Noninvasive management of soft tissue disorders of the shoulder: A clinical practice guideline from the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration

Yu, Hainan; Côté, Pierre; Wong, Jessica J.; Shearer, Heather M.; Mior, Silvano; Cancelliere, Carol; Randhawa, Kristi; Ameis, Arthur; Carroll, Linda; Nordin, Margareta; Varatharajan, Sharanya; Sutton, Deborah; Southerst, Danielle; Jacobs, Craig; Stupar, Maja; Taylor‐Vaisey, Anne; Gross, Douglas P.; Paulden, Mike; Ammendolia, Carlo; Cassidy, J. David; Bohay, Richard N.; Stapleton, John; Lacerte, Michel

doi:10.1002/ejp.1788

Cited by 8 publications

(6 citation statements)

References 112 publications

(338 reference statements)

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“…Before the interviews, we developed an online care pathway for managing shoulder pain based on the clinical practice guideline on the non-invasive management of soft tissue disorders of the shoulder (Fig. 2 ) [ 22 ]. The care pathway tool included information about the shoulder guideline [ 22 ], its scope and purpose, and links to outcome measurement tools.…”

Section: Methodsmentioning

confidence: 99%

“…2 ) [ 22 ]. The care pathway tool included information about the shoulder guideline [ 22 ], its scope and purpose, and links to outcome measurement tools. The care pathway also included essential aspects of the clinician-patient interaction, including components of the clinical evaluation and treatment recommendations.…”

Section: Methodsmentioning

confidence: 99%

“…The practice tool is an online care pathway that aims to facilitate the clinical management of soft-tissue shoulder pain in adults. The practice tool was developed based upon the recommendations and clinical pathway described in the clinical guideline for the management of soft tissue shoulder injuries by Yu et al [ 22 ]. While we used this guideline for the content of the care pathway tool, it was not the primary focus of our study.…”

Section: Introductionmentioning

confidence: 99%

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Exploring clinician perceptions of a care pathway for the management of shoulder pain: a qualitative study

Verville

Cancelliere

Connell

et al. 2022

BMC Health Serv Res

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Background Clinical care pathways may be useful tools to improve the quality of healthcare by facilitating the translation of evidence into practice. Our study is situated within a larger project, whereby end-users co-developed a care pathway for the management of shoulder pain. In this study, we explored end-user perceptions of the usefulness and practicality of implementing a care pathway to manage shoulder pain. We also solicited feedback for the pathway’s improvement. Methods We conducted a qualitative study using a transcendental phenomenological approach seen through a constructivist lens. Clinicians recorded themselves interacting with the care pathway while working through a clinical case. Clinicians described their thoughts and movements aloud as they completed the activity. Second, we conducted individual semi-structured interviews to discuss the usefulness and practicality of pathway implementation. Interview transcripts were coded independently by reviewers. Transcript codes and associated quotes were grouped into themes. Themes were sequenced and linked creating a ‘web’ of thematic connections. Summary statements were developed to synthesize the overall essence of the phenomena. Results Nine clinicians participated. Participants included eight chiropractors and one medical physician. We found that clinicians believed the care pathway could be useful at various levels, including education (students, interns), for early career clinicians, for engaging patients, facilitating interprofessional communication, and as a reminder of information for certain, less familiar conditions. When discussing the practicality of implementing the care pathway into practice settings, clinicians expressed that agreement with the care pathway and its recommendations may influence its acceptability among clinicians. Additionally, integrating recommendations into practice may be a skill requirement included into clinical training. Clinicians described the importance of opinion leaders in the acceptability of new evidence. Various difficulties with the replicability of interventions into clinical care was also discussed. In general, clinicians suggested the layout of the care pathway was manageable, and there was sufficient information for clinical decision-making. Clinicians also made several recommendations for improvement. Conclusions End-user involvement and collaboration provides tangible instruction to improve care pathways themselves, their implementation strategies and helps to support and strengthen future research for overcoming individual, systemic and contextual barriers.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Exploring clinician perceptions of a care pathway for the management of shoulder pain: a qualitative study

Verville

Cancelliere

Connell

et al. 2022

BMC Health Serv Res

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“…Most clinical guidelines for cervical and upper limb disorders suggest non-surgical management, as a first treatment option for UQMD 4–9. Spinal manipulation is one such management approach used in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of thoracic spine manipulation for upper quadrant musculoskeletal disorders: protocol for a systematic review

