The Effects of Pain and Disability Resulting from Shoulder Pathologies on Balance and Mobility

Yıl 2024, , 314 - 320, 28.06.2024

Güzin Kaya Aytutuldu , Buket Vural , Eylül Pınar Kısa , Büşra Budak , Teoman Aydın

https://doi.org/10.34087/cbusbed.1326326

Öz

Giriş ve Amaç: Omuz patolojilerinden kaynaklanan ağrı ve özürlülüğün denge ve mobilite üzerine etkisini araştırmaktı.
Gereç ve Yöntemler: Bu çalışma kesitsel tasarımlı bir çalışma olup, omuz sıkışma sendromu, rotator manşet yırtığı veya onarımı veya donuk omuz tanısı alan kırk hasta (40-65 yaş) ile yürütüldü. üst ekstremite omuzuyla ilgili. Omuz ağrısı ve fonksiyonelliği, Omuz Ağrısı ve Dizabilite İndeksi (SPADI) kullanılarak değerlendirildi. Statik denge, hastanın sağ ve sol ekstremitelerinde tek ayak üzerinde durma testi ile dengede kalma süresi ölçülerek değerlendirildi. Alt ekstremite fonksiyonel kuvvetinin ve fonksiyonel mobilitenin değerlendirilmesi için beş kez otur-kalk testi kullanıldı. Çalışmamızda hastaların yürüme ve denge durumları için Tinetti Denge ve Yürüme Testi kullanıldı.
Bulgular: Bu çalışmada hastaların %22,5'inde omuz sıkışma sendromu, %57,5'inde rotator manşet patolojisi, %20'sinde donuk omuz sendromu vardı. Tanılarına göre gruplandırıldığında, SPADI toplam ve alt puanları, beş kez otur-kalk testi, tek ayak üzerinde durma testi ve Tinetti toplam ve alt puanları açısından fark bulunmadı (p>0,05). Donuk omuzu olan hastalarda özürlülük alt puanı daha yüksek bulunsa da bu bulgu istatistiksel olarak anlamlı bulunmadı. SPADI'nin ortalama yeti yitimi alt puanı ile Beş kez otur-kalk testi arasında anlamlı bir ilişki vardı. (p<0.05) Tinetti toplam ve alt puan ortalamaları ile Beş Defa Oturup Kalkma Testi arasında anlamlı bir korelasyon bulunurken, Tinetti Testi toplam ve alt puanları ile Tek Ayak Üzerinde Durma Testi puanları arasında anlamlı bir korelasyon vardı (p<0.01).
Sonuç: Omuz problemlerine bağlı özürlülük mobiliteyi etkilemekte ve mobilitedeki azalma denge problemleriyle ilişkili görünmektedir. Bu popülasyonu denge problemlerinden korumak için omuz patolojisi olan hastaların rehabilitasyon programlarına denge ve postüral kontrol yaklaşımlarının eklenmesi önerilmektedir.

Anahtar Kelimeler: Ağrı, Denge, Özürlülük, Mobilite, Omuz patolojisi.

Objectives: The aim of this study to investigate the relationship between pain and disability in shoulder pathologies on balance and mobility.
Materials and Methods: The present study was a cross-sectional design study and was conducted with forty participants (between 40 and 65 years) with a pathology. related to the upper extremity shoulder such as impingement, rotator cuff tear or repair, frozen shoulder. Shoulder pain and functionality were evaluated using the Shoulder Pain and Disability Index (SPADI). Static balance was evaluated by measuring the duration of standing balance on the patient's right and left extremities with single leg stance test. Five times sit to stand test was used for assessment of the functional strength of the lower extremity and functional mobility. Tinetti Balance and Gait Test was used for gait and balance condition of patients in our study.
Results: 22.5% of the patients had shoulder impingement syndrome, 57.5% had rotator cuff pathology, 20% had frozen shoulder syndrome in this study. No differences were found between three subgroups according to diagnosis in terms of SPADI total and sub scores, five times sit to stand test, single leg stance test and Tinetti total and sub scores (p>0.05). Although the disability sub score was found higher in patients had frozen shoulder this finding was not found statistically significant. There was a significant correlation between the mean disability sub score of SPADI and Five times sit to stand test. (p<0.05) There was also a significant correlation between the mean Tinetti total and sub scores and Five Times Sit to Stand Test, while Tinetti Test total and sub scores was significantly correlated with the Single Leg Stance Test scores (p<0.01).
Conclusion: Disabilities due to the shoulder problems affects mobility and decrease in mobility seems to be associated with balance problems. Balance and postural control approaches to the rehabilitation programs of patients with shoulder pathology can be added to protect this population against balance problems.

