Literature DB >> 32880525

Does Functional Bracing of the Unstable Shoulder Improve Return to Play in Scholastic Athletes? Returning the Unstable Shoulder to Play.

Adam Kwapisz1,2, Ellen Shanley3, Amit M Momaya4, Chris Young5, Michael J Kissenberth4, Stefan J Tolan4, Keith T Lonergan4, Douglas J Wyland4, Richard J Hawkins1, Stephan G Pill4, John M Tokish6.   

Abstract

BACKGROUND: Functional bracing is often used as an adjunct to nonoperative treatment of anterior shoulder instability, but no study has evaluated the effectiveness of in-season bracing. The purpose of this study was to examine successful return to play in a nonoperative cohort of adolescent athletes with in-season shoulder instability and compare those athletes treated with bracing to those who were not. HYPOTHESIS: The use of functional bracing will improve success rates in a cohort of athletes treated nonoperatively for in-season shoulder instability. STUDY
DESIGN: Cohort study. LEVEL OF EVIDENCE: Level 3.
METHODS: A total of 97 athletes with anterior shoulder instability were followed for a minimum of 1 year. The mean age was 15.8 ± 1.4 years (range, 12.0-18.0 years). All athletes were treated with initial nonoperative management. Twenty athletes (21%) were also treated with bracing while 77 (79%) were not. The athlete completing the current season and 1 subsequent season without surgery or time lost from shoulder injury was defined as a successful outcome.
RESULTS: There was no statistical difference in nonoperative success rates between the braced and nonbraced athletes (P = 0.33). Braced athletes (n = 20) returned to play 80% of the time, while nonbraced athletes (n = 77) returned at a rate of 88%. Of the braced athletes, 85% were football players (n = 17). A football-only comparison demonstrated no difference between braced failures (26%) and nonbraced failures (16%) (P = 0.47).
CONCLUSION: This is the first study to evaluate the utility of functional bracing in returning an athlete to sport and completing a full subsequent season without surgery or time loss due to injury of the shoulder. In adolescent athletes with shoulder instability treated nonoperatively, functional bracing did not result in increased success rates when compared with no bracing. CLINICAL RELEVANCE: The data from this study indicate that functional bracing may not improve success rates for athletes with shoulder instability.

Entities:  

Keywords:  functional bracing; nonoperative treatment; recurrence; return to sport; shoulder instability

Mesh:

Year:  2020        PMID: 32880525      PMCID: PMC7734369          DOI: 10.1177/1941738120942239

Source DB:  PubMed          Journal:  Sports Health        ISSN: 1941-0921            Impact factor:   3.843


  15 in total

Review 1.  Managing anterior shoulder instability with bracing: an expanded update.

Authors:  Bryan L Reuss; Warren G Harding; Kevin D Nowicki
Journal:  Orthopedics       Date:  2004-06       Impact factor: 1.390

Review 2.  Conservative treatment of first-time shoulder dislocation with the arm in external rotation.

Authors:  Nobuyuki Yamamoto; Hirotaka Sano; Eiji Itoi
Journal:  J Shoulder Elbow Surg       Date:  2010-03       Impact factor: 3.019

3.  Return to play and recurrent instability after in-season anterior shoulder instability: a prospective multicenter study.

Authors:  Jonathan F Dickens; Brett D Owens; Kenneth L Cameron; Kelly Kilcoyne; C Dain Allred; Steven J Svoboda; Robert Sullivan; John M Tokish; Karen Y Peck; John-Paul Rue
Journal:  Am J Sports Med       Date:  2014-11-05       Impact factor: 6.202

4.  Successful Return to Sport After Arthroscopic Shoulder Stabilization Versus Nonoperative Management in Contact Athletes With Anterior Shoulder Instability: A Prospective Multicenter Study.

Authors:  Jonathan F Dickens; John-Paul Rue; Kenneth L Cameron; John M Tokish; Karen Y Peck; C Dain Allred; Steven J Svoboda; Robert Sullivan; Kelly G Kilcoyne; Brett D Owens
Journal:  Am J Sports Med       Date:  2017-06-28       Impact factor: 6.202

Review 5.  Management of primary acute anterior shoulder dislocation: systematic review and quantitative synthesis of the literature.

Authors:  Umile Giuseppe Longo; Mattia Loppini; Giacomo Rizzello; Mauro Ciuffreda; Nicola Maffulli; Vincenzo Denaro
Journal:  Arthroscopy       Date:  2014-04       Impact factor: 4.772

Review 6.  Conservative management following closed reduction of traumatic anterior dislocation of the shoulder.

Authors:  Nigel C A Hanchard; Lorna M Goodchild; Lucksy Kottam
Journal:  Cochrane Database Syst Rev       Date:  2014-04-30

7.  Redefining "Critical" Bone Loss in Shoulder Instability: Functional Outcomes Worsen With "Subcritical" Bone Loss.

Authors:  James S Shaha; Jay B Cook; Daniel J Song; Douglas J Rowles; Craig R Bottoni; Steven H Shaha; John M Tokish
Journal:  Am J Sports Med       Date:  2015-04-16       Impact factor: 6.202

8.  Functional outcome and risk of recurrent instability after primary traumatic anterior shoulder dislocation in young patients.

Authors:  C Michael Robinson; Jonathan Howes; Helen Murdoch; Elizabeth Will; Catriona Graham
Journal:  J Bone Joint Surg Am       Date:  2006-11       Impact factor: 5.284

9.  Shoulder Instability Management: A Survey of the American Shoulder and Elbow Surgeons.

Authors:  Grant H Garcia; Samuel A Taylor; Peter D Fabricant; Joshua S Dines
Journal:  Am J Orthop (Belle Mead NJ)       Date:  2016 Mar-Apr

10.  Epidemiology of Shoulder Dislocations in High School and Collegiate Athletics in the United States: 2004/2005 Through 2013/2014.

Authors:  Matthew J Kraeutler; Dustin W Currie; Zachary Y Kerr; Karen G Roos; Eric C McCarty; R Dawn Comstock
Journal:  Sports Health       Date:  2017-05-30       Impact factor: 3.843

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