scholarly journals Evaluation of shoulder kinesthesia in patients with unilateral frozen shoulder

2019 ◽  
Vol 7 (6) ◽  
pp. 2187
Author(s):  
Akansha A. Bhale ◽  
Surendra K. Wani
Keyword(s):  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Disease Process ◽  
Joint Position Sense ◽  
P Value ◽  
Case Group ◽  
Diabetic Patients ◽  
Joint Stability ◽  
Angle Reproduction Test ◽  
Reproduction Test

Background: Intact sensory-motor system provides kinesthesia for maintaining joint stability. Joint proprioception or joint kinesthetic sensation is often used alternately to describe a deep sensation of joint motion and joint position sense. Mechanoreceptors located in superficial layer of joint capsule, muscle spindle, golgi tendon organ complex and ligaments around joint provides joint kinesthetic sensation. Frozen shoulder or adhesive capsulitis is one of the common musculoskeletal disorders encountered in Indian population with a prevalence of almost 50% older patients with diabetes and 2-10% in non-diabetic patients. This study assessed joint kinesthetic sensation during shoulder movements in people with frozen shoulder and healthy controls which may be affected due to presence of disease process or pain. Authors hypothesized that pain and alterations in non-contractile tissues (mainly capsule) around shoulder joint due to frozen shoulder may interfere with the joint kinesthetic sensation.Methods: Case group consisted of 41 participants with frozen shoulder and 41 healthy participants without shoulder pathology. Joint kinesthesia was assessed in frozen shoulders and dominant shoulders using angle reproduction test by actively reproducing the target angle placed passively by the therapist during flexion, abduction, medial and lateral rotation movements. The angle reproduced was measured using universal goniometer by the same therapist and 3 readings were recorded.Results: Results indicate significant differences between the mean difference of angle reproduction test during shoulder movements in cases of frozen shoulder and healthy group (p value <0.05).Conclusions: Significant shoulder kinesthetic deficits were observed in patients with unilateral frozen shoulder. Therefore, clinicians should consider rehabilitation of kinesthesia in treatment of patients with frozen shoulder.

scholarly journals Immediate Effect of Muscle Energy Technique and Kalternborn Mobilisation Technique on Pain in Diabetic Patients with Periarthritis of Shoulder

2021 ◽  
pp. 220-228
Author(s):  
Kamya Somaiya ◽  
G. D. Vishnu Vardhan ◽  
Ashish Bele
Keyword(s):  
Quality Of Life ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Diabetic Patients ◽  
Tissue Degeneration ◽  
Muscle Energy Technique ◽  
Group A ◽  
Muscle Energy ◽  
Group B

Background: Periarthritis Shoulder, also known as adhesive capsulitis, is a condition that results in tissue degeneration, thickening of the joint capsule, and a narrowing of the glenoid cavity. Diabetes mellitus is linked to many debilitating musculoskeletal disorders of the hand and shoulder. Prevalence of adhesive capsulitis or frozen shoulder is estimated to be 11-30 percent in people with diabetes. Various interventions have already been used to prevent pain and improve quality of life. Both Muscle Energy Technique and Kalternborn Mobilization Technique are thought to have a pain-relieving effect. Aim & Objective: The study's aim is to compare the effects of both techniques on pain in diabetic patients. Methods/Design: In this study experimental study, the participants will be divided into two groups: Kalternborn Mobilization Technique Group (A) and Muscle Energy Technique Group (B) based on inclusion and exclusion criteria. Both interventions include 30-45 min session which will be carried out for duration of four days. Outcome will be Pain and Quality of Life and outcome measures will be evaluated at beginning and at the end of intervention period. Result: Successful Completion of trial of Muscle Energy Technique and Kalternborn Mobilisation Technique will provide evidence for best strategy targeting Pain and quality of life in diabetic patients with Periarthritis of Shoulder. Conclusion: The study will be concluded with the significant effect of Muscle Energy Technique and Kalternborn Mobilisation Technique on Periarthritis shoulder of diabetic patients.

scholarly journals Adhesive Capsulitis of Shoulder (Frozen Shoulder) among the Diabetic Patients with Rheumatic Complaints

2020 ◽  
Vol 32 (1) ◽  
pp. 67-69
Author(s):  
Kazi Abdulah Al Mamun ◽  
Md Nurullah ◽  
Md Anwar Husain ◽  
Farjana Mansur ◽  
Md Shah Alam
Keyword(s):  
Soft Tissue ◽  
Elderly People ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Diabetic Patients ◽  
Age Group ◽  
Physical Medicine ◽  
Physical Medicine And Rehabilitation ◽  
Soft Tissue Rheumatism ◽  
Medicine Today

