{"id":10751,"date":"2023-09-01T06:00:58","date_gmt":"2023-09-01T05:00:58","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=10751"},"modified":"2023-08-26T23:48:25","modified_gmt":"2023-08-26T22:48:25","slug":"effectiveness-of-combined-surgical-and-exercise-based-interventions-following-primary-traumatic-anterior-shoulder-dislocation-a-systematic-review-and-meta-analysis","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2023\/09\/01\/effectiveness-of-combined-surgical-and-exercise-based-interventions-following-primary-traumatic-anterior-shoulder-dislocation-a-systematic-review-and-meta-analysis\/","title":{"rendered":"Effectiveness of combined surgical and exercise-based interventions following primary traumatic anterior shoulder dislocation: a systematic review and meta-analysis"},"content":{"rendered":"

This blog explains the effectiveness of exercises for first-time shoulder dislocations that occur in the forward direction due to a direct blow to the shoulder [primary traumatic anterior shoulder dislocation]. As an author group, we spent the last 3 years working through existing research to compile it into what is one of the highest levels of scientific information [systematic review and meta-analysis]. We have combined this research into a <\/span>paper<\/span><\/a> which is summarised in this blog (<\/span>1)<\/span>.<\/span><\/p>\n

Why is this study important?<\/b><\/p>\n

Shoulder dislocation can be disabling, and is often accompanied by shoulder weakness, stiffness, pain, and inability to participate in day-to-day activities and sport. More men tend to participate in contact sports and physically challenging occupations, compared to women – putting them at a higher risk of shoulder dislocation (<\/span>2)<\/span>. Additionally, following an initial shoulder dislocation there is considerable risk of another dislocation within 6 months [i.e. recurrence]. Individuals who have dislocated a shoulder often have difficulty returning to occupational or athletic activities. There is also an economic burden associated with this injury. For example, <\/span>mean productivity losses amount to \u20ac1469, and mean healthcare expense is \u20ac3759 per patient (per dislocation) without surgery. Surgery expenses further add to this cost burden (<\/span>3)<\/span>.\u00a0<\/span><\/p>\n

Current shoulder dislocation management comprises a period of rest and healing in a sling [immobilization], followed by a structured exercise program. If the dislocation has caused additional damage to surrounding muscles and\/or ligaments then surgery is often required, followed by an exercise program. Exercises are a crucial part of shoulder dislocation management protocols, prompting a need to document their effect on dislocation recurrence and return to activity after a first-time shoulder dislocation.<\/span>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/p>\n

How did the study go about this?<\/b><\/p>\n

We searched online research databases for papers that used any form of exercise-based treatment for first-time shoulder dislocations, and found over 3600 related study titles. For our review 60 of these studies (N=3600) met our inclusion criteria which included investigating exercises for the treatment of shoulder dislocations, as well as studies that used exercises as a part of after-surgery shoulder dislocation management. After critically appraising the included studies, we were able to combine their results qualitatively, and also by pooling data from seven studies and completing a meta-analysis.<\/span><\/p>\n

What did the study find?<\/b><\/p>\n

We found that after an initial shoulder dislocation, exercises combined with surgery more effectively reduces the risk of another shoulder dislocation, and facilitates return to work or sports – when compared to treatment options that use exercise only. Exercise programs that integrate different types of exercise [i.e. multimodal] appear more effective than exercise programs that use only one type of exercise.<\/span><\/p>\n

What are the key take-home points?<\/b><\/p>\n

1] Young, active males are at a higher risk of shoulder dislocations. The cost of treating this injury is high.<\/span><\/p>\n

2] Exercise programs combined with surgery more effectively reduce the risk of future dislocations and facilitate return to activity, than treatment strategies that focus only on exercise.<\/span><\/p>\n

3] Clinicians managing patients following shoulder dislocation should consider implementing a comprehensive exercise program that aims to improve strength, mobility, and muscular control.<\/span><\/p>\n

4] Future studies should focus on contributing more high-quality evidence to the existing literature.<\/span><\/p>\n

\"\"<\/p>\n

Authors:<\/b><\/p>\n

Vaishnavi Chiddarwar,\u00a0Rutger de Zoete,\u00a0Cameron Dickson &\u00a0Timothy JH Lathlean<\/p>\n

References:<\/b>\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/p>\n

    \n
  1. Chiddarwar V, de Zoete RMJ, Dickson C, et al. Effectiveness of combined surgical and exercise-based interventions following primary traumatic anterior shoulder dislocation: a systematic review and meta-analysis. <\/span>Br J Sports Med<\/span><\/i> 2023 doi: 10.1136\/bjsports-2022-106422 [published Online First: 20230714]<\/span><\/li>\n
  2. Zacchilli MA, Owens BD. Epidemiology of shoulder dislocations presenting to emergency departments in the United States. <\/span>JBJS<\/span><\/i> 2010;92(3):542-49.<\/span><\/li>\n
  3. Polinder S, Haagsma J, Panneman M, et al. The economic burden of injury: Health care and productivity costs of injuries in the Netherlands. <\/span>Accident Analysis & Prevention<\/i> 2016;93:92-100.<\/span><\/li>\n<\/ol>\n

    <\/p>\n","protected":false},"excerpt":{"rendered":"

    This blog explains the effectiveness of exercises for first-time shoulder dislocations that occur in the forward direction due to a direct blow to the shoulder [primary traumatic anterior shoulder dislocation]. As an author group, we spent the last 3 years working through existing research to compile it into what is one of the highest levels […]<\/p>\n

    Read More…<\/a><\/p>\n","protected":false},"author":463,"featured_media":10752,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[16068,3045,16192],"class_list":["post-10751","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","tag-featured","tag-intervention","tag-shoulder"],"yoast_head":"\nEffectiveness of combined surgical and exercise-based interventions following primary traumatic anterior shoulder dislocation: a systematic review and meta-analysis - BJSM blog - social media's leading SEM voice<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bjsm\/?p=10751\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Effectiveness of combined surgical and exercise-based interventions following primary traumatic anterior shoulder dislocation: a systematic review and meta-analysis - BJSM blog - social media's leading SEM voice\" \/>\n<meta property=\"og:description\" content=\"This blog explains the effectiveness of exercises for first-time shoulder dislocations that occur in the forward direction due to a direct blow to the shoulder [primary traumatic anterior shoulder dislocation]. 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