Comparison of Shoulder Pain Upper Extremity Function Strength and Endurance in Partial Rotator Cuff Injury

Abstract

Aim: The study aims to compare shoulder pain, functionality, range of motion (ROM), endurance, and strength between individuals with partial rotator cuff injury (PRCI) and individuals without PRCI-like symptoms. Method: The study group of 16 individuals with PRCI aged 40-60 years who were treated at Başakşehir City Hospital, and 16 individuals without PRCI were included as asymptomatic groups. Participants were assessed by Visual Analog Score (VAS), Constant Murley Score (CMS), Timed Functional Arm and Shoulder Test (TFAST), and Simple Shoulder Test (SST). The groups were compared with t-test, Mann-Whitney U, and chi-square analysis. The effect size was calculated with Cohen’s d score. Results: The study group's pain at night and during movement was 8.06 (±5.68) and 7.06 (±2.76), respectively, with all parameters adversely affected at the statistically significant and large efficacy level in the study group. The most affected parameters were CMS (p<0.001, Cohen’s d=4.41) and BOT (p<0.001, Cohen’s d=3.16). The mean shoulder flexion was 142º (p<0.001, Cohen's d= 1.76, and the abduction was 111º (p<0.001, Cohen's d= 2.68) in the study group and significantly lower than in the control group. Conclusion: In PRCI, nocturnal pain of the shoulder is more severely affected than pain during movement, and shoulder abduction is more severely affected than shoulder flexion. The study results may support clinicians in goal setting and monitoring prognosis in the rehabilitation of patients with PRCI.

Keywords

• Shoulder
• Rotator Cuff Injuries
• Pain
• Movement

Kısmi Rotator Manşet Yırtığında Omuz Ağrısı, Fonksiyonellik, Kuvvet ve Enduransın İncelenmesi

Öz

Amaç: Çalışmanın amacı, kısmi rotator manşet yaralanması (KRMY) olan bireyler ile KRMY benzeri semptomu olmayan bireyler arasında omuz ağrısı, fonksiyonellik, eklem hareket açıklığı (EHA), endurans ve kuvveti karşılaştırmaktır. Yöntem: Çalışmaya Başakşehir Şehir Hastanesi’nde tedavi gören 40-60 yaş arası KRMY’li 16 birey çalışma grubu, KRMY benzeri semptomu olmayan 16 birey asemptomatik grup olarak alındı. Katılımcılara Görsel Analog Skorlaması (GAS), Constant Murley Skoru (CMS), Zamanlı Fonksiyonel Kol ve Omuz Testi (ZFKOT) ve Basit Omuz Testi (BOT), uygulandı. Gruplar t testi, Mann-Whitney U ve ki-kare analiziyle karşılaştırıldı ve etki büyüklüğü Cohen’s d skoru ile hesaplandı. Bulgular: Çalışma grubunun gece ve hareket sırasındaki ağrısı sırasıyla 8,06±5,68 ve 7,06±2,76 olup bütün parametreler çalışma grubunda istatistiksel olarak anlamlı ve büyük etki düzeyinde olumsuz etkilenmiştir. En yüksek etkilenim gösteren parametreler CMS (p<0,001; Cohen’s d=4,41) ve BOT (p=0,001; Cohen’s d=3,16) parametreleriydi. Çalışma grubunda ortalama omuz fleksiyonu 142º (p<0,001; Cohen’s d=1,76), abdüksiyonu 111º’dir (p<0,001; Cohen’s d=2,68) ve anlamlı bir şekilde kontrol grubuna göre düşüktür. Sonuç: KRMY’de omuzun gece ağrısı hareket sırasındaki ağrıya göre, omuz abdüksiyonu ise omuz fleksiyonuna göre daha şiddetli etkilenmektedir. Çalışma sonuçları klinisyenleri KRMY hastalarının rehabilitasyonunda hedef belirleme ve klinik seyir takibinde destekleyebilir.