Introduction: Adhesive capsulitis of shoulder is the most common soft tissue rheumatism among the diabetes patients with rheumatic complaints but the etiology is still unknown. To detect the incidence of adhesive capsulitis (frozen shoulder) among diabetic patients with rheumatic complaints. Materials and Methods: All patients having diabetes with rheumatic complaints attended in the department of Physical Medicine and Rehabilitation, BIRDEM and BSMMU, Dhaka during the period June 2003 to November 2003 were included in this study. Results: After discarding unsatisfactory samples, 273 samples were assayed for study. Out of 1665 patients 273 (16.40%) had adhesive capsulitis. Out of 273 patients 145 (53.12%) were female and 141 (51.65%) were housewives and of 206 (75.45%) patients was in age group 41-60 years. Conclusion: The incidence of adhesive capsulits of shoulder among diabetic patients female is more than male. It is found that housewives and elderly people are mostly sufferer with this disease. Medicine Today 2020 Vol.32(1): 67-69

scholarly journals Effect of Iron Deficiency Anemia on HbA1c in Non-Diabetics

2020 ◽  
Vol 4 (1) ◽  
pp. 10-16
Author(s):  
R.K. Bansal ◽  
Y.R. Yadav ◽  
H.S. Kulkarni ◽  
Sonam ◽  
S. Garg ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Hba1c Level ◽  
Deficiency Anemia ◽  
Control Group ◽  
P Value ◽  
Case Group ◽  
Diabetic Patients ◽  
Iron Deficient ◽  
Hba1c Levels

Background: Glycated hemoglobin A1c is a well-known indicator of glycemic control in diabetes patients. It comprises of 5% of total hemoglobin in non-diabetic patients as well. Iron Deficiency Anemia is most common cause of anemia, especially in this part of the world. So, we study the effects of Iron deficiency Anemia on HbA1c levels in non-diabetic adults to determine whether the HbA1c levels increase if any. Methods: A 100 non-diabetic adult patients with Iron Deficiency anemia admitted in various medicine wards and attending OPDs of J.L.N. Medical College and 100 healthy controls were enrolled after fulfilled inclusion and exclusion criteria. Detailed history of clinical examination and biochemical examination was performed including HbA1c. Results: Mean HbA1c level is more in iron deficient Anemic non-diabetic patients in comparison to non-Anemic non-diabetic patients. Mean HbA1c is 5.01 ± 0.41 in control group. While mean HbA1c level in case group is 6.11 ± 0.42. The difference is statistically significant (p value <.001). Conclusion: Iron deficiency Anemia is independent factor affecting HbA1c level in non diabetic patients & it should be interpreted carefully in all iron deficient anemic patients.  

scholarly journals IDIOPATHIC UNILATERAL FROZEN SHOULDER

2018 ◽  
Vol 25 (02) ◽  
Author(s):  
Kanwal Arshad ◽  
Farooq Islam ◽  
Sunaina Muneer
Keyword(s):  
Range Of Motion ◽  
Glenohumeral Joint ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Systematic Sampling ◽  
Shoulder Abduction ◽  
P Value ◽  
Surgical Interventions ◽  
Group I ◽  
Group Ii

Introduction: Frozen shoulder or adhesive capsulitis is a condition affectingthe glenohumeral joint and leads to restricted painful shoulder. It is very debilitating. This notonly affects the activities of daily living of a person but job related chores too. The inflammationof the capsule of the glenohumeral joint causes pain and restriction of the motion. Adhesivecapsulitis can be characterized as primary or secondary. It can be secondary due to anyunderlying disease such as cervical spondylosis or diabetes mellitus. People affected seekdifferent treatment options for this debilitating condition such as taking non-steroidal antiinflammatorydrugs (NSAIDS), steroid injections, taking physical therapy and some even gofor surgical interventions. Objective: the objective of this research was to find out whetherKaltenborn mobilization technique alone improved the restricted shoulder abduction range ofmotion in better way or a combination of Kaltenborn mobilization and range of motion exerciseswas a better option. Study Design: randomized clinical trial (RCT). Setting: Fatima MemorialHospital (FMH) Shadman Lahore. Period: a period of 6 months. Material and Methods:Group I: Thirty patients participated in this group and were treated with Kaltenborn mobilizationtechnique along with range of motion exercises. Group II: The second group also consisted ofthirty patients and were treated with Kaltenborn mobilization technique without range of motionexercises. Sample Size: Sixty patients were included in the research by taking 30 patients ineach group. Systematic sampling was used in which all the odd ordered patients (1st, 3rd, 5th etc.)were included in group I while all the even ordered patients (2nd, 4th, 6th etc.) in group II. Results:For abduction the mean change was 29.33±10.65 in combination while for kaltenborn alone themean change was 12.30±4.06. The values obtained for shoulder abduction were significantlyhigher in Kaltenborn + ROM group, p-value < 0.05. Conclusion: A combination of Kaltenbornmobilization along with range of motion exercises showed better results in improving shoulderabduction range of motion.

