Shoulder/Arm Disorders

The rehabilitation and evaluation of finger flexor tendon injuries

Tamara Hauri
tamara.hauri@insel.ch

Towards a preventive strategy for complaints of the arm, neck and/or shoulder - Vivian Bruls 2018

Link to dissertation

Ultrasound imaging to tailor treatment of shoulder pain in general practice - Ramon Ottenheijm 2015

The prognosis for patients with shoulder pain is poor. Unfortunately, general practitioners are not able to determine the underlying cause of shoulder pain during a consultation. Treatment therefore focuses on the symptoms and not the underlying cause. This dissertation shows that general practitioners find diagnosing shoulder pain complex, and that ultrasound is suitable for making a diagnosis and is also frequently used to do so. However, treatment based on ultrasound diagnosis in patients with a history of less than three months’ pain does not result in a better prognosis after one year. It is therefore recommended that general practitioners do not refer patients with shoulder pain for ultrasound.

Link to dissertation

The effectiveness of injections in cuffdisorders and improvement of diagnostics - Ludo Penning 2015

Shoulder disorders are frequently encountered in first and second line healthcare. In this chapter we give an outline of different causes and sources of shoulder disorders. An overview is given on common used conservative treatment strategies in first line health care. We address the limitations of currently available physical diagnostic tests for cuff disorders. In case of failure of conservative treatment there is a tendency to administer subacromial corticosteroid injections. We describe the use, effect and possible side effects of corticosteroid injections. Next to corticosteroid injections use of hyaluronic acid injections for shoulder disorders is described. We give an overview of this thesis in respect to the performed RCT, the studies we have performed to improve clinical testing in shoulder disorders and the aim to develop a simple diagnostic and treatment strategy in shoulder disorders for both first and second line healthcare. T he chapter is closed with an outline of the aims and questions addressed in this thesis.

Link to dissertation

Physiotherapy in shoulder impingement syndrome - Thilo Kormer 2014

Chapter 1 introduces the theme of shoulder complaints, which are often seen in primary care. The reported incidence and 1-year prevalence ranges from 0.9 to 2.5% and from 4.7% to 46.7% respectively. About 75% to 80% of patients with shoulder pain show clinical signs of subacromial impingement, characterized by pain and functional restrictions mostly during overhead activities in daily life or sporting activities. Physiotherapy is often the first choice of treatment for SIS. Conclusions from systematic reviews favour the use of both, exercises and manual therapy, often as a combined treatment. Although short term results suggest that patients benefit from these interventions, evidence is scarce and information about the long term effect of manual therapy is lacking. The main focus of this thesis was to provide evidence about the short and long term effect of manual physiotherapy and exercises in the treatment of patients with subacromial impingement syndrome of the shoulder. 

Link to dissertation

Work and pain - Shala Eltayed 2011

Risks and recommendations in WRULD - Marjon van Eijsden 2010

Mouse arms, currently no longer called RSI, but WRULD (work-related upper limb disorders), still occur frequently and involve high costs. Physiotherapy and posture therapy show insufficient results, even in the case of incipient complaints. At the origin of WRULD stressful situations and a perfectionist are important factors. When the complaints persist, the way a person experiences his complaints and perceives them as a psychological burden plays an important role. Risk factors such as a perfectionist mentality and anxiety, among others pain anxiety causing the avoidance of activities deserve more attention.
Therefore, in the treatment of WRULD, guidance by a psychologist (for perfectionist persons) and a behaviour therapist (for people with anxiety) should be included. Moreover, sports are important for WRULD patients. Fit persons experience fewer complaints.

Link to dissertation

The effectiveness of an education and activation programm in acute and sub-acute shoulder complaints presented in general practice - Camiel de Bruijn 2007

The annual incidence of shoulder complaints (SCs) in patients seen by general practitioners (GPs) in the Netherlands lies between 15 and 25 cases per 1000 patients registered with a GP. Half of these patients report persistent SCs after six months, in spite of usual care (UC), which is characterized by a mainly biomedical approach.

Psychosocial factors may cause a patient to develop inadequate cognitions and maladaptive behaviours, which are known to play a role in the persistence of musculoskeletal disorders such as SCs. To reduce the proportion of patients reporting chronic SCs after six months, a new intervention has been developed. This intervention, the education and activation programme (EAP), aims to prevent the development of inadequate cognitions and maladaptive behaviours in the early stages of the SCs.

To evaluate the effect of the EAP on the prevention of chronic SCs 26 weeks after the first presentation in general practice, a randomized clinical trial (RCT) was designed and implemented.

Link to dissertation