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.

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!PPENDIX #ONSULTATIONWITHSERVICEUSERS2ESULTS 4HE'$'HASENDEAVOUREDTOOBTAINPATIENTUSERINVOLVEMENTINTHISPROJECTBYASKINGFORFEEDBACK ONTHEEXERCISESHEETSIN!PPENDIX4HEEXERCISEDIAGRAMSWEREGIVENTOAGROUPOFPATIENTS ATTENDINGAHYDROTHERAPYEXERCISEGROUP4HEPATIENTSDIDNOTSUFFERSPECIFICALLYWITHSHOULDER IMPINGEMENT 4HEGROUPWERETAUGHTTHEEXERCISESBYA3ENIOR))PHYSIOTHERAPIST.

WHOWASNOTPARTOFTHE'$'.

AND THENGIVENTHEDIAGRAMSASANAIDEMEMOIREFORPERFORMINGTHEMATHOME4HEPATIENTSUSERSWERE ASKEDTOPERFORMTHEEXERCISESWITHINTHELIMITSOFPAIN.

ONCEORTWICEADAY.

WITHASUGGESTEDNUMBER OFREPETITIONSBEINGSETSOF.

WITHASECONDRESTAFTEREACHSETSEE 4HEPATIENTSUSERSWEREASKEDTOCONSIDERTHEFOLLOWINGPOINTS s 7ERETHEDIAGRAMSCLEARANDUSEFULASANAIDTOMEMORYFOLLOWINGTHEVERBALEXPLANATIONGIVENTO YOUBYTHEPHYSIOTHERAPIST s 7ERETHERECOMMENDEDNUMBERSOFREPETITIONSREALISTIC &EEDBACK PATIENTSUSERSGAVEWRITTENFEEDBACKTWOWEEKSLATERANDTHEFOLLOWINGCOMMENTS WEREMADE s PATIENTSFELTTHEDIAGRAMSNEEDEDARROWSTOINDICATETHEDIRECTIONOFMOVEMENTORASECOND PICTURETOINDICATEMORECLEARLYHOWITSHOULDBEPERFORMED s PATIENTSWEREHAPPYWITHTHEEXERCISESDEPICTED s !LLPATIENTSUSERSFELTTHEEXERCISEREPETITIONSWEREREALISTICANDACHIEVABLE 4HEPHYSIOTHERAPISTWHOTAUGHTTHEGROUPGAVETHEFOLLOWINGFEEDBACK s )NITIALLYTHEPATIENTSMISINTERPRETEDSOMEOFTHEEXERCISESONTHESHEET.

PRIORTOTHEVERBAL EXPLANATION s )THADBEENDIFFICULTTOEXPLAINALLTHENEWEXERCISESINAGROUPSITUATION.

ASINDIVIDUALQUERIESMAY NOTHAVEBEENDEALTWITHADEQUATELY 4HE'$'HAVECONSIDEREDTHISFEEDBACKANDRECOMMENDTHATIFAPHYSIOTHERAPISTCHOOSESTO USETHEDIAGRAMS  !FULLEXPLANATIONOFTHEEXERCISESSHOULDBEGIVEN.

PREFERABLYONAONE TO ONEBASIS  !RROWSINDICATINGDIRECTIONOFMOVEMENTORWRITTENINSTRUCTIONSSHOULDBEADDEDTOTHEDIAGRAMS ASNECESSARYTOENABLETHEPATIENTUSERTOPERFORMTHEEXERCISESSATISFACTORILY  .

!PPENDIX $ETAILEDELECTRONICSEARCHSTRATEGY 3EARCH3TRATEGIES 3UBJECT3EARCHFOR!-%$!LLIEDAND#OMPLEMETARY-EDICINE  3HOULDER)MPINGEMENT3YNDROME  3HOULDERIMPINGEMENTSYNDROMEMP  3UBACROMIALIMPINGEMENTSYNDROMEMP  SHOULDERORSUBACROMIAL ANDIMPINGEMENTANDSYNDROME MP .MPABSTRACT.

HEADINGWORDS.

%.TITLE=  OROROR  LIMITTO%NGLISHLANGUAGE  FROMKEEP  3UBJECT3EARCHFOR0RE -%$.).

