Highlights
- •Prospectively examined if shoulder pathology was due to the fall or compensation and/or disuse.
- •Shoulder pathology concurrent with DRF group had significantly higher pain.
- •Shoulder pathology concurrent with DRF group had significantly higher activity avoidance.
- •Themes describe impact of pain, loss of function, use of compensatory mechanisms, kinesiophobia.
- •Mixed analysis describes a fear avoidance model of pain.
Abstract
Background
Shoulder pathology can occur concurrently with a distal radius fracture (DRF) but
few studies have examined this population.
Purpose
The purpose of this study was to expand the understanding of the impact of shoulder
pathology on individuals with DRF. Study Design: Mixed Methods Design.
Methods
A total of 45 participants with a DRF were categorized into a DRF only (n = 29) and shoulder pathology concurrent with DRF (SPCDRF) (n = 16) groups. Quantitative data gathered included demographics, Quick Disabilities
of the Arm, Shoulder, and Hand, Tampa Scale of Kinesiophobia-11, Visual Analog Scale,
and Compensatory Mechanism Checklist. Qualitative interviews were performed with 7
participants in the SPCDRF group. Within group correlations were analyzed via the
Spearman Rank. The Mann Whitney U test was used to compare the two groups. Qualitative
analysis was performed to describe the experience of participants in the SPCDRF group.
A mixed methods analysis compared quantitative and qualitative data.
Results
Sixteen participants (35.6%) in the sample presented with shoulder pathology; 6 participants
(37.5%) presented at initial evaluation due to the fall; 10 participants (62.5%) developed
shoulder pathology due to compensation or disuse. Average number of days to develop
shoulder pathology after the DRF was 43 days. SPCDRF participants had significantly
greater pain levels (p = .02) and more activity avoidance (p = .03) than the DRF only group. Four qualitative themes emerged: It's difficult to
perform occupations and changes had to be made; There is fear and uncertainty; The
impact of pain; Tried to be normal but could not Mixed methods analysis found that
qualitative data further illuminated quantitative findings.
Conclusions
Individuals with shoulder pathology concurrent with a DRF may present with higher
pain levels and avoid activity more. In addition, they may describe fearfulness in
using their injured upper extremity especially if they have high levels of pain.
Study Design
Mixed Methods Design.
Keywords
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Article info
Publication history
Published online: October 28, 2021
Accepted:
September 13,
2021
Received in revised form:
July 20,
2021
Received:
May 7,
2020
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2021 Elsevier Inc. All rights reserved.
