Evolución del dolor y presencia de comorbilidades del paciente con desgarro del manguito rotador
El estudio tiene como objetivo describir la evolución del dolor y la funcionalidad en pacientes con tratamiento conservador para desgarro del manguito rotador en la primera valoración, a los 3 y 12 meses de seguimiento. Se realizó un estudio unicéntrico, descriptivo, con recolección prospectiva de d...
- Autores:
-
Cadena Rodríguez, Gustavo Andrés
Acosta Gutierrez, Harold Anderson
- Tipo de recurso:
- Fecha de publicación:
- 2023
- Institución:
- Universidad Nacional de Colombia
- Repositorio:
- Universidad Nacional de Colombia
- Idioma:
- spa
- OAI Identifier:
- oai:repositorio.unal.edu.co:unal/83182
- Palabra clave:
- 610 - Medicina y salud::616 - Enfermedades
Lesiones del Manguito de los Rotadores
Evolución del Concepto de Enfermedad
Rotator Cuff Injuries
Diseases
Desgarro del manguito rotador
Comorbilidades
ENA
SST
Rotator Cuff Tear
Comorbidities
- Rights
- openAccess
- License
- Atribución-NoComercial-SinDerivadas 4.0 Internacional
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UNACIONAL2_b2b093b8d79d07a3751adfef93e6b8c5 |
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oai:repositorio.unal.edu.co:unal/83182 |
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UNACIONAL2 |
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Universidad Nacional de Colombia |
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|
| dc.title.spa.fl_str_mv |
Evolución del dolor y presencia de comorbilidades del paciente con desgarro del manguito rotador |
| dc.title.translated.eng.fl_str_mv |
Evolution of pain and comorbidities in patients with rotator cuff tear |
| title |
Evolución del dolor y presencia de comorbilidades del paciente con desgarro del manguito rotador |
| spellingShingle |
Evolución del dolor y presencia de comorbilidades del paciente con desgarro del manguito rotador 610 - Medicina y salud::616 - Enfermedades Lesiones del Manguito de los Rotadores Evolución del Concepto de Enfermedad Rotator Cuff Injuries Diseases Desgarro del manguito rotador Comorbilidades ENA SST Rotator Cuff Tear Comorbidities |
| title_short |
Evolución del dolor y presencia de comorbilidades del paciente con desgarro del manguito rotador |
| title_full |
Evolución del dolor y presencia de comorbilidades del paciente con desgarro del manguito rotador |
| title_fullStr |
Evolución del dolor y presencia de comorbilidades del paciente con desgarro del manguito rotador |
| title_full_unstemmed |
Evolución del dolor y presencia de comorbilidades del paciente con desgarro del manguito rotador |
| title_sort |
Evolución del dolor y presencia de comorbilidades del paciente con desgarro del manguito rotador |
| dc.creator.fl_str_mv |
Cadena Rodríguez, Gustavo Andrés Acosta Gutierrez, Harold Anderson |
| dc.contributor.advisor.none.fl_str_mv |
Calixto Ballesteros, Luis Fernando Ortiz Corredor, Fernando |
| dc.contributor.author.none.fl_str_mv |
Cadena Rodríguez, Gustavo Andrés Acosta Gutierrez, Harold Anderson |
| dc.contributor.educationalvalidator.none.fl_str_mv |
Mendoza Pulido Juan Camilo |
| dc.contributor.researchgroup.spa.fl_str_mv |
Cifel Centro de Investigación en Fisiatría y Electrodiagnóstico |
| dc.subject.ddc.spa.fl_str_mv |
610 - Medicina y salud::616 - Enfermedades |
| topic |
610 - Medicina y salud::616 - Enfermedades Lesiones del Manguito de los Rotadores Evolución del Concepto de Enfermedad Rotator Cuff Injuries Diseases Desgarro del manguito rotador Comorbilidades ENA SST Rotator Cuff Tear Comorbidities |
| dc.subject.other.spa.fl_str_mv |
Lesiones del Manguito de los Rotadores Evolución del Concepto de Enfermedad |
| dc.subject.other.eng.fl_str_mv |
Rotator Cuff Injuries Diseases |
| dc.subject.proposal.spa.fl_str_mv |
Desgarro del manguito rotador Comorbilidades |
| dc.subject.proposal.none.fl_str_mv |
ENA SST |
| dc.subject.proposal.eng.fl_str_mv |
Rotator Cuff Tear Comorbidities |
| description |
El estudio tiene como objetivo describir la evolución del dolor y la funcionalidad en pacientes con tratamiento conservador para desgarro del manguito rotador en la primera valoración, a los 3 y 12 meses de seguimiento. Se realizó un estudio unicéntrico, descriptivo, con recolección prospectiva de datos. Se evaluaron 83 pacientes con edad media de 60 años, 75.9% de los cuales eran mujeres. Se encontró que las mujeres tenían un puntaje más bajo en la escala SST y mayor dolor comparado con los hombres. Se observó una disminución significativa en la ENA tres meses después de la evaluación inicial en paciente con ruptura parcial con síndrome de manguito rotador, pero a los 12 meses, el dolor volvió a los niveles basales. En el análisis multivariado se encontró que los pacientes con disminución en la abducción del hombro y de sexo femenino tienen una mayor probabilidad de tener un mal resultado después de 12 meses. En general, la mayoría de los pacientes tuvieron una respuesta favorable con el manejo conservador al dolor y funcionalidad a los 3 meses, pero no se presentaron cambios significativos a los 12 meses. (Texto tomado de la fuente) |
| publishDate |
2023 |
| dc.date.accessioned.none.fl_str_mv |
2023-01-30T16:28:41Z |
| dc.date.available.none.fl_str_mv |
2023-01-30T16:28:41Z |
| dc.date.issued.none.fl_str_mv |
2023 |
| dc.type.spa.fl_str_mv |
Trabajo de grado - Especialidad Médica |
| dc.type.driver.spa.fl_str_mv |
info:eu-repo/semantics/masterThesis |
| dc.type.version.spa.fl_str_mv |
info:eu-repo/semantics/acceptedVersion |
| dc.type.content.spa.fl_str_mv |
Text |
| dc.type.redcol.spa.fl_str_mv |
http://purl.org/redcol/resource_type/TM |
| status_str |
acceptedVersion |
| dc.identifier.uri.none.fl_str_mv |
https://repositorio.unal.edu.co/handle/unal/83182 |
| dc.identifier.instname.spa.fl_str_mv |
Universidad Nacional de Colombia |
| dc.identifier.reponame.spa.fl_str_mv |
Repositorio Institucional Universidad Nacional de Colombia |
| dc.identifier.repourl.spa.fl_str_mv |
https://repositorio.unal.edu.co/ |
| url |
https://repositorio.unal.edu.co/handle/unal/83182 https://repositorio.unal.edu.co/ |
| identifier_str_mv |
Universidad Nacional de Colombia Repositorio Institucional Universidad Nacional de Colombia |
| dc.language.iso.spa.fl_str_mv |
spa |
| language |
spa |
| dc.relation.references.spa.fl_str_mv |
