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A combination of systematic review and clinicians' beliefs in interventions for subacromial pain.

https://arctichealth.org/en/permalink/ahliterature49827
Source
Br J Gen Pract. 2002 Feb;52(475):145-52
Publication Type
Article
Date
Feb-2002
Author
Kajsa Johansson
Birgitta Oberg
Lars Adolfsson
Mats Foldevi
Author Affiliation
Department of Medicine and Care, Faculty of Health Sciences, Linköping, Sweden. Kajsa.Johansson@hul.liu.se
Source
Br J Gen Pract. 2002 Feb;52(475):145-52
Date
Feb-2002
Language
English
Publication Type
Article
Keywords
Acupuncture Therapy - methods
Adrenal Cortex Hormones - therapeutic use
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Attitude of Health Personnel
Exercise Therapy - methods
Family Practice
Humans
Pain - therapy
Questionnaires
Research Support, Non-U.S. Gov't
Review Literature
Shoulder Impingement Syndrome - therapy
Shoulder Pain - therapy - ultrasonography
Sweden
Abstract
The aim of the study is to determine which treatments for patients with subacromial pain are trusted by general practitioners (GPs) and physiotherapists, and to compare trusted treatments with evidence from a systematic critical review of the scientific literature. A two-step process was used: a questionnaire (written case simulation) and a systematic critical review. The questionnaire was mailed to 188 GPs and 71 physiotherapists in Sweden. The total response rate was 72% (186/259). The following treatments were trusted, ergonomics/adjustments at work, corticosteroids, non-steroidal anti-inflammatory drugs, movement exercises, acupuncture, ultrasound therapy, strengthening exercises, stretching, transcutaneous electric nerve stimulation, and superficial heat or ice therapy. The review, including efficacy studies for the treatments found to be trusted, was conducted using the CINAHL, EMBASE and MEDLINE databases. Evidence for efficacy was recorded in relation to methodological quality and to diagnostic criteria that labelled participants as having subacromial pain or a non-specific shoulder disorder. Forty studies were included. The methodological quality varied and only one treatment had definitive evidence for efficacy for non-specific patients, namely injection of corticosteroids. The trust in corticosteroids, injected in the subacromial bursa, was supported by definitive evidence for short-term efficacy. Acupuncture had tentative evidence for short-term efficacy in patients with subacromial pain. Ultrasound therapy was ineffective for subacromial pain. This is supported by tentative evidence and, together with earlier reviews, this questions both the trust in the treatment and its use. The clinicians' trust in treatments had a weak association with available scientific evidence.
PubMed ID
11885825 View in PubMed
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Consensus for physiotherapy for shoulder pain.

https://arctichealth.org/en/permalink/ahliterature266902
Source
Int Orthop. 2015 Apr;39(4):715-20
Publication Type
Conference/Meeting Material
Article
Date
Apr-2015
Author
Ingrid Hultenheim Klintberg
Ann M J Cools
Theresa M Holmgren
Ann-Christine Gunnarsson Holzhausen
Kajsa Johansson
Annelies G Maenhout
Jane S Moser
Valentina Spunton
Karen Ginn
Source
Int Orthop. 2015 Apr;39(4):715-20
Date
Apr-2015
Language
English
Publication Type
Conference/Meeting Material
Article
Keywords
Algorithms
Consensus
Exercise Therapy
Humans
Physical Therapy Modalities
Questionnaires
Range of Motion, Articular
Shoulder Pain - therapy
Sweden
Abstract
Shoulder pain is a common disorder. Despite growing evidence of the importance of physiotherapy, in particular active exercise therapy, little data is available to guide treatment. The aim of this project was to contribute to the development of an internationally accepted assessment and treatment algorithm for patients with shoulder pain.
Nine physiotherapists with expertise in the treatment of shoulder dysfunction met in Sweden 2012 to begin the process of developing a treatment algorithm. A questionnaire was completed prior to the meeting to guide discussions. Virtual conferences were thereafter the platform to reach consensus.
Consensus was achieved on a clinical reasoning algorithm to guide the assessment and treatment for patients presenting with local shoulder pain, without significant passive range of motion deficits and no symptoms or signs of instability. The algorithm emphasises that physiotherapy treatment decisions should be based on physical assessment findings and not structural pathology, that active exercises should be the primary treatment approach, and that regular re-assessment is performed to ensure that all clinical features contributing to the presenting shoulder pain are addressed. Consensus was also achieved on a set of guiding principles for implementing exercise therapy for shoulder pain, namely, a limited number of exercises, performed with appropriate scapulo-humeral coordination and humeral head alignment, in a graduated manner without provoking the presenting shoulder pain.
The assessment and treatment algorithm presented could contribute to a more formal, extensive process aimed at achieving international agreement on an algorithm to guide physiotherapy treatment for shoulder pain.
PubMed ID
25548127 View in PubMed
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No significant differences between intervention programmes on neck, shoulder and low back pain: a prospective randomized study among home-care personnel.

