Background: Generator-induced shoulder impairment is a common complication of cardiac implantable electronic device (CIED) implantation. Although implantable cardioverter-defibrillators (ICDs) have become smaller in size, they are still bigger than pacemakers (PMs). This study aimed to investigate the effects of single-chamber PM and ICD sizes on shoulder function. Methods: This retrospective study included 200 consecutive patients, of whom 123 had PMs and 77 had ICDs. The CIED implantation effects on shoulder function, pain, disability, and quality of life (QoL) were evaluated. The range of motion (ROM), Visual Analog Scale (VAS), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), and Short Form-36 (SF-36) Health Survey (Physical and Mental Component Summary [PCS and MCS]) were used. Results:The flexion and abduction range limitation rates were significantly higher in the ICD group than in the PM group (16.9% vs. 7.3%, p = .035 and 19.5% vs. 8.9%, p = .031, respectively). The two groups had similar VAS scores. The median QuickDASH score was significantly higher in the ICD group than in the PM group (8.2 [3.6-19.6] vs. 4.6 [2.6-17.9], p = .034). There were no significant differences in SF-36 components between the two groups. ICD implantation (OR: 1.642, 95% CI: 1.293-2.776; p = .001) and incision length (OR: 1.343, 95% CI: 1.194-2.064; p = .01) were independent predictors of shoulder ROM limitations.Conclusions: Reduced device sizes with advancing technology can decrease shoulder functional limitations and disability after implantation. Healthcare professionals should not neglect shoulder evaluations during the pre-and postimplantation periods.
Background: Shoulder impairment on the implant side is common after cardiac implantable electronic device (CIED) implantation. The aim of this study was to compare the efficacy and safety of the pendulum exercise (PE) and stretching and strengthening exercises (SSE) in preventing postimplantation shoulder impairment. Methods:This prospective, randomized study collected data from 89 patients, including 30 in a control group, 31 in a PE group, and 28 in an SSE group. Shoulder functions on the implant side were evaluated by grip strength (GS), range of motion (ROM), Visual Analog Scale (VAS), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), and 36-Item Short-Form Survey (SF-36).Results: Shoulder median flexion and abduction ROM were significantly improved 2month postimplantation compared to two-week postimplantation in PE (156 ± 11 vs. 146 ± 10, p = .002; 147 ± 9 vs. 136 ± 9, p = .001, respectively) and SSE (158 ± 13 vs. 147 ± 11, p = .003; 149 ± 13 vs. 138 ± 9, p = .002, respectively) groups, but not in the control group. Two months after implantation, the two exercise groups showed no significant differences in any assessment. Compared with the PE and SSE groups, the control group had significantly lower GS (p = .012 and p = .002, respectively) and SF-36 physical component summary (p = .007 and p = .003, respectively) and significantly higher VAS (p = .003 and p = .001, respectively) and QuickDASH (p = .002 and p = .005, respectively) scores 2-month postimplantation.Conclusions: PE and SSE for the ipsilateral upper arm starting two-week after CIED implantation provided similar benefits in preserving shoulder girdle muscle strength, maintaining shoulder motion, relieving shoulder pain, preventing shoulder injury, and improving quality of life, without the risk of lead dislodgement.
Purpose Shoulder disorders may occur for procedural reasons in patients fitted with a cardiac implantable electronic device (CIED). This study aimed to examine the effects of CIED implantation on shoulder functions and scapular dyskinesis. Materials and methods Thirty patients fitted with a CIED formed the study group (SG), whilst 30 participants without a CIED formed the control group (CG). The range of motion (ROM), grip strength, lateral scapular slide test (static), scapular dyskinesis test (dynamic), American Shoulder and Elbow Surgeons (ASES) Shoulder Score, and the Short Form-36 Health Survey (Physical and Mental Component Summary [PCS and MCS]) were applied in the study. Results The shoulder’s mean flexion and abduction ROM on the implant side were found to be significantly lower in the SG than the CG (p = .016 and p = .001, respectively). Similarly, a significant grip strength loss on the implant side was detected in the SG than in the CG (p = .036). Static and dynamic scapular dyskinesis frequencies were shown to be significantly higher in the SG than in the CG (p = .002 and p< .001, respectively). The ASES Shoulder Score and PCS score were significantly lower in the SG than in the CG (p = .014 and p = .007, respectively). However, no difference was revealed between the two groups with respect to the contralateral upper limb. Conclusion The frequency of scapular dyskinesis and disability was higher, and upper limb functions, grip strength, and physical subdivision of quality of life decreased in CIED recipients. These findings suggest that such parameters should be included in physiotherapy assessment and treatment programs.
Background: Device-related shoulder impairment is a common complication in cardiac implantable electronic device (CIED) recipients. This study examined the relationship between the extent of device displacement toward the shoulder while in the supine position and ipsilateral shoulder impairment. Methods:This cross-sectional study included 142 consecutive patients with CIEDs.The effects of the extent of device displacement on functional limitations, muscle strength, pain-disability, and quality of life were evaluated. Range of motion (ROM), grip strength (GS), the Shoulder Pain and Disability Index (SPADI), and the 36-item Short-Form (SF-36) Health Survey were used. Results:The mean device displacement was greater in patients with than without device-related shoulder impairment (51 ± 19 vs. 38 ± 15 mm; p < .001). Female gender (p = .046), high body mass index (p = .008), and defibrillator implantation (p = .004) were significantly more frequent in patients with than without impairment.Patients with excessive device displacement had significantly higher ROM limitation rates (p = .003) and SPADI scores (p = .02) and significantly lower GS (p = .04) and
Background: Coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization in March 2020. Despite all the strict precautions, the epidemic probably continues rapidly due to new mutations and negatively affects the whole world. The presence of comorbid diseases has been associated with poor clinical outcomes. We aimed to examine the return of COVID-19 patients with cardiovascular comorbidity to their former Activities of Daily Living (ADL). Methods: The research population was selected from patients who admitted to the outpatient clinic from November 2020 to January 2021. 80 consecutive patients with cardiovascular comorbidity were included in the Study Group (SG). The Control Group (CG) included 100 patients of similar age range and gender, without cardiovascular comorbidities. Nottingham Health Profi le (NHP) test was performed in both groups to evaluate changes in ADL. Outpatients were visited until return to their former ADL with telecommunications at appropriate intervals. Results: Symptoms limiting ADL, such as fatigue (weakness), shortness of breath, and myalgia, were signifi cantly higher in SG than CG (p < 0.05). In contrast, anosmia and ageusia were signifi cantly higher in CG than SG (p < 0.001). Pre-COVID-19 NHP scores were similar in both groups. However, at admission, SG's NHP scores were signifi cantly higher than CG's (p < 0.001). Related to this, limitations in ADL (p < 0.001) and recovery times (p < 0.05) were higher in SG than CG. Conclusion: In this study, we observed that COVID-19 was more symptomatic in those with cardiovascular comorbidities, such as a higher limitation in ADL and a longer recovery time.
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