Acebrón Fabregat, Á., Part Soriano, J., & Sánchez Alepuz, E. (2020). Epidemiología e historia natural de las roturas del manguito rotador. Revista Española de Traumatología Laboral, 3(2). https://doi.org/10.24129/j.retla.03206.fs2009022 Allen, H., Chan, B. Y., Davis, K. W., & Blankenbaker, D. G. (2019). Overuse Injuries of the Shoulder. Radiologic Clinics of North America, 57(5), 897–909. https://doi.org/10.1016/j.rcl.2019.03.003 Alsubheen, Sanaa A., Joy C. MacDermid, and Kenneth J. Faber. 2022. “Effectiveness of Surgical and Non-Surgical Interventions for Managing Diabetic Shoulder Pain: A Systematic Review.” Disability and Rehabilitation 44 (10): 1766–79. Amin, N. H., Kumar, N. S., & Schickendantz, M. S. (2015). Medial epicondylitis: evaluation and management. JAAOS-Journal of the American Academy of Orthopaedic Surgeons, 23(6), 348-355. Anthony, C. A., Glass, N., Hancock, K., Bollier, M., Hettrich, C. M., & Wolf, B. R. (2017). Preoperative Performance of the Patient-Reported Outcomes Measurement Information System in Patients with Rotator Cuff Pathology. Arthroscopy, 33(10), 1770-1774.e1771. doi: 10.1016/j.arthro.2017.04.018 Arcuri, F., Barclay, F., & Nacul, I. (2014). Translation, Cultural Adaptation and Validation of the Simple Shoulder Test to Spanish. Orthopaedic Journal of Sports Medicine, 2(12_suppl4), 2325967114S0023. doi: 10.1177/2325967114s00233 Arias-Vázquez PI, Tovilla-Zárate CA, González-Graniel K, Burad-Fonz W, González- Castro TB, López-Narváez ML, Castillo-Avila RG, & Arcila-Novelo R. (2021). Efficacy of hypertonic dextrose infiltrations for pain control in rotator cuff tendinopathy: systematic review and meta-analysis. Acta Reumatologica Portuguesa, 46(2), 156–170. Atuesta, N., Becerra, S., López, G., & Santamaría, C. (2007). Características demográficas y de la atención del síndrome de manguito rotador en un hospital de segundo nivel en Bogotá. Movimiento Científico, 1(1). https://doi.org/https://doi.org/10.33881/2011-7191. Borstad, John, and Christopher Woeste. 2015. “The Role of Sensitization in Musculoskeletal Shoulder Pain.” Brazilian Journal of Physical Therapy 19 (4): 251–57. Burne, G., Mansfield, M., Gaida, J. E., & Lewis, J. S. (2019). Is there an association between metabolic syndrome and rotator cuff-related shoulder pain? A systematic review. BMJ Open Sport and Exercise Medicine, 5(1). https://doi.org/10.1136/bmjsem-2019- 000544 Burns, David, Philip Boyer, Helen Razmjou, Robin Richards, and Cari Whyne. 2021. “Adherence Patterns and Dose Response of Physiotherapy for Rotator Cuff Pathology: Longitudinal Cohort Study.” JMIR Rehabilitation and Assistive Technologies 8 (1): e21374. Bush, Christopher, Joel J. Gagnier, James Carpenter, Asheesh Bedi, and Bruce Miller. 2021. “Predictors of Clinical Outcomes after Non-Operative Management of Symptomatic Full-Thickness Rotator Cuff Tears.” World Journal of Orthopedics 12 (4): 223–33. Carreño Mesa, F. A., & Osma Rueda, J. L. (2016). Diagnóstico de la rotura del manguito de los rotadores (pruebas clínicas e imagenología). Revisión de conceptos actuales. Revista Colombiana de Ortopedia y Traumatología, 30, 13–25. https://doi.org/10.1016/j.rccot.2016.09.009 Conget, I. (2002). Diagnóstico, clasificación y patogenia de la diabetes mellitus. Revista española de cardiología, 55(5), 528-535. Consigliere, P., Haddo, O., Levy, O., & Sforza, G. (2018). Subacromial impingement syndrome: Management challenges. Orthopedic Research and Reviews, 10, 83–91. https://doi.org/10.2147/ORR.S157864 Daghiani, M., Negahban, H., Ebrahimzadeh, M. H., Moradi, A., Kachooei, A. R., Raeesi, J., & Divandari, A. (2022). The effectiveness of comprehensive physiotherapy compared with corticosteroid injection on pain, disability, treatment effectiveness, and quality of life in patients with subacromial pain syndrome: a parallel, single-blind, randomized controlled trial. Physiotherapy Theory and Practice, 1–15. https://doi.org/10.1080/09593985.2022.2044421 Dickinson, R. N., Ayers, G. D., Archer, K. R., Fan, R., Page, C., Higgins, L. D., Jain, N. B. (2019). Physical therapy versus natural history in outcomes of rotator cuff tears: the Rotator Cuff Outcomes Workgroup (ROW) cohort study. J Shoulder Elbow Surg, 28(5), 833-838. doi: 10.1016/j.jse.2018.10.00 Dominguez-Romero, Juan G., José J. Jiménez-Rejano, Carmen Ridao-Fernández, and Gema Chamorro-Moriana. 2021. “Exercise-Based Muscle Development Programmes and Their Effectiveness in the Functional Recovery of Rotator Cuff Tendinopathy: A Systematic Review.” Diagnostics 11 (3): 529. Edwards, Peter, Jay Ebert, Brendan Joss, Gev Bhabra, Tim Ackland, and Allan Wang. 2016. “EXERCISE REHABILITATION IN THE NON-OPERATIVE MANAGEMENT OF ROTATOR CUFF TEARS: A REVIEW OF THE LITERATURE.” International Journal of Sports Physical Therapy 11 (2): 279–301. Ertan, S., Ayhan, E., Güven, M. F., Kesmezacar, H., Akgün, K., & Babacan, M. (2015). Medium-term natural history of subacromial impingement syndrome. J Shoulder Elbow Surg, 24(10), 1512-1518. https://doi.org/10.1016/j.jse.2015.06.007 Essery, Rosie, Adam W. A. Geraghty, Sarah Kirby, and Lucy Yardley. 2017. “Predictors of Adherence to Home-Based Physical Therapies: A Systematic Review.” Disability and Rehabilitation 39 (6): 519–34. Gagnier, J. J., Allen, B., Watson, S., Robbins, C. B., Bedi, A., Carpenter, J. E., & Miller, B. S. (2017). Do medical comorbidities affect outcomes in patients with rotator cuff tears?. Orthopaedic Journal of Sports Medicine, 5(8), 2325967117723834. Galatz, L. M., Griggs, S., Cameron, B. D., & Iannotti, J. P. (2001). Prospective longitudinal analysis of postoperative shoulder function: a ten-year follow-up study of full-thickness rotator cuff tears. J Bone Joint Surg Am, 83(7), 1052-1056. García Martínez, Orlando, García Martínez, Osvaldo, Martín León, Rafael, & Fernández López, Luis Antonio. (2020). Eficacia diagnóstica del ultrasonido de alta resolución en pacientes con rupturas del manguito rotador. Revista Cubana de Ortopedia y Traumatología, 34(2), e298. Garcia-Ramirez, J., Z. Nikoloski, and E. Mossialos. 2020. “Inequality in Healthcare Use among Older People in Colombia.” International Journal for Equity in Health 19 (1). https://doi.org/10.1186/s12939-020-01241-0. Garibaldi, R., D. Altomare, C. Sconza, E. Kon, A. Castagna, M. Marcacci, E. Monina, and B. Di Matteo. 2021. “Conservative Management vs. Surgical Repair in Degenerative Rotator Cuff Tears: A Systematic Review and Meta-Analysis.” European Review for Medical and Pharmacological Sciences 25 (2): 609–19. Godfrey, J., Hamman, R., Lowenstein, S., Briggs, K., & Kocher, M. (2007). Reliability, validity, and responsiveness of the simple shoulder test: Psychometric properties by age and injury type. Journal of Shoulder and Elbow Surgery, 16(3), 260–267. https://doi.org/10.1016/j.jse.2006.07.003. Goel, R., & Abzug, J. M. (2015). De Quervain's tenosynovitis: a review of the rehabilitative options. Hand, 10(1), 1-5. Goldberg, Benjamin A., Robert J. Nowinski, and Frederick A. Matsen. 2001. “Outcome of Nonoperative Management of Full-Thickness Rotator Cuff Tears.” Clinical Orthopaedics and Related Research. https://doi.org/10.1097/00003086-200101000-00015. Grandizio, L. C., Choe, L. J., Follett, L., Laychur, A., & Young, A. (2022). The impact of self- efficacy on nonoperative treatment of atraumatic shoulder pain. Journal of Osteopathic Medicine, 122(6), 297–302. https://doi.org/10.1515/jom-2021-0132 Gwark, J. Y., & Park, H. bin. (2022). Prediction of Bilaterality in Patients With 1 Posterosuperior Rotator Cuff Tear. American Journal of Sports Medicine, 50(7), 1928– 1937. https://doi.org/10.1177/03635465221094816 Gwilym, S. E., H. C. L. Oag, I. Tracey, and A. J. Carr. 2011. “Evidence That Central Sensitisation Is Present in Patients with Shoulder Impingement Syndrome and Influences the Outcome after Surgery.” The Journal of Bone and Joint Surgery. British Volume 93 (4): 498–502. Hodgetts, C. J., Leboeuf-Yde, C., Beynon, A., & Walker, B. F. (2021). Shoulder pain prevalence by age and within occupational groups: a systematic review. Archives of Physiotherapy, 11(1). https://doi.org/10.1186/s40945-021-00119-w Ishigaki, T., Yoshino, K., Hirokawa, M., Sugawara, M., & Yamanaka, M. (2022). Supraspinatus tendon thickness and subacromial impingement characteristics in younger and older adults. BMC Musculoskeletal Disorders, 23(1). https://doi.org/10.1186/s12891- 022-05179-y Itoi, E., and S. Tabata. 1992. “Incomplete Rotator Cuff Tears. Results of Operative Treatment.” Clinical Orthopaedics and Related Research, no. 284 (November): 128–35. Jain, N. B., Ayers, G. D., Fan, R., Kuhn, J. E., Baumgarten, K. M., Matzkin, E., & Higgins, L. D. (2018). Predictors of pain and functional outcomes after operative treatment for rotator cuff tears. J Shoulder Elbow Surg, 27(8), 1393-1400. doi:10.1016/j.jse.2018.04.016 Kazempour Mofrad, M., Rezasoltani, Z., Dadarkhah, A., Kazempour Mofrad, R., Abdorrazaghi, F., & Azizi, S. (2021). Periarticular Neurofascial Dextrose Prolotherapy Versus Physiotherapy for the Treatment of Chronic Rotator Cuff Tendinopathy: Randomized Clinical Trial. Journal of Clinical Rheumatology, 27(4), 136–142. https://doi.org/10.1097/RHU.0000000000001218 Keener, J. D., Patterson, B. M., Orvets, N., & Chamberlain, A. M. (2019). Degenerative Rotator Cuff Tears: Refining Surgical Indications Based on Natural History Data. J Am Acad Orthop Surg, 27(5), 156-165. https://doi.org/10.5435/jaaos-d-17-00480 Kim, J., Ryu, Y., & Kim, S. H. (2020). Surgical Options for Failed Rotator Cuff Repair, except Arthroplasty: Review of Current Methods. Clinics in Shoulder and Elbow, 23(1), 48–58. https://doi.org/10.5397/cise.2019.00416 Kirkley, A., Alvarez, C., & Griffin, S. (2003). The Development and Evaluation of a Disease- specific Quality-of-Life Questionnaire for Disorders of the Rotator Cuff: The Western Ontario Rotator Cuff Index. Clinical Journal of Sport Medicine, 13, 84–92. Kolk, A., Overbeek, C. L., de Witte, P. B., Canete, A. N., Reijnierse, M., Nagels, J., Nelissen, R. G. H. H., & de Groot, J. H. (2021). Kinematics and muscle activation in subacromial pain syndrome patients and asymptomatic controls. Clinical Biomechanics, 89. https://doi.org/10.1016/j.clinbiomech.2021.105483 Kukkonen, J., Joukainen, A., Lehtinen, J., Mattila, K. T., Tuominen, E. K. J., Kauko, T., Äärimaa, V., Kukkonen, n J, Surgeon, O., Äärimaa, n v, Joukainen, n A, Lehtinen, n J, Leong, H. T., Fu, S. C., He, X., Oh, J. H., Yamamoto, N., & Yung, S. H. P. (2019). Risk factors for rotator cuff tendinopathy: A systematic review and meta-analysis. Journal of Rehabilitation Medicine, 51(9), 627–637. https://doi.org/10.2340/16501977-2598 Longo, U. G., Risi Ambrogioni, L., Candela, V., Berton, A., Carnevale, A., Schena, E., & Denaro, V. (2021). Conservative versus surgical management for patients with rotator cuff tears: a systematic review and META-analysis. BMC Musculoskeletal Disorders, 22(1). https://doi.org/10.1186/s12891-020-03872-4 Lucas, J., P. van Doorn, E. Hegedus, J. Lewis, and D. van der Windt. 2022. “A Systematic Review of the Global Prevalence and Incidence of Shoulder Pain.” BMC Musculoskeletal Disorders 23 (1): 1–11. Ma, K. L., & Wang, H. Q. (2020). Management of lateral epicondylitis: a narrative literature review. Pain Research and Management, 2020. Malliaras, Peter, Renea Johnston, Gabriele Street, Chris Littlewood, Kim Bennell, Terry Haines, and Rachelle Buchbinder. 2020. “The Efficacy of Higher Versus Lower Dose Exercise in Rotator Cuff Tendinopathy: A Systematic Review of Randomized Controlled Trials.” Archives of Physical Medicine and Rehabilitation 101 (10): 1822–34. Martínez Cano, J. P., Arango Gutiérrez, A. S., Cabrera Salom, C., Castro Llanos, A. M., & Martínez Rondanelli, A. (2018). Reliability and Internal Consistency of the Spanish Version for Colombia of the Western Ontario Rotator Cuff Index (WORC). Universitas Médica, 59(3), 1 https://doi.org/10.11144/javeriana.umed59-3.worc Massier, J. R., Wolterbeek, N., & Wessel, R. N. (2021). The normative Western Ontario Rotator Cuff Index values for age and sex. Journal of Shoulder and Elbow Surgery, 30(6), e276-e281. Matsen, Frederick A., 3rd, Anna Tang, Stacy M. Russ, and Jason E. Hsu. 2017. “Relationship Between Patient-Reported Assessment of Shoulder Function and Objective Range-of-Motion Measurements.” The Journal of Bone and Joint Surgery. American Volume 99 (5): 417–26. Mattila, n K T, Radiologist, M., Tuominen, n E K J, & Kauko, n T. (2014). Treatment of non- traumatic rotator cuff tears: A RANDOMISED CONTROLLED TRIAL WITH ONE-YEAR CLINICAL RESULTS. Bone Joint J, 1, 96–75. https://doi.org/10.1302/0301-620X.96B1 Meissner-Haecker, A., Contreras, J., Valenzuela, A., Delgado, B., Taglioni, A., de Marinis, R., Calvo, C., Soza, F., & Liendo, R. (2022). Critical shoulder angle and failure of conservative treatment in patients with atraumatic full thickness rotator cuff tears. BMC Musculoskeletal Disorders, 23(1). https://doi.org/10.1186/s12891-022-05519-y Membrilla-Mesa, M. D., Tejero-Fernández, V., Cuesta-Vargas, A. I., & Arroyo-Morales, M. (2015). Validation and reliability of a Spanish version of Simple Shoulder Test (SST-Sp). Qual Life Res, 24(2), 411-416. doi:10.1007/s11136-014-0760-2 Michener, L. A., Snyder, A. R., & Leggin, B. G. (2011). Responsiveness of the numeric pain rating scale in patients with shoulder pain and the effect of surgical status. Journal of sport rehabilitation, 20(1). Namdari, Surena, Gautam Yagnik, D. David Ebaugh, Sameer Nagda, Matthew L. Ramsey, Gerald R. Williams, and Samir Mehta. 2012. “Defining Functional Shoulder Range of Motion for Activities of Daily Living.” Journal of Shoulder and Elbow Surgery. https://doi.org/10.1016/j.jse.2011.07.032. Narvani, A. A., Imam, M. A., Godenèche, A., Calvo, E., Corbett, S., Wallace, A. L., & Itoi, E. (2020). Degenerative rotator cuff tear, repair or not repair? A review of current evidence. Ann R Coll Surg Engl, 102(4), 248-255. doi:10.1308/rcsann.2019.0173 Newington, L., Harris, E. C., & Walker-Bone, K. (2015). Carpal tunnel syndrome and work. Best practice & research Clinical rheumatology, 29(3), 440-453. Oh, J. H., Lee, Y. H., Lee, T. H., Jang, S. I., & Kwon, J. (2020). The Natural History of High- Grade Partial Thickness Rotator Cuff Tears: The Conversion Rate to Full Thickness Tears and Affecting Factors. Clin Orthop Surg, 12(4), 514-520. https://doi.org/10.4055/cios19167 Onks Cayce, Silvis Matthew, Loeffert Jayson, Tucker James, & Gallo Robert. (2020). Conservative care or surgery for rotator cuff tears? The Journal of Family Practice, 69(02). Osborne, J. D., Gowda, A. L., Wiater, B., & Wiater, J. M. (2016). Rotator cuff rehabilitation: Current theories and practice. In Physician and Sports Medicine (Vol 44, Issue 1, pp. 85– 92). Taylor and Francis Ltd. https://doi.org/10.1080/00913847.2016.1108883 Page, Matthew J., Sally Green, Brodwen McBain, Stephen J. Surace, Jessica Deitch, Nicolette Lyttle, Marshall A. Mrocki, and Rachelle Buchbinder. 2016. “Manual Therapy and Exercise for Rotator Cuff Disease.” Cochrane Database of Systematic Reviews 2016 (6): CD012224. Park, H. B., Gwark, J. Y., Im, J. H., & Na, J. B. (2021). Factors Associated With Lateral Epicondylitis of the Elbow. Orthopaedic Journal of Sports Medicine, 9(5), 23259671211007734. Peduzzi, P., Concato, J., Kemper, E., Holford, T. R., & Feinstein, A. R. (1996). A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol, 49(12), 1373-1379. doi:10.1016/s0895-4356(96)00236-3 Raman, Jayaprakash, Joy C. MacDermid, David Walton, and George S. Athwal. 2017. “Rasch Analysis Indicates That the Simple Shoulder Test Is Robust, but Minor Item Modifications and Attention to Gender Differences Should Be Considered.” Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists 30 (3): 348–58. Richards, R. R., An, K. N., Bigliani, L. U., Friedman, R. J., Gartsman, G. M., Gristina, A. G. & Zuckerman, J. D. (1994). A standardized method for the assessment of shoulder function. Journal of Shoulder and Elbow Surgery, 3(6), 347-352. Roh, Young Hak, Jung Ho Noh, Joo Han Oh, Goo Hyun Baek, and Hyun Sik Gong. 2012. “To What Degree Do Shoulder Outcome Instruments Reflect Patients’ Psychologic Distress?” Clinical Orthopaedics & Related Research. https://doi.org/10.1007/s11999-012- 2503-4. Ryösä, A., Laimi, K., Äärimaa, V., Lehtimäki, K., Kukkonen, J., & Saltychev, M. (2016). Surgery or conservative treatment for rotator cuff tear: a meta-analysis. Disability and Rehabilitation, 39(14), 1357–1363. https://doi.org/10.1080/09638288.2016.1198431 Sabo, M. T., LeBlanc, J., & Hildebrand, K. A. (2021). Patient gender and rotator cuff surgery: are there differences in outcome? BMC Musculoskeletal Disorders, 22(1). https://doi.org/10.1186/s12891-021-04701-y Sacitharan, P. K. (2019). Ageing and osteoarthritis. Biochemistry and cell biology of ageing: part II clinical science, 123-159. Şahinoğlu, Ertan, Bayram Ünver, and Kamil Yamak. 2022. “The Associations of Emotional Health with Pain, Disability, and Health-Related Quality of Life in Patients with Rotator Cuff Disease.” Musculoskeletal Care 20 (1): 121–27. Sari, A., & Eroglu, A. (2020). Comparison of ultrasound-guided platelet-rich plasma, prolotherapy, and corticosteroid injections in rotator cuff lesions. Journal of Back and Musculoskeletal Rehabilitation, 33(3), 387–396. https://doi.org/10.3233/BMR-191519 Schwarz, I., Smith, J. H., Houck, D. A., Frank, R. M., Bravman, J. T., & McCarty, E. C. (2020). Use of the Patient-Reported Outcomes Measurement Information System (PROMIS) for Operative Shoulder Outcomes. Orthop J Sports Med, 8(6), 2325967120924345. doi:10.1177/2325967120924345 Smith, K. L., D. T. Harryman 2nd, J. Antoniou, B. Campbell, J. A. Sidles, and F. A. Matsen 3rd. 2000. “A Prospective, Multipractice Study of Shoulder Function and Health Status in Patients with Documented Rotator Cuff Tears.” Journal of Shoulder and Elbow Surgery / American Shoulder and Elbow Surgeons ... [et Al.] 9 (5): 395–402. Smith, K. M., Presson, A. P., Zhang, C., Horns, J. J., Hotaling, J. M., Tashjian, R. Z., & Chalmers, P. N. (2021). Does diabetes mellitus predispose to both rotator cuff surgery and subsequent failure?. JSES international, 5(4), 636-641. Sözen, T., Başaran, N. Ç., Tınazlı, M., & Özışık, L. (2018). Musculoskeletal problems in diabetes mellitus. European journal of rheumatology, 5(4), 258. Suarez Viviana. (2021). Prevalencia del síndrome de manguito rotador en pacientes valorados en una ips de alta complejidad, Bogotá, 2019. Tesis Doctoral. U. Rosario. Tashjian, R. Z. (2012). Epidemiology, natural history, and indications for treatment of rotator cuff tears. Clin Sports Med, 31(4), 589-604. doi: 10.1016/j.csm.2012.07.001 Tashjian, R. Z., Deloach, J., Green, A., Porucznik, C. A., & Powell, A. P. (2010). Minimal clinically important differences in ASES and simple shoulder test scores after nonoperative treatment of rotator cuff disease. Journal of Bone and Joint Surgery - Series A, 92(2), 296– 303. https://doi.org/10.2106/JBJS.H.01296 Tashjian, R. Z., Shin, J., Broschinsky, K., Yeh, C. C., Martin, B., Chalmers, P. N., Greis, P. E., Burks, R. T., & Zhang, Y. (2019). Minimal clinically important differences in the American Shoulder and Elbow Surgeons, Simple Shoulder Test, and visual analog scale pain scores after arthroscopic rotator cuff repair. Journal of Shoulder and Elbow Surgery, 29(7), 1406– 1411. https://doi.org/10.1016/j.jse.2019.11.018 Titchener, A. G., White, J. J., Hinchliffe, S. R., Tambe, A. A., Hubbard, R. B., & Clark, D. I. (2014). Comorbidities in rotator cuff disease: a case-control study. Journal of shoulder and elbow surgery, 23(9), 1282-1288. Varacallo, M., el Bitar, Y., & Affiliations, S. D. M. (2021). Rotator Cuff Syndrome Continuing Education Activity. In StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK531506/?report=printable Vrotsou, K., Cuéllar, R., Silió, F., Rodríguez, M. Á., Garay, D., Busto, G., Trancho, Z., & Escobar, A. (2016). Patient self-report section of the ASES questionnaire: a Spanish validation study using classical test theory and the Rasch model. Health and Quality of Life Outcomes, 14(1), 1-13. https://doi.org/10.1186/s12955-016-0552-1 Yagnik, G. P., Santos, E. D., Rothfeld, A. A., Uribe, J. W., & Cohn, T. M. (2020). Spanish Translation and Cross-Language 1 Validation of the American Shoulder and Elbow Surgeons Assessment Form. Journal of Shoulder and Elbow Surgery, 1-25. https://doi.org/10.1016/j.jse.2020.05.020 Yamamoto, A., Takagishi, K., Osawa, T., Yanagawa, T., Nakajima, D., Shitara, H., & Kobayashi, T. (2010). Prevalence and risk factors of a rotator cuff tear in the general population. Journal of Shoulder and Elbow Surgery, 19(1), 116–120. https://doi.org/10.1016/j.jse.2009.04.006 Yoon, T. H., Choi, C. H., Kim, S. J., Choi, Y. R., Yoon, S. P., & Chun, Y. M. (2019). Attrition of rotator cuff without progression to tears during 2-5 years of conservative treatment for impingement syndrome. Arch Orthop Trauma Surg, 139(3), 377-382. doi:10.1007/s00402- 018-3065-z Yuguero, M., Huguet, J., Griffin, S., Sirvent, E., Marcano, F., Balaguer, M., & Torner, P. (2016). Adaptación transcultural, validación y valoración de las propiedades psicométricas, de la versión española del cuestionario Western Ontario Shoulder Instability Index. Revista Española de Cirugía Ortopédica y Traumatología, 60(6), 335 345. https://doi.org/10.1016/j.recot.2016.07.003 |
