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1.
Article in Chinese | WPRIM | ID: wpr-980782

ABSTRACT

This study aims to construct the core outcome set for the clinical trials of adhesive capsulitis treated with acupuncture and moxibustion. Using systematic review, semi-structured interview, Delphi questionnaire survey, analytic hierarchy process and expert consensus meeting, the primary outcomes are obtained, i.e. local tenderness, pain degree during movement, range of motion, changes in range of motion, function score, and score of local symptoms of shoulder joint. The secondary outcomes are myofascial thickness, thickness of the inferior wall of the joint capsule, health status, activity of daily living, incidence of adverse events, laboratory indexes, vital signs, cost-effectiveness, total effective rate, and patient satisfaction. It is expected to provide a reference for the outcome selection in clinical trials and the generation of medical evidences in the treatment of adhesive capsulitis with acupuncture and moxibustion.


Subject(s)
Humans , Acupuncture Therapy , Bursitis/therapy , Consensus , Moxibustion , Outcome Assessment, Health Care
2.
Article in Chinese | WPRIM | ID: wpr-927364

ABSTRACT

The clinical evidences on acupuncture and moxibustion for the treatment of frozen shoulder were sorted and summarized systematically. The relevant articles of frozen shoulder treated with acupuncture and moxibustion were searched from PubMed, EMbase, Cochrane database of systematic review (CDSR), Cochrane database of controlled trials register (CENTRAL), China national knowledge infrastructure (CNKI), Wanfang, VIP, and Chinese biomedical literature databases (SinoMed), from database inception to May 31, 2021. Using AMSTAR-2, the methodological quality of the included systematic reviews was evaluated. With evidence map, the current status of clinical evidence was summarized on acupuncture and moxibustion in treatment of frozen shoulder. A total of 266 original studies and 6 systematic reviews were included finally. At present, many randomized controlled trials are designed with small sample size and the simple acupuncture and moxibustion therapy is dominant as the intervention, e.g. warm acupuncture, acupuncture with filiform needle, acupotomy and electroacupuncture. The outcomes considered in the current trials focus on clinical effective rate, the score of shoulder pain, the score of shoulder function and the score of quality of life. Most of the studies have shown that acupuncture and moxibustion is advantageous as an adjunctive therapy for frozen shoulder, but its clinical evidence is few in terms of the recurrence rate and safety. Moreover, it needs to improve the evidence quality of the relevant studies on acupuncture and moxibustion for frozen shoulder.


Subject(s)
Humans , Acupuncture Therapy , Bursitis/therapy , Electroacupuncture , Moxibustion , Quality of Life
3.
Artrosc. (B. Aires) ; 28(2): 192-196, 2021.
Article in Spanish | LILACS, BINACIS | ID: biblio-1282688

ABSTRACT

La capsulitis adhesiva de hombro se caracteriza por la inflamación crónica de la capa subsinovial de la cápsula articular que produce fibrosis, contractura y adherencia de la cápsula a sí misma y al cuello anatómico del húmero. La rehabilitación enfocada en optimizar el rango de movilidad en forma activa y pasiva es la base del tratamiento, independientemente de la etapa. Sobre la base de la historia natural de la enfermedad, la inyección con corticoides en forma precoz tiene utilidad en acortar la duración general de los síntomas, y permite a los pacientes trabajar el rango de movilidad en las etapas de rehabilitación y así volver a sus actividades cotidianas más rápidamente. La mayoría de los pacientes tratados con terapia física logran la resolución completa de síntomas. En casos con rigidez refractaria, puede estar indicada la manipulación bajo anestesia o la liberación capsular artroscópica; debido a varios riesgos potenciales de complicaciones con las manipulaciones, se prefiere esta última. Existen escasos estudios con alto nivel de evidencia que comparen diferentes técnicas para la liberación capsular: tanto la liberación circunferencial como la capsular anteroinferior han demostrado ser efectivas como técnica quirúrgica. La cirugía debe ser seguida de forma temprana por una terapia física diligente y dirigida a prevenir la rigidez recurrente


Adhesive capsulitis is characterized by chronic inflammation of the capsular subsynovial layer, which produces capsular fibrosis, contracture, and adherence of the capsule to itself and to the anatomic neck of the humerus. Physical therapy is the mainstay of treatment, regardless of stage. Based on the natural history of the disease, early corticosteroid injection has a role in shortening the overall duration of symptoms allowing patients to move faster in the stages of rehabilitation and thus return to their daily life activities more rapidly. Most patients will see complete resolution of symptoms with nonsurgical management. In cases with refractory stiffness, manipulation under anesthesia or arthroscopic capsular release may be indicated. Because of various potential risks of complications with manipulations, arthroscopic capsular release is preferred. There is a lack of high-level studies comparing different techniques for capsular release. Both circumferential and anteroinferior release have proven to be effective. Surgery should be followed by early, diligent and directed therapy to prevent recurrent stiffness


Subject(s)
Shoulder Joint , Bursitis/surgery , Bursitis/diagnosis , Bursitis/physiopathology , Bursitis/therapy , Shoulder Pain
4.
Rev. cuba. ortop. traumatol ; 33(1): e165, ene.-jun. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1093710

