BACKGROUND The optimal surgical approach for patients with primary glenohumeral osteoarthritis(GHOA)and an intact rotator cuff remains debated.While anatomic total shoulder arthroplasty(TSA)has traditionally been favo...BACKGROUND The optimal surgical approach for patients with primary glenohumeral osteoarthritis(GHOA)and an intact rotator cuff remains debated.While anatomic total shoulder arthroplasty(TSA)has traditionally been favoured,reverse TSA(RTSA)is increasingly utilized.AIM To systematically compare the outcomes of RTSA and TSA in this specific patient population.METHODS A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines.Retrospective comparative studies evaluating RTSA and TSA in patients with GHOA and intact rotator cuff were included.Key outcomes assessed included complication and reoperation rates,patient-reported outcome measures(PROMs),and range of motion.Risk of bias was assessed using the Risk of Bias in Non-randomized Studies of Interventions tool.RESULTS Twelve studies encompassing 1608 patients(580 RTSA,1028 TSA)met inclusion criteria.RTSA was associated with a lower reoperation rate compared to TSA[odds ratio=0.37;95%confidence interval(CI):0.14-0.94;P value=0.04],while no significant difference in overall complication rates was observed(odds ratio=0.47;95%CI:0.19-1.16;P value=0.10).RTSA patients showed superior outcomes in University of California Los Angeles,Simple Shoulder Test,and Shoulder Pain and Disability Index scores;however,the differences did not exceed the minimal clinically important difference.TSA patients had significantly better external rotation(mean difference=-9.0°;95%CI:-13.21 to-5.02;P value<0.0001).No significant differences were found in other range of motion measures or satisfaction scores.The overall methodological quality of included studies was moderate to serious.CONCLUSION In patients with GHOA and an intact rotator cuff,RTSA may offer comparable or improved outcomes to TSA with lower reoperation rates and similar complication profiles.Functional outcomes favour RTSA in certain patientreported outcome measures,while TSA retains an advantage in external rotation.Surgical decision-making should remain individualized based on patient characteristics and functional demands.展开更多
Pulmonary embolism(PE)is a rare but devastating complication of shoulder surgery.Apart from increased morbidity and mortality rates,it may significantly impair postoperative recovery and functional outcome.Its frequen...Pulmonary embolism(PE)is a rare but devastating complication of shoulder surgery.Apart from increased morbidity and mortality rates,it may significantly impair postoperative recovery and functional outcome.Its frequency accounts for up to 5.7%of all shoulder surgery procedures with a higher occurrence in women and patients older than 70 years.It is most commonly associated with thrombophilia,diabetes mellitus,obesity,smoking,hypertension,and a history of malignancy.PE usually occurs secondary to upper or lower-extremity deep vein thrombosis(DVT).However,in rare cases,the source of the thrombi cannot be determined.Prophylaxis for PE following shoulder surgery remains a topic of debate,and the standard of care does not routinely require prophylactic medication for DVT prophylaxis.Early ambulation and elastic stockings are important preventative measures for DVT of the lower extremity and medical agents such as aspirin,low-molecular-weight heparin,and vitamin K antagonists are indicated for high-risk patients,long-lasting operations,or concomitant severe acute respiratory syndrome coronavirus 2 infection.The most common symptoms of PE include chest pain and shortness of breath,but PE can also be asymptomatic in patients with intrinsic tolerance of hypoxia.Patients with DVT may also present with swelling and pain of the respective extremity.The treatment of PE includes inpatient or outpatient anticoagulant therapy if the patient is hemodynamically unstable or stable,respectively.Hemodynamic instability may require transfer to the intensive care unit,and cardiovascular arrest can be implicated in fatal events.An important issue for patients with PE in the postoperative period after shoulder surgery is residual stiffness due to a delay in rehabilitation and a prolonged hospital stay.Early physiotherapy and range-of-motion exercises do not adversely affect the prognosis of PE and are highly recommended to preserve shoulder mobility and function.展开更多
Objective To observe the correlation between analgesic effect and duration of analgesic effect of superficial needling for shoulder pain of shoulderhand syndrome（SHS） after stroke, so as to screen the best time peri...Objective To observe the correlation between analgesic effect and duration of analgesic effect of superficial needling for shoulder pain of shoulderhand syndrome（SHS） after stroke, so as to screen the best time period of analgesia. Methods A total of 120 patients with SHS after stroke（stage I） were recruited and superficial needling therapy was applied. Two obvious tenderness points on the affected shoulder of patients were found out. The site 80–100 mm down each tenderness point was selected for superficial needling. Bimanual needling technique was applied after inserting needles. The surrounding of tenderness points was pinched and grasped by left hand above the needling, and the technique of green dragon swaying tail was applied by right hand. The needles at each acupoint were manipulated for3 min and retained for 30 min. The analgesic effect was evaluated dynamically by visual analogue scale（VAS） in 120 patients before treatment, immediately after treatment, 30 min after treatment, 1 h after treatment and 24 h after treatment. The analgesic effects at different time were statistically analyzed by generalized estimating equation. Results The mean values of VAS were 7.483, 3.950, 4.767, 5.917 and 7.217, respectively, before treatment, immediately after treatment, 30 min after treatment, 1 h after treatment and 24 h after treatment. The difference of analgesic effect at different time was statistically significant（P〈0.01）; the difference of analgesic effect of superficial needling in treatment of SHS after stroke was significant between immediately after treatment and 30 min after treatment（both P〈0.05）, while there was no significant difference between 1 h after treatment and 24 h after treatment（both P〈0.05）. Conclusion Analgesic effect of superficial needling for shoulder pain of SHS after stroke was different at different time points and decreased over time; analgesic effect was the most significant immediately after treatment and the optimal duration of analgesic effect was from immediately to 30 min after superficial needling therapy.展开更多
Purpose: There have been many studies on the effects of different types of backpacks on posture from a biomechanical perspective and on the center of gravity. Considering the effects of autonomic nervous system activi...Purpose: There have been many studies on the effects of different types of backpacks on posture from a biomechanical perspective and on the center of gravity. Considering the effects of autonomic nervous system activity and mood associated with backpacks in mountaineering and hiking, research is also needed from a psychological perspective. In this study, the effects of adjusting the backpack shoulder stabilizer were preliminarily tested in terms of subjective fatigue and changes in autonomic nervous activity after hiking. Methods: The experimental 15 healthy participants hiked the mountain under two conditions: 1) without adjusting the stabilizer, a feature of the backpack (NAH condition), and 2) with the stabilizer adjusted (AH condition). First, all participants hiked the mountain in the NAH condition, and after a 30-minute break, they began the hike in the AH condition after confirming that a) their heart rate had recovered and b) they were in good physical condition. Results: HR was significantly lower after each hiking session than during the session. RMSSD was significantly lower pre-AH and post-AH than the NAH condition, but there was no significant difference between the NAH condition and either post-NAH or post-AH. Additionally, RMSSD was significantly lower in the AH condition than pre-AH or post-AH. The shoulders and back were significantly more burdened in the NAH condition than in the AH condition. The pleasure level was significantly higher in the AH condition than in the NAH condition. Conclusion: The results showed that also adjusting the position of the waist belt when adjusting the shoulder stabilizer, which is mainly used for the neck and shoulders, has a significant positive effect on the subjective burden on the upper body and parasympathetic nervous system activity after hiking.展开更多