scholarly journals SEMINAR PEMBERIAN CODMAN PENDULAR EXERCISE TERHADAP PENINGKATAN LINGKUP GERAK SENDI PENDERITA FROZEN SHOULDER DI RUMAH SAKIT GRANDMED LUBUK PAKAM

2021 ◽  
Vol 1 (1) ◽  
pp. 163-167
Author(s):  
Siti Sarah Bintang Sarah Bintang ◽  
Sabirin Berampu ◽  
Mawaddah Saleha ◽  
Miftahul Zannah ◽  
Simson Sinuhaji ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Limited Range ◽  
Statistical Test ◽  
P Value ◽  
Test Results ◽  
Limited Range Of Motion ◽  
Question And Answer ◽  
Service Activity

Frozen shoulder or another name for adhesive capsulitis is pain that results in limited Range of Motion (ROM). Frozen shoulder or another name for adhesive capsulitis is pain that results in limited Range of Motion (ROM). Codman pendular exercises are interventions or techniques often used by physiotherapists to increase Range of Motion (ROM). This service activity is carried out through seminars using lecture, question and answer methods and demonstrations. The samples taken were patients with frozen shoulder with a total of 14 people. The statistical test results obtained p-value <0.05, it can be concluded that the hypothesis in the study was accepted, namely: "There is an Effect of Giving Codman Pendular Exercises and Mulligan Mobilization With Movement on Increasing Range Of Motion in Frozen Shoulder Patients"

scholarly journals Adhesive capsulitis of the shoulder joint (?frozen shoulder?) in patients with diabetes mellitus

2014 ◽  
Vol 17 (4) ◽  
pp. 16-24
Author(s):  
Nadezhda Viktorovna Maximova ◽  
Maria Vadimovna Amosova ◽  
Evdokiya Sergeevna Tsvetkova ◽  
Natalya Alexandrovna Chubrova ◽  
Galina Afanas'evna Mel’nichenko
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Risk Factors ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Diabetic Patients ◽  
Patients With Diabetes ◽  
Loss Of Motion

Adhesive capsulitis (АС) has an incidence of 20% in diabetic patients. The tightening of the shoulder capsule ("freezing") can cause gradually increasing limitation in active and passive range of motion (ROM) of shoulder. Consequences of the increasing limitations are reduced quality of life and patient disability. It is thought that AC is a self-limiting disorder that resolves in 1?2.5 years in most cases. However, new clinical data indicate both long-term persistent pain and residual loss of motion in 10% of patients without diabetes and in 85% of patients with diabetes. In this review, we summarize the results from different clinical trials in which risk factors and pathogenesis of AC in diabetic patients as well as the diagnosis and efficacy of various methods for the treatment of AC were examined.

scholarly journals Glycemic control with four way model approach in rural area patients

2019 ◽  
Vol 7 (4) ◽  
pp. 977
Author(s):  
MD. Mansoor Ali Khan Lodhi
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Tight Glycemic Control ◽  
Control Group ◽  
P Value ◽  
Case Group ◽  
Diabetic Patients ◽  
Close Monitoring ◽  
Adherence To Medication

