Electrical injuries are common phenomena in developing countries, due to inadequate safety measures followed during day-to-day electrical repairs. Workplace injuries account for 20% of these. In some severe cases, electrical injuries lead to burns, indirect fracture dislocations, speech impairments, etc. Falls due to electrical injuries leading to secondary complications are very common and, even though not very severe, they do require immediate treatment and adequate rehabilitation. A 53-year-old male suffered a shoulder injury following an electrical shock. The patient also experienced irritation and speech disturbances. Examination revealed a reduced range of shoulder joints and tightness of muscles of the shoulder complex. Physiotherapy intervention included counseling for the patient and his family members, energy conservation methods for ease in daily activities, a rehabilitation protocol, and modified music therapy. Outcome measures used to assess the progression constituted the Shoulder Pain and Disability Index (SPADI), the Tampa Scale for Kinesiophobia (TSK), and the Depression and Anxiety and Stress Scale. Rehabilitation with adjunct therapy is effective in the overall improvement of the patient\'s condition concerning their mental health as well as physical health by early strength training.

BACKGROUND: Surgical treatment of Rockwood grade V AC joint injuries remains varied. We hypothesized that the addition of a second suspensory device between the clavicle and coracoid would yield superior biomechanical results over a single device. We also hypothesized that the addition of an internal brace across the AC joint to a suspensory device would yield superior results over the suspensory device in isolation.
METHODS: A total of 24 cadaveric shoulders were dissected and randomized to four groups with four different constructs implanted: Group A: Single AC TightRope (Arthrex Inc., Naples, FL, USA) Group B: Double AC TightRope Group C: Single Knotless AC TightRope (Arthrex Inc., Naples, FL, USA) Group D: Single Knotless AC TightRope with AC InternalBrace Ligament Augmentation (Arthrex Inc., Naples, FL, USA) These were then loaded in the Robotic arm (SIMVITRO) where 250 cycles of 50N of force in the superior plane was applied. Dynamic creep, displacement, translation and stiffness were assessed.
RESULTS: Testing was successfully completed for all specimens. There were no failures due to fracture or translation of the clavicle greater than 5mm from the starting position. Reduction was maintained with a mean superior displacement of 1.7 mm (± 1.4 mm). The mean peak to peak displacement, superior and posterior translation, dynamic creep and stiffness did not differ significantly between construct groups.
CONCLUSIONS: This study did not demonstrate any significant biomechanical differences between groups in terms of displacement, translation, creep or stiffness.

BACKGROUND: Nocturnal shoulder pain is seen in patients with rotator cuff tears. The purpose of the present study was to determine whether Doppler ultrasound parameters predict the intensity of nocturnal pain in patients with rotator cuff tears.
METHODS: A total of 60 patients with rotator cuff tears were included. Doppler ultrasound parameters (peak systolic velocity in the anterior humeral circumflex artery, Doppler activity in the glenohumeral joint and subacromial space) and clinical parameters were examined. For the presence of nocturnal pain, the clinical parameters were compared with and without nocturnal pain. For the intensity of the nocturnal pain, a multivariate analysis of clinical parameters and nocturnal pain intensity was performed.
RESULTS: In all, 39 patients (65%) reported nocturnal pain, and the mean pain intensity was 47.0 (standard deviation, 26.0) on the visual analogue scale. In nocturnal pain presence analysis, Doppler activity in the subacromial space showed significant associations (p < 0.001). In nocturnal pain intensity analysis, Doppler activity in the subacromial space and diabetes showed significant associations (p < 0.001, p = 0.01, respectively).
CONCLUSIONS: Doppler activity in the subacromial space emerges as an independent factor associated with the presence and intensity of nocturnal pain in patients with rotator cuff tears. Our findings may provide a basis for further exploration and refinement of treatment strategies.

To assess the effects of the eFisioTrack monitoring system on clinical variables in patients with prescribed physiotherapy for shoulder injuries, twenty-four adult patients with shoulder orthopaedic injuries who underwent physical therapy treatment in a hospital setting participated in the study (twelve in the experimental group and twelve as controls). Clinical outcome measures were shoulder function and pain (Constant-Murley Score and Disabilities of the Arm, Shoulder, and Hand or DASH score). Each variable was measured by a blinded physiotherapist at baseline and at one month follow-up. Patients performed the prescribed exercises either supervised by the physiotherapist (control group) or in a separate room without therapist supervision (experimental group). There were no statistically significant differences between groups before treatment or at follow-up for any outcomes (p ≥ 0.05). There was a statistically significant decrease (p ≤ 0.05) of at least 10 points in both groups for the DASH score at follow-up. Differences in the total score and subjective components of the Constant-Murley were also evidenced within groups. The use of the eFisioTrack system showed similar results in clinical measures compared to those performed under the direct supervision of the physiotherapist. This approach might be suitable for providing an effective shoulder exercise program at home.

