletes undergoing rotator cuff and shoulder stabilization procedures in order to safely return athletes to sport.

scholarly journals Return-to-Sport Criteria After Upper Extremity Surgery in Athletes—A Scoping Review, Part 2: Ulnar Collateral Ligament of the Elbow Procedures

2021 ◽  
Vol 9 (8) ◽  
pp. 232596712110218
Author(s):  
Rebecca Griffith ◽  
Ioanna K. Bolia ◽  
Nickolas Fretes ◽  
Iain R. Murray ◽  
John Meyer ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Upper Extremity ◽  
Scoping Review ◽  
English Language ◽  
Physical Therapists ◽  
Return To Sport ◽  
Ulnar Collateral Ligament ◽  
Collateral Ligament ◽  
Level Of Evidence ◽  
Meta Analyses

Background: There is a lack of consensus to guide patient return to sport (RTS) after elbow ulnar collateral ligament surgery (eUCLS). Purpose: To describe the reported RTS criteria after eUCLS in the athletic population. Study Design: Scoping review; Level of evidence, 4. Methods: This scoping review was performed by adhering to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses–Scoping Review) guidelines. We searched 5 electronic databases (MEDLINE, Scopus, SPORTDiscus, Embase, Google Scholar Advanced) and the gray literature for English-language studies that reported at least 1 RTS criterion in athletes after eUCLS. Data were extracted and summarized as frequencies or arithmetic mean and standard deviation. Results: Included were 14 studies and 1335 athletes with a mean age of 21.4 ± 1.1 years. Time from surgery (range, 6-16 months) was the most common RTS criterion used, and it was reported by all 14 of the included articles. RTS criteria reported less often were pain (3/14; 21%), successful completion of a throwing program (3/14; 21%), muscle strength of the forearm muscles (1/14; 7%), and “normal” range of motion and muscle strength of the elbow and shoulder joints on the operated upper extremity (1/14; 7%). All studies used 1 to 5 of the above RTS criteria. Conclusion: Only 14 studies reported 1 or more RTS criteria after eUCLS in athletes, and time was the most common RTS criterion used. Our results highlight the need for a coordinated effort among surgeons, physical therapists, and athletic trainers in order to establish evidence-based RTS criteria after eUCLS in athletes so athletes can safely to sport and prolong their athletic careers.

Evaluating the Outcomes of Rotator Cuff Repairs With Polytetrafluoroethylene Patches for Massive and Irreparable Rotator Cuff Tears With a Minimum 2-Year Follow-up

2018 ◽  
Vol 46 (13) ◽  
pp. 3155-3164 ◽  
Author(s):  
Vasanth Seker ◽  
Lisa Hackett ◽  
Patrick H. Lam ◽  
George A.C. Murrell
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
External Rotation ◽  
Case Series ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Level Of Evidence ◽  
Irreparable Tear ◽  
Pain At Rest

Background: Massive and irreparable rotator cuff tears are difficult to manage surgically. One technique is to use a synthetic polytetrafluoroethylene (PTFE) patch to bridge the tear. However, there is little information regarding the outcomes of this procedure. Purpose: To determine the ≥2-year outcomes of patients for whom synthetic patches were used as tendon substitutes to bridge irreparable rotator cuff defects. Study Design: Case series; Level of evidence, 4. Methods: This retrospective cohort study used prospectively collected data. Patients included those with a synthetic patch inserted as an interposition graft for large and/or irreparable rotator cuff tears with a minimum 2-year follow-up. Standardized assessment of shoulder pain, function, range of motion, and strength was performed preoperatively, at 6 and 12 weeks, and at 6 months and ≥2 years. Radiograph and ultrasound were performed preoperatively, at 6 months, and ≥2 years. Results: At a mean of 36 months, 58 of 68 eligible patients were followed up, and 53 of 58 (90%) patches remained in situ. Three patches failed at the patch-tendon interface, while 1 patient (2 shoulders/patches) went on to have reverse total shoulder replacements. Patient-ranked shoulder stiffness ( P < .001), frequency of pain with activity and sleep ( P < .0001), level of pain at rest and overhead ( P < .0001), and overall shoulder function improved from bad to very good ( P < .0001) by 6 months. Supraspinatus (mean ± SEM: 29 ± 16 N to 42 ± 13 N) and external rotation (39 ± 13 N to 59 ± 15 N) strength were the most notable increases at the ≥2-year follow-up ( P < .0001). Passive range of motion also improved by 49% to 67%; forward flexion, from 131° to 171°; abduction, from 117° to 161°; external rotation, from 38° to 55°; and internal rotation, from L3 to T10 ( P < .0001) preoperatively to ≥2 years. The most improvement in passive range of motion occurred between 12 months and ≥2 years. The mean (SD) Constant-Murley score was 90 (12), while the American Shoulder and Elbow Surgeons score was 95 (8). Conclusion: At 36 months postoperatively, patients who had synthetic patches used as tendon substitutes to bridge irreparable rotator cuff defects reported less pain and greater overall shoulder function as compared with preoperative assessments. They demonstrated improved range of passive motion and improved strength. The data support the hypothesis that the technique of using a synthetic PTFE patch to bridge a large and/or irreparable tear has good construct integrity and improves patient and clinical outcomes.

