AN UPDATE ON EUROPEAN SOCIETY FOR SHOULDER AND ELBOW REHABILITATION SCIENTIFIC COMMITTEE STRATEGY, VISION, BREXIT AND ITS IMPACT ON FUTURE COLLABORATION

Introduction The European Society for Shoulder and Elbow Rehabilitation (EUSSER) is made up of health professionals who specialise or have an interest in the field of shoulder & elbow dysfunction. The scientific committee of the EUSSER developed their strategies and vision and post-Brexit to work in collaboration with The European Society of Surgery for the Shoulder and Elbow (ESSSE), Société Europeenne de Chirurgeie I’Epaule et du Coude (SECEC), and British Elbow and Shoulder Society. Aim We aim to share EUSSER scientific committee’s achievements, our vision, Brexit, and its impact on our future collaborations for education and research. Materials and methods We developed our strategy in discussion with the EUSSER Board, evidence synthesis of published literature, monitoring and mapping the EUSSER scientific committee’s activities along with other equivalent professional networks scientific committee and with EUSSER scientific committee members consensus. Results Integration, collaboration, and transformation were three key areas of focus for the scientific committee this year. We worked together with other professional networks and societies, delivered a scientific lecture, and are working on developing collaborative research projects across Europe. Conclusion Despite Brexit and Covid-19 pandemic challenges, EUSSER scientific committee has worked towards expanding this year, developed strategies and vision to work with various stakeholders. Keywords: shoulder, elbow, rehabilitation, scientific, education, research, Brexit.

IMAGING IN ANTERIOR SHOULDER DISLOCATION

Shoulder dislocation is a very common musculoskeletal injury. Imaging in such cases serves an important role in the diagnostic and therapeutic process. Despite a pretty simple clinical diagnosis, the process itself is long for the patient and associated with multiple steps and decision making to regain function with low risk of prolonged disability (Zygmunt et al., 2013; Lubiatowski et al., 2016). There are also many controversies as well as significant diversity among surgeons regarding the timing and choice of particular diagnostic modalities used in diagnostics of different scenarios of shoulder dislocation. The aim of imaging in shoulder dislocation is to confirm dislocation and its direction and finally successful reduction. That usually is served by conventional radiography. Additionally, imaging may be required to identify soft tissue or bone injuries or, when necessary vascular and nerve injuries using different modalities (CT, MR, US). The selective radiographic evaluation may reduce the number of X-rays, costs, and most of all time before reduction and spent by a patient in an emergency unite. That should be used carefully to avoid misdiagnosis. Keywords: shoulder dislocation, imaging, radiography, instability, magnetic resonance

PENGARUH MANAJEMEN BAHU TERHADAP SHOULDER PAIN PADA PASIEN SESUDAH STROKE

ABSTRAK Shoulder pain merupakan komplikasi yang banyak ditemukan dan dapat mengganggu proses kemandirian pasien pasca stroke. Tujuan penelitian ini untuk mengetahui pengaruh manajemen bahu terhadap shoulder pain pada pasien sesudah stroke. Jenis penelitian ini adalah pre- eksperiment design dengan rancangan onegroup pre- test- post test design. Metode sampling yang digunakan yaitu Non-probability sampling dengan pendekatan consecutive sampling dengan jumlah sampel 40 responden yang dilakukan intervensi manajemen bahu selama empat bulan dengan latihan lima kali seminggu. Pengumpulan data menggunakan lembar observasi dan instrumen yang digunakan yaitu VAS (Visual Analog Scale). Uji statistik yang digunakan adalah uji T berpasangan dan diperoleh nilai p=0,000 dengan tingkat kemaknaan α=0,05. Hasil penelitian ini menunjukkan ada pengaruh manajemen bahu terhadap shoulder pain pada pasien sesudah stroke. Kata kunci : Manajemen bahu, Shoulder pain, stroke ABSTRACT Shoulder pain is common complication and interfere with the after stroke patients. The aim of this study was to determine the effect of shoulder management on shoulder pain for after stroke patients. This type of research was pre-experiments design with the design one of group pre-test-post test design. The sampling method used a Non-probability sampling with a consecutive sampling approach with a sample of 40 respondents who were given a shoulder management for four month with doing exercise once a day. The data collection used observation sheets and for the instruments used VAS ( Visual analog scale) The statistical test used paired T test and the value p=0.000 which obtained significance level with α=0.05 . The study result showed that there was an effect of shoulder management on shoulder pain after-stroke patients Keywords : Shoulder pain, Shoulder management, stroke