BACKGROUND The accuracy of blind intra-articular injections in the shoulder is rather low.Inaccurate injections tend to lead to poorer treatment outcomes.The“Delaware posterior bone touch technique”has shown higher ...BACKGROUND The accuracy of blind intra-articular injections in the shoulder is rather low.Inaccurate injections tend to lead to poorer treatment outcomes.The“Delaware posterior bone touch technique”has shown higher accuracy in young,slender,healthy volunteers than the classical“Cyriax technique”.AIM To investigate whether the Delaware technique would also be more accurate in older patients with capsulitis.METHODS We analyzed the files of 100 consecutive patients with capsulitis who were treated with an intra-articular injection containing a mixture of triamcinolone,lidocaine,and air.After the injection,the shoulder was moved to determine whether a squishing sound could be produced.The squishing sound was interpreted as an accurate injection.The scores with the new Delaware technique were compared against those with the Cyriax technique in a previous study.RESULTS Squishing was heard after 87%of the injections.This was 13%(10%points)more than the 77%in the previous study(P=0.004).CONCLUSION The Delaware technique was significantly more accurate than the Cyriax technique also in middle aged patients with capsulitis.We hypothesize that the difference is caused by a lower risk that a part of the opening of the needle is still outside the capsule.展开更多
BACKGROUND Shoulder arthroscopy is commonly used for the repair of glenohumeral ligament avulsions or tendon tears.The success of the operation depends on the ability of the ligaments or rotator cuff tendon to heal to...BACKGROUND Shoulder arthroscopy is commonly used for the repair of glenohumeral ligament avulsions or tendon tears.The success of the operation depends on the ability of the ligaments or rotator cuff tendon to heal to their original attachment site.Soft tissue healing can be evaluated with imaging methods or alternatively with second-look arthroscopy.AIM To investigate shoulder tendon and capsule healing after arthroscopic rotator cuff and instability repair using second-look arthroscopy.METHODS In this study,24 adult patients with rotator cuff tears(13 patients)or anterior shoulder instability(11 patients)were included.All patients were initially subjected to arthroscopic repair using suture anchors and were re-evaluated with second-look arthroscopy for reasons not related to the original pathology.The second operation was performed in 8 patients due to mild but persistent pain or stiffness,in 3 patients for recalcitrant stiffness,in 5 patients for secondary biceps tenotomy,in 6 patients for persistent acromioclavicular joint pain and in 2 patients for suture anchor prominence causing shoulder grinding.Soft tissue healing was evaluated visually and by probing,whereas clinical outcomes were evaluated using the University of California–Los Angeles(UCLA)and Rowe rating scales.RESULTS In almost all patients,complete soft tissue healing occurred at the site of tissue reattachment,either on the glenoid articular surface or the greater humeral tuberosity.The strongest repair,as confirmed by probe palpation,was encountered at the site of suture passage through the soft tissue.All suture material was covered with bursal synovial tissue,with no cases of knot impingement or cartilage fraying.The mean preoperative and postoperative UCLA scores for rotator cuff repair patients were 1354±3205 and 2931±2898,respectively(P<0.001),whereas for shoulder instability patients,the mean Rowe scores preoperatively and postoperatively were 2591±1338 and 9272±754,respectively(P<0.001).The use of bioabsorbable implants did not cause synovitis or other tissue reactions.CONCLUSION Soft tissue healing in the shoulder is successful and strongest at the site of suture anchor placement.展开更多
Sickle cell disease(SCD)is a genetic disorder characterized by chronic hemolysis and vaso-occlusive crises(VOCs),leading to musculoskeletal complications that significantly affect quality of life.Among these,shoulder ...Sickle cell disease(SCD)is a genetic disorder characterized by chronic hemolysis and vaso-occlusive crises(VOCs),leading to musculoskeletal complications that significantly affect quality of life.Among these,shoulder complications are a concern,with humeral head avascular necrosis(AVN)being the second most common site of involvement after the femoral head.Other shoulder pathologies,including osteomyelitis and septic arthritis,further contribute to morbidity.However,these conditions remain underdiagnosed and understudied,often due to overlapping symptoms with VOC-related bone infarctions.Imaging,particularly magnetic resonance imaging,is crucial for early diagnosis and accurate differentiation.Management strategies range from conservative pain control to surgical interventions,including core decompression for early-stage AVN and arthroplasty for advanced joint destruction.Surgical outcomes in SCD,however,remain inconsistent due to higher complication rates and a lack of standardized guidelines.Despite advancements in diagnosis and treatment,shoulder pathology in SCD remains an area of limited research.This review highlights the need for larger,long-term studies with a homogeneous etiology to support and refine current treatment strategies and improve patient outcomes.展开更多
BACKGROUND Posterior shoulder dislocation is a rare injury.It accounts for only 1%-4%of all shoulder dislocation cases.However,this injury is often underdiagnosed.Massive rotator cuff tears associated with posterior s...BACKGROUND Posterior shoulder dislocation is a rare injury.It accounts for only 1%-4%of all shoulder dislocation cases.However,this injury is often underdiagnosed.Massive rotator cuff tears associated with posterior shoulder dislocation are exceptionally rare.Early diagnosis and surgical management are crucial for restoring shoulder function and preventing long-term disability.CASE SUMMARY A 60-year-old male with no previous shoulder injuries presented to our hospital with severe right shoulder pain and immobility after a motorcycle accident.He reported that he braced his fall with his right hand.Initial imaging examination revealed posterior shoulder dislocation with minimal glenoid bone loss.Six days after the injury,the patient exhibited pseudoparalysis and active forward flexion limited to 10°.Two weeks after the injury,magnetic resonance imaging revealed complete tears of the supraspinatus,infraspinatus,and subscapularis muscles as well as dislocation of the long head of the biceps tendon.Arthroscopic rotator cuff repair was performed 6 weeks after injury.The tendon quality was acceptable with minimal fatty infiltration.At the 12-month surgical follow-up,the patient had recovered full strength and complete range of motion.CONCLUSION Early diagnosis and tailored repair of massive rotator cuff tears after dislocation are crucial for restoring shoulder function in older patients.展开更多
