2023 Data (Information)

Triangular forearm support and rotator cuff syndrome- EMG insight into how it works with 2-year follow-up

Fishman, Loren M.

Trial Design: Randomized control crossover of yoga-like maneuver treating MRI confirmed rotator cuff syndrome (RCS) with minimum 29-month follow-up.

Setting: Private office.

Patient selection: Patients with RCS pain >5/10 on the visual analogue scale (VAS). 167 patients: Intervention (80) and Placebo (87) groups.

Intervention: Triangular forearm support (TFS).

Main outcome measures: Patients and examiner rated maximum pain with abduction and flexion before intervention or sham treatment, immediately afterwards, for sham patients, a third time after they received TFS (crossover) with 2-year follow-up.

Statistical analysis: VAS; t-tests/Wilcoxon rank sum test.

Method: Patients and clinicians rated abduction and flexion pain pre- and post - TFS and placebo. Placebo group also rated pain after subsequent TFS.

Results: Results: Mean post-TFS and post-placebo VAS for abduction and flexion were 1.98 and 1.64 points lower. (CI: .0526; .0438), and 1.08 and .93 lower respectively (CI: .0357; .0357). t-test: p = .002; .008, respectively; Wilcoxon rank sum test value: p = .004 and .002 respectively. Mean examiner VAS for abduction and flexion after TFS dropped 2.4 and 2.02 (CI:.057; .048); placebo VAS dropped 1.06 and .71; (CI:.0317;.0317). All tests had p < .001. After placebo patients received TFS, mean VAS for abduction and flexion for patients and examiner dropped 1.25 and 1.39 (CI: .0425; .0383) and 1.65 and 1.77 (CI: .0425; .0425) respectively. All tests had p < .001. Mean 52-month follow-up: abduction and flexion VAS: mean improvement from initial post TFS VAS: 0.92 points (95% CI: 0.13 to 1.71), p = 0.02 and 1.3 points (95% CI 0.54 to 1.73), p <0.001) respectively. No limitations on abduction or flexion range of motion were reported by 31/54 and 32/54 patients at that time.

EMG indicated that TFS activated the subscapularis, cantilevering the humerus upward between 80 – 110 degrees.

Conclusion: The TFS maneuver may help treat RCS.