ABSTRACT

RESUMEN Introducción: La terapia con ondas de choque son ondas acústicas presentes en situaciones diarias. Es un método que se emplea en la actualidad para tratar la bursitis trocantérica. Objetivo: Evaluar la efectividad de la terapia con ondas de choque en el tratamiento de la bursitis trocantérica. Métodos: Se realizó un estudio descriptivo, de corte transversal, con 46 pacientes diagnosticados con bursitis trocantérica, los cuales fueron tratados con el equipo Piezolith-3000 (ondas de choque extracorpóreas) en el Complejo Científico Ortopédico Internacional "Frank País", en el periodo comprendido entre marzo de 2014 y abril de 2018. Se realizó el análisis de las variables (edad, sexo, dolor y escala de Harris). Se obtuvieron las frecuencias absolutas y relativas, y con ellas se confeccionaron las tablas y gráficos que resumen la información estadística de la investigación. Resultados: Hubo predominio del sexo femenino (86,9 por ciento) y del grupo etario de 46 - 55 años (50 por ciento). Todos los pacientes presentaban dolor antes de la aplicación de las ondas de choque. Luego del tratamiento esta situación se revirtió y 69,5 por ciento de los enfermos dejaron de sentirlo. Según la escala de Harris, 50 por ciento de los pacientes estudiados tuvo una interpretación cualitativa de pobre (<70 puntos) antes de iniciar el tratamiento; posteriormente, solo 8,6 por ciento permanecieron con esa puntuación. Conclusiones: La terapia con las ondas de choque es una técnica no invasiva, segura y eficaz. Posibilitó una rápida recuperación de los pacientes atendidos y su incorporación a las actividades diarias(AU)


ABSTRACT Introduction: Shock wave therapy is acoustic waves present in daily situations. This method is currently used to treat trochanteric bursitis. Objective: To evaluate the effectiveness of shockwave therapy in the treatment of trochanteric bursitis. Methods: A descriptive, cross-sectional study was conducted with 46 patients diagnosed with trochanteric bursitis. They were treated with Piezolith-3000 equipment (extracorporeal shock waves) at Frank País International Orthopedic Scientific Complex, from March 2014 to April 2018. The analysis of the variables (age, sex, pain and Harris scale) was performed. The absolute and relative frequencies were obtained. Tables and graphs were prepared to summarize the statistical information of the investigation. Results: There was a predominance of the female sex (86.9 percent) and the age group of 46-55 years (50 percent). All patients had pain before receiving shock waves. After treatment this situation was reversed; the pain stopped in 69.5 percent of the patients. According to Harris scale, 50 percent of the patients studied had a poor qualitative interpretation (<70 points) before starting treatment; subsequently, only 8.6 percent remained at that score. Conclusions: Shockwave therapy is a non-invasive, safe and effective technique. It enabled a rapid recovery of patients and their return into daily activities(AU)


RÉSUMÉ Introduction: Les ondes de choc extracorporelles sont des ondes acoustiques présentes dans des situations de la vie quotidienne. C'est une technique actuellement utilisée pour traiter la bursite trochantérienne. Objectif: Évaluer l'efficacité de la thérapie par ondes de choc dans le traitement de la bursite trochantérienne. Méthodes: Une étude transversale descriptive de 46 patients diagnostiqués de bursite trochantérienne, et traités par ondes de choc extracorporelles à l'aide de l'appareil Piezolith-3000, a été réalisée dans le Complexe scientifique international d'orthopédie « Frank Pais¼, pendant la période de mars 2014 et avril 2018. On a effectué une analyse des variables (âge, sexe, douleur, score de Harris). On a obtenu les fréquences absolues et relatives, et grâce à elles, on a élaboré les tableaux et graphiques abrégeant l'information statistique de la recherche. Résultats: Le sexe féminin (86.9 pourcent) et la tranche d'âge de 46-55 ans (50 pourcent ) ont prédominé. Tous les patients soufraient de douleur avant l'application des ondes de choc. Après le traitement, cette situation s'est inversée, et 69.5 pourcent des malades ont cessé de la ressentir. D'après le score de Harris, les résultats obtenus dans 50 pourcent des patients ont été considérés comme mauvais (<70 points) avant le commencement du traitement ; puis après, seulement 8.6 pourcent des patients ont conservé cette évaluation. Conclusions: La thérapie par ondes de choc extracorporelles est donc une technique non invasive, fiable et efficace. Elle a permis la récupération des patients et leur retour aux activités de la vie quotidienne(AU)


Subject(s)
Humans , Male , Female , Bursitis/therapy , Femur , Extracorporeal Shockwave Therapy/methods
5.
Rev. argent. cir. plást ; 25(1): 33-36, 20190000. fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1358053

ABSTRACT

Introducción. La úlcera trocantérea es una de las lesiones por presión más frecuente y está asociada generalmente a bursitis, por lo que su tratamiento es complejo. Materiales y Métodos. Se presenta el caso de un paciente masculino de 29 años, con antecedente de lesión medular asociada a paraplejía fláccida con desarrollo de úlcera trocantérea derecha elíptica vertical. Fue abordado de forma multidisciplinaria y resuelto con resección de la patología y reconstrucción con colgajo musculocutáneo de fascia lata. Resultado. El paciente fue dado de alta al 21 día posoperatorio. No presentó dehiscencias, infecciones de la herida ni recidiva al cumplirse 6 meses de la cirugía y el resultado estético y funcional fue satisfactorio. Conclusión. El colgajo musculocutáneo de fascia lata ascendido y con cierre de V en Y es una opción segura, versátil y reproducible para la resolución de úlceras trocantéreas. Sin embargo, deben respetarse todos los pasos de la técnica para evitar así complicaciones y recidivas.