This paper presents a novel rehabilitation robot designed to address the challenges of Passive Range of Motion(PROM)exercises for frozen shoulder patients by integrating advanced scapulohumeral rhythm stabilization.Fr...This paper presents a novel rehabilitation robot designed to address the challenges of Passive Range of Motion(PROM)exercises for frozen shoulder patients by integrating advanced scapulohumeral rhythm stabilization.Frozen shoulder is characterized by limited glenohumeral motion and disrupted scapulohumeral rhythm,with therapist-assisted interventions being highly effective for restoring normal shoulder function.While existing robotic solutions replicate natural shoulder biomechanics,they lack the ability to stabilize compensatory movements,such as shoulder shrugging,which are critical for effective rehabilitation.Our proposed device features a 6 Degrees of Freedom(DoF)mechanism,including 5 DoF for shoulder motion and an innovative 1 DoF Joint press for scapular stabilization.The robot employs a personalized two-phase operation:recording normal shoulder movement patterns from the unaffected side and applying them to guide the affected side.Experimental results demonstrated the robot’s ability to replicate recorded motion patterns with high precision,with Root Mean Square Error(RMSE)values consistently below 1 degree.In simulated frozen shoulder conditions,the robot effectively suppressed scapular elevation,delaying the onset of compensatory movements and guiding the affected shoulder to move more closely in alignment with normal shoulder motion,particularly during arm elevation movements such as abduction and flexion.These findings confirm the robot’s potential as a rehabilitation tool capable of automating PROM exercises while correcting compensatory movements.The system provides a foundation for advanced,personalized rehabilitation for patients with frozen shoulders.展开更多
A frozen shoulder is a common cause of shoulder pain and stiffness.The etiology and pathology of frozen shoulders is not fully understood yet.Frozen shoulderis characterized by a decrease in intra-articular volume and...A frozen shoulder is a common cause of shoulder pain and stiffness.The etiology and pathology of frozen shoulders is not fully understood yet.Frozen shoulderis characterized by a decrease in intra-articular volume and capsular compliance.This can lead to significant limitations in daily life.The majority of the patients can be treated conservatively,with functional recovery to be expected in two to three years.However,if conservative treatment fails,manipulation under anaesthesia and arthroscopic capsular release can both be considered as appropriate treatments.Manipulation is a traditionally well-established technique but in recent years it seems that arthroscopic capsular release has gained popularity.Manipulation is a relative time efficient and technically low-demanding procedure in which the glenohumeral joint is forced into different directions under general anaesthesia to release the capsular contracture,thereby increasing the range of motion of the joint.In arthroscopic capsular release the glenohumeral capsule can be released in a more controlled manner under direct vision.There are no prospective comparative trials available to display superiority of one procedure over the other.In addition,the optimal timing of both these interventions still has to be determined.An overview of the literature concerning this topic and a description of both procedures with its own advantages and disadvantages is provided.展开更多
BACKGROUND Many patients prioritize the ability to return to work(RTW)after shoulder replacement surgeries such as total shoulder arthroplasty(TSA),reverse TSA(rTSA),and shoulder hemiarthroplasty(HA).Due to satisfacto...BACKGROUND Many patients prioritize the ability to return to work(RTW)after shoulder replacement surgeries such as total shoulder arthroplasty(TSA),reverse TSA(rTSA),and shoulder hemiarthroplasty(HA).Due to satisfactory clinical and functional long-term outcomes,the number of shoulder replacements performed will continue to rise into this next decade.With younger individuals who compose a significant amount of the workforce receiving shoulder replacements,patients will begin to place a higher priority on their ability to RTW following shoulder arthroplasty.AIM To summarize RTW outcomes following TSA,rTSA,and HA,and analyze the effects of workers’compensation status on RTW rates and ability.METHODS This systematic review and analysis was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.A literature search regarding RTW following shoulder arthroplasty was performed using four databases(PubMed,Scopus,Embase,and Cochrane Library),and the Reference Citation Analysis(https://www.referencecitationanalysis.com/).All studies in English relevant to shoulder arthroplasty and RTW through January 2021 that had a level of evidence I to IV were included.Nonclinical studies,literature reviews,case reports,and those not reporting on RTW after shoulder arthroplasty were excluded.RESULTS The majority of patients undergoing TSA,rTSA,or HA were able to RTW betweenone to four months,depending on work demand stratification.While sedentary or light demand jobs generally have higher rates of RTW,moderate or heavy demand jobs tend to have poorer rates of return.The rates of RTW following TSA(71%-93%)were consistently higher than those reported for HA(69%-82%)and rTSA(56%-65%).Furthermore,workers’compensation status negatively influenced clinical outcomes following shoulder arthroplasty.Through a pooled means analysis,we proposed guidelines for the average time to RTW after TSA,rTSA,and HA.For TSA,rTSA,and HA,the average time to RTW regardless of work demand stratification was 1.93±3.74 mo,2.3±2.4 mo,and 2.29±3.66 mo,respectively.CONCLUSION The majority of patients are able to RTW following shoulder arthroplasty.Understanding outcomes for rates of RTW following shoulder arthroplasty would assist in managing expectations in clinical practice.展开更多
Objective To assess the efficacy and possible adverse effects of acupuncture on frozen shoulder. Methods Based on the key words, i.e. acupuncture, electroacupuncture, acupuncture-moxibustion, frozen shoulder, adhesive...Objective To assess the efficacy and possible adverse effects of acupuncture on frozen shoulder. Methods Based on the key words, i.e. acupuncture, electroacupuncture, acupuncture-moxibustion, frozen shoulder, adhesive capsulitis, shoulder disorders etc., the Chinese databases were retrieved, including Oochrane Musculoskeleta Group, Oochrane Controlled Trials Register, Oochrane Complementary Medicine Field, and the central database of the Oochrane Library as well as MEDLINE, EMBASE and Chinese Biomedical CD （OBM-disc）. 20 Chinese medical journals and relevant academic conference proceedings have been searched manually. The reference lists of identified documents were checked as the supplementary retrieval. Results 6 randomized controlled trials on frozen shoulder with acupuncture and electroacupuncture were included, indicating quite advanced study quality. There were 34 to 257 participants in the trials, 668 in total. The total OR of CMS/OSA was OR 3.49 （95 % CI - 2.64 to 9.63）, the total OR of VAS was OR - 1.24 （95% CI -3.50 to 1.01）, the total OR of ROM was OR 35.70 （95% CI 22.91 to 48.49）; the total OR of MELLE was OR 4.30 （95% OI 2.32 to 7.98）. Conclusion It is shown in the present limited inclusive trials on frozen shoulder that acupuncture is the safe therapy and effective on improving the global function, relieving pain, and improving the range of motion of shoulder. All the therapeutic effects of acupuncture are superior to those in control group. However, much more high quality trials are required to provide much stronger evidence. Additionally, much more evidences on validity of frozen shoulder with other assessing indexes involved are required in the treatment with acupuncture.展开更多
