An epidemiological study of musculoskeletal disorders of the shoulder in the city of Buenos Aires
Abstract
Objective: To determine the prevalence and epidemiological and clinical characteristics of subjects with shoulder disorders in two public hospitals over one year.
Materials and Method: A descriptive, cross-sectional, prospective, and multicenter study was conducted on subjects with musculoskeletal disorders of the shoulder in the physiotherapy unit of two public hospitals of the city of Buenos Aires over one year. Sociodemographic and clinical variables were collected and analyzed.
Results: We included 179 subjects with a mean age of 53.64 (SD 14.31) years; of them, 58.7% were female. Of the sample, 75% of subjects were diagnosed with rotator cuff-related shoulder pain (RCRSP), 72.32% reported no past shoulder pathology, and 63.79% received no previous physiotherapy treatment. The average American Shoulder and Elbow Surgeon (ASES) score was 49.4 (SD 22.08). Statistically significant differences according to sex (p = 0.02), educational level (p =0.02), and night pain (p <0.001) were observed. A significant positive correlation was found between the total range of motion of the affected arm and the ASES (rho = 0.33, p˂ 0.001).
Conclusion: This study allowed us to know the epidemiological and clinical characteristics of subjects with musculoskeletal disorders of the shoulder in two public hospitals. The prevalence of shoulder disorders was 11.38%, and RCRSP was the most frequent.
References
Muhafara GJ, Cura AJ, Tozzi WA, Villarruel M, Virgilio SA, Alí MA, Esperón LF. Prevalence of Musculoskeletal disorders of the Shoulder in a Hospital of the City of Buenos Aires. Retrospective study. J Shoulder Elbow Surg . 2017;2(2):20–23.
Greving K, Dorrestijn O, Winters JC, Groenhof F, Van Der Meer K, Stevens M, et al. Incidence, prevalence, and consultation rates of shoulder complaints in general practice. Scand J Rheumatol. 2012;41(2):150–5.
Struyf F, Geraets J, Noten S, Meeus M, Nijs J. A Multivariable Prediction Model for the Chronification of Non-traumatic Shoulder Pain: A Systematic Review. Pain Physician. 2016;19(2):1-10.
Ludewig PM, Kamonseki DH, Staker JL, Lawrence RL, Camargo PR, Braman JP. Changing Our Diagnostic Paradigm: Movement System Diagnostic Classification. Int J Sports Phys Ther. 2017;12(6):884–93.
Bahr R. Why screening tests to predict injury do not work — and probably never will … : a critical review. Br J Sports Med. 2016;50(13):776–80.
Kelley MJ, Shaffer MA, Kuhn JE, Michener LA, Seitz AL, Uhl TL, et al. Shoulder pain and mobility deficits: Adhesive capsulitis: Clinical practice guidelines linked to the international classification of functioning, disability, and ealth from the orthopaedic section of the american physical therapy association. J Orthop Sports Phys Ther. 2013;43(5).
Davenport TE, Watts HG, Kulig K, Resnik C. Current status and correlates of physicians’ referral diagnoses for physical therapy. J Orthop Sports Phys Ther. 2005;35(9):572–9.
Pierobon A, Policastro P, Amorín MP, Navarro E, Méndez D. Epidemiología de sujetos con afecciones músculo-esqueléticas que acuden a un consultorio privado de kinesiología en Argentina . Estudio retrospectivo. AJRPT. 2020;2(2):28–35.
Portney LG. Foundations of Clinical Research: Applications Evidence- Based Practice. 4th Ed: Philadelphia: Davis Company; 2020. p: 2-16.
Studies O. Annals of Internal Medicine Academia and Clinic The Strengthening the Reporting of Observational Studies in Epidemiology ( STROBE ) Statement : Guidelines for Reporting. 2015;147(8):573–8.
Policastro PO, Pierobon A, Pérez J, Novoa GA, Calvo Delfino M, Sajfar ME, et al. Cross-cultural adaptation and validation of the Argentine “American Shoulder and elbow surgeons, patient self-report section” questionnaire. Musculoskelet Sci Pract. 2019;43:37–44.
Cools AM, De Wilde L, van Tongel A, Ceyssens C, Ryckewaert R, Cambier DC. Measuring shoulder external and internal rotation strength and range of motion: Comprehensive intra-rater and inter-rater reliability study of several testing protocols. J Shoulder Elb Surg. 2014;23(10):1454–61.
Yang JI, Lin JJ. Reliability of function-related tests in patients with shoulder pathologies. J Orthop Sports Phys Ther. 2006;36(8):572–6.
Hegedus EJ, Cook C, Lewis J, Wright A, Park JY. Combining orthopedic special tests to improve diagnosis of shoulder pathology. Phys Ther Sport 2015;16(2):87–92.
