The immediate and subsequent impact of a first-time traumatic anterior shoulder dislocation in people aged 16–40: Results from a national cohort study

Abstract

Background Limited evidence exists which details changes in quality of life, shoulder activity level, kinesiophobia, shoulder pain and disability following a first-time traumatic anterior shoulder dislocation (FTASD) in people treated non-operatively. This study had three objectives: (1) to examine quality of life, pain, disability and kinesiophobia after an FTASD within 12 weeks, (2) to examine whether these variables were different in people with and without recurrent shoulder instability and (3) to assess how these variables changed over 12 months. Methods A prospective cohort study was undertaken in people with an FTASD aged between 16 and 40 years. Measures of quality of life, kinesiophobia, shoulder activity, shoulder pain and disability were recorded within 12 weeks of an FTASD and at 3, 6, 9 and 12 months. Results An FTASD negatively impacted quality of life, shoulder pain and function and these variables improved over time. People with recurrent shoulder instability had poorer quality of life 12 months after an FTASD. Across the entire cohort, kinesiophobia did not significantly change across time in people following an FTASD. Conclusions Quality of life was significantly affected by an FTASD in people with recurrent shoulder instability. Across the entire cohort of people with an FTASD, kinesiophobia remained elevated in people following an FTASD. Level of evidence Level 1 prognostic study.

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“…In the acute phase, patients with traumatic instabilities are likely to present with high levels of pain (SPADI-Pain) and disability (SPADI-Disability). Significant improvements are expected by 6 months (SPADI-Pain) and 9 months (SPADI-Disability) (Olds et al, 2020). The low SPADI-Pain score for the Instability group in this study is possibly due to the late presentation to physiotherapy (mean symptom duration > 3 months) at these clinics.…”

“…In a previous study (Olds et al, 2019), similar TSK-11 scores (26/44) were reported for people with glenohumeral dislocations within 12 weeks of their dislocation. Kinesiophobia scores did not demonstrate a significant change across time (Olds et al, 2020) and have been shown not to differ in primary or recurrent instability (Eshoj et al, 2019). Either kinesiophobia does not differ between traumatic and atraumatic instability and primary or recurrent instability, or current measures of kinesiophobia are not responsive in people with shoulder instability.…”

Factor Structure of the Shoulder Instability Return to Sport After Injury Scale: Performance Confidence, Reinjury Fear and Risk, Emotions, Rehabilitation and Surgery

“…This is in agreement with previous reports that kinesiophobia did not change significantly 1 year after a shoulder dislocation despite improvements in pain and quality of life. 19 However, an athlete's psychological status may be improved if he or she has successfully returned to sports. Athletes in this study who had returned to sports at a median of 112 days (17.4 weeks) had an SI-RSI total score of 48.4 6 19.…”

A systematic review to compare physiotherapy treatment programmes for atraumatic shoulder instability

“…They aimed to reduce fear of pain, emphasised patient capabilities, and underlined the importance of self-management of the condition. Addressing psychosocial factors through education is argued to be a pillar of selfmanagement promotion [37] and may help to reduce fear of movement that is seen in those with shoulder dislocations [38].…”