We selected 106 hemiplegic patients with shoulder pain hospitalized after stroke from three hospi- tals in Nanjing, China between February 2007 and January 2012. All patients had complete clinical data sets and accoun...We selected 106 hemiplegic patients with shoulder pain hospitalized after stroke from three hospi- tals in Nanjing, China between February 2007 and January 2012. All patients had complete clinical data sets and accounted for 45.5% of the inpatients because of stroke. Results showed that the number of patients with hemiplegic shoulder pain post stroke increased yearly, attacking mainly males 50-69 years of age. Of 106 patients, there were 60 cases （56.6%） of adhesive capsulitis, 19 （17.9%） of shoulder subluxation, 14 （13.2%） of complex regional pain syndrome, and 13 （12.6%） of central pain. The main symptoms were shoulder pain （100%）, limit of shoulder mobility （98.1%）, and adhesion of the scapula （56.6%）. MRI of the shoulder showed tendon and ligament lesions （57.1%） and rotator cuff tear （38.1%）. 53.8% of central pain was related to the thalamus, in addition to the basal ganglia, brain stem, and cerebellopontine angle. Shoulder pain, upper limb motor function, and function independence were significantly improved after comprehensive rehabilitation. In par- ticular, electroacupuncture based on basic physical therapy exhibited efficacy on shoulder subluxa- tion and complex regional pain syndrome. Multiple linear regression results showed a negative re- lationship of efficacy of pain management with the attack period of shoulder pain, involvement of the posterior limb of the internal capsule, and duration between onset and rehabilitation treatment, but a positive correlation with pain-related education, pain regression period, and pain diagnosis.展开更多
Objective To probe into therapeutic effect of acupuncture at Tiānzōng（天宗 ST 11） with Canggui Tanxue method on periarthritis of shoulder.Methods Sixty cases of periarthritis of shoulder were treated by acupunctur...Objective To probe into therapeutic effect of acupuncture at Tiānzōng（天宗 ST 11） with Canggui Tanxue method on periarthritis of shoulder.Methods Sixty cases of periarthritis of shoulder were treated by acupuncture at Tiānzōng（天宗 SI 11） with Canggui Tanxue method.The treatment was given once each day,and the needle was retained for 20 min,5 treatments constituting one course.After 3 courses,therapeutic effects were observed.Results Thirty-six cases were cured,15 cases were markedly effective,8 cases were effective and one case was ineffective,with a total effective rate of 98.3%（59/60）.Conclusion Acupuncture at Tiānzōng（天宗 SI 11） with Canggui Tanxue method has an obvious therapeutic effect on periarthritis of shoulder.展开更多
Objective To explore better therapies for the treatment of frozen shoulder. Methods One hundred and seventy-four cases were divided into a filiform needle group （56 cases）, an electroacupuncture group （57 cases） a...Objective To explore better therapies for the treatment of frozen shoulder. Methods One hundred and seventy-four cases were divided into a filiform needle group （56 cases）, an electroacupuncture group （57 cases） and a warming needle group （61 cases） according to the randomized, controlled and single-blind study principles. Jiānqián （肩前 Extra）, Jiānyú （肩髃 LI 15）, Jiānliáo （肩髎 TE 14）, Nàoshū （臑俞 SI 10）, Wàiguān （外关 TE 5）, Hégǔ （合谷 LI 4） were used in all three groups but treated with filiform needle, electroacupuncture and warming needle technique respectively. The needles were retained for 30 min. It was given once every other day and 5 times constituted as one course. Pain indices and activity degree of shoulders were measured and recorded before and after treatment every time. Results The total effective rate was 93.0% （53/57） in the electroacupuncture group and 95.1% （58/61） in the warming needle group, both superior to that of 78.6% （44/56） in the filiform needle group （both P〈0.01）, but there was no significant difference between electroacupuncture group and warming needle group （P〉0.05）. After one course of treatment, the decline indices of shoulder pain of electroacupuncture group （4.28±0.22） and warming needle group （3.74±0.17） were both significantly greater than that of filiform needle group （2.78±0.18）（both P〈0.01）. And the decline indices of electroacupuncture group was also greater than that of warming needle group （P〈0.05）. The improvements of shoulder activity degree of warming needle group （76.92±5.53） and electroacupuncture group （60.37±3.80） were both greater than that of filiform needle group （42.50±3.67） （both P〈0.01）. And shoulder activity degree of warming needle group was also greater than that of electroacupuncture group （P〈0.01）. After one course of treatment, improvement of shoulder activity degree and decline indices of shoulder pain in these three groups were better than that after the first time treatment （all P〈0.01）. Conclusion All these three acupuncture therapies can achieve good therapeutic effects for frozen shoulder. The therapeutic effects of electroacupuncture and warming needle groups are superior to that of filiform needle group. All these three therapies could significantly reduce patients’ pain and improve their shoulder activity degree. The analgesic effect of electroacupuncture is the best, and the shoulder activity degree improved by warming needle is the best. The improvement of clinical therapeutic effect mainly depends on the therapy and the treatment times when the same acupoints are selected and the condition of illness are similar.展开更多
Objective To compare differences in therapeutic effects between acupuncture accelerating qi-flow along meridians （AQF） and conventional acupuncture （CA） in treating periarthritis of shoulder to find better acupunc...Objective To compare differences in therapeutic effects between acupuncture accelerating qi-flow along meridians （AQF） and conventional acupuncture （CA） in treating periarthritis of shoulder to find better acupuncture methods. Methods Sixty-four patients were randomly divided into two groups： group AQF, and group CA with 32 cases in each group. Jiānyú （肩髃 LI 15）, Jiānliáo （肩髎 TE 14）, Jiānzhēn （肩贞 SI 9）, Bìnào （臂臑 LI 14）, Qūchí （曲池 LI 11） and Wàiguān （外关 TE 5） on the affected side were used in both groups, and the two acupuncture methods were respectively used in the two groups for consecutive 2 courses. Pain and moving functions of shoulder and ability in daily life （ADL） were used as indices for evaluating therapeutic effects. Results The total effective rate was 96.9% （31/32） and 81.3% （26/32） in group AQF and group CA, respectively, showing superiority of AQF to CA （P〈0.05）. Scores reflecting pain and moving functions of shoulder and ADL were all improved after treatment in both groups （all P〈0.05）, and the improvement in group AQF was more obvious than those in group CA （all P〈0.05）. Conclusion In treating periarthritis of shoulder, the acupuncture accelerating qi-flow along meridians was better than conventional acupuncture in alleviating pain of the shoulder, improving its moving function and elevating abilities in daily life.展开更多
Acute traumatic injuries to the glenohumeral articulation are common.The types of injuries depend on age,muscle strength,bone density,and biomechanics of the traumatic event.Understanding the different mechanisms of t...Acute traumatic injuries to the glenohumeral articulation are common.The types of injuries depend on age,muscle strength,bone density,and biomechanics of the traumatic event.Understanding the different mechanisms of trauma and how they affect the functional anatomical structures of the shoulder joint is crucial for the treatment of these lesions.Therefore,when clinicians have knowledge of these mechanisms they can accurately diagnose and treat shoulder pathology and predict distinct injury patterns.Here,we have described the fundamentals of the mechanisms of injury of the glenohumeral dislocation,dislocation with fracture of the humeral head,and the proximal humerus fracture.We have focused on common injury mechanisms and the correlation with radiological diagnostics.Radiological and laboratory findings of distinct types of injury were also discussed.展开更多
