First online survey on the physical therapist´s approach of the shoulder diseases in Argentina
Abstract
Objective: To describe how physical therapists approach shoulder disorders in Argentina.
Materials and method: A descriptive cross-sectional survey was carried out between November and December 2016. Physical therapists who treat patients with musculoskeletal shoulder disorders in Argentina were surveyed, voluntarily and anonymously, through Survey Monkey® tool. The 23-question survey was made by two physical therapists involved in the treatment of said patients.
Results: A total of 301 (93.5%) surveys were analyzed. The results revealed that for assessment, 69.4% measure the range of analytical movement, 72.7% evaluate muscle strength, 65.1% use clinical tests for the diagnosis of rotator cuff pathologies, and 80.1% systematically evaluate the presence of scapular dyskinesis.
And for treatment, 71.4% make use of different kinds of physical agents, 71.5% combine manual therapy with exercise.
Conclusion: According to the data collected, most respondents evaluate range of motion, scapular dyskinesis and/or muscle strength. The most commonly used interventions were physical agents and exercise along with manual therapy. The respondents’ approach partially agrees with the evidence.
References
Muhafara GJ, Cura AJ, Tozzi WA, Villarruel M et al. Prevalence of musculoskeletal disorders of the shoulder in a Hospital of the City of Buenos Aires. Retrospective Study. Acta of Shoulder and Elbow Surgery. 2017;2(2):20-23.
Schmidt S, Ferrer M, González M, González N, Valderas JM, Alonso J et al. Evaluation of shoulder-specific patient-reported outcome measures: a systematic and standardized comparison of available evidence. J Shoulder Elbow Surg. 2014;23(3):434-44.
Bennell K, Coburn S, Wee E, Green S, Harris A, Forbes A, Buchbinder R. Efficacy and cost-effectiveness of a physiotherapy program for chronic rotator cuff pathology: a protocol for a randomised, double-blind, placebo-controlled trial. 2007;31(8):86.
Kuhn JE, Dunn WR, Sanders R, An Q, Baumgarten KM, Bishop JY et al. Effectiveness of physical therapy in treating atraumatic full-thickness rotator cu tears: a multicenter prospective cohort study. J Shoulder Elbow Surg. 2013;22(10):1371-9.
Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn’t. BMJ. 1996; 312:71.
Phadke V, Makhija M, Singh H. The use of evidence-based practices for the management of shoulder impingement syndrome among Indian physical therapists: a cross-sectional survey. Braz J Phys Ther. 2015;19(6):473-81.
Dong W, Goost H, Lin XB, Burger C, Paul C, Wang ZL et al. Treatments for shoulder impingement syndrome: a PRISMA systematic review and network meta-analysis. Medicine (Baltimore). 2015;94(10):e510.
Klintberg IH, Cools AM, Holmgren TM, Holzhausen AC, Johansson K, Maenhout et al. Consensus for physiotherapy for shoulder pain. Int Orthop. 2015;39(4):715-20.
McClure PW, Michener LA. Staged Approach for Rehabilitation Classification: Shoulder Disorders (STAR-Shoulder). Phys Ther. 2015;95(5):791-800.
Ludewig PM, Lawrence RL, Braman JP. What's in a name? Using movement system diagnoses versus pathoanatomic diagnoses. J Orthop Sports Phys Ther. 2013;43(5):280-3.
Hughes PC, Taylor NF, Green RA. Most clinical tests cannot accurately diagnose rotator cuff pathology: a systematic review. Aust J Physiother. 2008;54(3):159-70.
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.
Macchi, Ricardo Luis. Introducción a la Estadística. 2da Edición. Buenos Aires: Editorial Médica Panamericana; 2013. P10.
Cools AM, Johansson FR, Borms D, Maenhout A. Prevention of shoulder injuries in overhead athletes: a science-based approach. Braz J Phys Ther. 2015;19(5):331-9.
Kelley MJ, Shaffer MA, Kuhn JE, Michener LA, Seitz AL, Uhl TL et al. Shoulder pain and mobility deficits: adhesive capsulitis. J Orthop Sports Phys Ther. 2013;43(5):A1-31.
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 Elbow Surg. 2014;23(10):1454-61.
Ishigaki T, Ishida T, Samukawa M, Saito H, Ezawa Y, Hirokawa M et al. Does restriction of glenohumeral horizontal adduction reflect posterior capsule thickening of the throwing shoulder? J Phys Ther Sci. 2015;27(5):1299-302.
Ratcliffe E, Pickering S, McLean S, Lewis J. Is there a relationship between subacromial impingement syndrome and scapular orientation? A systematic review. Br J Sports Med. 2014;48(16):1251-6.
Tate AR, McClure P, Kareha S, Irwin D, Barbe MF. A clinical method for identifying scapular dyskinesis, part 2: validity. J Athl Train. 2009;44(2):165-73.