%)NDEX-EDICUS  3HOULDER)MPINGEMENT3YNDROME  3HOULDERIMPINGEMENTSYNDROMEMP  3UBACROMIALIMPINGEMENTSYNDROMEMP  SHOULDERORSUBACROMIAL ANDIMPINGEMENTANDSYNDROME MP.).MPTI.-%$.

AB.

RW.

IMITNOTVALIDIN0RE -%$.MPTITLE.!(..URSINGAND!LLIED(EALTH  3HOULDERIMPINGEMENTSYNDROME  3HOULDERIMPINGEMENTSYNDROMEMP  3UBACROMIALIMPINGEMENTSYNDROMEMP  SHOULDERORSUBACROMIAL ANDIMPINGEMENTANDSYNDROME MP.%RECORDSWERERETAINED=   FROMKEEP  3UBJECT3EARCHFOR#).#UMMULATIVE)NDEXTO.).SH=  OROROR  LIMITTOHUMANAND%NGLISHLANGUAGE .

CINAHLSUBJECT HEADING.

ABSTRACT.

INSTRUMENTATION=  OROROR  LIMITTO%NGLISHLANGUAGE  .

!PPENDIX !RTICLEAPPRAISALSYSTEM #RITICALAPPRAISALSKILLS QUESTIONSTOHELPYOUMAKESENSEOFARESEARCHARTICLESABOUTCLINICALEFFECTIVENESS 'ENERAL#OMMENTS s 4HREEBROADISSUESNEEDTOBECONSIDEREDWHENAPPRAISINGARESEARCHARTICLEABOUTCLINICAL EFFECTIVENESS ! !RETHERESULTSOFTHEARTICLEVALID " 7HATARETHERESULTS # 7ILLTHERESULTSHELPME 4HEFOLLOWINGQUESTIONSAREDESIGNEDTOHELPYOUTHINKABOUTTHEISSUESSYSTEMATICALLY s 4HEFIRSTTWOQUESTIONSARESCREENINGQUESTIONSANDCANBEANSWEREDQUICKLY)FTHEANSWERTOBOTH ISYES.

ITISWORTHPROCEEDINGWITHTHEREMAININGQUESTIONS s 4HEREISAFAIRDEGREEOFOVERLAPBETWEENSEVERALOFTHEQUESTIONS s 9OUAREASKEDTORECORDYES.

NOORCANTTELLTOMOSTOFTHEQUESTIONS s !NUMBEROFITALICISEDPROMPTSAREGIVENAFTEREACHQUESTION4HESEAREDESIGNEDTOREMINDYOU WHYTHEQUESTIONISIMPORTANT s 4HEQUESTIONSAREADAPTEDFROM'UYATT'(.

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5SERS'UIDETO4HE-EDICAL .ITERATURE.

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" 7HATARETHERESULTS  7HATARETHERESULTSOFTHESTUDY s s s (INT#ONSIDER THESIZEOFTHETREATMENTEFFECT THEUNITSTHATTHERESULTSAREEXPRESSEDIN WHETHERTHESIZEOFTREATMENTEFFECTISLIKELYTOBECLINICALLYIMPORTANT  (OWPRECISEARETHERESULTS s s (INT#ONSIDER THELARGESTANDSMALLESTTREATMENTEFFECTSWHICHARECONSISTENTWITHTHE OBSERVEDRESULT WHETHERTHEPRECISIONWASGOODENOUGHTOEXCLUDEACHANCEEXPLANATION FORTHERESULT (AVEALTERNATIVEEXPLANATIONSFORTHERESULTSBEENEXPLOREDANDDISCOUNTED $OYOUTHINKTHATTHEPATIENTSRECRUITEDTOTHESTUDYWERESIMILARENOUGH TOYOURPOPULATION  7EREALLCLINICALLYIMPORTANTOUTCOMESCONSIDERED (INT#ONSIDERTHEIMPORTANCEOF OBJECTIVECLINICALMEASURES SUBJECTIVEPATIENT ORIENTATEDMEASURESEG.

O † 9ES † #ANTTELL † .O †  .O † 9ES † #ANTTELL † .QUALITYOFLIFE SIDEEFFECTS  !RETHEBENEFITSWORTHTHEHARMSANDCOSTS 9ES † #ANTTELL † .O † 7ILLTHERESULTSHELPME  #ANTHERESULTSBEAPPLIEDTOMYPATIENTS s s s 9ES † #ANTTELL † .O † 4HISISUNLIKELYTOBEADDRESSEDBYTHEARTICLE"UTWHATDOYOUTHINK 9ES † #ANTTELL † .