OBJECTIVE: To assess whether 5 mL would not be less effective than 10 mL when performing a suprascapular nerve block, regarding shoulder function and quality of life in primary adhesive capsulitis.
METHODS: This is a pilot study of a randomized, controlled, double-blind clinical trial conducted at a single center. Patients with AC characterized by constant pain and restricted movements in anterior elevation, 0°/90° external rotation, and internal rotation were selected. Two groups were randomly selected. In group I, a dose of 10 mL of bupivacaine was applied, while in group II, only 5 mL, in four weekly blocks. Sealed and sequentially numbered envelopes were used. The SF-36 and DASH questionnaires were applied in five moments. The t-Student test was used to compare the means, with a probability of rejecting null hypothesis of 5%.
RESULTS: There were 17 participants with primary AC, seven in group I and 10 in group II. The average age was 54.30 and 50.43 years in the 5 mL and 10 mL groups, respectively. There were no differences when the means were compared by DASH: T0 (p = 0.074); T2 (p = 0.285); T4 (p = 0.333); T8 (p = 0.392), and T12 (p = 0.453). As for the SF-36, there were sparse differences in T2 in the domains of vitality (p = 0.006) and social aspects (p = 0.036) in favor of group I, and in the general health status domain in T8, in favor of group II (p = 0.033).
CONCLUSIONS: The volume of 5 mL is not less effective than 10 mL when performing SSNB in the treatment of primary adhesive capsulitis.

UNASSIGNED: There are 2.8 million youth competitive swimmers in the United States (US), and shoulder pain is the most common complaint among swimmers.
UNASSIGNED: To determine prevalence of shoulder pain, disability, and dissatisfaction in youth competitive swimmers. A secondary purpose was to determine influence of age, competitive swimming experience, and previous history of shoulder pain or injury on shoulder pain, disability, and dissatisfaction, and finally to determine if sex, geographic area, and participation in a second sport relate to shoulder pain, disability, and dissatisfaction.
UNASSIGNED: Multi-site cross-sectional design.
UNASSIGNED: Six-hundred and seventy-one swimmers aged 9-17 years from six states in the US completed surveys which included demographics, the Penn Shoulder Score (PSS), and the Disability of Arm Shoulder Hand (DASH) Sports. Independent t-tests were used to compare pain, disability, dissatisfaction, the influence of age, sex, participation in second sport, geographic region, and history of shoulder pain. Linear regression analyses were performed to determine the interaction of these variables with reported pain and disability.
UNASSIGNED: Forty-nine percent of swimmers had shoulder symptoms. Greater shoulder pain and disability were reported in 15 to 17-year-olds compared to 9 to 10-year-olds (pain and disability: p<0.001), in swimmers with greater versus less years of experience (pain and disability: p<0.001), and in swimmers from eastern versus western states (pain: p=0.001, disability: p=0.0014). Swimmers not participating in a second sport had higher shoulder dissatisfaction (p=0.002). History of prior shoulder pain/traumatic injury was the best indicator of increased pain, disability, and dissatisfaction (p<0.001).
UNASSIGNED: Almost half of swimmers surveyed had shoulder pain, with a higher prevalence found in older age groups, those with greater experience, and in those with prior shoulder pain or traumatic injury. Further research should investigate shoulder pain prevention programs, and surveillance methods are recommended to identify symptomatic swimmers who may benefit from referral to prevent further pain and disability.
UNASSIGNED: III.

BACKGROUND: Anterior shoulder dislocations have a high recurrence rate, often necessitating stabilizing surgery, with residual long-term fear of reinjury.
OBJECTIVE: To explore patients\' experiences of anterior shoulder dislocations in relation to their lives, well-being, fear of reinjury, and future perspectives.
METHODS: Qualitative study.
METHODS: We interviewed fourteen individuals (median age 27.5 yrs, range 21-40; two women) with traumatic anterior glenohumeral dislocation within 5 years, with or without past stabilizing surgery. We analysed data using Interpretive Description.
RESULTS: We constructed three main themes. (1) Downward wellness spiral: The injury shattered their lives, influencing their self-identity and -confidence. Sleep disturbances added to stress levels, loss, depression and grief. The re-injury risk could lead to social isolation. (2) Out of arm\'s reach: Recurrences led to frustration as the prior surgery and rehabilitation appeared to have been unsuccessful, having to start again. Support from healthcare providers and whānau/family was crucial to regain trust in the body. (3) Obligatory compromise: Over time, some individuals accepted the re-injury risk, learnt to heed warning signals, or compromised by avoiding specific social and recreational activities, changing their sports or to other roles in their preferred sport, and adapting work-related and daily tasks.
CONCLUSIONS: Participants described in-depth socio-emotional responses following shoulder dislocations. Most participants described an ongoing interplay between fear and confidence in their shoulder. Healthcare provider support and professional relationship, on-going shoulder-related strengthening, and risk mitigation strategies were important to facilitate and maintain confidence and self-efficacy, and to re-consider and adjust the participant\'s goals when needed.

