Manual therapy
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Comparative Study
Intra- and interexaminer reliability of four manual shoulder maneuvers used to identify subacromial pain.
Shoulder pain is a diagnostic challenge and the physical clinical examination of the shoulder is crucial. It is important that the diagnostic tests used are valid as well as reliable. The objective of the study was to assess intra- and interexaminer reliability for four manual shoulder maneuvers; the Neer impingement sign, the Hawkins-Kennedy impingement test, the Patte maneuver, the Jobe supraspinatus test. ⋯ After a week, the maneuvers were performed again by the same physical therapist (test-retest) and by another physical therapist (test for interexaminer reliability). All four maneuvers have an almost perfect agreement (Kappa coefficients 0.91-1.00), if performed with suggested standardizations. Neer impingement sign, Hawkins-Kennedy impingement test, Patte maneuver as well as Jobe supraspinatus test, are highly reproducible and therefore reliable to use in clinical practice to identify patients with subacromial pain with an impingement phenomenon, but the maneuvers are limited as structural discriminators.
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We assessed the reliability, validity and responsiveness of the French short version of the scale Disability of the Arm, Shoulder and Hand-Disability/Symptom (F-QuickDASH-D/S) in patients with shoulder disorders. We extracted QuickDASH item responses from the responses to the full-length DASH questionnaire completed by 153 patients. In addition to collecting demographic and clinical data, subjective assessment of activities of daily living (ADL), active range of motion (ROM), and measurement of abduction strength (strength) were recorded by use of the Constant scale. ⋯ The responsiveness of F-QuickDASH-D/S was excellent, with standardized response mean and effect size values of 1.09 and 1.23, respectively. The F-QuickDASH-D/S has good reliability, construct validity and responsiveness. The strong correlation of its score with the full-length DASH-D/S scale score suggests that the QuickDASH-D/S could be the preferred scale because it is easier to use.
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Comparative Study
A neuropathic pain component is common in acute whiplash and associated with a more complex clinical presentation.
Whiplash is a heterogeneous condition with some individuals showing features suggestive of neuropathic pain. This study investigated the presence of a neuropathic pain component in acute whiplash using the Self-reported Leeds Assessment of Neuropathic Signs and Symptoms' scale (S-LANSS) and evaluated relationships among S-LANSS responses, pain/disability, sensory characteristics (mechanical, thermal pain thresholds, and Brachial plexus provocation test (BPPT) responses) and psychological distress (General Health Questionnaire-28 (GHQ-28)). Participants were 85 people with acute whiplash (<4 weeks) (54 females, age 36.27+/-12.69 years). ⋯ None of the S-LANSS items could discriminate those with cold hyperalgesia (p=0.06). A predominantly neuropathic pain component is related to a complex presentation of higher pain/disability and sensory hypersensitivity. The S-LANSS may be a useful tool and the BPPT a useful clinical test in the early assessment of whiplash.