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Atribución-NoComercial-SinDerivadas 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Calixto Ballesteros, Luis Fernando062fb04f42b539e3f19e0e7808406261Ortiz Corredor, Fernandodd9170f7d7c356c2ce1438bdff6a9d1dCadena Rodríguez, Gustavo Andrésd0c611a76e9b64b7c15bcf4806416a2eAcosta Gutierrez, Harold Anderson40d717824f49c65c537bf8082e4d67f3Mendoza Pulido Juan CamiloCifel Centro de Investigación en Fisiatría y Electrodiagnóstico2023-01-30T16:28:41Z2023-01-30T16:28:41Z2023https://repositorio.unal.edu.co/handle/unal/83182Universidad Nacional de ColombiaRepositorio Institucional Universidad Nacional de Colombiahttps://repositorio.unal.edu.co/El estudio tiene como objetivo describir la evolución del dolor y la funcionalidad en pacientes con tratamiento conservador para desgarro del manguito rotador en la primera valoración, a los 3 y 12 meses de seguimiento. Se realizó un estudio unicéntrico, descriptivo, con recolección prospectiva de datos. Se evaluaron 83 pacientes con edad media de 60 años, 75.9% de los cuales eran mujeres. Se encontró que las mujeres tenían un puntaje más bajo en la escala SST y mayor dolor comparado con los hombres. Se observó una disminución significativa en la ENA tres meses después de la evaluación inicial en paciente con ruptura parcial con síndrome de manguito rotador, pero a los 12 meses, el dolor volvió a los niveles basales. En el análisis multivariado se encontró que los pacientes con disminución en la abducción del hombro y de sexo femenino tienen una mayor probabilidad de tener un mal resultado después de 12 meses. En general, la mayoría de los pacientes tuvieron una respuesta favorable con el manejo conservador al dolor y funcionalidad a los 3 meses, pero no se presentaron cambios significativos a los 12 meses. (Texto tomado de la fuente)The study aims to describe the evolution of pain and functionality in patients with conservative treatment for rotator cuff tear at the first assessment, at 3 and 12 months of follow-up. A single-center, descriptive, prospective data collection study was conducted. 83 patients were evaluated with 60 years average age, 75.9% of whom were women. It was found that women had a lower score on the SST scale and greater pain compared to men. A significant decrease in ENA was observed three months after the initial evaluation in patients with partial rupture with rotator cuff syndrome, but at 12 months, pain returned to baseline levels. In the multivariate analysis, it was found that patients with decreased shoulder abduction and female sex have a higher probability of having a poor outcome after 12 months. In general, most patients had a favorable response to conservative management of pain and functionality at 3 months, but there were no significant changes at 12 months.Especialidades MédicasEspecialista en Medicina Física y RehabilitaciónEstudio descriptivo prospectivo, unicéntrico, en pacientes mayores de 18 años, con diagnóstico de patología del manguito rotador, atendidos en la consulta de Ortopedia de hombro del Hospital Universitario Nacional de Colombia. Se tomaron datos de pacientes desde diciembre del 2020 hasta septiembre de 2021 con seguimiento telefónico a los 3 y 12 meses posterior a la primera valoración. El diagnóstico fue establecido por parte del grupo de ortopedia de hombro del Hospital Universitario Nacional de Colombia, según la presencia de dolor en hombro superior a 3 meses y pruebas para síndrome de manguito rotador positivas (prueba de Neer, Hawkins y Jobe) confirmado por diagnóstico imagenológico con ecografía y/o resonancia magnética nuclear de hombro. Se realizó una primera valoración presencial por parte del grupo de Medicina Física y Rehabilitación en la que se incluyó una anamnesis, evaluación del dolor promedio en los últimos 7 días con la escala numérica de dolor (ENA) y presencia de comorbilidades según la respuesta del paciente a una anamnesis dirigida de antecedentes personales, la información de la historia clínica del paciente y el examen físico. Adicionalmente se realizaron las pruebas WORC, SST, y un examen físico que incluyó la evaluación de los arcos de movimiento (flexión, rotación interna, rotación externa, abducción). Posteriormente se hizo un seguimiento a los 3 y 12 meses de la primera evaluación de forma telefónica, evaluando dolor del paciente según el promedio de la ENA en los 7 días previos a la llamada, valoración funcional con el cuestionario SST y se interrogó sobre el tratamiento recibido; cabe resaltar que los tratamientos recibidos no fueron modificados, ya que se trata de una investigación de seguimiento exclusivamente.Enfermedades Osteomuscularesxv, 60 páginasapplication/pdfspaUniversidad Nacional de ColombiaBogotá - Medicina - Especialidad en Medicina Física y RehabilitaciónFacultad de MedicinaBogotá, ColombiaUniversidad Nacional de Colombia - Sede Bogotá610 - Medicina y salud::616 - EnfermedadesLesiones del Manguito de los RotadoresEvolución del Concepto de EnfermedadRotator Cuff InjuriesDiseasesDesgarro del manguito rotadorComorbilidadesENASSTRotator Cuff TearComorbiditiesEvolución del dolor y presencia de comorbilidades del paciente con desgarro del manguito rotadorEvolution of pain and comorbidities in patients with rotator cuff tearTrabajo de grado - Especialidad Médicainfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/acceptedVersionTexthttp://purl.org/redcol/resource_type/TMAcebrón Fabregat, Á., Part Soriano, J., & Sánchez Alepuz, E. (2020). Epidemiología e historia natural de las roturas del manguito rotador. Revista Española de Traumatología Laboral, 3(2). https://doi.org/10.24129/j.retla.03206.fs2009022Allen, H., Chan, B. Y., Davis, K. W., & Blankenbaker, D. G. (2019). Overuse Injuries of the Shoulder. Radiologic Clinics of North America, 57(5), 897–909. https://doi.org/10.1016/j.rcl.2019.03.003Alsubheen, Sanaa A., Joy C. MacDermid, and Kenneth J. Faber. 