Objective:To investigate the clinical effects of electroacupuncture combined with extracorporeal shock wave in the treatment of periarthritis of shoulder.Methods:136 patients with periarthritis of shoulder admitted to...Objective:To investigate the clinical effects of electroacupuncture combined with extracorporeal shock wave in the treatment of periarthritis of shoulder.Methods:136 patients with periarthritis of shoulder admitted to our hospital from September 2018 to September 2019 were randomly divided into two groups by double-blind method.68 patients in the control group were treated with extracorporeal shock wave;68 patients in the observation group were treated with electroacupuncture combined with extracorporeal shock wave.The shoulder joint pain,joint function and activities of daily living were compared between the two groups.Results:The VAS score of shoulder joint pain in the observation group after treatment(1.92±0.24)was lower than that in the control group(3.51±0.32),and the UCLA score of shoulder joint function(31.28±1.96)was higher than that of the control group(27.42±2.36),the differences were statistically significant(P<0.05).After treatment,the active degree of forward flexion and extension of shoulder joint in the observation group was higher than those of the control group,and the activities of daily living was higher than that of the control group,with statistically significant differences(P<0.05)Conclusion:Electroacupuncture combined with extracorporeal shock wave treatment for periarthritis of shoulder has achieved ideal effects,safety and non-invasiveness,and can quickly restore the functions of shoulder joints.展开更多
give someone the cold shoulder的意思是“采取冷淡的态度”。shoulder是指“牛羊等连前腿在内的肩肉”,因此,所谓cold shoulde就是“凉了的前腿肉”的意思。古时候有这样的风俗习惯:在招待贵客时,飨以美味佳肴;对于行商和乞丐,则给“...give someone the cold shoulder的意思是“采取冷淡的态度”。shoulder是指“牛羊等连前腿在内的肩肉”,因此,所谓cold shoulde就是“凉了的前腿肉”的意思。古时候有这样的风俗习惯:在招待贵客时,飨以美味佳肴;对于行商和乞丐,则给“凉了的前腿肉”吃。这就是give someone thecold shoulder具有“采取冷淡态度”意思的来源。在日常会话中,give someone the cold shoulder, 既可以指表示冷淡的耸肩动作,也可以指“采取冷淡的态度”。例如:展开更多
文摘BACKGROUND The optimal surgical approach for patients with primary glenohumeral osteoarthritis(GHOA)and an intact rotator cuff remains debated.While anatomic total shoulder arthroplasty(TSA)has traditionally been favoured,reverse TSA(RTSA)is increasingly utilized.AIM To systematically compare the outcomes of RTSA and TSA in this specific patient population.METHODS A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines.Retrospective comparative studies evaluating RTSA and TSA in patients with GHOA and intact rotator cuff were included.Key outcomes assessed included complication and reoperation rates,patient-reported outcome measures(PROMs),and range of motion.Risk of bias was assessed using the Risk of Bias in Non-randomized Studies of Interventions tool.RESULTS Twelve studies encompassing 1608 patients(580 RTSA,1028 TSA)met inclusion criteria.RTSA was associated with a lower reoperation rate compared to TSA[odds ratio=0.37;95%confidence interval(CI):0.14-0.94;P value=0.04],while no significant difference in overall complication rates was observed(odds ratio=0.47;95%CI:0.19-1.16;P value=0.10).RTSA patients showed superior outcomes in University of California Los Angeles,Simple Shoulder Test,and Shoulder Pain and Disability Index scores;however,the differences did not exceed the minimal clinically important difference.TSA patients had significantly better external rotation(mean difference=-9.0°;95%CI:-13.21 to-5.02;P value<0.0001).No significant differences were found in other range of motion measures or satisfaction scores.The overall methodological quality of included studies was moderate to serious.CONCLUSION In patients with GHOA and an intact rotator cuff,RTSA may offer comparable or improved outcomes to TSA with lower reoperation rates and similar complication profiles.Functional outcomes favour RTSA in certain patientreported outcome measures,while TSA retains an advantage in external rotation.Surgical decision-making should remain individualized based on patient characteristics and functional demands.
文摘Pulmonary embolism(PE)is a rare but devastating complication of shoulder surgery.Apart from increased morbidity and mortality rates,it may significantly impair postoperative recovery and functional outcome.Its frequency accounts for up to 5.7%of all shoulder surgery procedures with a higher occurrence in women and patients older than 70 years.It is most commonly associated with thrombophilia,diabetes mellitus,obesity,smoking,hypertension,and a history of malignancy.PE usually occurs secondary to upper or lower-extremity deep vein thrombosis(DVT).However,in rare cases,the source of the thrombi cannot be determined.Prophylaxis for PE following shoulder surgery remains a topic of debate,and the standard of care does not routinely require prophylactic medication for DVT prophylaxis.Early ambulation and elastic stockings are important preventative measures for DVT of the lower extremity and medical agents such as aspirin,low-molecular-weight heparin,and vitamin K antagonists are indicated for high-risk patients,long-lasting operations,or concomitant severe acute respiratory syndrome coronavirus 2 infection.The most common symptoms of PE include chest pain and shortness of breath,but PE can also be asymptomatic in patients with intrinsic tolerance of hypoxia.Patients with DVT may also present with swelling and pain of the respective extremity.The treatment of PE includes inpatient or outpatient anticoagulant therapy if the patient is hemodynamically unstable or stable,respectively.Hemodynamic instability may require transfer to the intensive care unit,and cardiovascular arrest can be implicated in fatal events.An important issue for patients with PE in the postoperative period after shoulder surgery is residual stiffness due to a delay in rehabilitation and a prolonged hospital stay.Early physiotherapy and range-of-motion exercises do not adversely affect the prognosis of PE and are highly recommended to preserve shoulder mobility and function.
基金Supported by State Administration of Traditional Chinese Medicine of the People’s Republic of China "Twelfth FiveYear Plan" key specialty construction projectMajor scientific project of Changning District Science and Technology Commission:CNKW2013Z05+1 种基金Traditional Chinese medicine scientific research fund project of Shanghai Municipal Commission of Health and Family Planning:2014LQ021ATCM of Shanghai style heritage research base project of Shanghai Municipal Health Bureau:ZYSNXD-CCHPGC-JD-004
文摘Objective To observe the correlation between analgesic effect and duration of analgesic effect of superficial needling for shoulder pain of shoulderhand syndrome（SHS） after stroke, so as to screen the best time period of analgesia. Methods A total of 120 patients with SHS after stroke（stage I） were recruited and superficial needling therapy was applied. Two obvious tenderness points on the affected shoulder of patients were found out. The site 80–100 mm down each tenderness point was selected for superficial needling. Bimanual needling technique was applied after inserting needles. The surrounding of tenderness points was pinched and grasped by left hand above the needling, and the technique of green dragon swaying tail was applied by right hand. The needles at each acupoint were manipulated for3 min and retained for 30 min. The analgesic effect was evaluated dynamically by visual analogue scale（VAS） in 120 patients before treatment, immediately after treatment, 30 min after treatment, 1 h after treatment and 24 h after treatment. The analgesic effects at different time were statistically analyzed by generalized estimating equation. Results The mean values of VAS were 7.483, 3.950, 4.767, 5.917 and 7.217, respectively, before treatment, immediately after treatment, 30 min after treatment, 1 h after treatment and 24 h after treatment. The difference of analgesic effect at different time was statistically significant（P〈0.01）; the difference of analgesic effect of superficial needling in treatment of SHS after stroke was significant between immediately after treatment and 30 min after treatment（both P〈0.05）, while there was no significant difference between 1 h after treatment and 24 h after treatment（both P〈0.05）. Conclusion Analgesic effect of superficial needling for shoulder pain of SHS after stroke was different at different time points and decreased over time; analgesic effect was the most significant immediately after treatment and the optimal duration of analgesic effect was from immediately to 30 min after superficial needling therapy.
