Treatment of shoulder pathologies based on irritability: a case series.

Study Design: Case Series. Background: Shoulder pain is a prevalent problem in health care. Traditionally, treatment is based on a pathoanatomical diagnosis determined through the use of special tests. The validity of these special tests is questionable and minimal evidence exists to support these t...

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Published in:Physiotherapy Theory & Practice Vol. 36; no. 11; pp. 1266 - 1275
Main Authors: Somerville, Kristin, Walston, Zachary, Marr, Tye, Yake, Dale
Format: case study tables/charts Journal Article
Published: Taylor & Francis Ltd Nov2020
Online Access:View this record in EBSCOhost
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      dt: Nov2020
      vid: 36
      iid: 11
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      pub: Taylor & Francis Ltd
      place: Philadelphia, Pennsylvania
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        10.1080/09593985.2019.1571136
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        atl: Treatment of shoulder pathologies based on irritability: a case series.
      aug:
        au:
          Somerville, Kristin
          Walston, Zachary
          Marr, Tye
          Yake, Dale
        affil: PT Solutions Physical Therapy, Atlanta, GA, USA
      sug:
        subj:
          Shoulder Pathology
          Shoulder Anatomy and Histology
          Shoulder Pain Rehabilitation
          Adult
          Physical Therapy Practice
          Tendons Pathology
          Adhesive Capsulitis Pathology
          Signs and Symptoms
          Office Visits
          Treatment Outcomes
          Scales
          Disability Evaluation
          Pain Measurement
          Middle Age
          Aged
          Female
          Male
          Shoulder Injuries Classification
          Shoulder Pain Classification
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Female
          Male
      ab: Study Design: Case Series. Background: Shoulder pain is a prevalent problem in health care. Traditionally, treatment is based on a pathoanatomical diagnosis determined through the use of special tests. The validity of these special tests is questionable and minimal evidence exists to support these tests to guide treatment. The purpose of this case series is to apply the principles of irritability, proposed by McClure and Michener in the Staged Approach Rehabilitation Classification, to adult patients with varying anatomical diagnoses. Case Description: Three patients diagnosed with different shoulder pathologies by referring physicians were recruited from a physical therapy clinic. Diagnoses included unspecified disorder of synovium and tendon, adhesive capsulitis, and other shoulder lesions. Patients were classified using a system based on stages of irritability. Patients received treatment based on impairments and irritability. Outcomes: Patients were treated for a total of 14–18 visits over a course of 7 to 8 weeks. Primary outcome measures included pain measured by the numeric pain rating scale (NPRS) and disability measured by FOTO (Focus on Therapeutic Outcomes). Pain was reduced to 0/10 in all cases and all patients exceeded their predicted outcome scores on FOTO. Discussion: This case series describes the use of an irritability-based classification system for treatment of adults with varying shoulder diagnoses. The positive outcomes indicate that treatment guided by irritability appeared to be beneficial for conservative treatment of three patients in a physical therapy setting. Further research, including randomized controlled trials, is needed to determine effectiveness in a larger population.
      pubtype: Academic Journal
      doctype:
        case study
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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