A protocol for a new methodological model for work-related shoulder complex injuries: From diagnosis to rehabilitation

Igor Setuain, Miriam Gonzalez-Izal, Ainara Paularena, Jose Luis Luque, Lars L Andersen, Mikel Izquierdo, Igor Setuain, Miriam Gonzalez-Izal, Ainara Paularena, Jose Luis Luque, Lars L Andersen, Mikel Izquierdo

Abstract

Background: Work-related injuries of the shoulder complex represent a challenge for clinicians because of the large variety of clinical entities involved and the broad anatomic structures that can be affected. Furthermore, commonly performed orthopedic tests have demonstrated limited accuracy for diagnosing the injury despite considerable research efforts. The aim of this study protocol is therefore to describe a comprehensive approach integrating both a clinical- and functional status-based pathology and an adapted rehabilitation prescription.

Methods/design: A longitudinal cohort study will be performed at the Department of Rehabilitation and Medical Assistance of a mutual insurance society for work-related injury management in Spain (Mutua Navarra, Pamplona, Navarra Spain). Patients will be attended by an occupational physician who specializes in work-related injuries and is part of the project team that will systematically visit all the participants. After the medical diagnosis and any requested supplementary evaluations (i.e., radiological examinations), the patients will be referred to the rehabilitation service. Before the physiotherapeutic rehabilitation program is initiated, the patients will undergo a comprehensive functional screening at the biomechanics laboratory. Using a decision-making scheme, the identified functional deficits will be used to customize the individual rehabilitation plan.

Discussion: The proposed objective criteria-based shoulder diagnosis and rehabilitation model could be a new effective strategy for minimizing the time required to regain functional capacity and recover from symptoms among patients with work-related shoulder injuries.

Trial registration: The study protocol has been registered on Clinical Trials.gov as NCT02732002 (April 10th 2016).

Keywords: Injury; Management; Shoulder; Work environment.

Figures

Fig. 1
Fig. 1
Multi-etiologic shoulder injury management model for rehabilitation algorithm description
Fig. 2
Fig. 2
Range of Movement (ROM) measurement during the internal and external rotation evaluation using the inertial sensors. a Placement of the sensors (the reference sensor between the scapulas, and the others in the arm and forearm) and representation of the calculation of the angle as the projection in the sagittal plane. b Analysis software. c Example of ROM-Time curve
Fig. 3
Fig. 3
Example of a orthopedic test measurement using a dynamometer (Microfet 3, Hoggan Health)

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