Thoomes,

Tilborghs,

Heneghan

et al. 2023

BMJ Open

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IntroductionUpper quadrant musculoskeletal disorders (UQMD), comprising of cranial, cervical, shoulder and upper extremity disorders, are among the most frequently reported disorders in clinical practice. Thoracic high velocity low amplitude thrust (Tx-HVLAT) manipulation is a form of conservative management recommended in systematic reviews as an effective treatment option for aspects of UQMD disorders such headache, shoulder pain and lateral elbow pain. However, no recent systematic reviews have assessed the effectiveness across UQMD. Therefore, this systematic review aims to update the current evidence on the effectiveness of Tx-HVLAT for patients with UQMD on (1) patient-reported outcomes, (2) performance measures or (3) psychosocial outcomes.Methods and analysisThe Cochrane Controlled Trials Register, MEDLINE, EMBASE, CINAHL, PEDro and Index to Chiropractic Literature will be searched from inception using Medical Subject Headings (MeSH), Thesaurus and/or free-text words. Combinations will be made based on localisation, disorder, intervention and design. Following guidelines as advised by the Cochrane Back Review Group, published randomised controlled trials will be included. Two review authors will independently assess the risk of bias (ROB) using the Cochrane Back Review Group’s recommended ROB2 tool and will independently extract the data using a standardised data extraction form. Overall quality of the evidence will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) method. For continuous data, we will calculate standardised mean differences with 95% CIs. For dichotomous outcomes, relative risks and 95% CIs will be calculated. Where possible we will present a subgroup analysis by disorder. For pooling, a random-effects model will be used.Ethics and disseminationEthics approval is not required for this systematic review. The study findings will be submitted to a relevant peer-reviewed journal for dissemination and presented at relevant conferences.PROSPERO registration numberCRD42023429996.

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“…Finally, Yu et al, in a review about the noninvasive management of soft tissue disorders of the shoulder [12], recommended that DF should not be offered for soft tissue disorders of the shoulder after analyzing the results of the previously mentioned double-blind randomized controlled trial [10]. Although the results were similar between the group treated with DF and the control group after three months, immediately after treatment, that is, after three weeks, including six DF sessions improved the functionality and the active extension and external rotation movements compared to the control group and the differences between the placebo and control groups were statistically significant only in extension movement.…”

Section: Introductionmentioning

confidence: 99%

Diacutaneous Fibrolysis: An Update on Research into Musculoskeletal and Neural Clinical Entities

Lucha-López,

Hidalgo-García,

Monti-Ballano

et al. 2023

Biomedicines

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Diacutaneous Fibrolysis (DF) is an instrumentally assisted manual therapy technique defined as “a specific instrumental intervention for normalizing the musculoskeletal system function after a precise diagnosis and preserving the skin’s integrity”. The aim of this technique is soft tissue mobilization with the assistance of specially designed, hook-shaped steel instruments in different musculoskeletal structures, such as the myofascia, aponeurosis, tendons, ligaments and scar tissues. Due to discrepant results between previous reviews and the quite abundant new evidence provided by recently published randomized clinical trials, we propound this narrative review to provide an update on the scientific evidence related to the fundamentals and clinical efficacy of DF. Current evidence primarily supports the mechanical effect of DF on connective soft tissues. Diminished deep tendon reflex and rigidity have been registered after the implementation of DF in healthy subjects. Though there is still much to uncover, scientific evidence supports the use of the technique for the clinical treatment of subacromial impingement syndrome, chronic lateral epicondylalgia, chronic patellofemoral pain syndrome, mild to moderate carpal tunnel syndrome, hamstring shortening, temporomandibular disorders, tension-type headache and chronic low back pain. Additional data are essential for better recommendations in the clinical practice of DF.

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Noninvasive management of soft tissue disorders of the shoulder: A clinical practice guideline from the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration

Cited by 8 publications

References 112 publications

Exploring clinician perceptions of a care pathway for the management of shoulder pain: a qualitative study

Exploring clinician perceptions of a care pathway for the management of shoulder pain: a qualitative study

Effectiveness of thoracic spine manipulation for upper quadrant musculoskeletal disorders: protocol for a systematic review

Diacutaneous Fibrolysis: An Update on Research into Musculoskeletal and Neural Clinical Entities

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