Background. Trochanteric ulcer is one of the most frequent pressure sore and is usually related with bursitis, therefore its treatment is complex. Material and Methods. We present a case of a 29 year-old male patient with medical history of spinalcord injury (SCI) related to flaccid paraplegia and the development of right trochanteric vertical elliptical sore. He was treated by a multidisciplinary team and solved by the resection of the pathology and immediate reconstruction with tensor fascia lata (TFL) musculo cutaneous flap. Results. The patient was discharged from the institution on the 21st postoperative day. With a follow-up of a 6 months period, complications such as wound infection, suture dehiscense or recurrence were not observed. Aesthetic and functional results were satisfactory. Conclusion. Ascended TFL flap with a V-Y closure is a reproducible, reliable and versatile procedure for the coverage of trochanteric pressure sore defects. However all surgical techniques tages must be considered in order to avoid complications and recurrence of the disease


Subject(s)
Humans , Male , Adult , Paraplegia/surgery , Bursitis/therapy , Plastic Surgery Procedures/methods , Pressure Ulcer/therapy , Fascia Lata/transplantation , Femur/injuries , Free Tissue Flaps/transplantation , Wound Closure Techniques
6.
Medwave ; 18(5): e7265, 2018.
Article in English, Spanish | LILACS | ID: biblio-915381

ABSTRACT

Resumen OBJETIVO: Determinar la efectividad de las técnicas de movilización articular en el rango de movimiento en pacientes adultos con capsulitis adhesiva primaria de hombro. MÉTODO: Revisión sistemática con metanálisis. La búsqueda fue realizada en las bases de datos MEDLINE/PubMed, PEDro, CENTRAL, LILACS, EMBASE, CINAHL, Scopus y Web of Science. Los criterios de elegibilidad fueron estudios que utilizaran una técnica de movilización articular oscilatoria y/o mantenida aplicada, sola o adicionada, a un programa de tratamiento en pacientes con capsulitis adhesiva primaria, en cualquier estadio. La selección de estudios y la extracción de datos fueron realizadas por dos autores de forma independiente. El riesgo de sesgo se evaluó según la herramienta propuesta por Cochrane. RESULTADOS: Se incluyeron 14 estudios con variados riesgos de sesgo. La movilización posterior versus otra técnica articular no presenta diferencia de media significativa (- 0,95 grados; intervalo de confianza de 95%; - 5,93 a 4,02), mientras que comparada con un grupo control la diferencia es de 26,80 grados (intervalo de confianza 95%; 22,71 a 30,89), además cuando se aplica un conjunto de técnicas articulares versus un grupo control, para la abducción la diferencia es de 20,14 grados (intervalo de confianza 95%; 10,22 a 30,05). En ambos casos, los resultados son estadísticamente significativos y se aprecia un tamaño de efecto moderado. CONCLUSIONES: La evidencia científica no es concluyente acerca de la efectividad de la movilización articular, dada la heterogeneidad en la metodología y sesgo de los artículos incluidos en esta revisión. Al compararla con tratamientos que no incluyen terapia manual, parecieran favorecer la mejoría del rango de movimiento y reducción del dolor, en pacientes con capsulitis adhesiva primaria de hombro.


Abstract OBJECTIVE: To determine the effectiveness of joint mobilization techniques in the range of motion in adult patients with primary adhesive shoulder capsulitis. METHODS: Systematic review with meta-analysis. The search was performed in the MEDLINE/PubMed, PEDro, CENTRAL, LILACS, EMBASE, CINAHL, Scopus and Web of Science databases. The eligibility criteria were studies that used an oscillatory and/or maintained joint mobilization technique applied alone or added-on to a treatment program in patients with primary adhesive capsulitis at any stage. Two authors carried out the selection of studies and the extraction of data, independently. Risk of bias was evaluated according to the tool proposed by Cochrane. RESULTS: We included 14 studies with variable risk of bias. Posterior mobilization compared to any other technique was not significantly different (0.95 degrees; 95% CI: - 5.93 to 4.02), whereas compared to a control group, the difference is 26.80 degrees (CI 95%: 22.71 to 30.89). When applying a set of joint techniques versus a control group, for abduction the difference is 20.14 degrees (95% CI: 10.22 to 30.05). In both cases, the results are statistically significant, and the effect size is moderate. CONCLUSIONS: The evidence is not conclusive about the effectiveness of joint mobilization. When compared with treatments that do not include manual therapy, joint mobilization seems to have a favorable effect on the range of motion and pain reduction in patients with primary adhesive shoulder capsulitis.


Subject(s)
Humans , Shoulder Joint/pathology , Bursitis/therapy , Physical Therapy Modalities , Pain/etiology , Randomized Controlled Trials as Topic , Range of Motion, Articular , Treatment Outcome
7.
Rev. bras. reumatol ; 57(5): 445-451, Sept.-Oct. 2017. tab
Article in English | LILACS | ID: biblio-899440

ABSTRACT

Abstract Introduction: The objectives of this study were to assess the quality of life and functional capacity of adhesive capsulitis patients at the beginning and end of procedure and to identify risk factors associated to better outcomes after treatment with nerve blocking. Methods: A prospective cohort study was performed. Inclusion criteria were clinical signs of adhesive capsulitis and disease changes on shoulder imaging exams. The short form of World Health Organization Quality of life and Disabilities of the Arm, Shoulder and Hand questionnaires were administered at the beginning and end of treatment. A score of 55 points or more on the Constant index was used for discontinuation of treatment. We used the Wilcoxon test for paired samples. Multiple regression analysis of Poisson was carried out using exposure variables with p < 0.20 in the univariate analysis and the satisfactory quality of life and better functional capability as outcomes. The significance level was 5%. Results: 43 patients were evaluated. For the comparison between medians values at the beginning and end of treatment (physical domain: 46.43-67.86; psychologic domain: 66.67-79.17; social domain: 66.67-75; environment domain: 62.5-68.75; DASH: 64.16-38.33), p was <0.05. Aging (physical/psychologic/DASH), higher educational level (physical/environment/DASH), less severity (only physical) and fewer nerve blocking (only psychologic) were these independent risk factors. Conclusions: Quality of life and functional capacity of the patients improve at the end of procedure. Older patients and higher education levels are the risk factors most associated to satisfactory quality of life and better functional capacity after treatment with nerve blocking.