文摘Purpose: There have been many studies on the effects of different types of backpacks on posture from a biomechanical perspective and on the center of gravity. Considering the effects of autonomic nervous system activity and mood associated with backpacks in mountaineering and hiking, research is also needed from a psychological perspective. In this study, the effects of adjusting the backpack shoulder stabilizer were preliminarily tested in terms of subjective fatigue and changes in autonomic nervous activity after hiking. Methods: The experimental 15 healthy participants hiked the mountain under two conditions: 1) without adjusting the stabilizer, a feature of the backpack (NAH condition), and 2) with the stabilizer adjusted (AH condition). First, all participants hiked the mountain in the NAH condition, and after a 30-minute break, they began the hike in the AH condition after confirming that a) their heart rate had recovered and b) they were in good physical condition. Results: HR was significantly lower after each hiking session than during the session. RMSSD was significantly lower pre-AH and post-AH than the NAH condition, but there was no significant difference between the NAH condition and either post-NAH or post-AH. Additionally, RMSSD was significantly lower in the AH condition than pre-AH or post-AH. The shoulders and back were significantly more burdened in the NAH condition than in the AH condition. The pleasure level was significantly higher in the AH condition than in the NAH condition. Conclusion: The results showed that also adjusting the position of the waist belt when adjusting the shoulder stabilizer, which is mainly used for the neck and shoulders, has a significant positive effect on the subjective burden on the upper body and parasympathetic nervous system activity after hiking.
文摘BACKGROUND The accuracy of blind intra-articular injections in the shoulder is rather low.Inaccurate injections tend to lead to poorer treatment outcomes.The“Delaware posterior bone touch technique”has shown higher accuracy in young,slender,healthy volunteers than the classical“Cyriax technique”.AIM To investigate whether the Delaware technique would also be more accurate in older patients with capsulitis.METHODS We analyzed the files of 100 consecutive patients with capsulitis who were treated with an intra-articular injection containing a mixture of triamcinolone,lidocaine,and air.After the injection,the shoulder was moved to determine whether a squishing sound could be produced.The squishing sound was interpreted as an accurate injection.The scores with the new Delaware technique were compared against those with the Cyriax technique in a previous study.RESULTS Squishing was heard after 87%of the injections.This was 13%(10%points)more than the 77%in the previous study(P=0.004).CONCLUSION The Delaware technique was significantly more accurate than the Cyriax technique also in middle aged patients with capsulitis.We hypothesize that the difference is caused by a lower risk that a part of the opening of the needle is still outside the capsule.
文摘BACKGROUND Shoulder arthroscopy is commonly used for the repair of glenohumeral ligament avulsions or tendon tears.The success of the operation depends on the ability of the ligaments or rotator cuff tendon to heal to their original attachment site.Soft tissue healing can be evaluated with imaging methods or alternatively with second-look arthroscopy.AIM To investigate shoulder tendon and capsule healing after arthroscopic rotator cuff and instability repair using second-look arthroscopy.METHODS In this study,24 adult patients with rotator cuff tears(13 patients)or anterior shoulder instability(11 patients)were included.All patients were initially subjected to arthroscopic repair using suture anchors and were re-evaluated with second-look arthroscopy for reasons not related to the original pathology.The second operation was performed in 8 patients due to mild but persistent pain or stiffness,in 3 patients for recalcitrant stiffness,in 5 patients for secondary biceps tenotomy,in 6 patients for persistent acromioclavicular joint pain and in 2 patients for suture anchor prominence causing shoulder grinding.Soft tissue healing was evaluated visually and by probing,whereas clinical outcomes were evaluated using the University of California–Los Angeles(UCLA)and Rowe rating scales.RESULTS In almost all patients,complete soft tissue healing occurred at the site of tissue reattachment,either on the glenoid articular surface or the greater humeral tuberosity.The strongest repair,as confirmed by probe palpation,was encountered at the site of suture passage through the soft tissue.All suture material was covered with bursal synovial tissue,with no cases of knot impingement or cartilage fraying.The mean preoperative and postoperative UCLA scores for rotator cuff repair patients were 1354±3205 and 2931±2898,respectively(P<0.001),whereas for shoulder instability patients,the mean Rowe scores preoperatively and postoperatively were 2591±1338 and 9272±754,respectively(P<0.001).The use of bioabsorbable implants did not cause synovitis or other tissue reactions.CONCLUSION Soft tissue healing in the shoulder is successful and strongest at the site of suture anchor placement.
文摘Sickle cell disease(SCD)is a genetic disorder characterized by chronic hemolysis and vaso-occlusive crises(VOCs),leading to musculoskeletal complications that significantly affect quality of life.Among these,shoulder complications are a concern,with humeral head avascular necrosis(AVN)being the second most common site of involvement after the femoral head.Other shoulder pathologies,including osteomyelitis and septic arthritis,further contribute to morbidity.However,these conditions remain underdiagnosed and understudied,often due to overlapping symptoms with VOC-related bone infarctions.Imaging,particularly magnetic resonance imaging,is crucial for early diagnosis and accurate differentiation.Management strategies range from conservative pain control to surgical interventions,including core decompression for early-stage AVN and arthroplasty for advanced joint destruction.Surgical outcomes in SCD,however,remain inconsistent due to higher complication rates and a lack of standardized guidelines.Despite advancements in diagnosis and treatment,shoulder pathology in SCD remains an area of limited research.This review highlights the need for larger,long-term studies with a homogeneous etiology to support and refine current treatment strategies and improve patient outcomes.
文摘BACKGROUND Posterior shoulder dislocation is a rare injury.It accounts for only 1%-4%of all shoulder dislocation cases.However,this injury is often underdiagnosed.Massive rotator cuff tears associated with posterior shoulder dislocation are exceptionally rare.Early diagnosis and surgical management are crucial for restoring shoulder function and preventing long-term disability.CASE SUMMARY A 60-year-old male with no previous shoulder injuries presented to our hospital with severe right shoulder pain and immobility after a motorcycle accident.He reported that he braced his fall with his right hand.Initial imaging examination revealed posterior shoulder dislocation with minimal glenoid bone loss.Six days after the injury,the patient exhibited pseudoparalysis and active forward flexion limited to 10°.Two weeks after the injury,magnetic resonance imaging revealed complete tears of the supraspinatus,infraspinatus,and subscapularis muscles as well as dislocation of the long head of the biceps tendon.Arthroscopic rotator cuff repair was performed 6 weeks after injury.The tendon quality was acceptable with minimal fatty infiltration.At the 12-month surgical follow-up,the patient had recovered full strength and complete range of motion.CONCLUSION Early diagnosis and tailored repair of massive rotator cuff tears after dislocation are crucial for restoring shoulder function in older patients.