Lewis J, McCreesh K, Roy JS, Ginn K. Rotator cuff tendinopathy: Navigating the diagnosis-management conundrum. J Orthop Sports Phys Ther. 2015;45(11):923–37.
Itoi E, Arce G, Bain GI, Diercks RL, Guttmann D, Imhoff AB, et al. Shoulder Stiffness: Current Concepts and Concerns. Arthroscopy. 2016;32(7):1402–14.
Lo IKY, Nonweiler B, Woolfrey M, Litchfield R, Kirkley A. An Evaluation of the Apprehension, Relocation, and Surprise Tests for Anterior Shoulder Instability. Am J Sports Med. 2004;32(2):301-7.
Reilingh ML, Kuijpers T, Windt DA Van Der. Course and prognosis of shoulder symptoms in general practice. Rheumatology. 2008;47(5):724–30.
Doiron-Cadrin P, Lafrance S, Saulnier M, Cournoyer E, Roy JS, Dyer JO, et al. Shoulder rotator cuff disorders: a systematic review of clinical practice guidelines and semantic analyses of recommendations. Arch Phys Med Rehabil. 2020;101(7):1233-1242.
INDEC. No Title [Internet]. Available from: https://www.indec.gob.ar/indec/web/Institucional-Indec-IndicadoresDemograficos
Strazdins L, Bammer G. Women, work and musculoskeletal health. Soc Sci Med. 2004;58(6):997–1005.
Kauppinen K, Kumpulainen R, Houtman I, Copsey S. Gender issues in safety and health at work. Vol. 19, Psychology and Health. 2004. 93–94 p.
Mitchell C, Adebajo A, Hay E, Carr A. Shoulder Pain: diagnosis and management in primary care. BMJ. 2005. Nov 12;331(7525):1124–8.
Salamh P, Lewis J. It Is Time to Put Special Tests for Rotator Cuff Related Shoulder Pain Out to Pasture. J Orthop Sport Phys Ther. 2020;50(5):222-225.
Cadogan A, McNair PJ, Laslett M, Hing WA. Diagnostic accuracy of clinical examination and imaging findings for identifying subacromial pain. PLoS One. 2016;11(12):e016738.
Leong HT, Fu SC, He X, Oh JH, Yamamoto N, Hang S. Risk factors for rotator cuff tendinopathy: A systematic review and meta-analysis. J Rehabil Med. 2019;51(9):627–37.
Jørgensen MB, Faber A, Hansen JV, Holtermann A, Søgaard K. Effects on musculoskeletal pain , work ability and sickness absence in a 1-year randomised controlled trial among cleaners. BMC Public Health. 2011;11(1):840.
Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett DR Jr, Tudor-Locke C et al. 2011 Compendium of Physical Activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011 Aug;43(8):1575-81.
Wakabayashi I, Itoi E, Minagawa H, Kobayashi M, Seki N, Shimada Y, et al. Does reaching the back reflect the actual internal rotation of the shoulder? J Shoulder Elb Surg. 2006;15(3):306–10.
Satpute KH, Hall T, Adanani A. Validity of an Alternate Hand Behind Back Shoulder Range of Motion Measurement in Patients With Shoulder Pain and Movement Dysfunction. J Manipulative Physiol Ther. 2018;41(3):242-251.
Cho CH, Jung SW, Park JY, Song KO, Yu KI. Is shoulder pain for three months or longer correlated with depression, anxiety, and sleep disturbance ? J Shoulder Elb Surg. 2013;22(2):222–8.
Dunn WR, Kuhn JE, Sanders R, An Q, Baumgarten KM, Bishop JY, et al. Symptoms of pain do not correlate with rotator cuff tear severity a cross-sectional study of 393 patients with a symptomatic atraumatic full-thickness rotator cuff tear. J Bone Joint Surg Am. 2014;96(10):793–800.
Testa M, Rossettini G. Enhance placebo, avoid nocebo: How contextual factors affect physiotherapy outcomes. Man Ther. 2016;24:65-4.
Mulligan EP, Brunette M, Shirley Z, Khazzam M. Sleep quality and nocturnal pain in patients with shoulder disorders. J Shoulder Elbow Surg. 2015 Sep;24(9):1452-7.
Lewis J. The End of an Era? J Orthop Sports Phys Ther. 2018 Mar;48(3):127-129.
Chester R, Jerosch-Herold C, Lewis J, Shepstone L. Psychological factors are associated with the outcome of physiotherapy for people with shoulder pain: A multicentre longitudinal cohort study. Br J Sports Med. 2018;52(4):269–75.
