Limited evidence exists which details changes in quality of life, shoulder activity level, kinesiophobia, shoulder pain and disability following a first-time traumatic anterior shoulder dislocation (FTASD) in people treated non-operatively. This study had three objectives: (1) to examine quality of life, pain, disability and kinesiophobia after an FTASD within 12 weeks, (2) to examine whether these variables were different in people with and without recurrent shoulder instability and (3) to assess how these variables changed over 12 months.
Methods
A prospective cohort study was undertaken in people with an FTASD aged between 16 and 40 years. Measures of quality of life, kinesiophobia, shoulder activity, shoulder pain and disability were recorded within 12 weeks of an FTASD and at 3, 6, 9 and 12 months.
Results
An FTASD negatively impacted quality of life, shoulder pain and function and these variables improved over time. People with recurrent shoulder instability had poorer quality of life 12 months after an FTASD. Across the entire cohort, kinesiophobia did not significantly change across time in people following an FTASD.
Conclusions
Quality of life was significantly affected by an FTASD in people with recurrent shoulder instability. Across the entire cohort of people with an FTASD, kinesiophobia remained elevated in people following an FTASD.
te SlaaRLWijffelsMPJMBrandR, et al.A prospective arthroscopic study of acute first-time anterior shoulder dislocation in the young: a five-year follow-up study. J Shoulder Elbow Surg2003; 12: 529–534.
2.
MaransHJJAngelKRRSchemitschEHH, et al.The fate of traumatic anterior dislocation of the shoulder in children. J Bone Joint Surg Am1992; 74: 1242–1244.
3.
WassersteinDNShethUColbensonK, et al.The true recurrence rate and factors predicting recurrent instability after nonsurgical management of traumatic primary anterior shoulder dislocation: a systematic review. Arthroscopy2016; 32: 2616–2625.
4.
OldsMEllisRDonaldsonK, et al.Risk factors which predispose first-time traumatic anterior shoulder dislocations to recurrent instability in adults: a systematic review and meta-analysis. Br J Sports Med2015; 49: 913–922.
5.
LentersTRFrantaAKWolfFM, et al.Arthroscopic compared with open repairs for recurrent anterior shoulder instability. A systematic review and meta-analysis of the literature. J Bone Joint Surg Am2007; 89: 244–254.
6.
HoveliusLOlofssonASandströmB, et al.Nonoperative treatment of primary anterior shoulder dislocation in patients forty years of age and younger. a prospective twenty-five-year follow-up. J Bone Joint Surg Am2008; 90: 945–952.
7.
SachsRALouSMPaxtonE, et al.Can the need for future surgery for acute traumatic anterior shoulder dislocation be predicted?J Bone Joint Surg Am2007; 89: 1665–1674.
8.
GeromettaAKloucheSHermanS, et al.The shoulder instability-return to sport after injury (SIRSI): a valid and reproducible scale to quantify psychological readiness to return to sport after traumatic shoulder instability. Knee Surg Sports Traumatol Arthrosc2018; 26: 203–211.
9.
KirkleyAWerstineRRatjekA, et al.Prospective randomized clinical trial comparing the effectiveness of immediate arthroscopic stabilization versus immobilization and rehabilitation in first traumatic anterior dislocations of the shoulder: long-term evaluation. Arthroscopy2005; 21: 55–63.
10.
RobinsonCMHowesJMurdochH, et al.Functional outcome and risk of recurrent instability after primary traumatic anterior shoulder dislocation in young patients. J Bone Joint Surg Am2006; 88: 2326–2336.
11.
TjongVKDevittBMMurnaghanML, et al.A qualitative investigation of return to sport after arthroscopic bankart repair: beyond stability. Am J Sports Med2015; 43: 2005–2011.
12.
OzturkBMaakTFabricantP, et al.Return to sports after arthroscopic stabilization in patients aged younger than 25 years. Arthroscopy2013; 29: 1922–1931.
13.
ParrJJBorsaPFillingimR, et al.Psychological influences predict recovery following exercise induced shoulder pain. Int J Sports Med2014; 35: 232–237.
14.
EshojHRasmussenSFrichLH, et al.Patients with non-operated traumatic primary or recurrent anterior shoulder dislocation have equally poor self-reported and measured shoulder function : a cross-sectional study. BMC Musculoskelet Disord2019; 20: 59–59.
15.
OldsMDonaldsonKEllisR, et al.In children 18 years and under, what promotes recurrent shoulder instability after traumatic anterior shoulder dislocation? A systematic review and meta-analysis of risk factors. Br J Sports Med2016; 50: 1135–1141.
16.
KirkleyAGriffinSMcLintockH, et al.The development and evaluation of a disease-specific quality of life measurement tool for shoulder instability: The Western Ontario Shoulder Instability Index (WOSI). Am J Sports Med1998; 26: 764–771.
17.
RoachKEBudiman-MakESongsiridejN, et al.Development of a shoulder pain and disability index. Arthritis Care Res1991; 4: 143–9.
18.
WobySRRoachNKUrmstonM, et al.Psychometric properties of the TSK-11: a shortened version of the Tampa Scale for Kinesiophobia. Pain2005; 117: 137–144.
19.
DickensJFOwensBDCameronKL, et al.Return to play and reccurent instability after in season anterior shoulder instability. Am J Sports Med2014; 42: 2842–2850.
20.
MaRBrimmoOALiX, et al.Current concepts in rehabilitation for traumatic anterior shoulder instability. Curr Rev Musculoskelet Med2017, pp. 499–506.
21.
JohnstonLHCarrollD. The context of emotional responses to athletic injury: a qualitative analysis. J Sport Rehabil1998; 7: 206–220.
22.
ParrJJBorsaPAFillingimRB, et al.Pain-related fear and catastrophizing predict pain intensity and disability independently using an induced muscle injury model. J Pain2012; 13: 370–378.
23.
PrughJZeppieriGGeorgeSZ. Impact of psychosocial factors, pain, and functional limitations on throwing athletes who return to sport following elbow injuries: a case series. Physiother Theory Pract2012; 28: 633–640.
24.
CunninghamGZanchiDEmmertK, et al.Neural correlates of clinical scores in patients with anterior shoulder apprehension. Med Sci Sports Exerc2015; 47: 2612–2620.
25.
KraeutlerMJMcCartyECBelkJW, et al.Descriptive epidemiology of the MOON shoulder instability cohort. Am J Sports Med2018; 46: 1064–1069.
26.
KirkleyAGriffinSDaintyK. Scoring systems for the functional assessment of the shoulder. Arthroscopy2003; 19: 1109–1120.
27.
ButeauJLEriksrudOHassonSM. Rehabilitation of a glenohumeral instability utilizing the body blade. Physiother Theory Pract2007; 23: 333–349.
28.
Statistics New Zealand. Migration, New Zealand: Statistics New Zealand, 2016.
29.
AtkinsonMJLennoxRD. Extending basic principles of measurement models to the design and validation of Patient Reported Outcomes. Health Qual Life Outcomes2006; 4: 1–12.
30.
NunnallyJCBernsteinIH. Psychometric theory, 3rd ed. New York: McGraw-Hill, Inc., 1994.