!PPENDIX 4ABLEOFSYSTEMATICREVIEWSANDCRITICALAPPRAISALOFTHE PRIMARYLITERATURE 3TUDY 4YPE 3ETTING 3AMPLE !LBRIGHT*ETAL.

 3YSTEMATICREVIEW #LINICAL 2#4SONTHEEFFICACY OFPHYSIOTHERAPY INTERVENTIONSFORSHOULDER PAIN "ANGAND$EYLE.

 2#4 #LINICAL PATIENTSMALE WITH3)3 )NTERVENTION 'ROUPRECEIVED SUPERVISEDEXERCISES FORMOBILISING -EANAGEOFTHE STRENGTHENINGOVER TREATMENTGROUPGROUP SESSIONS WAS3$.

RANGE 'ROUPRECEIVEDPASSIVE   OFTHECONTROL GROUPGROUP WAS MOBILISATIONSINADDITION .

n  $URATIONOFSYMPTOMS WASCOMPARABLE YEARS3$ INGROUP  INGROUP  "ECKER(ETAL.

 $ESCRIPTIVE.

RETROSPECTIVE #LINICAL REVIEW UNSELECTEDPATIENTS WITHFINGERFLEXORTENDON LACERATIONSWERE FOLLOWEDUPFORAN AVERAGEOFMONTHS "ROSSEAU.ETAL.

 3YSTEMATICREVIEW #LINICAL 2#4SONTHEEFFICACYOF $4&FORTENDINITIS 3URGICALREPAIRWITH GENTLEACTIVEMOVEMENTS FROMTHEFIRSTPOST OPERATIVEDAY .

/UTCOME MEASURES 2ESULTS  )SOMETRICSTRENGTH USINGANELECTRONIC DYNAMOMETER 3TRENGTHIMPROVED SIGNIFICANTLYINGROUP BUTNOTGROUP  0AINONACTIVE ABDUCTION.

ISOMETRIC @BREAKTESTINGFUNCTIONAL ACTIVITIES "OTHGROUPSPAIN FUNCTIONIMPROVED SIGNIFICANTLYBUTGROUP SSIGNIFICANTLYMORESO  !FUNCTIONAL QUESTIONNAIRE #RITICALAPPRAISALCHECKLISTFORCLINICAL )NCLUDEDIN EFFECTIVENESSSTUDIES.

WHEREAPPLICABLE ASYSTEMATIC REVIEW 3EEFOOTOFTABLE.

. 9 9 9 9 9 .PFORKEY           9 9 9 .    'REEN.

 !SSESSORSWERE@BLINDAS TOPATIENTGROUPS 2ANGEOFMOTION )NCIDENCEOFTENDON RUPTURE 4HEPATTERNOFRECOVERY 9 .DIFFERED=FROMTHATSEEN INPATIENTSTREATEDBY CONVENTIONALMETHODSx MOSTPATIENTSHADGOOD RANGEOFMOTIONAT WEEKANDWEREABLETO TOUCHTHEIRPALMSATTO WEEKS 4HEINCIDENCEOF RUPTUREWAS4HE AUTHORATTRIBUTEDTHIS TONON SELECTIONOFTHE PATIENTS.

SOMEOFWHOM WOULDNOTCOMPLYWITH INSTRUCTIONSTOMOBILISE GENTLY  .

3TUDY 4YPE 3ETTING 3AMPLE )NTERVENTION "’HMER!3ETAL.

 $ESCRIPTIVE #LINICAL 3EE"ROX 3EE"ROX "ROX*)ETAL.

 2#4 #LINICAL 3EE"ROX 3EE"ROX "ROX*)ETAL.

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3!)$S PHYSIOTHERAPY 'ROUPUNDERTOOK LOW RESISTANCE. RESISTANTTO.

HIGH REPETITIONEXERCISESFOR HOURDAILY.

INITIALLY INSLINGSUSPENSION %MPHASISWASPLACED ONESTABLISHINGNORMAL MOVEMENTPATTERNS 5NRESTRICTEDACTIVITYWAS TYPICALLYALLOWEDAFTER nWEEKS.

