• Physiotherapy · Jun 2009

    Increased palpation tenderness and muscle strength deficit in the prediction of tendon hypertrophy in symptomatic unilateral shoulder tendinopathy: an ultrasonographic study.

    • Jon Joensen, Christian Couppe, and Jan Magnus Bjordal.
    • Department of Physiotherapy, Faculty of Health and Social Science, Bergen University College, Norway. jon.joensen@hib.no
    • Physiotherapy. 2009 Jun 1; 95 (2): 83-93.

    ObjectiveIn asymptomatic, normal tendons, the difference in tendon thickness between sides is less than 15%. In this study, three tests were used to examine differences between symptomatic and asymptomatic shoulders.DesignCross-sectional study. The three tests were performed in sequence. The observer was blinded in the maximal pain-free isometric force test.SettingOutpatient physiotherapy clinic at Bergen University College, Norway.ParticipantsSixty-four patients with an exclusive, tentative diagnosis of unilateral shoulder tendinopathy.Main Outcome MeasuresDifferences in maximal pain-free isometric force, tendon pain pressure and tendon thickness measured by ultrasonography.ResultsThis paper follows the STARD recommendations for papers on diagnostic accuracy. When cut-off values for within-subject side differences were selected at >or=0.8mm for tendon thickness (TT(diff)), >or=10N for maximal pain-free isometric force (PFF(diff)) and >or=0.6 kg for tendon pain pressure (PPT(diff)), positive tests were found in 92% of patients. All three tests were sensitive for the detection of within-subject side differences with the selected cut-off values (TT(diff), n=60/64; PPT(diff), n=59/64; PFF(diff), n=57/64; P>0.35). There were strong agreements between the three tests: TT(diff) and PFF(diff), 0.89; TT(diff) and PPT(diff), 0.83; and PFF(diff) and PPT(diff), 0.84. When both clinical tests were positive (PFF(diff) and PPT(diff)), the positive predictive value was excellent (94%) for finding increased tendon thickness in the symptomatic side on ultrasonography.ConclusionsWithin the limitations of this partially blinded study, patients with unilateral shoulder tendinopathy exhibited significant differences between sides in all three tests. The combination of the two clinical tests seems to be valid for the detection of unilateral shoulder tendinopathy if other diagnoses have been excluded.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.