Anahtar Kelimeler

• Omuz
• Rotator Manşet Yaralanmaları
• Ağrı
• Hareket

Kaynakça

1. 1. Shah KM, Baker T, Dingle A, et al. Early development and reliability of the timed functional arm and shoulder test. J Orthop Sports Phys Ther. 2017;47(6):420-431.
2. 2. Reilly P, Macleod I, Macfarlane R, Windley J, Emery RJH. Dead men and radiologists don’t lie: a review of cadaveric and radiological studies of rotator cuff tear prevalence. Ann R Coll Surg Engl. 2006;88(2):116-121.
3. 3. Colomb-Lippa D, Klingler AM. Rotator cuff disease. JAAPA. 2009;22(9):52-53.
4. 4. Henseler JF, Kolk A, van der Zwaal P, Nagels J, Vliet Vlieland TPM, Nelissen RGHH. The minimal detectable change of the Constant score in impingement, full-thickness tears, and massive rotator cuff tears. J Shoulder Elbow Surg. 2015;24(3):376-381.
5. 5. Pandey V, Jaap Willems W. Rotator cuff tear: A detailed update. Asia Pac J Sports Med Arthrosc Rehabil Technol. 2015;2(1):1-14.
6. 6. Shanahan EM, Sladek R. Shoulder pain at the workplace. Best Pract Res Clin Rheumatol. 2011;25(1):59-68.
7. 7. Yoon SH, Lee D, Li H, Kweon H, Ahn JH. Discrimination between pain and contracture in limited passive motion patients with rotator cuff tear: A STROBE-compliant cross-sectional study. Medicine. 2020;99(31):e21391.
8. 8. Maffulli N, Longo UG, Berton A, Loppini M, Denaro V. Biological factors in the pathogenesis of rotator cuff tears. Sports Med Arthrosc Rev. 2011;19(3):194-201.

9. 9. Düzgün I, Baltacı G, Atay OA. Comparison of slow and accelerated rehabilitation protocol after arthroscopic rotator cuff repair: pain and functional activity. Acta Orthop Traumatol Turc. 2011;45(1):23-33.
10. 10. Itoi E. Rotator cuff tear: physical examination and conservative treatment. J Orthop Sci. 2013;18(2):197-204.
11. 11. Oksuz C, Cesi̇m ÖB, Akel BS. Üst ekstremite yaralanması olan bireylerde kol, omuz ve el sorunları anketi (DASH) ile Lawton günlük yaşam aktiviteleri anketi arasındaki ilişkinin incelenmesi. Ergoterapi ve Rehabilitasyon Dergisi. 2017;5(3):189-196.
12. 12. Mengi A, Akif Guler M. Nocturnal pain in patients with rotator cuff related shoulder pain: A prospective study. Musculoskelet Sci Pract. 2022;59:102536.
13. 13. Takahashi K, Shitara H, Ichinose T, et al. Delayed detection of passive motion in shoulders with a rotator cuff tear. J Orthop Res. 2022;40(6):1263-1269.
14. 14. Faiz KW. VAS visual analog scale. Tidsskr Nor Laegeforen. 2014;134(3):323.
15. 15. Çelik D. Turkish version of the modified Constant-Murley score and standardized test protocol: reliability and validity. Acta Orthop Traumatol Turc. 2016;50(1):69-75.
16. 16. Ayhan Kuru C, Ünal E, Yakut Y. Turkish version of the Simple Shoulder Test: A reliability and validity study. Fizyoterapi Rehabilitasyon. 2010;21:68-74.
17. 17. Terzi D, Zeybek A. Rotator cuff syndrome and current approaches in treatment. NKTD. 2021;9(1):1-5. doi: 10.4274/nkmj.galenos.2020.788853
18. 18. Akkaya S, Büker N, Ki̇ti̇ş A, Akkaya N, Yörükoğlu AÇ. Investigation of relationship between pain, functional status and depression level in patients with rotator cuff lesions. Pamukkale Medical Journal. 2010;(2):84-89.
19. 19. Collin P, Matsumura N, Lädermann A, Denard PJ, Walch G. Relationship between massive chronic rotator cuff tear pattern and loss of active shoulder range of motion. Journal of Shoulder and Elbow Surgery. 2014;23(8):1195-1202.
20. 20. McCabe RA, Nicholas SJ, Montgomery KD, Finneran JJ, McHugh MP. The effect of rotator cuff tear size on shoulder strength and range of motion. J Orthop Sports Phys Ther. 2005;35(3):130-135.