BUTTHE PROGRAMMECONTINUED FORnMONTHS !PHYSIOTHERAPIST SUPERVISEDTHEEXERCISES TWICEAWEEKINTHEEARLY STAGES.

BUTTHISWAS GRADUALLYREDUCED 'ROUPUNDERWENT ARTHROSCOPICSURGERY 'ROUPRECEIVEDPLACEBO DETUNEDLASER TWICE WEEKLYFORWEEKS  "UCHBINDER2ETAL.

 3YSTEMATICREVIEW #LINICAL 2#4SONTHEEFFICACY OFCORTICOSTEROID INJECTIONSFORSHOULDER PAIN #ONROY$%AND(AYES.

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GROUP   PHYSIOLOGICALSTRETCHES.

SOFTTISSUEMOBILISATION.

/THERVARIABLESWERE ANDADVICE COMPARABLEACROSSTHE GROUP 'ROUPRECEIVED ACCESSORYSHOULDERJOINT MOBILISATIONS.

ACCORDING TOSTANDARD-AITLAND PRINCIPLES.

INADDITION .

/UTCOME MEASURES 2ESULTS #RITICALAPPRAISALCHECKLISTFORCLINICAL )NCLUDEDIN EFFECTIVENESSSTUDIES.

WHEREAPPLICABLE ASYSTEMATIC REVIEW 3EEFOOTOFTABLE.

PFORKEY           3EE"ROX 3EE"ROX 3EE"ROX 3EE"ROX.

 3EE"ROX 3EE"ROX 3EE"ROX 'REEN.

.

VANDER(EIJDEN.

 .EERSHOULDERSCORE.

WHICHINCLUDESMEASURES OFPAINOVERTHEPREVIOUS WEEKCLINICALTESTSOF STRENGTH.

REACHING STABILITYACTIVERANGEOF MOTIONANDRADIOLOGICAL EVALUATION0OSSIBLE SCORESRANGEFROMn 4HECRITERIONFORSUCCESS WASASCORE %VALUATIONAT MONTHSANDFOLLOWUPAT YEARS 4HESUCCESSRATEWAS HIGHERFORGROUPS ANDTHANGROUP ATMONTHSP ANDYEARSP  9 9 9 . 9 9 9 9 .  'REEN.

9 . 'ROUPHADASIGNIFICANT 9 REDUCTIONINHOUR PAININTENSITYP ANDPAINONIMPINGEMENT  0AINONIMPINGEMENT TESTINGP VGROUP  TESTING6!3  9 9 . . 9 . 9 'REEN.

 'ROUPSDIDNOT SIGNIFICANTLYDIFFERFROM ONEANOTHERINTERMSOF OUTCOME  -AXIMUMPAIN INTENSITYINPRECEDING HOURS6!3   !CTIVERANGEOF MOTION "OTHGROUPSMOTIONAND FUNCTIONIMPROVED  !BILITYTOPERFORM ASTANDARDISEDSETOF FUNCTIONALACTIVITIES !SSESSORSWERE@BLINDAS TOPATIENTGROUPS  .

3TUDY 4YPE 3ETTING 3AMPLE )NTERVENTION $AVIDSON#*ETAL.

ABORATORY MALE3PRAGUE $AWLEY !NIMALSWEREASSIGNEDTO RATS GROUPS 'ROUPUNDERWENTNO INTERVENTION 'ROUPSHADACHILLES TENDINOSISINDUCEDBY COLLAGENASEINJECTION 'ROUPSRECEIVED DEEPLONGITUDINAL MASSAGE. #ONTROLLEDTRIAL .

BYMEANSOFAN ALUMINIUMINSTRUMENT.

TO THELESIONFORMINUTES ONEACHOFDAYS.

.

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ABORATORY 7ISTARRATS !LLANIMALSUNDERWENT UNILATERALACHILLESTENDON TRANSECTIONSUTURING. %XPERIMENTAL #LINICAL PATIENTSWITHVARIOUS SOFTTISSUELESIONS $EEPTRANSVERSEFRICTION .

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/UTCOME MEASURES 2ESULTS #RITICALAPPRAISALCHECKLISTFORCLINICAL )NCLUDEDIN EFFECTIVENESSSTUDIES.

WHEREAPPLICABLE ASYSTEMATIC REVIEW 3EEFOOTOFTABLE.