scholarly journals Pseudoparalysis and pseudoparesis of the shoulder

2021 ◽  
Author(s):  
Roland Stefan Camenzind ◽  
Laurent Lafosse ◽  
Thibault Lafosse
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Rotator Cuff Tear ◽  
Rotator Cuff Tears ◽  
Subscapularis Tendon ◽  
Cuff Tear ◽  
Active Range Of Motion ◽  
Definition Of ◽  
Shoulder Elevation ◽  
Scapular Plane

Abstract Background Clinical presentation of massive rotator cuff tears range from pain to loss of active range of motion. Pseudoparalysis and pseudoparesis are defined inconsistently in the literature, but both include limited active with maintained passive range of motion. Objective This article aims to provide a consistent definition of pseudoparalysis and pseudoparesis of the shoulder and show structural and biomechanical differences between these two types of rotator cuff tear with their implications for treatment. Methods A literature review including key and basic papers discussing clinical symptoms, biomechanical differences, and their impact on therapeutic options for pseudoparalysis and pseudoparesis was performed. Results Biomechanically, structural differences between pseudoparalysis (active scapular plane abduction <45°) and pseudoparesis (active scapular plane abduction 45–90°) exist. For massive posterosuperior rotator cuff tears, the integrity of the inferior subscapularis tendon is the most predictive factor for active humeral elevation. Patients with pseudoparalysis have a higher grade of subscapularis tendon involvement (>50%) and fatty infiltration of the subscapularis muscle. Treatment options depend on the acuteness and repairability of the tear. Rotator cuff repair can reliably reverse the active loss of active range of motion in acute and reparable rotator cuff tears. In chronic and irreparable cases reverse total shoulder arthroplasty is the most reliable treatment option in elderly patients. Conclusion The most concise definition of pseudoparalysis is a massive rotator cuff tear that leads to limited active (<45° shoulder elevation) with free passive range of motion in the absence of neurologic deficits as the reason for loss of active elevation. The integrity of the subscapularis tendon is the most important difference between a pseudoparalytic and pseudoparetic (active shoulder elevation 45–90°) shoulder. Decision-making for surgical options depends more on reparability of the tendon tear and patient age than on differentiation between pseudoparalysis and pseudoparesis.

scholarly journals The evaluation of the long-term influence of the Kinesio Taping method on the selected parameters in patients with rotator cuff lesions: a randomized controlled trial

2020 ◽  
Author(s):  
Magdalena Wróbel ◽  
Aneta Bac ◽  
Katarzyna Ogrodzka-Ciechanowicz ◽  
Mateusz Zalewski ◽  
Edyta Michalik ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Rotator Cuff ◽  
Muscle Strength ◽  
Range Of Motion ◽  
Controlled Trial ◽  
Rehabilitation Program ◽  
Control Group ◽  
Randomized Controlled ◽  
Kinesio Taping

Abstract BackgroundThe aim of our study was to assess the influence of KT on the pain, range of motion and muscle strength of the rotator cuff during long-term rehabilitation process. Methods In pre post treatment randomized controlled trial took part sixty outpatients with the rotator cuff injury. Thirty participants were assigned into a researched group in which Kinesio Taping was combined with a six-week rehabilitation program and a control group (30 patients) in which only rehabilitation program was employed. Patients underwent functional testing according to the protocol of Orthopaedic Medicine Cyriax and were subjected to the measurement of muscle strength using Biodex System 4 dynamometer. ResultsThe therapy brought positive results in both groups when it comes to the increase of their muscle strength and the improvement of the upper limb functionality. Better effects were achieved by the therapy that used Kinesio Taping method, although the differences were not statistically significant. ConclusionsThe use of the Kinesio Taping method combined with the rehabilitation program gave the same results as the employment of the rehabilitation program alone in reference to the pain, range of motion and muscle strength of the rotator cuff. Trail Registration This study was registered prospectively in the Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN12617000624381.https://www.anzctr.org.au/ ACTRN12617000624381.

Intrinsic Risk Factors for Inversion Ankle Sprains in Male Subjects: A Prospective Study

2005 ◽  
Vol 33 (3) ◽  
pp. 415-423 ◽  
Author(s):  
Tine Marieke Willems ◽  
Erik Witvrouw ◽  
Kim Delbaere ◽  
Nele Mahieu ◽  
Llse De Bourdeaudhuij ◽  
...  
Keyword(s):  
Risk Factors ◽  
Muscle Strength ◽  
Range Of Motion ◽  
Cox Regression ◽  
Ankle Sprains ◽  
Running Speed ◽  
Level Of Evidence ◽  
Cox Regression Analysis ◽  
Cardiorespiratory Endurance ◽  
Male Subjects