基金supported in part by the Technology Innovation Program(20017345)funded by the Ministry of Trade,Industry and Energy(MOTIE),Republic of Korea.
文摘This paper presents a novel rehabilitation robot designed to address the challenges of Passive Range of Motion(PROM)exercises for frozen shoulder patients by integrating advanced scapulohumeral rhythm stabilization.Frozen shoulder is characterized by limited glenohumeral motion and disrupted scapulohumeral rhythm,with therapist-assisted interventions being highly effective for restoring normal shoulder function.While existing robotic solutions replicate natural shoulder biomechanics,they lack the ability to stabilize compensatory movements,such as shoulder shrugging,which are critical for effective rehabilitation.Our proposed device features a 6 Degrees of Freedom(DoF)mechanism,including 5 DoF for shoulder motion and an innovative 1 DoF Joint press for scapular stabilization.The robot employs a personalized two-phase operation:recording normal shoulder movement patterns from the unaffected side and applying them to guide the affected side.Experimental results demonstrated the robot’s ability to replicate recorded motion patterns with high precision,with Root Mean Square Error(RMSE)values consistently below 1 degree.In simulated frozen shoulder conditions,the robot effectively suppressed scapular elevation,delaying the onset of compensatory movements and guiding the affected shoulder to move more closely in alignment with normal shoulder motion,particularly during arm elevation movements such as abduction and flexion.These findings confirm the robot’s potential as a rehabilitation tool capable of automating PROM exercises while correcting compensatory movements.The system provides a foundation for advanced,personalized rehabilitation for patients with frozen shoulders.
文摘A frozen shoulder is a common cause of shoulder pain and stiffness.The etiology and pathology of frozen shoulders is not fully understood yet.Frozen shoulderis characterized by a decrease in intra-articular volume and capsular compliance.This can lead to significant limitations in daily life.The majority of the patients can be treated conservatively,with functional recovery to be expected in two to three years.However,if conservative treatment fails,manipulation under anaesthesia and arthroscopic capsular release can both be considered as appropriate treatments.Manipulation is a traditionally well-established technique but in recent years it seems that arthroscopic capsular release has gained popularity.Manipulation is a relative time efficient and technically low-demanding procedure in which the glenohumeral joint is forced into different directions under general anaesthesia to release the capsular contracture,thereby increasing the range of motion of the joint.In arthroscopic capsular release the glenohumeral capsule can be released in a more controlled manner under direct vision.There are no prospective comparative trials available to display superiority of one procedure over the other.In addition,the optimal timing of both these interventions still has to be determined.An overview of the literature concerning this topic and a description of both procedures with its own advantages and disadvantages is provided.
文摘BACKGROUND Many patients prioritize the ability to return to work(RTW)after shoulder replacement surgeries such as total shoulder arthroplasty(TSA),reverse TSA(rTSA),and shoulder hemiarthroplasty(HA).Due to satisfactory clinical and functional long-term outcomes,the number of shoulder replacements performed will continue to rise into this next decade.With younger individuals who compose a significant amount of the workforce receiving shoulder replacements,patients will begin to place a higher priority on their ability to RTW following shoulder arthroplasty.AIM To summarize RTW outcomes following TSA,rTSA,and HA,and analyze the effects of workers’compensation status on RTW rates and ability.METHODS This systematic review and analysis was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.A literature search regarding RTW following shoulder arthroplasty was performed using four databases(PubMed,Scopus,Embase,and Cochrane Library),and the Reference Citation Analysis(https://www.referencecitationanalysis.com/).All studies in English relevant to shoulder arthroplasty and RTW through January 2021 that had a level of evidence I to IV were included.Nonclinical studies,literature reviews,case reports,and those not reporting on RTW after shoulder arthroplasty were excluded.RESULTS The majority of patients undergoing TSA,rTSA,or HA were able to RTW betweenone to four months,depending on work demand stratification.While sedentary or light demand jobs generally have higher rates of RTW,moderate or heavy demand jobs tend to have poorer rates of return.The rates of RTW following TSA(71%-93%)were consistently higher than those reported for HA(69%-82%)and rTSA(56%-65%).Furthermore,workers’compensation status negatively influenced clinical outcomes following shoulder arthroplasty.Through a pooled means analysis,we proposed guidelines for the average time to RTW after TSA,rTSA,and HA.For TSA,rTSA,and HA,the average time to RTW regardless of work demand stratification was 1.93±3.74 mo,2.3±2.4 mo,and 2.29±3.66 mo,respectively.CONCLUSION The majority of patients are able to RTW following shoulder arthroplasty.Understanding outcomes for rates of RTW following shoulder arthroplasty would assist in managing expectations in clinical practice.
文摘Objective To assess the efficacy and possible adverse effects of acupuncture on frozen shoulder. Methods Based on the key words, i.e. acupuncture, electroacupuncture, acupuncture-moxibustion, frozen shoulder, adhesive capsulitis, shoulder disorders etc., the Chinese databases were retrieved, including Oochrane Musculoskeleta Group, Oochrane Controlled Trials Register, Oochrane Complementary Medicine Field, and the central database of the Oochrane Library as well as MEDLINE, EMBASE and Chinese Biomedical CD （OBM-disc）. 20 Chinese medical journals and relevant academic conference proceedings have been searched manually. The reference lists of identified documents were checked as the supplementary retrieval. Results 6 randomized controlled trials on frozen shoulder with acupuncture and electroacupuncture were included, indicating quite advanced study quality. There were 34 to 257 participants in the trials, 668 in total. The total OR of CMS/OSA was OR 3.49 （95 % CI - 2.64 to 9.63）, the total OR of VAS was OR - 1.24 （95% CI -3.50 to 1.01）, the total OR of ROM was OR 35.70 （95% CI 22.91 to 48.49）; the total OR of MELLE was OR 4.30 （95% OI 2.32 to 7.98）. Conclusion It is shown in the present limited inclusive trials on frozen shoulder that acupuncture is the safe therapy and effective on improving the global function, relieving pain, and improving the range of motion of shoulder. All the therapeutic effects of acupuncture are superior to those in control group. However, much more high quality trials are required to provide much stronger evidence. Additionally, much more evidences on validity of frozen shoulder with other assessing indexes involved are required in the treatment with acupuncture.
基金supported by the Qinglan Engineering of Higher Institutes Foundation for Outstanding Young Teachers of Jiangsu Province in China
文摘We selected 106 hemiplegic patients with shoulder pain hospitalized after stroke from three hospi- tals in Nanjing, China between February 2007 and January 2012. All patients had complete clinical data sets and accounted for 45.5% of the inpatients because of stroke. Results showed that the number of patients with hemiplegic shoulder pain post stroke increased yearly, attacking mainly males 50-69 years of age. Of 106 patients, there were 60 cases （56.6%） of adhesive capsulitis, 19 （17.9%） of shoulder subluxation, 14 （13.2%） of complex regional pain syndrome, and 13 （12.6%） of central pain. The main symptoms were shoulder pain （100%）, limit of shoulder mobility （98.1%）, and adhesion of the scapula （56.6%）. MRI of the shoulder showed tendon and ligament lesions （57.1%） and rotator cuff tear （38.1%）. 53.8% of central pain was related to the thalamus, in addition to the basal ganglia, brain stem, and cerebellopontine angle. Shoulder pain, upper limb motor function, and function independence were significantly improved after comprehensive rehabilitation. In par- ticular, electroacupuncture based on basic physical therapy exhibited efficacy on shoulder subluxa- tion and complex regional pain syndrome. Multiple linear regression results showed a negative re- lationship of efficacy of pain management with the attack period of shoulder pain, involvement of the posterior limb of the internal capsule, and duration between onset and rehabilitation treatment, but a positive correlation with pain-related education, pain regression period, and pain diagnosis.