The effectiveness of routine physiotherapy with and without neuromobilization in patients with shoulder impingement syndrome

Objective: The purpose of this study was to evaluate the neuromobilization (NM) on the pain and active forward flexion of participants with shoulder impingement syndrome (SIS). Methods: A randomized control trial was conducted in Social Security Hospital, Gujranwala. The duration of study was September 2016 to March 2018. A sample of 80 participants was selected and allocated in to two groups using computer generator method in simple random sampling technique. Consent was taken from patients with SIS for this trial. At the first session, participants were randomly assigned to either control group (40) or experimental group (40). After the baseline assessment routine physiotherapy was executed for both groups, while NM was provided to experimental group. Pain and active forward flexion (AFF) were evaluated on baseline, 5th week and 11th week. The data were entered and analyzed using SPSS (version 22.0). Results: The experimental group compared with control group at 11th week had lower mean pain score 2.15(1.66-2.64) vs 4.90(4.41-5.40); between group difference, 1.82; 95% confidence interval (CI), -2.38 to -1.25; P ? 0.001 and Partial ?2=0.33, similarly with AFF 147.13(142.46-151.79) vs 123.45(118.79-128.11); between group difference ,19.35; 95% CI,(12.86-25.83); P ? 0.001 and Partial ?2=0.30. Over all pain and AFF were improved among experimental group relative to control group at 11th week. Conclusion: In an experimental setting, the delivery of neuromobilization led to significantly different outcomes in participants than in control group. Clinical Trial Number: IRCT20190121042445N1. Keywords: shoulder impingement syndrome, pain, rotator cuff. Continuous...

IDENTIFIKASI UKURAN-UKURAN TUBUH DOMBA GARUT JANTAN TANGKAS DI ARENA KETANGKASAN DOMBA RANCABANGO KABUPATEN GARUT (Identification Of Body Sizes On Fight Garut Ram In Arena Agility Sheep Rancabango Garut Regency)

Abstrak Penelitian ini dilaksanakan di arena ketangkasan Rancabango Kabupaten Garut pada tanggal 07 Januari 2018, bertujuan untuk mengetahui ukuran-ukuran tubuh domba garut jantan tangkas yang meliputi tinggi pundak, panjang badan, dan lingkar dada di arena ketangkasan domba Rancabango. Metode yang digunakan adalah metode deskriptif analitik dengan penentuan sampel berdasarkan teknik random sampling. Jumlah domba garut jantan tangkas yang diteliti sebanyak 57 ekor (30%) dari jumlah populasi domba garut jantan tangkas yang terdaptar di panitia sebanyak 190 ekor. Hasil penelitian menunjukkan bahwa rata-rata tinggi pundak 80,19 ± 3,07 cm dengan nilai koefisien variasi 3,82 %, panjang badan 76,25 ± 5,07 cm dengan nilai koefisien variasi 5,07 %, dan lingkar dada 94,96 ± 5,49 cm dengan nilai koefisien variasi 5,78 %. Hasil ini menunjukkan bahwa ukuran-ukuran tubuh domba garut jantan tangkas di arena ketangkasan domba Rancabango sudah sesuai dengan standar SNI bahkan berada di atas standar SNI yaitu tinggi pundak minimum 73 cm, panjang badan minimum 61 cm, dan lingkar dada minimum 87 cm. Kata Kunci : tinggi pundak, panjang badan, lingkar dada, domba, tangkas Abstract This research was conducted in the arena agility Rancabango, Garut Regency on January 7, 2018. This study aim to determine the body sizes of fight garut ram which includes shoulder height, body length, and chest circumference in the arena agility Rancabango. The method used in this research is analytical descriptive with sample determination based on random sampling. The number of fights ram that examined as many as 57 tail (30%) of the total population of fight ram that there are as many as 190 tails. The results showed that the average shoulder height of 80.19 ± 3.07 cm with the coefficient of variation 3.82%, body length of 76.25 ± 5.07 cm with the coefficient of variation 5.07%, and the chest circumference of 94, 96 ± 5.49 cm with a coefficient of variation 5.78%. This indicates that the body sizes of fight garut ram in the arena agility Rancabango is accordance with SNI standards even above the SNI standard is the minimum shoulder height of 73 cm, minimum body length of 61 cm, and a minimum chest circumference of 87 cm. Keywords : shoulder height, body length, chest circumference, sheep, fight ram.