Keywords: Pain, Balance, Disability, Mobility, Shoulder pathology.

Anahtar Kelimeler

Pain, Balance, Disability, Mobility, Shoulder pathology

The Effects of Pain and Disability Resulting from Shoulder Pathologies on Balance and Mobility

Öz

Objectives: The aim of this study to investigate the relationship between pain and disability in shoulder pathologies on balance and mobility.
Materials and Methods: The present study was a cross-sectional design study and was conducted with forty participants (between 40 and 65 years) with a pathology. related to the upper extremity shoulder such as impingement, rotator cuff tear or repair, frozen shoulder. Shoulder pain and functionality were evaluated using the Shoulder Pain and Disability Index (SPADI). Static balance was evaluated by measuring the duration of standing balance on the patient's right and left extremities with single leg stance test. Five times sit to stand test was used for assessment of the functional strength of the lower extremity and functional mobility. Tinetti Balance and Gait Test was used for gait and balance condition of patients in our study.
Results: 22.5% of the patients had shoulder impingement syndrome, 57.5% had rotator cuff pathology, 20% had frozen shoulder syndrome in this study. No differences were found between three subgroups according to diagnosis in terms of SPADI total and sub scores, five times sit to stand test, single leg stance test and Tinetti total and sub scores (p>0.05). Although the disability sub score was found higher in patients had frozen shoulder this finding was not found statistically significant. There was a significant correlation between the mean disability sub score of SPADI and Five times sit to stand test. (p<0.05) There was also a significant correlation between the mean Tinetti total and sub scores and Five Times Sit to Stand Test, while Tinetti Test total and sub scores was significantly correlated with the Single Leg Stance Test scores (p<0.01).
Conclusion: Disabilities due to the shoulder problems affects mobility and decrease in mobility seems to be associated with balance problems. Balance and postural control approaches to the rehabilitation programs of patients with shoulder pathology can be added to protect this population against balance problems.

