In many instances , no or minimal attempts to screen were undertaken or reported .
Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain .
Assessment of dynamic humeral centering in shoulder pain with impingement syndrome: a randomised clinical trial
Objectives Treatment for degenerative rotator cuff disease of the shoulder includes physiotherapy . Dynamic humeral centering ( DHC ) aims at preventing subacromial impingement , which contributes to the disease . The goal of this study was to assess the effectiveness of DHC . Method 69 patients with shoulder pain and impingement syndrome were prospect ively included in a single-centre r and omised trial with a 12-month follow-up . Patients and assessor were blinded to the study hypothesis and treatment , respectively . DHC and non-specific mobilisation as control were performed for 6 weeks , in 15 supervised individual outpatient sessions , and patients performed daily home exercises . The planned primary outcome was the Constant score including subscores for pain , activity , mobility and strength at 3 months . Secondary outcomes were the Constant score and subscores at 12 months , and medication use for pain at 3 and 12 months . Results The DHC group did not differ from the control group in the total Constant score at 3 months . However , the DHC group showed a higher Constant subscore for pain ( 12.2 ( SD 2.8 ) vs 9.9 ( 2.9 ) , least square means difference 2.1 , 95 % CI 0.7 to 3.5 , p=0.004 ) . At 3 months , the DHC group also showed a higher rate of no medication use ( 96.7 % vs 71 % , proportional difference 25.7 , 95 % CI 3.7 to 51.9 , p=0.012 ) . There was no other intergroup difference . Conclusions There was no difference in the total Constant score between DHC and controls . However , pain was improved at 3 months after DHC . The differences found in subscores for pain should be explored in future studies . Trial registration clinical trials.gov Identifier : NCT 01022775
In many instances , no or minimal attempts to screen were undertaken or reported .
Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain .