Title UTJECAJ MORFOLOGIJE KALCIFIKATA ROTATORNE MANŠETE NA BOL I FUNKCIJU RAMENA
Title (english) Impact of the morphology of calcified deposits within the rotator cuff on the pain and functioning of the shoulder
Author Gordana Cesarec
Mentor Nikola Čičak (mentor)
Committee member Mira Kadojić (predsjednik povjerenstva)
Granter Josip Juraj Strossmayer University of Osijek Faculty of Medicine Osijek Osijek
Defense date and country 2020-09-03, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Physical Medicine and Rehabilitation
Universal decimal classification (UDC ) 61 - Medical sciences
Abstract Cilj rada: Odrediti utjecaj morfologije kalcifikata na bol i funkciju ramena kod bolesnika s kalcificirajućom tendinopatijom rotatorne manšete. Nacrt studije: prospektivno istraživanje. Ispitanici i metode: Analizirani su radiološki, ultrazvučni i doplerski parametri 52 ispitanika oboljelih od jednostrane kalcificirajuće tendinopatije na početku istraživanja i nakon godinu dana. Jedan ispitanik podvrgnut je artroskopskom uklanjanju kalcifikata zbog čega je isključen iz studije. Učinjen je klinički pregled ramena, procjena boli pomoću vizualno analogne skale boli te tri funkcijska upitnika: Oxford upitika za rame, kratka verzija upitnika Nesposobnost ruke, ramena i šake -Quick DASH i Constant upitnik za rame. Korištena je metoda neparametrijske statistike: hi-kvadrat test. Dogovorena razina statističke značajnosti bila je p < 0,05. Rezultati: Razina boli prema VAS bila je statistički značajno različita na razini manjoj od 1% (2 = 30,929; df = 4; p < 0,001) u bolesnika s različitom morfologijom kalcifikata. Jaka bol ( VAS 8 - 10) javlja se najčešće u ispitanika s fragmentiranim, oblačastim kalcifikatima što je u skladu s dosad objavljenim istraživanjima. Razlika između pacijenata s različitom morfologijom kalcifikata u CSS rezultatu statistički je značajna na razini manjoj od 1% (2 = 36,098; df = 6; p < 0,001). Rezultat „Odlično“ javlja se najčešće kod lučnih (75 %), a rezultat „Loše“ kod fragmentiranih kalcifikata (73 %). Razlika između pacijenata s različitom morfologijom kalcifikata u rezultatu OSS statistički je značajna na razini manjoj od 5% (2 = 25,250; df = 6; p < 0,001). Jaka onesposobljenost (rezultat 0 - 19) javlja se najčešće (77 %) kod ispitanika s fragmentiranim kalcifikatom, a zadovoljavajuća funkcija (rezultat 40 - 48) u ispitanika s lučnim kalcifikatom (67 %). Rezultati Quick DASH-a pokazuju da lošiji funkcijski rezultat postižu pacijenti s fragmentiranim kalcifikatom (F = 7,930; df = 3; p < 0,001). Nema do sada objavljenih istraživanja koja su usmjerena na izravni utjecaj morfologije kalcifikata na funkciju ramena. Fragmentirani kalcifikati imaju statički značajno viši stupanj „osnaženog“ Dopplera (2 = 35,685; df = 9; p < 0,001). PD 2. stupnja (86 %). i 3. stupnja (81,8%) javlja se najčešće kod fragmentiranih kalcifikata. Zaključci: Ovo istraživanje je pakazalo da ispitanici s fragmentiranim, oblačastim kalcifikatom postižu statistiki značajno lošije rezultate na funkcijskim upitnicima, prijavljuju jaču bol i imaju zabilježen viši stupanj „osnaženog“ Dopplera.
Abstract (english) Objectives: The aim of the study is to examine the influence of the morphology of the calcium deposits on pain and function of the shoulder in patients with the calcific tendinopathy of the rotator cuff. Study Design: Prospective survey. Subjects and Methods Radiological, ultrasound and Doppler parameters of 52 subjects with unilateral calcific tendinopathy were analysed, at the beginning of the study, and one year after inclusion in the study. One of the subjects underwent arthroscopic removal of calcium deposits, and was therefore excluded from the study. A clinical examination of both shoulders and pain estimation using a visual analogue pain scale were performed including the conducting of three functional questionnaires, specifically the Oxford shoulder score, Quick DASH and Constant Shoulder Score. Nonparametric statistics was used, i.e., the Chi-squared test. The agreed level of statistical significance was p<0.05. The results: A statistically significant difference of less than 1% was demonstrated among patients with different morphology of deposits and the level of pain on the VAS scale (2= 30.929; df = 4; p < 0.001). Severe pain (VAS 8-10) occurs most commonly in subjects with fragmented, cloudy deposits, which is consistent with previous published studies. The difference between patients with three different morphologies of deposits on the CSS score is statistically significant at less than 1% (2 = 36.098; df = 6; p < 0.001). The result "Excellent" was most commonly described in cases with arch-shaped deposits (75 %), and the result "Poor" in cases with fragmented, cloudy deposits (73 %). The difference between patients with three different types of deposits measured by the Oxford Shoulder Score is statistically significant at less than 5% (2 = 25.250; df = 6; p< 0.001). Severe disability (score 0-19) occurs most often in patients with fragmented deposits and proper functioning (score 40-48) in patients with arch-shaped deposits (67 %). Quick DASH results show that subjects with fragmented deposits achieve a poorer functional result (F = 7.930; df = 3; p < 0.001). So far, there have been no published studies focusing on the direct impact of deposit morphology on the functioning of the shoulder. A statistically significant higher grade of the Power Doppler, most commonly grade 2. and grade 3., was found in patients with fragmented deposits (2 = 35.685, df = 9, p < 0.001). Conclusion This research has shown that subjects with fragmented, cloudy deposits achieve statistically significantly worse results on functional questionnaires, experience stronger pain and have higher Power Doppler grades.
Keywords
kalcificirajuća tendinopatija
morfologija kalcifikata
osnaženi Doppler
rame
ultrazvuk
Keywords (english)
calcific tendinopathy
morphology of calcific deposits
Power Doppler
shoulder
ultrasonography
Language croatian
URN:NBN urn:nbn:hr:152:028237
Promotion 2020
Study programme Title: University Postgraduate Study Study programme type: university Study level: postgraduate Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Repository Repository of the Faculty of Medicine Osijek
Created on 2020-09-29 09:49:01