Anahtar Kelimeler

Pain, Balance, Disability, Mobility, Shoulder pathology

Kaynakça

• 1. Pope, D.P., Croft, P.R., Pritchard, C.M., Macfarlane, G.J., Silman, A.J. The frequency of restricted range of movement in individuals with self-reported shoulder pain: Results from a population based survey. Br J Rheumatol, 1996; 35,1137-1141.
• 2. Andrews, J.R. Diagnosis and treatment of chronic painful shoulder: review of nonsurgical interventions. Arthroscopy, 2005, 21,333-47.
• 3. Chester R, Shepstone L, Daniell H, Sweeting D, Lewis J, Jerosch-Herold C. Predicting response to physiotherapy treatment for musculoskeletal shoulder pain: a systematic review. BMC Musculoskelet Disord. 2013;14:203–19.
• 4. Luque-Suarez A, Rondon-Ramos A, Fernandez-Sanchez M, Roach KE, Morales-Asencio JM. Spanish version of SPADI (shoulder pain and disability index) in musculoskeletal shoulder pain: a new 10-items version after confirmatory factor analysis. Health Qual Life Outcomes. 2016;14:32–40.
• 5. Akalın, E., El, Ö., Bircan, Ç., Gülbahar, S., Özkan, M., Bacakoğlu, K., Yılmaz, S., Kaner, B., Şahin, E., Ekin, A., Öncel, S. Omuz Problemi Olan Hastaların Genel Özellikleri, Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi, 2006; 20(2),75-78.
• 6. Lewis, JS. Rotator cuff tendinopathy/subacromial impingement syndrome: is it time for a new method of assessment?. British journal of sports medicine, 2009; 43(4), 259-264.
• 7. Whittle, S., & Buchbinder, R. Rotator cuff disease. Annals of internal medicine, 2015; 162(1), ITC1-ITC16.
• 8. Baierle T, Kromer T, Petermann C, Magosch P, Luomajoki H. Balance ability and postural stability among patients with painful shoulder disorders and healthy controls. BMC Musculoskelet Disord. 2013;14:282–91.
• 9. Sciascia A, Cromwell R. Kinetic chain rehabilitation: a theoretical framework. Rehabil Res Pract. 2012;2012:853037.
• 10. Kibler, W.B., Press, J., Sciascia, A. The role of core stability in athletic function. Am J Sports Med, 2006; 36,189–198.
• 11. Meyers, J.B., Wassinger, C.A., Lephart, S.M. Sensorimotor contribution to shoulder stability:effect of injury and rehabilitation. Man Ther, 2006; 3,197–201.
• 12. Hansen M, Dieckmann B, Jensen K, Jakobsen B. The reliability of balance tests performed on the kinesthetic ability trainer (KAT 2000) Knee Surg Sports Traumatol Arthrosc. 2000;8:180–5.
• 13. Horlings CG, Van Engelen BG, Allum JH, Bloem BR. A weak balance: the contribution of muscle weakness to postural instability and falls. Nat Rev Neurol. 2008;4:504–15.
• 14. Paillard T, Noé F. Techniques and methods for testing the postural function in healthy and pathological subjects. Biomed Res Int. 2015;2015:891390.
• 15. Treede RD, Apkarian AV, Bromm B, Greenspan JD, Lenz FA. Cortical representation of pain: functional characterization of nociceptive areas near the lateral sulcus. Pain. 2000;87:113–9.
• 16. Ruhe A, Fejer R, Walker B. Pain relief is associated with decreasing postural sway in patients with non-specific low back pain. BMC Musculoskelet Disord. 2012;13:39.
• 17. Shumway-Cook, A., Woollacott, M. (2000). Attentional demands and postural control: the effect of sensory context. J Gerontol Ser A Biol Sci Med Sci, 1,M10–M16.
• 18. Roe, Y., Soberg, H. L., Bautz-Holter, E., & Ostensjo, S. (2013). A systematic review of measures of shoulder pain and functioning using the International classification of functioning, disability and health (ICF). BMC musculoskeletal disorders, 14, 1-12.
• 19. Doyle, T.L., Dugan, E.L., Humphries, B., Newton, R.U. (2004). Discriminating between elderly and young using a fractal dimension analysis of centre of pressure. Intern J Med Sci, 1,11–20.
• 3. 20.Lihavainen, K., Sipilä, S., Rantanen, T., Sihvonen, S., Sulkava, R., Hartikainen, S. (2010). Contribution of musculoskeletal pain to postural balance in community-dwelling people aged 75 years and older. J Gerontol A Biol Sci Med Sci, 65,990-6.