https://arctichealth.org/en/permalink/ahliterature49866
Source
J Rehabil Med. 2001 Jul;33(4):170-6
Publication Type
Article
Date
Jul-2001
Author
E. Horneij
B. Hemborg
I. Jensen
C. Ekdahl
Author Affiliation
Hälsoinvest, Ramlösa Clinic, Sweden. eva.horneij@swipnet.se
Source
J Rehabil Med. 2001 Jul;33(4):170-6
Date
Jul-2001
Language
English
Publication Type
Article
Keywords
Adult
Exercise Therapy
Female
Home Health Aides - statistics & numerical data
Humans
Low Back Pain - therapy
Middle Aged
Neck Pain - therapy
Nurses' Aides - statistics & numerical data
Occupational Diseases - therapy
Prospective Studies
Questionnaires
Research Support, Non-U.S. Gov't
Shoulder Pain - therapy
Sweden
Treatment Outcome
Abstract
The effects of two different prevention programmes on: (1) reported neck, shoulder and back pain, (2) perceived physical exertion at work and perceived work-related psychosocial factors, were evaluated by questionnaires after 12 and 18 months. Female nursing aides and assistant nurses (n = 282) working in the home-care services, were randomly assigned to one of three groups for: (1) individually designed physical training programme, (2) work-place stress management, (3) control group. Results revealed no significant differences between the three groups. However, improvements in low back pain were registered within both intervention groups for up to 18 months. Perceived physical exertion at work was reduced in the physical training group. Improvements in neck and shoulder pain did not differ within the three groups. Dissatisfaction with work-related, psychosocial factors was generally increased in all groups. As the aetiology of neck, shoulder and back disorders is multifactorial, a combination of the two intervention programmes might be preferable and should be further studied.
PubMed ID
11506215 View in PubMed
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Radial extracorporeal shockwave treatment compared with supervised exercises in patients with subacromial pain syndrome: single blind randomised study.

https://arctichealth.org/en/permalink/ahliterature94257
Source
BMJ. 2009;339:b3360
Publication Type
Article
Date
2009
Author
Engebretsen Kaia
Grotle Margreth
Bautz-Holter Erik
Sandvik Leiv
Juel Niels G
Ekeberg Ole Marius
Brox Jens Ivar
Author Affiliation
Department of Physical Medicine and Rehabilitation, Ullevaal University Hospital, Kirkeveien 166, 0407 Oslo, Norway. kaiabe@medisin.uio.no
Source
BMJ. 2009;339:b3360
Date
2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Exercise Therapy - methods
Female
Humans
Lithotripsy - methods
Male
Middle Aged
Shoulder Impingement Syndrome - therapy
Shoulder Pain - therapy
Single-Blind Method
Treatment Outcome
Young Adult
Abstract
OBJECTIVE: To compare the effectiveness of radial extracorporeal shockwave treatment with that of supervised exercises in patients with shoulder pain. DESIGN: Single blind randomised study. SETTING: Outpatient clinic of physical medicine and rehabilitation department in Oslo, Norway. PARTICIPANTS: 104 patients with subacromial shoulder pain lasting at least three months. INTERVENTIONS: Radial extracorporeal shockwave treatment: one session weekly for four to six weeks. Supervised exercises: two 45 minute sessions weekly for up to 12 weeks. Primary outcome measure Shoulder pain and disability index. RESULTS: A treatment effect in favour of supervised exercises at 6, 12, and 18 weeks was found. The adjusted treatment effect was -8.4 (95% confidence interval -16.5 to -0.6) points. A significantly higher proportion of patients in the group treated with supervised exercises improved-odds ratio 3.2 (1.3 to 7.8). More patients in the shockwave treatment group had additional treatment between 12 and 18 weeks-odds ratio 5.5 (1.3 to 26.4). CONCLUSION: Supervised exercises were more effective than radial extracorporeal shockwave treatment for short term improvement in patients with subacromial shoulder pain. TRIAL REGISTRATION: Clinical trials NCT00653081.
PubMed ID
19755551 View in PubMed
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Study protocol for Norwegian Psychomotor Physiotherapy versus Cognitive Patient Education in combination with active individualized physiotherapy in patients with long-lasting musculoskeletal pain - a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature287547
Source
BMC Musculoskelet Disord. 2016 08 05;17:325
Publication Type
Article
Date
08-05-2016
Author
Tove Dragesund
Alice Kvåle
Source
BMC Musculoskelet Disord. 2016 08 05;17:325
Date
08-05-2016
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Cognition
Humans
Musculoskeletal Pain - psychology - therapy
Neck Pain - psychology - therapy
Norway
Pain Measurement
Patient Education as Topic
Physical Therapists
Physical Therapy Modalities - psychology
Precision Medicine - methods
Psychomotor Performance
Shoulder Pain - therapy
Single-Blind Method
Treatment Outcome
Abstract
Norwegian Psychomotor Physiotherapy (NPMP) has been an established treatment approach for more than 50 years, although mostly in the Scandinavian countries, and is usually applied to patients with widespread and long-lasting musculoskeletal pain and/or psychosomatic disorders. Few studies have been investigating outcome of NPMP and no randomized clinical trials (RCT) have been systematically tried out on individuals.
This is a study protocol for a pragmatic, single blinded RCT, which will take place in a city of Norway. The participants will be block randomized either to receive NPMP or Cognitive Patient Education in combination with active individualized physiotherapy (COPE-PT). The intervention will reflect usual care and will be conducted in physiotherapy clinics by five experienced physiotherapists in each of the two treatment approaches.
The findings of the present study may give an important contribution to our knowledge of the outcome of NPMP, on patients with long-lasting widespread musculoskeletal pain and/or pain located to the neck and shoulder region.
The study has been registered with ClinicalTrials.gov (June 9 th 2015, NCT02482792).
Notes
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PubMed ID
27496046 View in PubMed
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