PFORKEY  !LLANIMALSUNDERWENT RUNNINGGAITANALYSIS STRIDELENGTH FREQUENCYHIP.

/NLYGROUPSIGNIFICANTLY .OTACLINICALEFFECTIVENESSSTUDY IMPROVEDITSRUNNING PERFORMANCEAFTERINJURY.KNEE ANKLEANGULAR DISPLACEMENT ONA FIXED SPEEDTREADMILL 4HISWASCONDUCTEDPRE INJECTIONANDONTHEDAYS PRECEDINGMASSAGEDAYS           .

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WITHTHELARGEST SIGNIFICANTINCREMENT 4HEANIMALSWERE INTHELATTERPV SACRIFICEDDAYS GROUPS.

ONPOST AFTERTHELASTMASSAGE HOCTESTING &IBROBLASTIC TREATMENT.

THETENDONS ACTIVATIONWASOBSERVED EXCISEDFORMICROSCOPY INGROUPS.

 )NCREMENTSINFIBRONECTIN WEREALSOOBSERVED INGROUPS.

.

0ATIENTREPORTEDANALGESIC /NSETOFANALGESIAIN EFFECT nMINMEAN  $URATIONMINnHRS MEANHOURS  . SUGGESTINGTHATMASSAGE PERSESTIMULATES FIBROBLASTICACTIVATIONAND FIBRONECTINSYNTHESIS 'ROUPDIDNOT DEMONSTRATEBENEFITSIN COLLAGENDISPOSITIONOVER GROUP 9 .OTACLINICALEFFECTIVENESSSTUDY !NIMALSWERESACRIFICED 4HEHIGHESTMEAN ATDAYSTENDON BREAKINGSTRENGTHWAS BREAKINGSTRENGTHS RECORDEDFORGROUP EVALUATED PVEACHOF GROUPS   4ENDON ENDSEPARATIONS RE RUPTURESWERE OBSERVEDINGROUPS .

BUTNOTINGROUP  .

 3TUDY 4YPE 3ETTING 3AMPLE %USTACE*!ETAL.

 $ESCRIPTIVE #LINICAL PATIENTSWITHSHOULDER )NTRA ARTICULARINJECTION SYMPTOMSOFATLEAST OFTRIAMCINILONE MONTHSDURATION RADIOGRAPHICCONTRAST MATERIALUSING STANDARDISEDTECHNIQUE 'INN+!ETAL.

 2#4 #LINICAL PATIENTSMALE WITHUNILATERALSHOULDER PAIN0AINATTRIBUTABLE TO3)3IN-EDIAN AGEOFTREATMENTGROUP GROUP    CONTROLGROUPGROUP   !LLOTHER VARIABLESCLOSELYMATCHED 'REEN3ETAL.

 3YSTEMATICREVIEW #LINICAL TRIALSONTHEEFFICACY OFPHYSIOTHERAPY INTERVENTIONSFORSHOULDER PAIN 'REENFIELD"ETAL.

 $ESCRIPTIVE #LINICAL HEALTHYSUBJECTS PATIENTSWITHSHOULDER @OVERUSEINJURIES )NTERVENTION 'ROUPRECEIVEDNO TREATMENT )NGROUP.

SPECIFIC TREATMENTWASAT PHYSIOTHERAPISTS DISCRETION.

BUTWAS DIRECTEDATSTRETCHING AND  ORSTRENGTHENING MUSCLESASDEEMED APPROPRIATE.

RETRAINING SCAPULOHUMERALRHYTHM .

/UTCOME MEASURES 2ADIOGRAPHSWERE TAKENIMMEDIATELY POST INJECTION.

 SYMPTOMS6!3 RANGE OFMOVEMENTWERE EVALUATEDPRE INJECTION WEEKSPOST INJECTION 2ESULTS #RITICALAPPRAISALCHECKLISTFORCLINICAL )NCLUDEDIN EFFECTIVENESSSTUDIES.

WHEREAPPLICABLE ASYSTEMATIC REVIEW 3EEFOOTOFTABLE.

PFORKEY            OFATTEMPTED 9 SUBACROMIALINJECTIONS WEREJUDGEDTOBE ACCURATELYPLACED.

.  . 9 9  9 'REEN. 9 9 .  OF ATTEMPTEDGLENOHUMERAL INJECTIONS .

.

6ANDER(EIJDEN.

