International Journal of Environmental Research and Public Health

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11 pages, 980 KiB

Open AccessArticle

An Instrument-Assisted Coracoid Pain Test: An Exploratory Diagnostic Accuracy Study

by Michel GCAM Mertens, Mira Meeus, Louise Pieters, Mercè Balasch-Bernat, Lirios Dueñas, Olivier Verborgt and Filip Struyf

Int. J. Environ. Res. Public Health 2022, 19(19), 12735; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191912735 - 5 Oct 2022

Cited by 1 | Viewed by 1728

Abstract

The coracoid pain test (CPT) could contribute to the diagnosis of frozen shoulder (FS) with palpation. However, due to assessor performance these values might be unreliable. Therefore, the aim was to explore the diagnostic accuracy of an instrument-assisted CPT and two alternative approaches [...] Read more.

The coracoid pain test (CPT) could contribute to the diagnosis of frozen shoulder (FS) with palpation. However, due to assessor performance these values might be unreliable. Therefore, the aim was to explore the diagnostic accuracy of an instrument-assisted CPT and two alternative approaches (pain severity and side comparison) for assistance in the diagnosis of FS. Patients with FS and healthy age-matched controls were recruited. All participants underwent the instrument-assisted CPT on both shoulders with a pressure algometer. Sensitivity, specificity, and likelihood ratios were determined for the three approaches. In total, 35 patients with FS and 35 healthy participants were included. The original approach was positive in eight participants (11.4%), with only sufficient specificity to draw a conclusion. The pain severity approach was positive in 31 participants (44.3%) with sufficient sensitivity, specificity and likelihood ratios. The side comparison approach was positive in 10 participants (14.3%) with excellent specificity and positive likelihood ratio. The specificity of the instrument-assisted CPT can be used to increase the probability of FS with both the original and alternative approaches. Only the pain severity approach can draw a conclusion with a negative test result. This study should be repeated with a cross-sectional design to strengthen and confirm the conclusions. Full article

(This article belongs to the Special Issue Physical Activity and Integrative Medicine in Health and Chronic Conditions)

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10 pages, 1050 KiB

Open AccessArticle

Patellar and Achilles Tendon Thickness Differences among Athletes with Different Numbers of Meals per Day: A Cross-Sectional Study

by Santiago Navarro-Ledesma, Gabriel Gijon-Nogueron, Inmaculada Reina-Martín, Ana Belen Ortega-Avila and Leo Pruimboom

Int. J. Environ. Res. Public Health 2022, 19(4), 2468; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19042468 - 21 Feb 2022

Cited by 1 | Viewed by 3351

Abstract

The objective of this study is to analyse differences in the thickness of the patellar (PT) and Achilles tendons (AT) among athletes with different number of meals per day. The design is a cross-sectional, observational study. A total of thirty-six male athletes (with [...] Read more.

The objective of this study is to analyse differences in the thickness of the patellar (PT) and Achilles tendons (AT) among athletes with different number of meals per day. The design is a cross-sectional, observational study. A total of thirty-six male athletes (with mean age groups ranging from 31 to 40) were recruited and divided into three groups based on the number of daily meals they had (3, 4 or 5 meals). PT and AT were assessed by ultrasound. There were statistically significant differences in PT when comparing groups 1 and 3, at both longitudinal (p < 0.03) and transversal (p < 0.002) planes. There were no differences when comparing groups 1 and 2 or groups 2 and 3. There was a negative correlation between the number of meals per day and tendon thicknesses in both PT (longitudinal plane: r = −0.384; p = 0.02/transversal plane: r = −0.406; p = 0.01) and AT (transversal plane: r = −0.386; p = 0.02). In conclusion, there were patellar tendon thickness differences between participants and the number of daily meals could play a key role in tendon thickness, healing and performance. Full article

(This article belongs to the Special Issue Physical Activity and Integrative Medicine in Health and Chronic Conditions)

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Review

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12 pages, 364 KiB

Open AccessReview

The Place of Botulinum Toxin in Spastic Hemiplegic Shoulder Pain after Stroke: A Scoping Review

by Pieter Struyf, Lisa Tedesco Triccas, Fabienne Schillebeeckx and Filip Struyf

Int. J. Environ. Res. Public Health 2023, 20(4), 2797; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20042797 - 4 Feb 2023

Cited by 1 | Viewed by 2215

Abstract

Stroke is a common pathology worldwide, with an age-standardized global rate of new strokes of 150.5 per 100,000 population in 2017. Stroke causes upper motor neuron impairment leading to a spectrum of muscle weakness around the shoulder joint, changes in muscle tone, and [...] Read more.

Stroke is a common pathology worldwide, with an age-standardized global rate of new strokes of 150.5 per 100,000 population in 2017. Stroke causes upper motor neuron impairment leading to a spectrum of muscle weakness around the shoulder joint, changes in muscle tone, and subsequent soft tissue changes. Hemiplegic shoulder pain (HSP) is the most common pain condition in stroke patients and one of the four most common medical complications after stroke. The importance of the appropriate positioning and handling of the hemiplegic shoulder for prevention of HSP is therefore of high clinical relevance. Nevertheless, HSP remains a frequent and disabling problem after stroke, with a 1-year prevalence rate up to 39%. Furthermore, the severity of the motor impairment is one of the most important identified risk factors for HSP in literature. Spasticity is one of these motor impairments that is likely to be modifiable. After ruling out or treating other shoulder pathologies, spasticity must be assessed and treated because it could lead to a cascade of unwanted complications, including spastic HSP. In clinical practice, Botulinum toxin A (BTA) is regarded as the first-choice treatment of focal spasticity in the upper limb, as it gives the opportunity to target specifically selected muscles. It thereby provides the possibility of a unique patient tailored focal and reversible treatment for post stroke spasticity. This scoping review aims to summarize the current evidence of BTA treatment for spastic HSP. First, the clinical manifestation and outcome measures of spastic HSP will be addressed, and second the current evidence of BTA treatment of spastic HSP will be reviewed. We also go in-depth into the elements of BTA application that may optimize the therapeutic effect of BTA. Finally, future considerations for the use of BTA for spastic HSP in clinical practice and research settings will be discussed. Full article

(This article belongs to the Special Issue Physical Activity and Integrative Medicine in Health and Chronic Conditions)

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