2022. “Effectiveness of Surgical and Non-Surgical Interventions for Managing Diabetic Shoulder Pain: A Systematic Review.” Disability and Rehabilitation 44 (10): 1766–79. Amin, N. H., Kumar, N. S., & Schickendantz, M. S. (2015). Medial epicondylitis: evaluation and management. JAAOS-Journal of the American Academy of Orthopaedic Surgeons, 23(6), 348-355.Anthony, C. A., Glass, N., Hancock, K., Bollier, M., Hettrich, C. M., & Wolf, B. R. (2017). Preoperative Performance of the Patient-Reported Outcomes Measurement Information System in Patients with Rotator Cuff Pathology. Arthroscopy, 33(10), 1770-1774.e1771. doi: 10.1016/j.arthro.2017.04.018Arcuri, F., Barclay, F., & Nacul, I. (2014). Translation, Cultural Adaptation and Validation of the Simple Shoulder Test to Spanish. Orthopaedic Journal of Sports Medicine, 2(12_suppl4), 2325967114S0023. doi: 10.1177/2325967114s00233Arias-Vázquez PI, Tovilla-Zárate CA, González-Graniel K, Burad-Fonz W, González- Castro TB, López-Narváez ML, Castillo-Avila RG, & Arcila-Novelo R. (2021). Efficacy of hypertonic dextrose infiltrations for pain control in rotator cuff tendinopathy: systematic review and meta-analysis. Acta Reumatologica Portuguesa, 46(2), 156–170.Atuesta, N., Becerra, S., López, G., & Santamaría, C. (2007). Características demográficas y de la atención del síndrome de manguito rotador en un hospital de segundo nivel en Bogotá. Movimiento Científico, 1(1). https://doi.org/https://doi.org/10.33881/2011-7191.Borstad, John, and Christopher Woeste. 2015. “The Role of Sensitization in Musculoskeletal Shoulder Pain.” Brazilian Journal of Physical Therapy 19 (4): 251–57.Burne, G., Mansfield, M., Gaida, J. E., & Lewis, J. S. (2019). Is there an association between metabolic syndrome and rotator cuff-related shoulder pain? A systematic review. BMJ Open Sport and Exercise Medicine, 5(1). https://doi.org/10.1136/bmjsem-2019- 000544Burns, David, Philip Boyer, Helen Razmjou, Robin Richards, and Cari Whyne. 2021. “Adherence Patterns and Dose Response of Physiotherapy for Rotator Cuff Pathology: Longitudinal Cohort Study.” JMIR Rehabilitation and Assistive Technologies 8 (1): e21374.Bush, Christopher, Joel J. Gagnier, James Carpenter, Asheesh Bedi, and Bruce Miller. 2021. “Predictors of Clinical Outcomes after Non-Operative Management of Symptomatic Full-Thickness Rotator Cuff Tears.” World Journal of Orthopedics 12 (4): 223–33.Carreño Mesa, F. A., & Osma Rueda, J. L. (2016). Diagnóstico de la rotura del manguito de los rotadores (pruebas clínicas e imagenología). Revisión de conceptos actuales. Revista Colombiana de Ortopedia y Traumatología, 30, 13–25. https://doi.org/10.1016/j.rccot.2016.09.009Conget, I. (2002). Diagnóstico, clasificación y patogenia de la diabetes mellitus. Revista española de cardiología, 55(5), 528-535.Consigliere, P., Haddo, O., Levy, O., & Sforza, G. (2018). Subacromial impingement syndrome: Management challenges. Orthopedic Research and Reviews, 10, 83–91. https://doi.org/10.2147/ORR.S157864Daghiani, M., Negahban, H., Ebrahimzadeh, M. H., Moradi, A., Kachooei, A. R., Raeesi, J., & Divandari, A. (2022). The effectiveness of comprehensive physiotherapy compared with corticosteroid injection on pain, disability, treatment effectiveness, and quality of life in patients with subacromial pain syndrome: a parallel, single-blind, randomized controlled trial. Physiotherapy Theory and Practice, 1–15. https://doi.org/10.1080/09593985.2022.2044421Dickinson, R. N., Ayers, G. D., Archer, K. R., Fan, R., Page, C., Higgins, L. D., Jain, N. B. (2019). Physical therapy versus natural history in outcomes of rotator cuff tears: the Rotator Cuff Outcomes Workgroup (ROW) cohort study. J Shoulder Elbow Surg, 28(5), 833-838. doi: 10.1016/j.jse.2018.10.00Dominguez-Romero, Juan G., José J. Jiménez-Rejano, Carmen Ridao-Fernández, and Gema Chamorro-Moriana. 2021. “Exercise-Based Muscle Development Programmes and Their Effectiveness in the Functional Recovery of Rotator Cuff Tendinopathy: A Systematic Review.” Diagnostics 11 (3): 529.Edwards, Peter, Jay Ebert, Brendan Joss, Gev Bhabra, Tim Ackland, and Allan Wang. 2016. “EXERCISE REHABILITATION IN THE NON-OPERATIVE MANAGEMENT OF ROTATOR CUFF TEARS: A REVIEW OF THE LITERATURE.” International Journal of Sports Physical Therapy 11 (2): 279–301.Ertan, S., Ayhan, E., Güven, M. F., Kesmezacar, H., Akgün, K., & Babacan, M. (2015). Medium-term natural history of subacromial impingement syndrome. J Shoulder Elbow Surg, 24(10), 1512-1518. https://doi.org/10.1016/j.jse.2015.06.007Essery, Rosie, Adam W. A. Geraghty, Sarah Kirby, and Lucy Yardley. 2017. “Predictors of Adherence to Home-Based Physical Therapies: A Systematic Review.” Disability and Rehabilitation 39 (6): 519–34.Gagnier, J. J., Allen, B., Watson, S., Robbins, C. B., Bedi, A., Carpenter, J. E., & Miller, B. S. (2017). Do medical comorbidities affect outcomes in patients with rotator cuff tears?. Orthopaedic Journal of Sports Medicine, 5(8), 2325967117723834.Galatz, L. M., Griggs, S., Cameron, B. D., & Iannotti, J. P. (2001). Prospective longitudinal analysis of postoperative shoulder function: a ten-year follow-up study of full-thickness rotator cuff tears. J Bone Joint Surg Am, 83(7), 1052-1056.García Martínez, Orlando, García Martínez, Osvaldo, Martín León, Rafael, & Fernández López, Luis Antonio. (2020). Eficacia diagnóstica del ultrasonido de alta resolución en pacientes con rupturas del manguito rotador. Revista Cubana de Ortopedia y Traumatología, 34(2), e298.Garcia-Ramirez, J., Z. Nikoloski, and E. Mossialos. 2020. “Inequality in Healthcare Use among Older People in Colombia.” International Journal for Equity in Health 19 (1). https://doi.org/10.1186/s12939-020-01241-0.Garibaldi, R., D. Altomare, C. Sconza, E. Kon, A. Castagna, M. Marcacci, E. Monina, and B. Di Matteo. 2021. “Conservative Management vs. Surgical Repair in Degenerative Rotator Cuff Tears: A Systematic Review and Meta-Analysis.” European Review for Medical and Pharmacological Sciences 25 (2): 609–19.Godfrey, J., Hamman, R., Lowenstein, S., Briggs, K., & Kocher, M. (2007). Reliability, validity, and responsiveness of the simple shoulder test: Psychometric properties by age and injury type. Journal of Shoulder and Elbow Surgery, 16(3), 260–267. https://doi.org/10.1016/j.jse.2006.07.003.Goel, R., & Abzug, J. M. (2015). De Quervain's tenosynovitis: a review of the rehabilitative options. Hand, 10(1), 1-5.Goldberg, Benjamin A., Robert J. Nowinski, and Frederick A. Matsen. 