Background: It is very important to keep the Glucose levels under control continuously and without any holidays. Type 2 diabetes is increasingly common in the industrialized world. Tight glycemic control attempts to rigidly glucose control levels (A1c: 6.5% -7.0% or lower). Maintaining tight glycemic control is lifesaving. Proper counselling, proper nutrition and if regular exercise is done it can result is good glycemic control.Methods: In the present study a total of 350 diabetic patients were selected out of which only 208 participants were eligible for study. Inclusion criteria in the study were 1) Age: men and women between age group 30 years to 70 years and 2) Type 2 Diabetes mellitus with HbA1c between 8 to 10%. Exclusion criteria in the study were 1) Type 1diabetes mellitus, Pre-existing renal, hepatic or cardiac disease, Hba1c >10%. A quadriad was established between patients, personal health worker, dietician and doctor.Results: Participants had regularly followed up and were divided randomly into cases (n = 112) and controls (n = 96). Patient were followed up as per study design it was observed that at the end of 3 months period mean FBS (case group 168.2±26.4 control group 200.8±38.3 p value <0.001) , Mean PPBS (case group 204.8±53.0 control group 271.0±45.5 p value <0.001) and Mean Hba1c (case group 8.7±0.5 control group 8.9±0.6 p value .003) in cases was significantly lower than control group.at the end 6 months it was observed that the mean cholesterol, mean triglyceride, mean LDL and mean VLDL was significantly lower in the cases compared to controls.Conclusions: A systematic approach and close monitoring that increased the adherence to medication, diet, and counselling would help in better glycemic control and prevent long term complication.

COMPARISON OF EFFECTIVENESS OF MOBILIZATION AND SELF-EXERCISES IN ADHESIVE CAPSULITIS OF SHOULDER

2018 ◽  
Vol 7 (1) ◽  
pp. 35-41
Author(s):  
Muhammad Usman Khan ◽  
Ghazala Noor Nizami ◽  
Ali Farhad
Keyword(s):  
Pain Intensity ◽  
Adhesive Capsulitis ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
T Test ◽  
P Value ◽  
Group A ◽  
Group B

OBJECTIVE To compare the effectiveness of mobilization and self-exercises in the management of adhesive capsulitis of shoulder STUDY DESIGN Randomized Control Trial SAMPLE SELECTION 30 patients of adhesive capsulitis of shoulder from physiotherapy department of tertiary care hospitals of Karachi were selected through simple random sampling technique. PROCEDURE Treatment was continued for 5 days per week for the period of 3 weeks followed by assessment. Patients were randomly divided into two equal groups. Group A was treated with midrange mobilization while group B performed self-exercises. Both groups received TENS and hot pack prior to the exercises. Mean ± SD, frequencies and percentages were used for descriptive analysis. ROM via goniometry and pain intensity through VAS was analyzed by paired t-test within the groups and by independent t-test between the groups, using SPSS. P-value of less than 0.05 was considered significant. RESULTS 60% were females (n=18) and 40% were males (n=12) with mean age of 50.17±6.37 years. Significant improvement (p-value <0.05) in pain and shoulder ROM was observed among patients of Group A as compared to Group B. Pain intensity was decreased to 1.67 ± 0.62 in group A, whereas ROMs in these patients were also better than other group.

scholarly journals Association of interleukin-17A rs2275913 polymorphism with rheumatoid arthritis susceptibility in Sudanese population

2021 ◽  
Vol 9 ◽  
pp. 205031212110202
Author(s):  
Rgda Mohamed Osman ◽  
Mounkaila Noma ◽  
Abdallah Elssir Ahmed ◽  
Hanadi Abdelbagi ◽  
Rihab Ali Omer ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Confidence Interval ◽  
Statistical Tests ◽  
Demographic Data ◽  
Control Group ◽  
P Value ◽  
Case Group ◽  
Molecular Technique ◽  
Interleukin 17A ◽  
Significant Difference

Objectives: Rheumatoid arthritis is a chronic inflammatory autoimmune disease. This study aimed to determine the association of interleukin-17A-197G/A polymorphism with rheumatoid arthritis in Sudanese patients. Methods: A case–control study was conducted between March and December 2018. Clinical and demographic data of the study participants were collected and analyzed. Polymerase chain reaction restriction fragment length polymorphism molecular technique was done to investigate interleukin-17A-197G/A polymorphisms. All statistical tests were considered statistically significant when p < 0.05. Results: The study population included 266 participants aged between 1 and 85 years, with an average of 40 years, classified into 85 (31.2%) cases (mean age 48.5 ± 11.3 years), and 181 (68.8%) controls (mean age 35.3 ± 15.9 years). The interleukin-17A homozygote AA genotype was more frequent among the control group compared to the case group; 95 (52.5%) and 7 (8.2%), respectively. The homozygote GG and the heterozygote AG genotypes were proportionally not different among the cases and control groups; 13 (54.2%) and 11 (45.8%), and 65 (46.4%) and 75 (53.6%), respectively. According to the distribution of interleukin-17A genotypes, a statistically significant difference was observed among cases with the interleukin-17A AA and AG genotypes, p values 0.001 and 0.004, respectively. For the association interleukin-17A genotypes and family history a negatively significant association was reported (95% confidence interval, –0.219, p value = 0.001). There was also a negatively significant association of interleukin-17A genotypes and anti-cyclic citrullinated peptide (95% confidence interval, −0.141, p value = 0.002). Conclusion: This study is the first study in Sudan established the association between interleukin-17A-197G/A (rs2275913) polymorphisms and susceptibly to rheumatoid arthritis. These findings appeal for further research in Sudan to investigate the exact role of IL-17A in immunopathology and disease severity among Sudanese rheumatoid arthritis