Resumo Introdução: Os objetivos deste estudo foram avaliar a qualidade de vida e a capacidade funcional de pacientes com capsulite adesiva no início e no fim do procedimento de bloqueio de nervo e identificar fatores de risco associados a melhores desfechos após o tratamento. Métodos: Fez-se um estudo de coorte prospectiva. Os critérios de inclusão foram sinais clínicos de capsulite adesiva e alterações da doença nos exames de imagem do ombro. Administrou-se a forma abreviada do questionário World Health Organization Quality of Life e o questionário Disabilities of the Arm, Shoulder and Hand no início e no fim do tratamento. Foi usada uma pontuação de 55 pontos ou mais no índice de Constant para descontinuar o tratamento. Usou-se o teste de Wilcoxon para amostras pareadas. Aplicou-se a análise de regressão múltipla de Poisson com variáveis de exposição com p < 0,20 na análise univariada. Usou-se a qualidade de vida satisfatória e a melhor capacidade funcional como desfechos. O nível de significância foi de 5%. Resultados: Avaliaram-se 43 pacientes. Na comparação entre os valores medianos no início e no fim do tratamento (Domínio Físico: 46,43 a 67,86; Domínio Psicológico: 66,67 a 79,17; Domínio Social: 66,67 a 75; Domínio Ambiental: 62,5 a 68,75; DASH: 64,16 a 38,33), o p foi < 0,05. O envelhecimento (Físico/Psicológico/DASH), a maior escolaridade (Físico/Ambiental/DASH), a menor gravidade (apenas Físico) e a menor quantidade de bloqueios de nervo (apenas Psicológico) foram fatores de risco independentes. Conclusões: A qualidade de vida e a capacidade funcional dos pacientes melhoram no fim do procedimento. Pacientes mais idosos e uma maior escolaridade são os fatores de risco associados à qualidade de vida satisfatória e à melhor capacidade funcional depois do tratamento com bloqueio de nervo


Subject(s)
Humans , Male , Female , Adult , Aged , Quality of Life , Bursitis/therapy , Recovery of Function , Bursitis/physiopathology , Prospective Studies , Risk Factors , Health Status Indicators , Treatment Outcome , Disability Evaluation , Middle Aged , Nerve Block
8.
Rev. cuba. ortop. traumatol ; 31(1): 110-117, ene.-jun. 2017.
Article in Spanish | LILACS, CUMED | ID: biblio-901407

ABSTRACT

La bursitis olecraniana es un problema relativamente frecuente que se presenta en los servicios de emergencia. Un tercio de los casos están vinculados a procesos sépticos. Los otros dos tercios están vinculados a bursitis del olécranon no séptica, que incluye los casos traumáticos e idiopáticos. Otros casos, ocasionalmente, están relacionados con la artritis reumatoide o gota. El diagnóstico clínico puede ser difícil, y frecuentemente no son diagnosticados; el tratamiento de primera elección son los antinflamatorios pero muchas veces estos conducen a un retraso en el diagnóstico. Cuando los casos son de etiología séptica se pueden tratar con incisión, drenaje y uso de antibióticos. Es propósito de este trabajo valorar las opciones diagnósticas y de tratamiento, que permitan un mejor manejo de esta afección en los servicios de emergencia(AU)


Olecranial bursitis is a relatively frequent problem that come to emergency services. One-third of the cases are linked to septic processes. The other two thirds are linked to non-septic olecranon bursitis, which includes traumatic and idiopathic cases. Other cases, occasionally, are related to rheumatoid arthritis or gout. The clinical diagnosis turns difficult, it is not frequently diagnosed; anti-inflammatory drugs is the first choice of treatment, but these often lead to a delay in diagnosis. Cases of septic etiology can be treated with incision, drainage and use of antibiotics. The purpose of this study is to assess the diagnostic and treatment options that allow better management of this condition in the emergency services(AU)


La bursite olécranienne est un problème relativement nouveau aux services d'urgence. Un tiers des cas est associé à des processus infectieux. Les deux tiers restants sont associés à la bursite d'origine non-infectieuse, comprenant les cas traumatiques et idiopathiques. D'autres cas sont parfois associés à l'arthrite rhumatoïde ou goutte. Leur diagnostic clinique peut être difficile, de sorte qu'ils sont fréquemment mal diagnostiqués. Le traitement de choix sont les antiinflammatoires, mais d'habitude ils conduisent au retard du diagnostic. Lorsque les cas sont d'origine infectieuse, ils peuvent être traités par incision, drainage et antibiotiques. Le but de ce travail est d'évaluer les options diagnostiques et thérapeutiques permettant une meilleure prise en charge de cette affection aux services d'urgence(AU)


Subject(s)
Humans , Bursitis/diagnosis , Bursitis/etiology , Elbow/anatomy & histology , Bursitis/therapy , Bursitis/epidemiology
9.
Rev. Assoc. Med. Bras. (1992, Impr.) ; 63(4): 347-354, Apr. 2017. tab, graf
Article in English | LILACS | ID: biblio-842554

