A simple classification system was recommended for patients with restricted shoulder or neck range of motion

Groenier, Klaas H.; Winters, Jan C.; Schuur, Wijbrand H. van; Winter, Andrea F. de; Jong, Betty Meyboom-de

doi:10.1016/j.jclinepi.2005.10.006

Cited by 16 publications

(5 citation statements)

References 18 publications

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“…This advice was based on research that illustrated the lack of interobserver agreement on the appropriate diagnostic criteria and various classifications used for the diagnostic interpretation [7–9]. Later research showed that establishment of a detailed classification of shoulder pain is not possible [10]. Therefore, the shoulder guidelines issued by the DCGP and the National Institute for Health and Clinical Excellence (available as Clinical Knowledge Summaries) in the UK propose a non‐specific classification based on pain and physical examination findings, which can be linked to the origin of the complaints (e.g.…”

Section: Introductionmentioning

confidence: 99%

GPs' perspectives on the diagnostic work‐up in patients with shoulder pain: a qualitative study

Ottenheijm

Hesselmans

Kemper

et al. 2014

Evaluation Clinical Practice

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Despite the availability of evidence-based shoulder guidelines, GPs experience uncertainties during diagnostic work-up and apply different strategies when dealing with these uncertainties. At some point, GPs as well as patients seem to have a need for a specific diagnosis. Currently, there appears to be little agreement if, or in which phase of shoulder pain, diagnostic ultrasound is useful or indicated.

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Section: Introductionmentioning

confidence: 99%

GPs' perspectives on the diagnostic work‐up in patients with shoulder pain: a qualitative study

Ottenheijm

Hesselmans

Kemper

et al. 2014

Evaluation Clinical Practice

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“…One experienced band 6 physiotherapist supervised each of the classes. The diagnosis of "subacromial pain" is defined by range as: no limitation in passive range of movement or restriction of passive range of movement mainly in abduction rather than external rotation [13].…”

Section: Interventionmentioning

confidence: 99%

The Effectiveness of Individual or Group Physiotherapy in the Management of Sub-Acromial Impingement: A Randomised Controlled Trial and Health Economic Analysis

Ryans¹,

Galway

Harte³

et al. 2020

IJERPH

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Background: Shoulder pain is common in primary care. The management of subacromial impingement (SAI) can include corticosteroid injections and physiotherapy. Physiotherapy can be on an individual or group basis. Aim: To examine the clinical effectiveness and make an economic analysis of individual versus group physiotherapy, following corticosteroid injection for SAI. Design and Setting: A single-blind, open-label, randomised equivalence study comparing group and individual physiotherapy. Patients referred by local general practitioners and physiotherapists were considered for inclusion. Method: Patients were randomised to individual or group physiotherapy groups, and all received corticosteroid injection before physiotherapy. The primary outcome measure was shoulder pain and disability index (SPADI) at 26 weeks. An economic analysis was conducted. Results and Conclusion: 136 patients were recruited, 68 randomised to each group. Recruitment was 68% of the target 200 participants. SPADI (from baseline to 26 weeks) demonstrated a difference (SE) in mean change between groups of −0.43 (5.7) (p-value = 0.050001), and the TOST (two-one-sided test for equivalence) 90% CI for this difference was (−10.0 to 9.14). This was borderline. In a secondary analysis using inputted data, patients without SPADI at week 26 were analysed by carrying forward scores at week 12 (mean difference (95% CI) = −0.14 (−7.5 to 7.3), p-value = 0.014). There is little difference in outcome at 26 weeks. Group physiotherapy was cheaper to deliver per patient (£252 versus £84). Group physiotherapy for SAI produces similar clinical outcomes to individual physiotherapy with potential cost savings. Due to low recruitment to our study, firm conclusions are difficult and further research is required to give a definitive answer to this research question. (NCT Clinical Trial Registration Number NCT04058522).

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“…Because the etiology of the shoulder complaints is usually unclear or even unknown, the findings from the active and passive range of motion examination are used to classify the shoulder complaints 5 . On the basis of the active and passive abduction, external rotation and horizontal adduction of the shoulder, one can detect the underlying cause of the shoulder complaints and categorize it in the following three groups: 6 …”

Section: Diagnosismentioning

confidence: 99%

“…This is to prevent the patient from lateral flexion to the left during the horizontal shoulder adduction of the Because the etiology of the shoulder complaints is usually unclear or even unknown, the findings from the active and passive range of motion examination are used to classify the shoulder complaints. 5 On the basis of the active and passive abduction, external rotation and horizontal adduction of the shoulder, one can detect the underlying cause of the shoulder complaints and categorize it in the following three groups: 6 • Shoulder complaints with limited range of passive motion • Shoulder complaints without limited range of passive motion but with pain on shoulder abduction or retro-abduction • Shoulder complaints without limited range of passive motion and no painful abduction trajectory Table 2 shows the shoulder complaints with a limited range of motion. It does not include shoulder affections that are considered to be the result of a systemic condition such as rheumatoid arthritis, for example.…”

Section: Normal Active and Passive Horizontal Shoulder Adductionmentioning

confidence: 99%

9. Painful Shoulder Complaints

et al. 2010

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Painful shoulder complaints have a high incidence and prevalence. The etiology is not always clear. Clinical history and the active and passive motion examination of the shoulder are the cornerstones of the diagnostic process. Three shoulder tests are important for the examination of shoulder complaints: shoulder abduction, shoulder external rotation, and horizontal shoulder adduction. These tests can guide the examiner to the correct diagnosis. Based on this diagnosis, in most cases, primarily a conservative treatment with nonsteroidal anti-inflammatory drugs possibly in combination with manual and/or exercise therapy can be started. When conservative treatment fails, injection with local anesthetics and corticosteroids can be considered. In the case of frozen shoulder, a continuous cervical epidural infusion of local anesthetic and small doses of opioids or a pulsed radiofrequency treatment of the nervus suprascapularis can be considered.

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A simple classification system was recommended for patients with restricted shoulder or neck range of motion

Abstract: Patients experiencing shoulder pain can be classified in a simple way into four categories, reflecting the distinction between problems of the shoulder and those of the neck. A simple classification rule is proposed with which almost all patients can be classified into the four clusters.

Cited by 16 publications

References 18 publications

GPs' perspectives on the diagnostic work‐up in patients with shoulder pain: a qualitative study

GPs' perspectives on the diagnostic work‐up in patients with shoulder pain: a qualitative study

The Effectiveness of Individual or Group Physiotherapy in the Management of Sub-Acromial Impingement: A Randomised Controlled Trial and Health Economic Analysis

9. Painful Shoulder Complaints

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