Summary of an evidence-based guideline on soft tissue injuries and related disorders – Part 1: Assessment

AIM: To provide a succinct summary of the diagnosis of soft tissue injuries to the shoulder for primary health care practitioners based on the New Zealand guideline. METHODS: A multidisciplinary team developed the guideline by critically appraising and grading retrieved literature using the Graphic Appraisal Tool for Epidemiology (GATE). Recommendations were derived from resulting evidence tables. RESULTS: Diagnostic ultrasound is a valid tool for the diagnosis of a full thickness rotator cuff tear. If a significant tear is suspected, referral for diagnostic ultrasound is recommended. There is a paucity of evidence for the diagnosis of soft tissue shoulder injuries and most recommendations are based on the consensus of the guideline team. CONCLUSION: Assessment relies on thorough history-taking and physician examination with appropriate referral where there is evidence of serious damage or the diagnosis remains unclear. KEYWORDS: Shoulder, shoulder pain, diagnosis, soft tissue injuries

Skausmas peties sąnario srityje: priežastys, klinikiniai simptomai, diagnostika ir gydymas

Rimvaldas BrogaVilniaus universiteto Ortopedijos,traumatologijos ir plastinės chirurgijos klinika,Vilniaus Greitosios pagalbos universitetinė ligoninė,Šiltnamių g. 29, LT-2043 VilniusEl paštas: [email protected] Peties skausmą yra pajutęs dažnas pacientas, kuriam jau per 40 metų. Dėl šio skausmo jis kreipiasi į įvairių specialybių gydytojus. Pečių juostos anatomija ir biomechanika labai sudėtinga ir visai nepanaši į kitų sąnarių. Pečių juostos judesių amplitudė įvairiose ašyse ir plokštumose labai plati dėl trijų tikrųjų sąnarių ir dviejų jungčių. Pečių juostos funkciją atlieka 26 raumenys ir jų dalys, tačiau biomechanikai svarbiausi yra mažieji sukamieji raumenys ir deltinis raumuo. Trinkant minėtų raumenų veiklai, ligonis pajunta skausmus, blogėja peties funkcija. Straipsnyje minimos peties sąnario degeneracijos priežastys, dėstomas ištyrimo planas. Kai kurie anamnezės ir apžiūros duomenys labai būdingi peties ligoms. Apžvelgiami patys populiariausi ištyrimo metodai: skausminiai, funkciniai ir jėgos pasipriešinimo. Rentgenologinis tyrimas palyginti nebrangus, tačiau labai informatyvus. Aptariami būdingiausi peties sąnario rentgenologiniai simptomai. Laiku diagnozuoto mažųjų sukamųjų raumenų degeneracinio ar trauminio pažeidimo operacinis gydymas labai veiksmingas. Jei liga užleista ir įsisenėjusi, t. y. minėti raumenys seniai nuplyšę, surandėję ir negali atlikti pagrindinės funkcijos (stabiliai ir kartu judriai fiksuoti žastikaulio galvą), operacinio gydymo rezultatai būna prastesni. Prasminiai žodžiai: peties sąnarys, klinikinis ištyrimas, mažieji sukamieji raumenys, degeneracija, ankštumo sindromas. Pain in the region of shoulder joint: causes, clinical symptoms,diagnostics and treatment Rimvaldas Broga At the age over 40 many patients experience shoulder pain. Due to this pain they are refered to doctors of different specialities. The anatomy of the shoulder joint as well as its biomechanics is very complicated and not similar to any other joint. The range of motion in the shoulder joint is very wide in all axes and planes. The wide motion is achieved by means of three true joints and two junctions. In the function of the shoulder joint 26 muscles and their parts take part, but most important in the biomechanics are the smallest rotation muscles and the deltoid muscle. The patient experiences pain and aches and the function of the shoulder is impaired in the case of dysfunction of the above mentioned muscles. In the paper, causes of shoulder joint degeneration are mentioned and a clinical examination scheme is presented. Some of the accents from the anamnesis and evaluation are very common to shoulder sicknesses. The most popular examination tests concerning pain, function and strength restriction are discussed. Roentgenological examination is rather cheap but very informative. The most informative and most common roentgenological features are discussed. In case of early diagnosis of the degenerative and traumatic impairment of small rotator muscles operative treatment is very effective. In cases of delayed and inveterate illnesses when the above mentioned muscles have been disrupted long ago, are shortened and cannot perform their basic function (stable and mobile fixation of the humeral head), the results of operative treatment are worse. Keywords: shoulder joint, clinical examination, small rotator muscles, degeneration, compartment syndrome.