International physical therapists consensus on clinical descriptors for diagnosing rotator cuff related shoulder pain: A Delphi study

Requejo-Salinas, Néstor; Lewis, Jeremy; Michener, Lori A.; Touche, Roy La; Fernández-Matías, Rubén; Tercero-Lucas, Juan; Camargo, Paula Rezende; Bateman, Marcus; Struyf, Filip; Roy, Jean-Sébastien; Jaggi, Anju; Uhl, Timothy L.; Bisset, Leanne; Wassinger, Craig A.; Donatelli, R; Haik, Melina Nevoeiro; Lluch-Girbés, Enrique

doi:10.1016/j.bjpt.2022.100395

Cited by 23 publications

(16 citation statements)

References 118 publications

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“…Rotator cuff‐related shoulder pain (RCRSP) is reported to be the most frequent manifestation of shoulder pain (Luime et al., 2004) and unfortunately can prove resistant to medical, surgical and non‐surgical interventions. The veracity and usefulness of RCRSP as a diagnostic label for shoulder pain has been explored elsewhere (Lewis, 2016; Lewis & Powell, 2022; Lo et al., 2022a; Requejo‐Salinas et al., 2022; Zadro, 2021) and is beyond the scope of this study.…”

Section: Introductionmentioning

confidence: 99%

Physiotherapists nearly always prescribe exercise for rotator cuff‐related shoulder pain; but why? A cross‐sectional international survey of physiotherapists

Powell

Schram

Lewis

et al. 2022

Musculoskeletal Care

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Section: Introductionmentioning

confidence: 99%

Physiotherapists nearly always prescribe exercise for rotator cuff‐related shoulder pain; but why? A cross‐sectional international survey of physiotherapists

Powell

Schram

Lewis

et al. 2022

Musculoskeletal Care

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“…As indicated in the previous literature review included in this manuscript, some editorial comments and research articles suggest none of the special tests for rotator cuff pathology are helpful in the diagnosis of the rotator cuff 4,5,7 -while others reported that using special tests for the shoulder allows a more accurate diagnosis in identifying rotator cuff involvement. 9,10 The present survey reinforces previous research by finding that many of the respondents believed some special tests were helpful in the clinical setting in coming to an accurate diagnosis involving the rotator cuff.…”

Section: Discussionmentioning

confidence: 79%

“…Salamh and Lewis 4 wrote in an editorial that special tests do not impart diagnostic information and should not be an important part of the physical therapist examination. Requejo-Salinas et al 5 used a group of international expert physical therapists to come to a consensus statement suggesting that resistive testing, response to overhead loading, and reported symptoms were more effective at creating a diagnostic impression than any of the special tests. Van Kampen et al 6 stated in a systematic review, that predictive values of special tests are low.…”

Section: Introductionmentioning

confidence: 99%

Survey on Knowledge, Use, and Diagnostic Applicability of Special Tests for Rotator Cuff Involvement in Clinical Practice

Forbush¹,

Bandy

Back-Kremers

et al. 2023

International Journal of Sports Physical Therapy

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Background Recently, researchers have commented that shoulder special tests cannot identify the structure causing rotator cuff symptoms and should only be considered pain provocation tests. Others have disagreed, reporting that special tests were able to accurately detect the presence of rotator cuff involvement. Purpose The purpose of this study was to determine the knowledge, use, and perceived effectiveness of 15 selected special tests utilized to examine patients with possible rotator cuff dysfunction. Study Design Descriptive study using survey. Methods An electronic survey was returned by 346 members of the Academies of Orthopedic and Sports Physical Therapy through list serves. Descriptions and pictures for 15 special tests of the shoulder were included in the survey. Information regarding years of clinical experience and American Board of Physical Therapy Specialties (ABPTS) specialist certification in Sports or Orthopedics was collected. Respondents were asked if they could identify and use the special tests to evaluate dysfunction of the rotator cuff - and how confident they were in ability of the tests to diagnose dysfunction of the rotator cuff. Results The four tests most readily known by respondents included the empty can, drop arm, full can, and Gerber’s tests, and the four tests used regularly by the respondents included the infraspinatus, full can, supraspinatus, and champagne toast tests. The infraspinatus, champagne toast, external rotation lag (ERLS), and the belly-off tests were found to be the be most useful for establishing a diagnosis of the muscle-tendon complex involved. Years of experience and clinical specialization was not relevant to knowledge or use or these tests. Conclusions This study will allow clinicians and educators to understand which special tests are easily identified, regularly used, and perceived as helpful for the diagnosis of muscles involved in a rotator cuff dysfunction. Level of Evidence 3b