ABSTRACT

Summary Objective: To evaluate patient-reported measures of quality of life and functional capacity in adhesive capsulitis before and after suprascapular nerve block treatment; to analyze the influence of clinical and sociodemographic variables on both the outcome and correlation between the respective instruments. Method: A prospective clinical study was performed with adhesive capsulitis patients. Inclusion criteria were clinical diagnosis of adhesive capsulitis and a shoulder imaging test. The WHOQOL-BREF and DASH instruments were administered before and after treatment. A Constant test score of 55 points was used as a cutoff point for discontinuation of treatment. Mean values were compared using paired t-test and Wilcoxon. The Pearson or Spearman coefficients were used for correlation analysis. Multiple linear regression analysis was carried out using variables with p<0.20 as predictors in univariate analysis and WHOQOL domains and DASH as outcomes. The significance level was 5%. Results: Forty-three patients were evaluated. The comparison between WHOQOL-BREF and DASH mean values before and after the blocks, p<0.05. DASH correlated negatively with the physical, psychological and environmental WHOQOL-BREF domains. Older patients and those with higher levels of education influenced the improvement in patients' quality of life and functional capacity. Conclusion: The improvement of adhesive capsulitis with treatment involves an improvement in quality of life and functional capacity. The greater functional capacity of the shoulder matches a better quality of life for patients. Age and education level are the variables that most influence improvement in quality of life and functional capacity.


Resumo Objetivo: Avaliar as medidas relatadas pelos pacientes sobre qualidade de vida e capacidade funcional em capsulite adesiva antes e após tratamento com bloqueios do nervo supraescapular; analisar a influência das variáveis clínicas e sociodemográficas em ambos os desfechos e a correlação entre os respectivos instrumentos. Método: Estudo clínico prospectivo foi realizado em pacientes com capsulite adesiva. Os critérios de inclusão foram diagnóstico clínico de capsulite adesiva e realização de exames de imagem do ombro. Os instrumentos WHOQOL-BREF e DASH foram aplicados antes e após o tratamento. Utilizou-se o escore de Constant com ponto de corte em 55 para a interrupção do tratamento. As médias dos valores foram comparadas pelos testes t-pareado e Wilcoxon. Na análise de correlação foi utilizado o coeficiente de Pearson ou de Spearman. Foi realizada análise de regressão linear múltipla utilizando como preditoras as variáveis com p<0,20 na análise univariada e como desfechos os domínios do WHOQOL e o DASH. O nível de significância foi de 5%. Resultados: Foram avaliados 43 pacientes. A comparação entre as médias dos valores do WHOQOL-BREF e DASH antes e após os bloqueios apresentou um p<0,05. Houve correlação negativa entre o DASH e os domínios físico, psicológico e ambiental do WHOQOL-BREF. Os pacientes mais velhos e com maior grau de escolaridade influenciaram a melhora da qualidade de vida e capacidade funcional dos pacientes. Conclusão: A melhora da capsulite adesiva com o tratamento implica melhora da qualidade de vida e capacidade funcional. Quanto maior a capacidade funcional do ombro, melhor a qualidade de vida dos pacientes. A faixa etária e o grau de escolaridade são as variáveis que mais influenciam a melhora da qualidade de vida e capacidade funcional.


Subject(s)
Humans , Male , Female , Adult , Aged , Quality of Life , Bursitis/physiopathology , Bursitis/therapy , Self Report , Patient Reported Outcome Measures , Motor Activity/physiology , Nerve Block/methods , Reference Values , Socioeconomic Factors , Time Factors , Severity of Illness Index , Pain Measurement , Prospective Studies , Analysis of Variance , Range of Motion, Articular , Age Factors , Treatment Outcome , Statistics, Nonparametric , Sickness Impact Profile , Shoulder Pain/physiopathology , Shoulder Pain/therapy , Middle Aged
10.
Rev. bras. ortop ; 48(3): 272-277, May/June/2013. tab, graf
Article in English | LILACS | ID: lil-680883

ABSTRACT

OBJECTIVE: Describe the outcomes of patients with adhesive capsulitis treated with arthroscopic surgical procedure. METHODS: Between January and September of 2009, 9 patients (10 cases) underwent arthroscopic surgical release. There were 4 male (one bilateral) and 5 female patients. Their mean age was 51 years (27-63). The time from onset of symptoms to the surgical procedure averaged 23.4 months (6-38). Preoperative assessment was based on the UCLA and Constant score. ROM was evaluated with one week and six months of surgery. RESULTS: According to UCLA shoulder score (p < 0.01) it increased from 9.8 preoperatively (6-14) to 31.6 postoperatively (26-35) and the Constant (p < 0.01) from 20 (13-27) to 79.2 (66-91). ROM improved significantly, with mean passive elevation changing from 89° (80-100°) preoperatively to 150° postoperatively with one week and 153° with six months, mean passive external rotation changing from 12.5° (0-30°) preoperatively to 46° (one week) and 56° (six months) postoperatively, and passive internal rotation from L5 (T12-gluteus) to T11 (one week) and T9 (six months). There was not statistical significance of the duration of the disease and the postoperative result. CONCLUSION: This study shows that the surgical treatment of adhesive capsulitis with arthroscopic capsular release and manipulation appears to be a safe procedure that results in pain relief and functional gain.