 4HEREWERESIGNIFICANT DIFFERENCESINRELATION TOOUTCOMEBETWEEN THEACCURATELYPLACED INACCURATELYPLACED GROUPS  2ANGEOFMOTION  )SOMETRICSTRENGTH  6!3FOLLOWING STANDARDISEDREACHING TASK 9 'ROUPIMPROVED SIGNIFICANTLYVGROUP INTERMSOFRANGEOF ABDUCTIONP AND FLEXIONP .

AND SELFRATEDDISABILITYSCORE P  9  3ELFRATEDDISABILITY SCORE !SSESSORSWEREBLINDAS TOPATIENTGROUPS 3CAPULARPROTRACTION ROTATION.

FORWARDHEAD POSITION.

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%.3TUDY 4YPE (ART$0AND$AHNERS.

%XPERIMENTAL  (OLLINGWORTH'2ETAL.

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SECONDARYSTABILISING LIGAMENTSWERELEFT INTACT)NANIMALS GROUP THESECONDARY STABILISINGLIGAMENTSWERE TRANSACTEDINADDITIONTO THECOLLATERALLIGAMENT %ACHGROUPWAS DIVIDEDINTO@SURGICAL REPAIROR@NOREPAIR SUBGROUPS.

ANDTHESE WEREFURTHERDIVIDEDINTO @IMMOBILISATIONOR@FREE MOBILISATIONSUBGROUPS #LINICAL PATIENTSWITHMIXED DIAGNOSISSHOULDERPAIN )NJECTIONOFML METHYLPREDNISOLONE ACETATEMGML MIXED WITHLIDOCAINEINTO 'ROUPTENDERPOINT 'ROUPANATOMICAL STRUCTUREDETERMINEDBY #YRIAXSSELECTIVETISSUE TENSIONEXAMINATION #ROSS OVERINJECTIONGIVEN IFPAINNOTCONSIDERABLY REDUCEDAFTERWEEK )TZKOVITCH$ETAL.

  2#4 #LINICAL OUTPATIENTSWITH MEANAGEYEARS3$ YEARS.

RANGE  WITH3)3¢MOVEMENT RESTRICTION.

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/UTCOME MEASURES 2ESULTS #RITICALAPPRAISALCHECKLISTFORCLINICAL )NCLUDEDIN EFFECTIVENESSSTUDIES.

WHEREAPPLICABLE ASYSTEMATIC REVIEW 3EEFOOTOFTABLE.

OTACLINICALEFFECTIVENESSSTUDY STABILISERSWEREINTACT.PFORKEY  4HEANIMALSWERE SACRIFICEDATDAYSAND THELIGAMENTSEVALUATED FORLAXITYANDSTRENGTH          )FTHESECONDARY .

THELIGAMENTSWERE LESSLAXINTHE@FREE MOBILISATIONTHANIN THE@IMMOBILISATION SUBGROUPS)FTHE SECONDARYSTABILISERSWERE NOTINTACT.

THISSITUATION REVERSED !LLLIGAMENTSWERE WEAKERTHANCONTROLS.

. 9 #LINICALINDEX.BUT THE@FREEMOBILISATION SUBGROUPSWEREALL SIGNIFICANTLYSTRONGERTHAN THEIR@IMMOBILISATION COUNTERPARTSP  9 9 9 9 9 9 9 9 .

PAINDURING !LLOUTCOMEMEASURES ACTIVEMOVEMENTANDAT IMPROVEDSIGNIFICANTLY REST6!3 .

ACTIVERANGEOF MOREINTHETENOXICAM MOTION.

PAINONPRESSURE.

9 3UCCESSDEFINEDAS REDUCTIONOFPAINFROM SEVERETOMILDORNIL. TREATEDGROUPVTHE PATIENTSANDCLINICIANS CONTROLS GLOBALIMPRESSION 4HEREWERENOSIGNIFICANT DIFFERENCESINSAFETY ASSESSMENTSBETWEEN GROUPS 9 9  9 9  9 .

WITHCORRESPONDING CLEARINGOFSIGNSON OBJECTIVEEXAMINATION 3IGNIFICANTBENEFITIN ANATOMICALINJECTION GROUPOVERTENDERPOINT INJECTIONV SUCCESS.

P "UCHBINDER.

  .

3TUDY 4YPE 3ETTING -ORRISON$3ETAL.