文摘Objective To probe into therapeutic effect of acupuncture at Tiānzōng（天宗 ST 11） with Canggui Tanxue method on periarthritis of shoulder.Methods Sixty cases of periarthritis of shoulder were treated by acupuncture at Tiānzōng（天宗 SI 11） with Canggui Tanxue method.The treatment was given once each day,and the needle was retained for 20 min,5 treatments constituting one course.After 3 courses,therapeutic effects were observed.Results Thirty-six cases were cured,15 cases were markedly effective,8 cases were effective and one case was ineffective,with a total effective rate of 98.3%（59/60）.Conclusion Acupuncture at Tiānzōng（天宗 SI 11） with Canggui Tanxue method has an obvious therapeutic effect on periarthritis of shoulder.
基金Supported by key project of Zhejiang Administra on of Tradi onal Chinese Medicine: 2007 ZA 011
文摘Objective To explore better therapies for the treatment of frozen shoulder. Methods One hundred and seventy-four cases were divided into a filiform needle group （56 cases）, an electroacupuncture group （57 cases） and a warming needle group （61 cases） according to the randomized, controlled and single-blind study principles. Jiānqián （肩前 Extra）, Jiānyú （肩髃 LI 15）, Jiānliáo （肩髎 TE 14）, Nàoshū （臑俞 SI 10）, Wàiguān （外关 TE 5）, Hégǔ （合谷 LI 4） were used in all three groups but treated with filiform needle, electroacupuncture and warming needle technique respectively. The needles were retained for 30 min. It was given once every other day and 5 times constituted as one course. Pain indices and activity degree of shoulders were measured and recorded before and after treatment every time. Results The total effective rate was 93.0% （53/57） in the electroacupuncture group and 95.1% （58/61） in the warming needle group, both superior to that of 78.6% （44/56） in the filiform needle group （both P〈0.01）, but there was no significant difference between electroacupuncture group and warming needle group （P〉0.05）. After one course of treatment, the decline indices of shoulder pain of electroacupuncture group （4.28±0.22） and warming needle group （3.74±0.17） were both significantly greater than that of filiform needle group （2.78±0.18）（both P〈0.01）. And the decline indices of electroacupuncture group was also greater than that of warming needle group （P〈0.05）. The improvements of shoulder activity degree of warming needle group （76.92±5.53） and electroacupuncture group （60.37±3.80） were both greater than that of filiform needle group （42.50±3.67） （both P〈0.01）. And shoulder activity degree of warming needle group was also greater than that of electroacupuncture group （P〈0.01）. After one course of treatment, improvement of shoulder activity degree and decline indices of shoulder pain in these three groups were better than that after the first time treatment （all P〈0.01）. Conclusion All these three acupuncture therapies can achieve good therapeutic effects for frozen shoulder. The therapeutic effects of electroacupuncture and warming needle groups are superior to that of filiform needle group. All these three therapies could significantly reduce patients’ pain and improve their shoulder activity degree. The analgesic effect of electroacupuncture is the best, and the shoulder activity degree improved by warming needle is the best. The improvement of clinical therapeutic effect mainly depends on the therapy and the treatment times when the same acupoints are selected and the condition of illness are similar.
文摘Objective To compare differences in therapeutic effects between acupuncture accelerating qi-flow along meridians （AQF） and conventional acupuncture （CA） in treating periarthritis of shoulder to find better acupuncture methods. Methods Sixty-four patients were randomly divided into two groups： group AQF, and group CA with 32 cases in each group. Jiānyú （肩髃 LI 15）, Jiānliáo （肩髎 TE 14）, Jiānzhēn （肩贞 SI 9）, Bìnào （臂臑 LI 14）, Qūchí （曲池 LI 11） and Wàiguān （外关 TE 5） on the affected side were used in both groups, and the two acupuncture methods were respectively used in the two groups for consecutive 2 courses. Pain and moving functions of shoulder and ability in daily life （ADL） were used as indices for evaluating therapeutic effects. Results The total effective rate was 96.9% （31/32） and 81.3% （26/32） in group AQF and group CA, respectively, showing superiority of AQF to CA （P〈0.05）. Scores reflecting pain and moving functions of shoulder and ADL were all improved after treatment in both groups （all P〈0.05）, and the improvement in group AQF was more obvious than those in group CA （all P〈0.05）. Conclusion In treating periarthritis of shoulder, the acupuncture accelerating qi-flow along meridians was better than conventional acupuncture in alleviating pain of the shoulder, improving its moving function and elevating abilities in daily life.
文摘Acute traumatic injuries to the glenohumeral articulation are common.The types of injuries depend on age,muscle strength,bone density,and biomechanics of the traumatic event.Understanding the different mechanisms of trauma and how they affect the functional anatomical structures of the shoulder joint is crucial for the treatment of these lesions.Therefore,when clinicians have knowledge of these mechanisms they can accurately diagnose and treat shoulder pathology and predict distinct injury patterns.Here,we have described the fundamentals of the mechanisms of injury of the glenohumeral dislocation,dislocation with fracture of the humeral head,and the proximal humerus fracture.We have focused on common injury mechanisms and the correlation with radiological diagnostics.Radiological and laboratory findings of distinct types of injury were also discussed.
基金Shandong Province Traditional Chinese Medicine Science and Technology Development Plan Project Task Document(2017-2018).No.(2017-500).
文摘Objective:To investigate the clinical effects of electroacupuncture combined with extracorporeal shock wave in the treatment of periarthritis of shoulder.Methods:136 patients with periarthritis of shoulder admitted to our hospital from September 2018 to September 2019 were randomly divided into two groups by double-blind method.68 patients in the control group were treated with extracorporeal shock wave;68 patients in the observation group were treated with electroacupuncture combined with extracorporeal shock wave.The shoulder joint pain,joint function and activities of daily living were compared between the two groups.Results:The VAS score of shoulder joint pain in the observation group after treatment(1.92±0.24)was lower than that in the control group(3.51±0.32),and the UCLA score of shoulder joint function(31.28±1.96)was higher than that of the control group(27.42±2.36),the differences were statistically significant(P<0.05).After treatment,the active degree of forward flexion and extension of shoulder joint in the observation group was higher than those of the control group,and the activities of daily living was higher than that of the control group,with statistically significant differences(P<0.05)Conclusion:Electroacupuncture combined with extracorporeal shock wave treatment for periarthritis of shoulder has achieved ideal effects,safety and non-invasiveness,and can quickly restore the functions of shoulder joints.