Background Many variables have been retrospectively associated with ankle sprains. However, very little is known about factors predisposing people to these injuries. Hypothesis Measurable intrinsic factors might predispose male athletes to ankle sprains. Study Design Cohort study; Level of evidence, 2. Methods A total of 241 male physical education students were evaluated for possible intrinsic risk factors for inversion sprains at the beginning of their academic study. The evaluated intrinsic risk factors included anthropometrical characteristics, functional motor performances, ankle joint position sense, isokinetic ankle muscle strength, lower leg alignment characteristics, postural control, and muscle reaction time during a sudden inversion perturbation. Subjects were followed prospectively for 1 to 3 years. Results A total of 44 (18%) of the 241 male subjects sustained an inversion sprain; 4 sprained both ankles. Cox regression analysis revealed that male subjects with slower running speed, less cardiorespiratory endurance, less balance, decreased dorsiflexion muscle strength, decreased dorsiflexion range of motion, less coordination, and faster reaction of the tibialis anterior and gastrocnemius muscles are at greater risk of ankle sprains. Conclusion Based on our findings, it is suggested that running speed, cardiorespiratory endurance, balance, dorsiflexion strength, coordination, muscle reaction, and dorsiflexion range of motion at the ankle are associated with the risk of ankle inversion sprains in male subjects.

scholarly journals Defining Return to Sport: A Systematic Review

2021 ◽  
Vol 9 (7) ◽  
pp. 232596712110095
Author(s):  
Joshua Doege ◽  
Jack M. Ayres ◽  
Matthew J. Mackay ◽  
Armin Tarakemeh ◽  
Symone M. Brown ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sports Medicine ◽  
Return To Sport ◽  
Eligibility Criteria ◽  
Level Of Evidence ◽  
Search Terms ◽  
Competition Level ◽  
Or Practice ◽  
Definition Of ◽  
Meta Analyses

Background: Return to sport (RTS) commonly serves as a measure for assessment of clinical outcomes in orthopaedic sports medicine surgery. Unfortunately, while RTS is commonly utilized in research for this purpose, currently there is no widely accepted or standardized definition for when an athlete has officially returned to his or her sport. Purpose: To conduct a systematic review to evaluate and report the differences in specific definitions of RTS utilized in the orthopaedic surgery literature. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was performed using PubMed, EMBASE, and Cochrane Trials databases per PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Search terms consisted of variations of “RTS” combined with variations of “orthopedic surgery” and “define” to capture as many relevant articles as possible. The definition of RTS was recorded and analyzed. Results: A total of 718 articles were identified in the initial search, 29 of which met eligibility criteria, providing a clear definition of RTS. Of the 29 studies included, 20 (69.0%) defined RTS as an athlete competing in a game or other competitive play. Three (10.3%) defined this as the athlete competing in a game or other competitive play but with an explicitly stated competition-level modifier of the athlete returning to his or her preinjury level of competition. Two articles (6.9%) included returning to training or practice, and the remaining 4 articles (13.8%) used terminology other than the standard RTS. Conclusion: There is variability in the definition of RTS used in orthopaedic sports medicine literature. Most studies refer to the athlete competing in a game or other competitive play. Other variants include returning to practice/training and explicitly defined competition levels and objectives. Future studies should aim to standardize the definition of RTS to facilitate more precise assessment of outcome after sports medicine surgery. Using terminology that describes components of the recovery and rehabilitation process, such as “return to participation” and “return to performance,” in addition to RTS will allow us to more clearly understand the athlete’s recovery and associated level of competition or performance.

scholarly journals The Relationship between Kinesiophobia and Return to Sport after Shoulder Surgery for Recurrent Anterior Instability

Joints ◽  
2021 ◽  
Author(s):  
Alberto Vascellari ◽  
Carlo Ramponi ◽  
Davide Venturin ◽  
Giulia Ben ◽  
Nicolò Coletti
Keyword(s):  
Sport Participation ◽  
Case Series ◽  
Return To Sport ◽  
Shoulder Function ◽  
Retrospective Case ◽  
Shoulder Stabilization ◽  
Level Of Evidence ◽  
Significant Difference ◽  
The Difference ◽  
The Relationship

Abstract Purpose To evaluate the relationship between kinesiophobia and patient's return to sport after shoulder stabilization surgery. The hypothesis was that kinesiophobia represents an independent factor correlated to the difference between preinjury and postoperative level of sport. Methods This study retrospectively evaluated 66 patients (mean age: 35.5, standard deviation [SD] = 9.9 years) and at a mean follow-up of 61.1 (SD = 37.5) months after arthroscopic Bankart's repair or open Bristow–Latarjet procedure. Kinesiophobia was assessed with the Tampa Scale for Kinesiophobia (TSK); return to the preinjury sport was assessed by the difference between baseline and postoperative degree of shoulder involvement in sport (D-DOSIS) scale. The Western Ontario Shoulder Instability index (WOSI) was used to evaluate participants' perceptions of shoulder function. Results TSK showed correlation with D-DOSIS (ρ = 0.505, p < 0.001) and the WOSI score (ρ = 0.589, p < 0.001). There was significant difference in TSK and WOSI scores between participants who had and had not returned to their previous level of sport participation (p = 0.006, and 0.0001, respectively). Conclusion This study demonstrated that kinesiophobia is correlated to the return to sport after shoulder stabilization surgery. Level of Evidence Level IV, retrospective case series.

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