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RETROSPECTIVE #LINICAL REVIEW 3AMPLE )NTERVENTION SHOULDERSIN PATIENTSMALE DIAGNOSEDWITH3)3 -EANAGEYEARS n  WEEKCOURSEOF.3!)$S 7HENPAINALLOWED.

SOFT TISSUESTRETCHINGUNTILFULL RANGERESTORED4HENA WEEKPROGRAMMEOF STRENGTHENINGEXERCISES EMPHASISINGSHOULDER MEDIALANDLATERAL ROTATION 7HENTHESHOULDER WASPAINLESSAND FULLYFUNCTIONAL.

A GENERALSTRENGTHENING PROGRAMMEWAS INSTITUTEDINPATIENTSWITH HIGHFUNCTIONALDEMANDS  -OSELEY*"JRETAL.

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/UTCOME MEASURES #LINICIAN ADMINISTERED 3HOULDER 2ATING3CALE OFTHE5NIVERSITYOF #ALIFORNIAAT.OS!NGELES.

COVERINGTHEDOMAINSOF PAIN.

FUNCTION.

RANGEOF MOVEMENT.

STRENGTH.

AND PATIENTSATISFACTION 2ESULTS /FTHETOTAL.

HAD ASATISFACTORY.

GOODOR EXCELLENTRESULT DERIVEDNOBENEFITAND PROCEEDEDTOSURGERY DERIVEDNOBENEFIT BUTDECLINEDSURGERY #RITICALAPPRAISALCHECKLISTFORCLINICAL )NCLUDEDIN EFFECTIVENESSSTUDIES.

WHEREAPPLICABLE ASYSTEMATIC REVIEW 3EEFOOTOFTABLE.

9 . 9 /FTHOSEWITHA SATISFACTORY.PFORKEY           9 .

GOODOR EXCELLENTRESULT.

 RELAPSEDAGAIN RESPONDEDTOTHE INTERVENTIONDID NOT  $YNAMIC.

FINE WIREINTRAMUSCULAR ELECTROMYOGRAPHY &UNCTIONALPERFORMANCE WASDETERMINEDBY MEASURINGHINDPAW PRINTSOFWALKINGRATS PRE OPERATIVELYON ALTERNATEPOST OPERATIVE DAYS !GEYEARS .

ACROMIAL TYPE)ASAGAINSTTYPES)) OR))) .

ANDACUTENESS V@NON ACUTENESSOR CHRONICITY WEREALL ASSOCIATEDWITHMORE SUCCESSFULOUTCOMES !CORESETOFEXERCISES.

.OTACLINICALEFFECTIVENESSSTUDY NAMELY  SCAPTION.

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 @PUSHUPPLUS IEPLUSPROTRACTION .

  @PRESSUPINSITTING POSITION.

LIFTINGBOTTOM FROMCHAIR .

OTACLINICALEFFECTIVENESSSTUDY HADNOEFFECTON FUNCTIONALORMECHANICAL RECOVERY 2ATSWERESACRIFICEDON DAYTHETENDONS EVALUATEDMORPHOLOGICALLY MECHANICALLY  . WASFOUNDTOEFFICIENTLY ACTIVATEALLMUSCLES 3UPPLEMENTALEXERCISE .

3TUDY 4YPE 3ETTING 0ARKER2$ETAL.

 $ESCRIPTIVE.

RETROSPECTIVE #LINICAL REVIEW 3AMPLE )NTERVENTION CONSECUTIVE PATIENTSMALE WITH IMPINGEMENTINSTABILITY OVERLAPSYNDROME -EANAGEWASYEARS RANGEnYEARS  2EST.

.3!)$SANDHEAT FORnDAYS.

ORUNTIL SIGNIFICANTPAINABATED !LLHADAPOSITIVE IMPINGEMENTSIGN.

A POSITIVEAPPREHENSION TESTWHICHREMAINEDSO AFTERTHEIMPINGEMENT INJECTIONTEST .

ANDSYMPTOMSOF IMPINGEMENTAND INSTABILITY  0ARTINGTON0&AND "ROOME'(.

 $ESCRIPTIVE #ADAVERIC CADAVERICSHOULDERS 3PEED#AND (AZLEMAN".

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ABORATORY NORMALMALE VOLUNTEERS 7HENPAINALLOWED. $ESCRIPTIVE .

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