OBJETIVO: Descrever os resultados dos pacientes com capsulite adesiva submetidos ao tratamento cirúrgico artroscópico. MÉTODOS : Estudo prospectivo com nove pacientes (10 casos) de capsulite adesiva submetidos ao tratamento cirúrgico entre janeiro e setembro de 2009. Cinco pacientes eram do sexo feminino e quatro do masculino (um bilateral), com faixa etária média de 51 anos (27-63). O tempo médio entre o início dos sintomas e a cirurgia foi 23,4 meses (6-38). Foram usados os escores da UCLA e Constant para avaliar os resultados e o ganho do arco de movimento com uma semana e seis meses. RESULTADOS : Houve aumento no escore da UCLA (p < 0,01) de 9,8 no pré-operatório (6-14) para 31,6 no pós-operatório (26-35) e no de Constant (p < 0,01) de 20 (13-27) para 79,2 (66-91). As médias da mobilidade articular passiva no período pré-operatório foram de 89º de flexão anterior (80º-100º), 12,5º de rotação lateral (0º-30º) e L5 de rotação medial (T12-Glúteo), com aumento médio significante estatisticamente na primeira semana para 150º/46º/T11 e para 153º/56º/T9 com seis meses. Não existiu significância estatística com relação ao tempo de evolução da doença e o resultado pós-operatório. CONCLUSÃO : Este estudo demonstrou que o tratamento cirúrgico para capsulite adesiva com liberação capsular artroscópica associada à manipulação é um procedimento seguro e que resulta em alívio da dor e recuperação do arco de movimento.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Arthroscopy , Bursitis/therapy , Shoulder Pain/diagnosis , Shoulder Pain/therapy , Treatment Outcome
11.
JSP-Journal of Surgery Pakistan International. 2012; 17 (1): 27-31
in English | IMEMR | ID: emr-124944

ABSTRACT

To determine the effectiveness of suprascapular nerve block in the treatment of frozen shoulder. Quasi experimental study. Department of Orthopedic Surgery Hayatabad Medical Complex Peshawar, from March 2010 to December 2010. Patients with frozen shoulder received a single suprascapular nerve block. Shoulder pain and disability index [SPADI] were used as main outcome measure of pain and disability. To determine the effectiveness of suprascapular nerve block in the treatment of frozen shoulder. There were total of 64 patients in this study. The mean age was 65.3 +/- 10.1 year. Using SPADI, the mean baseline total, subscale pain and disability scores were 70.9 +/- 6.8, 72.3 +/- 6.9 and 69.5 +/- 8.5 respectively which improved to 24.6 +/- 5.6, 22.3 +/- 5.3 and 27.5 +/- 6.6 respectively at 4 week of suprascapular nerve block of the affected shoulder with p value of 0.000 each. Suprascapular nerve block is safe and effective treatment for relieving pain and decreasing disability in frozen shoulder


Subject(s)
Humans , Female , Male , Shoulder Pain/therapy , Treatment Outcome , Bursitis/therapy , Orthopedics
12.
RBM rev. bras. med ; 67(supl.3)mar. 2010.
Article in Portuguese | LILACS | ID: lil-545634

ABSTRACT

Objetivo: Avaliar 136 pacientes (144 ombros) com capsulite adesiva tratados no período de junho de 1994 a fevereiro de 2000 pela técnica dos bloqueios seriados do nervo supraescapular. Método: Analisamos os pacientes em relação à faixa etária, sexo, dominância e classificação, sendo os resultados obtidos com o tratamento avaliados de acordo com critérios da UCLA. O seguimento médio foi de 39 meses. Resultados: Obtivemos resultados satisfatórios em 84,0% (121 ombros) e melhora da dor em 91,7% (132 ombros). Avaliamos os pacientes diabéticos com capsulite adesiva, não sendo notada diferença estatisticamente significativa na gravidade de acometimento destes com relação à população geral do nosso trabalho. Conclusão: O tratamento da capsulite adesiva com bloqueios seriados do nervo supraescapular se mostrou eficaz não apenas nos pacientes não diabéticos como também nos diabéticos.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Nerve Block , Bursitis/diagnosis , Bursitis/therapy , Brachial Plexus Neuritis/diagnosis , Brachial Plexus Neuritis/therapy , Shoulder/injuries , Retrospective Studies
13.
Rev. cuba. med. gen. integr ; 25(3)jul.-sep. 2009.
Article in Spanish | LILACS | ID: lil-745345

ABSTRACT

Se presenta el caso de un paciente del sexo masculino, de 43 años de edad, con historia de dolor en el hombro derecho desde hace aproximadamente 3 meses, a raíz de una contusión superficial, el cual recibió tratamiento conservador con reposo y medicamentos, pero no resolvió la sintomatología. Ahora, con diagnóstico de bursitis subdeltoidea calcificada, recibe tratamiento acupuntural en el Departamento de Medicina Natural y Tradicional de la sala de rehabilitación de su área de salud. Se presenta esta variante de tratamiento mediante sus estudios radiológicos...


This is the case of a male patient aged 43 with a pain history in right shoulder of approximately 3 months ago caused by a superficial contusion receiving conservative treatment with rest and drugs, without symptoms resolution. For the tine being time diagnosed with calcified subdeltoid bursitis and acupuncture treatment in Natural and Traditional Medicine Service of rehabilitation ward of his health area. This treatment variant is presented by its radiologic studies...