scholarly journals POS1276 LONG TERM OUTCOME OF MULTIPLE ULTRASOUND GUIDED SUPRASCAPULAR NERVE BLOCK IN TREATMENT OF FROZEN SHOULDER IN DIABETIC PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 922.2-922
Author(s):  
M. A. Mortada ◽  
R. Hassan ◽  
Y. A. Amer
Keyword(s):  
Nerve Block ◽  
External Rotation ◽  
Frozen Shoulder ◽  
Suprascapular Nerve ◽  
Diabetic Patients ◽  
Ultrasound Guided ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Suprascapular Nerve Block

Background:Frozen shoulder is prevalent among diabetic patients, and usually has aggressive course, with more tendency to be bilateral and resistant to treatment. Suprascapular nerve block (SSNB) is used with increasing frequency by anesthetists and rheumatologists in the management of frozen shoulder. We previously introduced a protocol of nine injections for SSNB with better short term outcome than single SSNB injection (1). Long term outcome of SSNB in management of frozen shoulder is still not detected.Objectives:To evaluate the long term effect of multiple (nine) ultrasound guided supra-scapular nerve block in treatment of diabetic frozen shoulder.Methods:A retrospective cohort study followed up 40 diabetic patients who received a course of ultrasound guided multiple supra-scapular nerve block (9 injections) on 2014. In this study we retrospectively assessed the patients from previously recorded data at a mean duration of 6 years after completing the 9 injection course SSNB clinically by measuring the shoulder active range of motion (using a goniometer in three planes: abduction, internal, and external rotation). Visual analogue scale and Functional assessment by shoulder pain and disability index (SPADI).Results:Thirty four patients (85% of original cohort) completed the long term follow up.The patients were 19 (55.9%) females, 60.6 y mean age, and the mean of disease duration was 85.6 months. The majority of patients (33 patients 97.05%) continues improvement and gained within normal complete range of motions in all directions and excellent grades of shoulder function (Table 1).Table 1.Clinical ParametersAt base lineAt 4 monthsLast follow up at (72months±4)**P valueSPADI pain score (100)(68.8 ± 0.5)a(10.3 ± 7.4)b(0.9±1.9)c0.00*SPADI disability score (100)(69.2 ± 7.7)a(6.25 ± 2.25)b(0.4±0.8)c0.00*SPADI total (100)(69.1 ± 8.5)a(8.15 ± 5.4)b(1.1±0.9)c0.00*Patient global assessment (100)(90.2 ± 8.2)a(8.2 ± 4.2)b(0.4±2.1)c0.00*Night pain (100)(55.4±10.2)a(10.3 ± 4.9)b(2.3±1.1)c0.00*Abduction (180°)(77.5 ± 4.7)a(170.3 ± 10.3)b(174.2±6.2)b0.00*External rotation (100 °)(46 ± 12.6)a(80.1 ± 10.2)b(86.4±10.3)b0.00*Internal rotation (70 °)(34.5 ± 2.4)a(55.4 ± 10.1)b(60.2±9.5)b0.00** P <0.05 there was a statistical significant difference•A,b,c--- the alphabet of different symbols ---means a significant statistical difference between groupsSPADI: shoulder pain and disability indexConclusion:The multiple injection courses for supra-scapular nerve block has an excellent long term efficacy as treatment of diabetic frozen shoulder. This method should be the treatment of choice in patients of diabetic frozen shoulder who do not respond to physiotherapy.References:[1]Mortada, M. A., Ezzeldin, N., Abbas, S. F., Ammar, H. A. & Salama, N. A. Multiple versus single ultrasound guided suprascapular nerve block in treatment of frozen shoulder in diabetic patients. J. Back Musculoskelet. Rehabil. 30, 537–542 (2017).Disclosure of Interests:None declared

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