2001. “Outcome of Nonoperative Management of Full-Thickness Rotator Cuff Tears.” Clinical Orthopaedics and Related Research. https://doi.org/10.1097/00003086-200101000-00015.Grandizio, L. C., Choe, L. J., Follett, L., Laychur, A., & Young, A. (2022). The impact of self- efficacy on nonoperative treatment of atraumatic shoulder pain. Journal of Osteopathic Medicine, 122(6), 297–302. https://doi.org/10.1515/jom-2021-0132Gwark, J. Y., & Park, H. bin. (2022). Prediction of Bilaterality in Patients With 1 Posterosuperior Rotator Cuff Tear. American Journal of Sports Medicine, 50(7), 1928– 1937. https://doi.org/10.1177/03635465221094816Gwilym, S. E., H. C. L. Oag, I. Tracey, and A. J. Carr. 2011. “Evidence That Central Sensitisation Is Present in Patients with Shoulder Impingement Syndrome and Influences the Outcome after Surgery.” The Journal of Bone and Joint Surgery. British Volume 93 (4): 498–502.Hodgetts, C. J., Leboeuf-Yde, C., Beynon, A., & Walker, B. F. (2021). Shoulder pain prevalence by age and within occupational groups: a systematic review. Archives of Physiotherapy, 11(1). https://doi.org/10.1186/s40945-021-00119-wIshigaki, T., Yoshino, K., Hirokawa, M., Sugawara, M., & Yamanaka, M. (2022). Supraspinatus tendon thickness and subacromial impingement characteristics in younger and older adults. BMC Musculoskeletal Disorders, 23(1). https://doi.org/10.1186/s12891- 022-05179-yItoi, E., and S. Tabata. 1992. “Incomplete Rotator Cuff Tears. Results of Operative Treatment.” Clinical Orthopaedics and Related Research, no. 284 (November): 128–35.Jain, N. B., Ayers, G. D., Fan, R., Kuhn, J. E., Baumgarten, K. M., Matzkin, E., & Higgins, L. D. (2018). Predictors of pain and functional outcomes after operative treatment for rotator cuff tears. J Shoulder Elbow Surg, 27(8), 1393-1400. doi:10.1016/j.jse.2018.04.016Kazempour Mofrad, M., Rezasoltani, Z., Dadarkhah, A., Kazempour Mofrad, R., Abdorrazaghi, F., & Azizi, S. (2021). Periarticular Neurofascial Dextrose Prolotherapy Versus Physiotherapy for the Treatment of Chronic Rotator Cuff Tendinopathy: Randomized Clinical Trial. Journal of Clinical Rheumatology, 27(4), 136–142. https://doi.org/10.1097/RHU.0000000000001218Keener, J. D., Patterson, B. M., Orvets, N., & Chamberlain, A. M. (2019). Degenerative Rotator Cuff Tears: Refining Surgical Indications Based on Natural History Data. J Am Acad Orthop Surg, 27(5), 156-165. https://doi.org/10.5435/jaaos-d-17-00480Kim, J., Ryu, Y., & Kim, S. H. (2020). Surgical Options for Failed Rotator Cuff Repair, except Arthroplasty: Review of Current Methods. Clinics in Shoulder and Elbow, 23(1), 48–58. https://doi.org/10.5397/cise.2019.00416Kirkley, A., Alvarez, C., & Griffin, S. (2003). The Development and Evaluation of a Disease- specific Quality-of-Life Questionnaire for Disorders of the Rotator Cuff: The Western Ontario Rotator Cuff Index. Clinical Journal of Sport Medicine, 13, 84–92.Kolk, A., Overbeek, C. L., de Witte, P. B., Canete, A. N., Reijnierse, M., Nagels, J., Nelissen, R. G. H. H., & de Groot, J. H. (2021). Kinematics and muscle activation in subacromial pain syndrome patients and asymptomatic controls. Clinical Biomechanics, 89. https://doi.org/10.1016/j.clinbiomech.2021.105483Kukkonen, J., Joukainen, A., Lehtinen, J., Mattila, K. T., Tuominen, E. K. J., Kauko, T., Äärimaa, V., Kukkonen, n J, Surgeon, O., Äärimaa, n v, Joukainen, n A, Lehtinen, n J, Leong, H. T., Fu, S. C., He, X., Oh, J. H., Yamamoto, N., & Yung, S. H. P. (2019). Risk factors for rotator cuff tendinopathy: A systematic review and meta-analysis. Journal of Rehabilitation Medicine, 51(9), 627–637. https://doi.org/10.2340/16501977-2598Longo, U. G., Risi Ambrogioni, L., Candela, V., Berton, A., Carnevale, A., Schena, E., & Denaro, V. (2021). Conservative versus surgical management for patients with rotator cuff tears: a systematic review and META-analysis. BMC Musculoskeletal Disorders, 22(1). https://doi.org/10.1186/s12891-020-03872-4Lucas, J., P. van Doorn, E. Hegedus, J. Lewis, and D. van der Windt. 2022. “A Systematic Review of the Global Prevalence and Incidence of Shoulder Pain.” BMC Musculoskeletal Disorders 23 (1): 1–11.Ma, K. L., & Wang, H. Q. (2020). Management of lateral epicondylitis: a narrative literature review. Pain Research and Management, 2020. Malliaras, Peter, Renea Johnston, Gabriele Street, Chris Littlewood, Kim Bennell, Terry Haines, and Rachelle Buchbinder. 2020. “The Efficacy of Higher Versus Lower Dose Exercise in Rotator Cuff Tendinopathy: A Systematic Review of Randomized Controlled Trials.” Archives of Physical Medicine and Rehabilitation 101 (10): 1822–34.Martínez Cano, J. P., Arango Gutiérrez, A. S., Cabrera Salom, C., Castro Llanos, A. M., & Martínez Rondanelli, A. (2018). Reliability and Internal Consistency of the Spanish Version for Colombia of the Western Ontario Rotator Cuff Index (WORC). Universitas Médica, 59(3), 1 https://doi.org/10.11144/javeriana.umed59-3.worcMassier, J. R., Wolterbeek, N., & Wessel, R. N. (2021). The normative Western Ontario Rotator Cuff Index values for age and sex. Journal of Shoulder and Elbow Surgery, 30(6), e276-e281.Matsen, Frederick A., 3rd, Anna Tang, Stacy M. Russ, and Jason E. Hsu. 2017. “Relationship Between Patient-Reported Assessment of Shoulder Function and Objective Range-of-Motion Measurements.” The Journal of Bone and Joint Surgery. American Volume 99 (5): 417–26.Mattila, n K T, Radiologist, M., Tuominen, n E K J, & Kauko, n T. (2014). Treatment of non- traumatic rotator cuff tears: A RANDOMISED CONTROLLED TRIAL WITH ONE-YEAR CLINICAL RESULTS. Bone Joint J, 1, 96–75. https://doi.org/10.1302/0301-620X.96B1Meissner-Haecker, A., Contreras, J., Valenzuela, A., Delgado, B., Taglioni, A., de Marinis, R., Calvo, C., Soza, F., & Liendo, R. (2022). Critical shoulder angle and failure of conservative treatment in patients with atraumatic full thickness rotator cuff tears. BMC Musculoskeletal Disorders, 23(1). https://doi.org/10.1186/s12891-022-05519-yMembrilla-Mesa, M. D., Tejero-Fernández, V., Cuesta-Vargas, A. I., & Arroyo-Morales, M. (2015). Validation and reliability of a Spanish version of Simple Shoulder Test (SST-Sp). Qual Life Res, 24(2), 411-416. doi:10.1007/s11136-014-0760-2Michener, L. A., Snyder, A. R., & Leggin, B. G. (2011). Responsiveness of the numeric pain rating scale in patients with shoulder pain and the effect of surgical status. Journal of sport rehabilitation, 20(1).Namdari, Surena, Gautam Yagnik, D. David Ebaugh, Sameer Nagda, Matthew L. Ramsey, Gerald R. Williams, and Samir Mehta. 2012. “Defining Functional Shoulder Range of Motion for Activities of Daily Living.” Journal of Shoulder and Elbow Surgery. https://doi.org/10.1016/j.jse.2011.07.032.Narvani, A. A., Imam, M. A., Godenèche, A., Calvo, E., Corbett, S., Wallace, A. L., & Itoi, E. (2020). Degenerative rotator cuff tear, repair or not repair? A review of current evidence. Ann R Coll Surg Engl, 102(4), 248-255. doi:10.1308/rcsann.2019.0173Newington, L., Harris, E. C., & Walker-Bone, K. (2015). Carpal tunnel syndrome and work. Best practice & research Clinical rheumatology, 29(3), 440-453.Oh, J. H., Lee, Y. H., Lee, T. H., Jang, S. I., & Kwon, J. (2020). The Natural History of High- Grade Partial Thickness Rotator Cuff Tears: The Conversion Rate to Full Thickness Tears and Affecting Factors. Clin Orthop Surg, 12(4), 514-520. https://doi.org/10.4055/cios19167Onks Cayce, Silvis Matthew, Loeffert Jayson, Tucker James, & Gallo Robert. (2020). Conservative care or surgery for rotator cuff tears? The Journal of Family Practice, 69(02).Osborne, J. D., Gowda, A. L., Wiater, B., & Wiater, J. M. (2016). Rotator cuff rehabilitation: Current theories and practice. In Physician and Sports Medicine (Vol 44, Issue 1, pp. 85– 92). Taylor and Francis Ltd. https://doi.org/10.1080/00913847.2016.1108883Page, Matthew J., Sally Green, Brodwen McBain, Stephen J. Surace, Jessica Deitch, Nicolette Lyttle, Marshall A. Mrocki, and Rachelle Buchbinder. 