BACKGROUND: Rotator cuff-related shoulder pain (RCRSP) is the most common cause of shoulder pain. Currently, exercise is proposed as the first-line treatment for patients suffering from RCRSP. However, adherence to therapeutic exercise programmes can be poor in the long term in a home setting. The aim of this study is to evaluate the effects of adding video animations to a traditional paper-based exercise programme.
METHODS: A single-centre, randomised, open-labelled clinical trial will be conducted in a hospital in Spain. Adults aged between 18 and 80 years diagnosed with RCRSP who meet the eligibility criteria will be included. Patients (n=132) will be randomised into two groups, with both receiving paper-based exercises, and the experimental group will also be provided with video animations. The participants will receive seven face-to-face physical therapy sessions and will be asked to perform the exercises at home for 6 months. The primary outcome measure will be the Shoulder Pain and Disability Index, measured at baseline, 3 weeks, 3 months (primary analysis) and 6 months. Secondary outcomes will be the patient\'s pain intensity during the last week (rest, during movement and at night); expectations of improvement; satisfaction with treatment; impression of improvement; perceived usability, usefulness and satisfaction of multimedia animations; and adherence to exercises. Generalised least squares regression models with an autoregressive-moving average lag one correlation structure will be implemented, with an intention-to-treat analysis.
BACKGROUND: This study has been approved by the ethics committee of Hospital Universitario Fundación Alcorcón (Madrid, Spain), reference number CI18/16. All participants will sign an informed consent. The results will be published in a peer-reviewed scientific journal.
BACKGROUND: ClinicalTrials.gov, NCT05770908.

UNASSIGNED: Standardized consensus-based radiological reports for shoulder instability may improve clinical quality, reduce heterogeneity, and reduce workload. Therefore, the aim of this study was to determine important elements for the x-ray, magnetic resonance imaging (MRI) arthrography (MRA), and computed tomography (CT) report, the extent of variability, and important MRI views and settings.
UNASSIGNED: An expert panel of musculoskeletal radiologists and orthopedic surgeons was recruited in a three-round Delphi design. Important elements were identified for the x-ray, MRA, and CT report and important MRI views and setting. These were rated on a 0-9 Likert scale. High variability was defined as at least one score between 1-3 and 7-9. Consensus was reached when ≥80% scored an element 1-3 or 7-9.
UNASSIGNED: The expert panel consisted of 21 musculoskeletal radiologists and 15 orthopedic surgeons. The number of elements identified in the first round was seventeen for the x-ray report, 52 for MRA, 21 for CT, and 23 for the MRI protocol. The number of elements that reached consensus was five for x-ray, twenty for MRA, nine for CT, and two for the MRI protocol. High variability was observed in 76.5% (n = 13) x-ray elements, 85.0% (n = 45) MRA, 76.2% (n = 16) CT, and 85.7% (n = 18) MRI protocol.
UNASSIGNED: Substantial variability was observed in the scoring of important elements in the radiological for the evaluation of anterior shoulder instability, regardless of modality. Consensus was reached for five elements in the x-ray report, twenty in the MRA report, and nine in the CT report. Finally, consensus was reached on two elements regarding MRA views and settings.

UNASSIGNED: The purpose of this study was to evaluate and compare the clinical and structural outcomes after arthroscopic repair of isolated supraspinatus tears in patients older than 70 years vs. patients younger than 50 years to determine whether age influences the treatment of these tears.
UNASSIGNED: We conducted a retrospective, comparative study of 87 shoulders of 86 patients older than 70 years who underwent rotator cuff repair after isolated full-thickness supraspinatus tear between January 2010 and December 2020. A control group of 87 patients younger than 50 years was matched for sex, body mass index, smoking habits, tendon retraction according to Patte and fatty infiltration according to Goutallier. Clinical assessment used Constant-Murley Score (CMS), age- and sex-matched Constant Scores and Subjective Shoulder Value at 6 months. Cuff integrity was evaluated using ultrasonography based on the Sugaya criteria, types I-II-III being considered as healed.
UNASSIGNED: The CMS significantly improved by +17.91 points in elderly patients compared with +7.47 points in controls (P < .1) and activity (P = .2), mobility (P < .1), and strength (P < .1). The adjusted CMS significantly improved by +24.94 in elderly patients compared with +8.49 points in controls (P < .1). The Subjective Shoulder Value improved by +29.48 points in elderly patients compared with +23.47 points in controls. The improvement was similar in both groups. (P < .10). Satisfaction was similar in both groups (P = .31). Regarding structural outcomes, patients younger than 50 years presented better results in terms of healing than patients older than 70 years, as the healing rate was 73.7% in the elderly group and 88.5% in the control group (P = .1). The clinical outcomes were not significantly associated with the tendon healing (P = .1).
UNASSIGNED: Functional gain for patients older than 70 years is better than their younger peers despite their low-grade healing. Arthroscopic repair after isolated supraspinatus tears should be considered as a valuable treatment regardless the age.