Subject(s)
Humans , Male , Adult , Bursitis/therapy , Acupuncture Therapy/methods
14.
Medisan ; 13(4)jul.-ago. 2009. graf
Article in Spanish | LILACS | ID: lil-548064

ABSTRACT

Se realizó un ensayo clinicoterapéutico controlado para evaluar la eficacia de la peloidoterapia y cinesioterapia en 64 pacientes con capsulitis adhesiva primaria del hombro, atendidos en el Departamento de Fisioterapia y Rehabilitación del Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba desde enero del 2006 hasta igual mes del 2007. Se conformaron 2 grupos (de estudio y control) de 32 integrantes en cada caso: los primeros recibieron peloidoterapia y cinesioterapia; los segundos: electroterapia y cinesioterapia. A las 10 sesiones terapéuticas había mejorado un mayor número de pacientes del grupo de estudio, mientras que los del grupo control necesitaron más de 20 sesiones para lograrlo. A los 3 meses continuaba la mejoría en 90,6 por ciento de los pacientes del primer grupo, por lo cual se planteó que la combinación de peloidoterapia y cinesioterapia fue más eficaz para eliminar las manifestaciones clínicas de esa inflamación, validada por un nivel de significación de 0,03.


A controlled clinical therapeutical trial was carried out to evaluate the effectiveness of the peloidotherapy and kinesiotherapy in 64 patients with primary adhesive capsulitis of the shoulder, assisted in the Department of Physiotherapy and Rehabilitation of Dr Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba from January, 2006 to January, 2007. Two groups were conformed (study and control groups) of 32 members in each: the first group received peloidotherapy and kinesiotherapy; the second group: electrotherapy and kinesiotherapy. At the 10 therapeutic sessions a great number of patients of the study group had improved, while those of the control group needed more than 20 sessions to achieve this. At the 3 months the improvement continued in 90,6 percent of the first group patients, reason why it was stated that the peloidotherapy and kinesiotherapy combination was more effective to eliminate the clinical manifestations of that inflammation, validated by a significance level of 0,03.


Subject(s)
Humans , Male , Adult , Female , Middle Aged , Bursitis/diagnosis , Bursitis/therapy , Shoulder Pain/therapy , Electric Stimulation Therapy , Kinesiology, Applied , Mud Therapy
15.
Rev. medica electron ; 30(4)jul.-ago. 2008. tab
Article in Spanish | LILACS | ID: lil-532243

ABSTRACT

En este estudio se seleccionaron 30 pacientes con el diagnóstico de bursitis aguda de hombro no traumática compatible con un síndrome Bi por frío en medicina tradicional asiática, que acudieron al cuerpo de guardia del Instituto Superior de Medicina Mlitar (ISMM) Luis Díaz Soto en el período comprendido de julio de 1998 a noviembre de 1999. A los mismos se les realizó un diagnóstico tradicional así como una valoración cualitativa del dolor y la movilidad articular antes y después de recibir el tratamiento con moxibustión. Se realizó un estudio prospectivo observacional analítico y se le aplicó el test de Wilcoxon. Todo se realizó con un nivel de significación µ = 0,05 (con un 95 de compatibilidad). Se hizo una evaluación de la respuesta terapéutica, comprobándose la efectividad de la moxibustión en el hombro doloroso, por lo que hubo modificación del dolor en la mayoría de los casos, aumentando el ángulo de abducción la mayor cantidad de pacientes, terminando con evolución satisfactoria el 83,33 de los casos.


We chose 30 patients diagnosed with non-traumatic acute bursitis of the shoulder, compatible with a Bi Syndrome by cold in Asiatic Traditional Medicine, assisting the High Institute of Military Medicine Luis Díaz Soto from July 1998 to November 1999. They were diagnozed in traditional way, and pain and articular mobility were qualitative evaluated before and after being treated with moxibustion. An analitic, observational, prospective study was carried out and the Wilcoxon´s test was applied. Everithing was made with a signification level ? = 0,05 (95 percent of compatibility). We evaluated the therapeutic answer, proving the efectiveness of moxibustion in painly shoulder. There was a pain modification in most of the cases; in most of the patients the abduction angle was increased. 83.33 percent of the cases showed a satisfactory evolution.


Subject(s)
Humans , Adult , Bursitis/diagnosis , Bursitis/therapy , Statistics, Nonparametric , Medicine, Chinese Traditional/methods , Moxibustion/methods , Emergency Service, Hospital
16.
Rev. bras. ortop ; 41(7): 245-252, jul. 2006. ilus, tab, graf
Article in Portuguese | LILACS | ID: lil-438280

ABSTRACT

Objetivo: Avaliar 136 pacientes (144 ombros) com capsulite adesiva tratados no período de junho de 1994 a fevereiro de 2000 pela técnica dos bloqueios seriados do nervo supra-escapular. Método: Os pacientes foram analisados em relação à faixa etária, sexo, dominância e classificação, sendo os resultados obtidos com o tratamento avaliados de acordo com critérios da VCLA. O seguimento médio foi de 39 meses. Resultados: Foram obtidos resultados satisfatórios em 121 ombros (84,0) e melhora da dor em 132 ombros (91,7 ). Avaliados os pacientes diabéticos com capsulite adesiva, não foi notada diferença estatisticamente significativa na gravidade de acometimento desses com relação à população geral. Conclusão: O tratamento da capsulite adesiva com bloqueios seriados do nervo supra-escapular mostrou-se eficaz não apenas nos pacientes não diabéticos como também nos diabéticos.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Autonomic Nerve Block , Bursitis/therapy , Treatment Outcome , Retrospective Studies
17.
Rev. colomb. reumatol ; 7(3): 267-71, sept. 2000. tab
Article in Spanish | LILACS | ID: lil-295741

ABSTRACT

EI reumatismo de partes blandas constituye la primera causa de consulta reumatológica y en la mayoría de los casos ocurre sin compromiso sistémico y como consecuencia de trauma crónico o sobre uso. Ellos pueden ser locales en los casos de bursitis, tendinitis o tenosinovitis regionales como la lumbalgia y el síndrome miofascial y generalizados como la fibromialgia y el síndrome de fatiga crónica. Su enfoque diagnóstico es eminentemente clínico, su tratamiento exige un enfoque interdisciplinario.


