http://repub.eur.nl/res/aut/18524/ List of Publications en http://repub.eur.nl/static-eur/img/logo.png http://repub.eur.nl http://repub.eur.nl/res/pub/15682/ 2006-06-01T00:00:00Z For the posterior interosseus nerve syndrome (PINS), no randomised controlled trials or controlled clinical trials about the effectiveness of interventions are available; only case series can be found. Although the validity of case series is inferior to controlled trials, they may provide valuable data about the efficacy of treatment options. Therefore, we systematically reviewed all available observational studies on treatment of PINS. A literature search and additional reference checking was done. On the basis of previous checklists, we constructed a quality assessment and rating system to analyse the included case series. Studies with less than 50% of the maximum points on the methodological quality assessment were excluded from the analysis. The results are summarised according to a rating system for the strength of the scientific evidence. Six eligible case series for this review were found. After the data extraction and methodological quality assessment, two higher quality studies that evaluated the effectiveness of surgical decompression of the PIN were included in the final analysis. There is a tendency for the effectiveness of surgical decompression of the PIN in patients with PINS. The effectiveness of a conservative treatment for PINS is unknown because no higher quality studies are available. Additional high-quality controlled studies are needed to assess the level of 'conclusive evidence' for surgical treatment. There is also a need for high-quality controlled trials into the effectiveness of conservative treatments for PINS. http://repub.eur.nl/res/pub/15679/ 2006-03-01T00:00:00Z The goal of this systematic review is to evaluate the effectiveness of different treatments for impingement syndrome and rotator cuff tear on the improvement in functional limitations and concomitant duration of sick leave. A systematic search for clinical trials or controlled studies was conducted with the following text words: should*, rotator cuff, impingement, work, sick leave, disabilit*, function*. Nineteen articles were included in this review. For functional limitations, there is strong evidence that extracorporeal shock-wave therapy is not effective, moderate evidence that exercise combined with manual therapy is more effective than exercise alone, that ultrasound is not effective, and that open and arthroscopic acromioplasty are equally effective on the long term. For all other interventions there is only limited evidence. We found many studies using range of motion and pain as outcome measures but functional limitations were less often used as an outcome measure in this type of research. Duration of sick leave was seldom included as an outcome measure. http://repub.eur.nl/res/pub/13530/ 2004-10-27T00:00:00Z CONTEXT: History taking and clinical tests are commonly used to diagnose shoulder pain. Unclear is whether tests and history accurately diagnose instability or intra-articular pathology (IAP). OBJECTIVE: To analyze the accuracy of clinical tests and history taking for shoulder instability or IAP. DATA SOURCES: Relevant studies identified through PubMed, EMBASE, CINAHL, and bibliographies of known primary and review articles. STUDY SELECTION: Studies comparing the performance of history items or physical examination with a reference standard were included. Studies on fibromyalgia, fractures, or systemic disorders were excluded. Of 1449 articles, 35 were eligible, and 17 were selected. DATA EXTRACTION: Data were extracted on study population, clinical tests, reference tests, and outcome. The studies' methodological quality (patient spectrum, verification, blinding, and replication) was assessed with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) checklist. DATA SYNTHESIS: Six tests showed positive likelihood ratios (LRs) and confidence intervals (CIs). Tests favoring the diagnosis for establishing instability included: relocation (LR, 6.5; 95% CI, 3.0-14.0) and anterior release (LR, 8.3; 95% CI, 3.6-19). Tests showing promise for establishing labral lesions included: the biceps load I and II (LR, 29; 95% CI, 7.3-115.0 and LR, 26; 95% CI, 8.6-80.0), respectively, pain provocation of Mimori (LR, 7.2; 95% CI, 1.6-32.0), and internal rotation resistance strength (LR, 25; 95% CI, 8.1-76.0). The apprehension, clunk, release, load and shift, and sulcus sign tests proved less useful. Results should be cautiously interpreted because studies were completed in select populations in orthopedic practice, mostly assessed by the test designers, and evaluated in single studies only. No accuracy studies were found for history taking or for clinical tests in primary care. CONCLUSIONS: Shoulder complaints are frequently recurrent. Instability might cause some of these complaints. Best evidence supports the value of the relocation and anterior release tests. Symptoms related to IAP (labral tears) remain unclear. Most promising for establishing labral tears are currently the biceps load I and II, pain provocation of Mimori, and the internal rotation resistance strength tests. http://repub.eur.nl/res/pub/15636/ 2004-08-01T00:00:00Z OBJECTIVES: This study assessed the differences and similarities in the incidence and recurrence of shoulder and neck complaints with respect to work-related physical, psychosocial, and personal risk factors. METHODS: A prospective cohort study was carried out among 769 workers of nursing homes and homes for the elderly. At baseline, a questionnaire was used to collect data on personal characteristics, physical workload, psychosocial workload, and the presence of shoulder and neck complaints. After 1 and 2 years, follow-up data were collected on shoulder and neck complaints. Generalized estimation equations were used for analyzing risk factors for the participants with at least one follow-up measurement available (N=556, 72%). RESULTS: In the multivariate model, adjusted for age and gender, obesity [odds ratio (OR) 2.12, 95% confidence interval (95%CI) 1.23-3.65] was related to the incidence of shoulder complaints. The incidence of neck complaints was increased for obesity (OR 1.81, 95% CI 1.07-3.05), work in awkward postures (OR 1.76, 95% CI 1.11-2.78), and poor or fair general health (OR 1.53, 95% CI 1.02-2.31). The recurrence of both shoulder and neck complaints was associated with chronic complaints at baseline (shoulder: OR 1.91, 95% 1.36-2.67; neck: OR 1.71, 95% 1.14-2.55) but not with work-related risk factors. CONCLUSIONS: The results suggest that there are differences in risk factors for the incidence and recurrence of shoulder and neck complaints.