2016. “Manual Therapy and Exercise for Rotator Cuff Disease.” Cochrane Database of Systematic Reviews 2016 (6): CD012224.Park, H. B., Gwark, J. Y., Im, J. H., & Na, J. B. (2021). Factors Associated With Lateral Epicondylitis of the Elbow. Orthopaedic Journal of Sports Medicine, 9(5), 23259671211007734.Peduzzi, P., Concato, J., Kemper, E., Holford, T. R., & Feinstein, A. R. (1996). A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol, 49(12), 1373-1379. doi:10.1016/s0895-4356(96)00236-3Raman, Jayaprakash, Joy C. MacDermid, David Walton, and George S. Athwal. 2017. “Rasch Analysis Indicates That the Simple Shoulder Test Is Robust, but Minor Item Modifications and Attention to Gender Differences Should Be Considered.” Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists 30 (3): 348–58.Richards, R. R., An, K. N., Bigliani, L. U., Friedman, R. J., Gartsman, G. M., Gristina, A. G. & Zuckerman, J. D. (1994). A standardized method for the assessment of shoulder function. Journal of Shoulder and Elbow Surgery, 3(6), 347-352.Roh, Young Hak, Jung Ho Noh, Joo Han Oh, Goo Hyun Baek, and Hyun Sik Gong. 2012. “To What Degree Do Shoulder Outcome Instruments Reflect Patients’ Psychologic Distress?” Clinical Orthopaedics & Related Research. https://doi.org/10.1007/s11999-012- 2503-4.Ryösä, A., Laimi, K., Äärimaa, V., Lehtimäki, K., Kukkonen, J., & Saltychev, M. (2016). Surgery or conservative treatment for rotator cuff tear: a meta-analysis. Disability and Rehabilitation, 39(14), 1357–1363. https://doi.org/10.1080/09638288.2016.1198431Sabo, M. T., LeBlanc, J., & Hildebrand, K. A. (2021). Patient gender and rotator cuff surgery: are there differences in outcome? BMC Musculoskeletal Disorders, 22(1). https://doi.org/10.1186/s12891-021-04701-ySacitharan, P. K. (2019). Ageing and osteoarthritis. Biochemistry and cell biology of ageing: part II clinical science, 123-159.Şahinoğlu, Ertan, Bayram Ünver, and Kamil Yamak. 2022. “The Associations of Emotional Health with Pain, Disability, and Health-Related Quality of Life in Patients with Rotator Cuff Disease.” Musculoskeletal Care 20 (1): 121–27.Sari, A., & Eroglu, A. (2020). Comparison of ultrasound-guided platelet-rich plasma, prolotherapy, and corticosteroid injections in rotator cuff lesions. Journal of Back and Musculoskeletal Rehabilitation, 33(3), 387–396. https://doi.org/10.3233/BMR-191519Schwarz, I., Smith, J. H., Houck, D. A., Frank, R. M., Bravman, J. T., & McCarty, E. C. (2020). Use of the Patient-Reported Outcomes Measurement Information System (PROMIS) for Operative Shoulder Outcomes. Orthop J Sports Med, 8(6), 2325967120924345. doi:10.1177/2325967120924345Smith, K. L., D. T. Harryman 2nd, J. Antoniou, B. Campbell, J. A. Sidles, and F. A. Matsen 3rd. 2000. “A Prospective, Multipractice Study of Shoulder Function and Health Status in Patients with Documented Rotator Cuff Tears.” Journal of Shoulder and Elbow Surgery / American Shoulder and Elbow Surgeons ... [et Al.] 9 (5): 395–402.Smith, K. M., Presson, A. P., Zhang, C., Horns, J. J., Hotaling, J. M., Tashjian, R. Z., & Chalmers, P. N. (2021). Does diabetes mellitus predispose to both rotator cuff surgery and subsequent failure?. JSES international, 5(4), 636-641.Sözen, T., Başaran, N. Ç., Tınazlı, M., & Özışık, L. (2018). Musculoskeletal problems in diabetes mellitus. European journal of rheumatology, 5(4), 258.Suarez Viviana. (2021). Prevalencia del síndrome de manguito rotador en pacientes valorados en una ips de alta complejidad, Bogotá, 2019. Tesis Doctoral. U. Rosario.Tashjian, R. Z. (2012). Epidemiology, natural history, and indications for treatment of rotator cuff tears. Clin Sports Med, 31(4), 589-604. doi: 10.1016/j.csm.2012.07.001Tashjian, R. Z., Deloach, J., Green, A., Porucznik, C. A., & Powell, A. P. (2010). Minimal clinically important differences in ASES and simple shoulder test scores after nonoperative treatment of rotator cuff disease. Journal of Bone and Joint Surgery - Series A, 92(2), 296– 303. https://doi.org/10.2106/JBJS.H.01296Tashjian, R. Z., Shin, J., Broschinsky, K., Yeh, C. C., Martin, B., Chalmers, P. N., Greis, P. E., Burks, R. T., & Zhang, Y. (2019). Minimal clinically important differences in the American Shoulder and Elbow Surgeons, Simple Shoulder Test, and visual analog scale pain scores after arthroscopic rotator cuff repair. Journal of Shoulder and Elbow Surgery, 29(7), 1406– 1411. https://doi.org/10.1016/j.jse.2019.11.018Titchener, A. G., White, J. J., Hinchliffe, S. R., Tambe, A. A., Hubbard, R. B., & Clark, D. I. (2014). Comorbidities in rotator cuff disease: a case-control study. Journal of shoulder and elbow surgery, 23(9), 1282-1288.Varacallo, M., el Bitar, Y., & Affiliations, S. D. M. (2021). Rotator Cuff Syndrome Continuing Education Activity. In StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK531506/?report=printableVrotsou, K., Cuéllar, R., Silió, F., Rodríguez, M. Á., Garay, D., Busto, G., Trancho, Z., & Escobar, A. (2016). Patient self-report section of the ASES questionnaire: a Spanish validation study using classical test theory and the Rasch model. Health and Quality of Life Outcomes, 14(1), 1-13. https://doi.org/10.1186/s12955-016-0552-1Yagnik, G. P., Santos, E. D., Rothfeld, A. A., Uribe, J. W., & Cohn, T. M. (2020). Spanish Translation and Cross-Language 1 Validation of the American Shoulder and Elbow Surgeons Assessment Form. Journal of Shoulder and Elbow Surgery, 1-25. https://doi.org/10.1016/j.jse.2020.05.020Yamamoto, A., Takagishi, K., Osawa, T., Yanagawa, T., Nakajima, D., Shitara, H., & Kobayashi, T. (2010). Prevalence and risk factors of a rotator cuff tear in the general population. Journal of Shoulder and Elbow Surgery, 19(1), 116–120. https://doi.org/10.1016/j.jse.2009.04.006Yoon, T. H., Choi, C. H., Kim, S. J., Choi, Y. R., Yoon, S. P., & Chun, Y. M. (2019). Attrition of rotator cuff without progression to tears during 2-5 years of conservative treatment for impingement syndrome. Arch Orthop Trauma Surg, 139(3), 377-382. doi:10.1007/s00402- 018-3065-zYuguero, M., Huguet, J., Griffin, S., Sirvent, E., Marcano, F., Balaguer, M., & Torner, P. (2016). Adaptación transcultural, validación y valoración de las propiedades psicométricas, de la versión española del cuestionario Western Ontario Shoulder Instability Index. 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