Subject(s)
Bursitis/diagnosis , Bursitis/therapy , Low Back Pain/diagnosis , Low Back Pain/therapy , Fibromyalgia/diagnosis , Fibromyalgia/therapy , Rheumatic Diseases , Fatigue Syndrome, Chronic/diagnosis , Fatigue Syndrome, Chronic/therapy , Tendinopathy/diagnosis , Tendinopathy/therapy , Tenosynovitis/diagnosis , Tenosynovitis/therapy
18.
Fisioter. mov ; 13(1): 49-60, abr.-set. 1999. ilus, graf
Article in Portuguese | LILACS | ID: lil-256477

ABSTRACT

A capsulite adesiva é frequente causa de dor e incapacidade funcional do membro superior e afeta amis mulheres do que homens durante a quarta, quinta ou sexta década de vida. Este estudo avaliou os resultados da abordagem fisioterapêutica com ênfase na mobilizaçäo passiva oscilatória controlada (MPOC) associada a exercícios ativos assistidos, ultra-som e a outras alternativas de tratamento. Ciquenta e um pacientes (32 mulheres e 19 homens) com idade entre 35 e 76 anos e média de 50,9 anos foram encaminhados para fisioterapia com sistomas variando de 1 a 48 meses de evoluçäo, média de 5,8 meses. O tempo de tratamento variou de 2 a 14 meses com média de 5,4 meses. Trinta e seis pacientes (70,5 por cento) atingiram resultado satisfatório, enquanto que 15 casos (29,5 por cento) foram classificados como insatisfatórios. Os autores concluem que: 1. a AMPOC é eficaz para analgesia ao moviemnto; 2. os exercícios devem ser realizados de forma indolor e assiduamente pelo paciente; 3. os melhores resultados obtidos foram aqueles com condutas combinadas, principalmente medicaçäo e fisioterapia simultaneamente


Subject(s)
Bursitis/therapy , Physical Therapy Specialty , Shoulder
19.
Rev. mex. anestesiol ; 21(1): 17-20, ene.-mar. 1998. ilus, graf
Article in Spanish | LILACS | ID: lil-248360

ABSTRACT

La bursitis del hombro forma parte del síndrome de la periartritis escapulohumeral, nosotros para su alivio y tratamiento hemos utilizado el bloqueo del nervio supraescapular utilizando una técnica modificada. Material y método: En nuestro protocolo de trabajo se incluyeron 100 pacientes de los cuales 66 pertenecían al sexo femenino y 34 al sexo masculino. La edad de los mismos osciló entre los 25 y 68 años. A los mismos se les realizó la técnica 3 veces por semana (días alternos) con Bupivacaina 0.5 por ciento 5 ml sin adrenérgico y se inyectó 1 cc de acetato de triancinolona (40 mg) por vía intramuscular cada 15 días según la duración del tratamiento. Resultados y discusión: Del total de pacientes 60 requieren entre 1 y 4 bloqueos y 40 pacientes entre 5 y 8 bloqueos. En este segundo grupo estuvieron incluidos todos los que presentaban calcificaciónes articulares importantes. Con respecto al alivio del dolor hubo remisión total del mismo, en 90 pacientes, 8 tuvieron dolores ocasionales y 2 no presentaron alivio. Quedó limitación función articular en 3 pacientes; se presento vahídos en 5 pacientes después del bloqueo. Está técnica además de proveer alivio del dolor y relajación de la musculatura periarticular produce un bloqueo simpático con aumento de la circulación de las estructuras articulares evitando la retracción capsular, aumentando la nutrición local y disminuyendo o desapareciendo las deposiciones cálcaicas. Conclusiones: Proponemos está técnica como una alternativa terapéutica ante la bursitis del hombro con mínimas complicaciones y magníficos resultados


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Pain/etiology , Pain/therapy , Bursitis/therapy , Nerve Block , Nerve Block/instrumentation , Shoulder Joint , Shoulder Joint/physiopathology , Scapula , Scapula/innervation , Autonomic Nerve Block/methods , Homeopathic Therapeutic Approaches
20.
Rev. bras. ortop ; 30(9): 660-4, set. 1995. ilus, tab
Article in Portuguese | LILACS | ID: lil-157034

ABSTRACT

Os autores apresentam estudo de revisäo de 175 pacientes portadores de capsulite adesiva do ombro, tratados no período de 1987 a 1994. Destes, foram excluídos todos os casos tratados por manipulaçöes, infiltraçöes, distensäo hídrica ou cirurgica artroscópica, resultando num grupo final de 51 pacientes, com 59 ombros acometidos, que compareceram para avaliaçäo clínica. Catorze pacientes foram caracterizados como portadores da forma primária e 37 pacientes, como da forma secundária, tratados indistintamente apenas por meios clínicos e fisioterapia de suporte. Os autores baseiam a metodologia do tratamento empregado no fato de ser a capsulite adesiva uma patologia autolimitante e seguem os passos da história natural da doença, para reduzir seu tempo de evoluçäo


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Bursitis/therapy , Shoulder , Aged, 80 and over , Anti-Inflammatory Agents/therapeutic use , Bursitis/drug therapy , Bursitis/rehabilitation , Physical Therapy Specialty , Time Factors , Treatment Outcome
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