Kibler WB, Ludewig PM, McClure P, Uhl TL, Sciascia A. Scapular Summit 2009: introduction. July 16, 2009, Lexington, Kentucky. J Orthop Sports Phys Ther. 2009;39(11):A1-A13.
Tate AR, McClure PW, Kareha S, Irwin D. Effect of the Scapula Reposition Test on shoulder impingement symptoms and elevation strength in overhead athletes. J Orthop Sports Phys Ther. 2008;38(1):4-11.
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.
Parreira Pdo C, Costa Lda C, Hespanhol LC Jr, Lopes AD, Costa LO. Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review. J Physiother. 2014;60(1):31-9.
Lewis JS, Green A, Wright C. Subacromial impingement syndrome: the role of posture and muscle imbalance. J Shoulder Elbow Surg. 2005;14(4):385-92.
Schmidt S, Ferrer M, González M, González N, Valderas JM, Alonso J et al. Evaluation of shoulder-specific patient-reported outcome measures: a systematic and standardized comparison of available evidence. J Shoulder Elbow Surg. 2014;23(3):434-44.
Nagatomi T, Mae T, Nagafuchi T, Yamada SI, Nagai K, Yoneda M. Shoulder manual muscle resistance test cannot fully detect muscle weakness. Knee Surg SportsTraumatol Arthrosc. 2017;25(7):2081-2088.
Cools AM, Vanderstukken F, Vereecken F, Duprez M, Heyman K, Goethals N, Johansson F. Eccentric and isometric shoulder rotator cuff strength testing usinga hand-held dynamometer: reference values for overhead athletes. Knee Surg SportsTraumatol Arthrosc. 2016;24(12):3838-3847.
O'Sullivan P, Caneiro JP, O'Keeffe M, O'Sullivan K. Unraveling the Complexity of Low Back Pain. J Orthop Sports Phys Ther. 2016;46(11):932-937.
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):269-275.
Sanchis MN, Lluch E, Nijs J, Struyf F, Kangasperko M. The role of central sensitization in shoulder pain: A systematic literature review. Semin Arthritis Rheum. 2015;44(6):710-6.
Noten S, Struyf F, Lluch E, D'Hoore M, Van Looveren E, Meeus M. Central Pain Processing in Patients with Shoulder Pain: A Review of the Literature. Pain Pract. 2017;17(2):267-280.
Page MJ, Green S, Mrocki MA, Surace SJ, Deitch J, McBain B et al. Electrotherapy modalities for rotator cuff disease. Cochrane Database Syst Rev. 2016;(6):CD012225.
Desmeules F, Boudreault J, Roy JS, Dionne C, Frémont P, MacDermid JC. The efficacy of therapeutic ultrasound for rotator cuff tendinopathy: A systematic review and meta-analysis. Phys Ther Sport. 2015;16(3):276-84.
Hanratty CE, McVeigh JG, Kerr DP, Basford JR, Finch MB, Pendleton A, Sim J. The effectiveness of physiotherapy exercises in subacromial impingement syndrome: a systematic review and meta-analysis. Semin Arthritis Rheum. 2012;42(3):297-316.
Reinold MM, Escamilla RF, Wilk KE. Current concepts in the scientific and clinical rationale behind exercises for glenohumeral and scapulothoracic musculature. J Orthop Sports Phys Ther. 2009;39(2):105-17.
Desjardins-Charbonneau A, Roy JS, Dionne CE, Frémont P, MacDermid JC, Desmeules F. The efficacy of manual therapy for rotator cuff tendinopathy: a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2015;45(5):330-50.
Da Silva TM, Costa Lda C, Garcia AN, Costa LO. What do physical therapists think about evidence-based practice? A systematic review. Man Ther. 2015;20(3):388-401.
Kuhn JE. Exercise in the treatment of rotator cuff impingement: a systematic review and a synthesized evidence-based rehabilitation protocol. J Shoulder Elbow Surg. 2009;18(1):138-60.33
Condon C, McGrane N, Mockler D, Stokes E. Ability of physiotherapists to undertake evidence-based practice steps: a scoping review. Physiotherapy. 2016;102(1):10-9.
Codman, EA. The Shoulder. Boston. MA: Thomas Todd Company; 1934.
Ellsworth AA, Mullaney M, Tyler TF, McHugh M, Nicholas S. Electromyography of Selected Shoulder Musculature During Un-weighted and Weighted Pendulum Exercises. N Am J Sports Phys Ther. 2006;1(2):73-9.
Long JL, Ruberte Thiele RA, Skendzel JG, Jeon J, Hughes RE, Miller BS, Carpenter JE. Activation of the shoulder musculature during pendulum exercises and light activities. J Orthop Sports Phys Ther. 2010;40(4):230-7.
Akkaya N, Akkaya S, Gungor HR, Yaşar G, Atalay NS, Sahin F. Effects of weighted and un-weighted pendulum exercises on ultrasonographic acromiohumeral distance in patients with subacromial impingement syndrome. J Back Musculoskelet Rehabil. 2017;30(2):221-228.