• 20. Cohen, J. Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, 1998;NJ: Lawrence Earlbaum Associates
• 21. McClure, P., Michener, L. Measures of Adult Shoulder Function The American Shoulder and Elbow Surgeons Standardized Shoulder Form Patient Self-report Section (ASES), Disabilities of the Arm, Shoulder, and Hand (DASH), Shoulder Disability Questionnaire, Shoulder Pain and Disability Index (SPADI), and Simple Shoulder Test. Arthritis Rheum; 2003, 49(5S): S50-S58.
• 22. Williams,J.W., Holleman, D.R., Simel, D.L. Measuring shoulder function with the Shoulder Pain and Disability Index. J Rheumatol; 1995, 22: 727-732.
• 23. Goldberg A, Casby A ve Wasielewski M. Minimum detectable change for single-leg stance-time in older adults. Gait & posture. 2011;33(4): 737-739.
• 24. Bruno J. Vellas J Am Geriatr Soc. 1997 Jun;45(6):735-8
• 25. Bohannon RW. Reference values for the five-repetition sit-to-stand test: a descriptive meta-analysis of data from elders. Perceptual and Motor Skills. 2006;103(1): 215-222.
• 26. Whitney SL, Wrisley DM, Marchetti GF, Gee MA, Redfern MS, Furman JM. Clinical measurement of sit-to-stand performance in people with balance disorders: validity of data for the Five-Times-Sit-to-Stand Test. Phys Ther. 2005;85(10):1034-45.
• 27. Mong, Y., Teo, T. W., Archives of Physical Medicine and Rehabilitation. 2010; 91(3): 407-413.
• 28. Raîche M, Hébert R, Prince F ve Corriveau H. Screening older adults at risk of falling with the Tinetti balance scale. The Lancet. 2000;356(9234): 1001-1002.
• 29. Guskiewicz, Kevin M., Scott E. Ross, and Stephen W. Marshall. "Postural stability and neuropsychological deficits after concussion in collegiate athletes." Journal of athletic training 36.3 2001: 263.
• 30. Khalaj N, Osman NAA, Mokhtar AH, Mehdikhani M, Abas WABW. Balance and risk of fall in individuals with bilateral mild and moderate knee osteoarthritis. PLoS One. 2014;9:e92270.
• 31. Eker Y, Belgen Kaygısız B. The effect of pain severity on balance, postural stability and fall risk in patients with shoulder pathologies. Arch Med Sci. 2019 Apr 19;17(2):390-396. doi: 10.5114/aoms.2020.94491. PMID: 33747275;
• 32. Park MH, Yu JH, Hong JH, Kim JS, Jung SW, Lee DY. Effect of core muscle thickness and static or dynamic balance on prone bridge exercise with sling by shoulder joint angle in healthy adults. J Phys Ther Sci. 2016;28(3):945-50.
• 33. Ko, JY & Wang, FS. Rotator cuff lesions with shoulder stiffness: updated pathomechanisms and management. Chang Gung Med J, 2011, 34(4), 331-340.
• 34. Braman, J. P., Zhao, K. D., Lawrence, R. L., Harrison, A. K., & Ludewig, PM. Shoulder impingement revisited: evolution of diagnostic understanding in orthopedic surgery and physical therapy. Medical & biological engineering & computing, 2014; 52, 211-219.
• 35. McClure, P. W., Michener, L. A., & Karduna, A. R. Shoulder function and 3-dimensional scapular kinematics in people with and without shoulder impingement syndrome. Physical therapy, 2006; 86(8), 1075-1090.
• 36. Baierle T, Kromer T, Petermann C, Magosch P, Luomajoki H. Balance ability and postural stability among patients with painful shoulder disorders and healthy controls. BMC Musculoskelet Disord. 2013;14:282–91.
• 37. Myers JB, Wassinger CA, Lephart SM. Sensorimotor contribution to shoulder stability: effect of injury and rehabilitation. Man Ther 2006; 11(3): 197 - 201. doi:10.1016/j.math.2006.04.002
• 38. Treede RD, Apkarian AV, Bromm B, Greenspan JD, Lenz FA. Cortical representation of pain: functional characterization of nociceptive areas near the lateral sulcus. Pain 2000; 87(2): 113 - 119. doi:10.1016/s0304-3959(00)00350-x
• 39. Jaggi A, Lambert S: Rehabilitation for shoulder instability. Br J Sports Med. 2009, 44: 333-340.
• 40. Rubin BD, Kibler WB: Fundamental principles of shoulder rehabilitation. Conservative to postoperative management. Arthroscopy: Journal of arthroscopic and related surgery. 2002, 9: 29-39.