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“…Another method to perform large-scale surveys is the application of Delphi investigations. Delphi studies can be used to identify the optimal diagnostic criteria, such as for rotator cuf-related shoulder pain [57]. However, the Delphi methodology can also be applied to investigate therapeutic interventions.…”

Section: Discussionmentioning

confidence: 99%

Considerations on the Obstacles That Lead to Slow Recruitment in a Pain Management Clinical Trial: Experiences from the Belgian PELICAN (PrEgabalin Lidocaine Capsaicin Neuropathic Pain) Pragmatic Study

Hans

Almeshal

Vanlommel

et al. 2023

Pain Research and Management

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Background. A qualitative evaluation study of the prematurely terminated PrEgabalin Lidocaine Capsaicin Neuropathic Pain (PELICAN) study was performed. The PELICAN study aimed to examine pain management for localized neuropathic pain (LNP), as epidemiological figures have shown a high percentage of LNP patients in Belgium. The study compared systemic and topical medications according to pain relief, adverse effects, and several measures of quality of life. Objective. Achieving better study patient recruitment through qualitative research. To investigate and determine the causes of the observed recruitment problems in the PELICAN study, pain centers involved in the study as well as nonrecruiting pain centers were included. Furthermore, it aimed to highlight the positive and negative lessons learned from the conducted study and the number of obstacles the team had to overcome. Methods. A qualitative study, using a mixed methods approach, was performed. Multiple pain centers in Belgium completed an online survey, after which a structured interview was conducted to elaborate the responses in more detail. The broad topics of these meetings were feedback about the study, reviewing survey answers, and actions undertaken to enhance recruitment. Results. Different factors contributed to the low recruitment rate in the PELICAN study, such as limited and late referral from the general practitioners to the Belgian pain centers, insufficient internal referrals from nonpain specialists, lack of specific expertise on LNP in some centers, scarcity of staff, limited reimbursement to administer complex analgesic schemes, overestimation of the patient population, and the reluctance of patients to participate in pain research. Additionally, shortcomings in the implemented study design and the need for more logistical investments were identified. Conclusion. The findings of the qualitative study demonstrate the need for further, more varied LNP research in Belgium, not limited to pharmacological studies. It also sheds important light on the recruitment obstacles that may be faced during these studies. Future studies could support this research by offering better proposals for feasibility and recruitment, for instance, by designing and conducting a compelling pilot study or applying social media during the recruitment phase. Clinical Trials. This trial is registered with NCT03348735. EUDRACT number 2018-003617-17.

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International physical therapists consensus on clinical descriptors for diagnosing rotator cuff related shoulder pain: A Delphi study

Cited by 23 publications

References 118 publications

Physiotherapists nearly always prescribe exercise for rotator cuff‐related shoulder pain; but why? A cross‐sectional international survey of physiotherapists

Physiotherapists nearly always prescribe exercise for rotator cuff‐related shoulder pain; but why? A cross‐sectional international survey of physiotherapists

Survey on Knowledge, Use, and Diagnostic Applicability of Special Tests for Rotator Cuff Involvement in Clinical Practice

Considerations on the Obstacles That Lead to Slow Recruitment in a Pain Management Clinical Trial: Experiences from the Belgian PELICAN (PrEgabalin Lidocaine Capsaicin Neuropathic Pain) Pragmatic Study

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