50 YOM with Shoulder Impingement Syndrome Improves with Neuro-Rehabilitation

Field: Health Professions (Health Sciences)

Event Abstract Back to Event 50 YOM with Shoulder Impingement Syndrome Improves with Neuro-Rehabilitation Michael Schmidt1* 1 Missouri Functional Neurology and Chiropractic, LLC, United States Background: 50 YOM patient presents with right shoulder pain and a diagnosis of shoulder impingement syndrome. The impingement syndrome has been refractory to physical therapy and an MRI came back negative for any tears. He states his left hand will also fall asleep at night whereas he shakes it and the numbness/tingling will go away. He states driving, buckling pants, or lifting an object in front of him will exacerbate his right shoulder pain. Methods: Neurological testing was performed which included Btracks modified Clinical Test of Sensory Integration and Balance (mCTSIB), the Rand short form health questionnaire intake form (SF-36), and the Borg subjective pain scale. mCTSIB testing results showed patient scoring at the 5th percentile with eyes open on a firm surface, 6th percentile with eyes closed on a firm surface, 55th percentile with eyes open on a perturbed surface, and 6th percentile with eyes closed on a perturbed surface, SF-36 questionnaire scored 75th percentile on Physical Function, 100th percentile on Role Physical, 32nd percentile on Body Pain, 61st percentile on General Health, 30th percentile on Vitality, 100th percentile on Social Functioning, 100th percentile on Role Emotional, and 92nd percentile on Mental Health categories, right shoulder subjective Borg pain scale rated at a 2/10 while not moving, and 8/10 with right shoulder abduction. The bedside neurological examination revealed bilaterally rounded and internally rotated shoulders left worse, positive right head impulse testing, right end-gaze nystagmus following pursuits, decreased gain of upward eye pursuits, patient had neck movement in the direction of all eye movement testing, left arm intention tremor during finger-to-nose testing, left arm dysdiadochokinesia during rapid alternating movement testing, positive two-point localization for extinction of bilateral shoulders during cheek/shoulder testing, musculoskeletal examination revealed decreased shoulder internal rotation bilaterally, hypertonicity of scalene muscles bilaterally worse left. Treatment consisted of 6 visits in 3 weeks and included 1 left posterior canal Epley’s maneuver for non-BPPV purposes, left scalene soft tissue release, leftward microsaccades, times 2 viewing with head rightward/eyes leftward, left arm body blade exercises for rapid alternating movements. At-Home Exercises prescribed at the end of the 6 visits included left shoulder internal/external rotation and abduction isometrics and left scalene stretches. At 2 weeks post treatment visit the patient was asked to return for follow-up diagnostics. Outcome: 2 weeks follow-up diagnostics: SF-36: Physical Function at the 85th percentile, Role Physical at the 100th, Body Pain at the 84th percentile, General Health at the 67th percentile, Vitality at the 80th percentile, Social Functioning at the 100th percentile, Role Emotional at the 100th percentile, Mental Health at the 100th percentile; Btracks mCTSIB Assessment scored at the 60th percentile with eyes open on a firm surface, 18th percentile with eyes closed on a firm surface, 91st percentile with eyes open on a perturbed surface, and 19th percentile with eyes closed on a perturbed surface. Patient right shoulder subjective Borg pain scale score of 2/10 at rest and 8/10 with right shoulder abduction went to a 0/10 at rest and with all ranges of motion. Conclusion: Patient maintained above the 90th percentile with Btracks mCTSIB testing at the time of the 2-week follow-up diagnostics. There was significant improvement of the SF-36 questionnaire score especially in the Physical Function, Body Pain, and Vitality categories at 2 weeks. There was a significant improvement in patient subjective scoring of pain sensation at 2 weeks. The current case supports multimodal neurological rehabilitation as an effective treatment for the improvement of shoulder impingement syndrome. Important things to note are that rehab consisted of addressing the abnormal Neurological findings instead of “chasing the pain.” Further research needs to be conducted and investigated in this field. Keywords: Clinical Neuroscience, Neurology, Shoulder Impingement Syndrome, Neurorehabilitation, Shoulder Pain Conference: International Symposium on Clinical Neuroscience, Orlando, United States, 24 May - 26 May, 2019. Presentation Type: Poster Presentation Topic: Clinical Neuroscience Citation: Schmidt M (2019). 50 YOM with Shoulder Impingement Syndrome Improves with Neuro-Rehabilitation. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience. doi: 10.3389/conf.fneur.2019.62.00059 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 28 Mar 2019; Published Online: 27 Sep 2019. * Correspondence: Dr. Michael Schmidt, Missouri Functional Neurology and Chiropractic, LLC, Centralia, United States, mofuncneuro@gmail.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Michael Schmidt Google Michael Schmidt Google Scholar Michael Schmidt PubMed Michael Schmidt Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. 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