Research Filip Struyf

Abstract

Shoulder pain is estimated to be the third most common musculoskeletal complaint in primary care, following low back pain and knee pain. Approximately 408,090 people in Belgium report shoulder pain annually, with estimated costs of €345 million in the Netherlands and €227 million in Belgium, mainly due to sick leave. Much of the economic and patient burden stems from chronic pathologies like frozen shoulder and shoulder surgery, with a higher risk of hypertrophic scarring in the shoulder area. The incidence of hypertrophic scarring post-surgery ranges from 40% to 70%, significantly impacting quality of life. Adequate assessment is crucial to alleviate this burden, providing essential information for tailored treatment plans. The lack of robust orthopedic tests impedes shoulder pain assessment, necessitating enhancement with non-invasive tools such as rehabilitative ultrasound imaging (RUSI). RUSI, considered the first-choice technique for assessing various shoulder conditions, offers comparable diagnostic sensitivity and specificity to MRI when performed by experienced healthcare providers. My research sabbatical has 1 societal (S1), 2 educational (E1&2), and 2 scientific (SC1&2) objectives: 1. Write a clinically accessible book on shoulder assessment for an international audience. 2. Learn and apply skills for basic and advanced shoulder and skin/scar ultrasound imaging. 3. Validate applied ultrasound skills with an experienced sonographer (international stay). 4. Develop a standardized ultrasound protocol for shoulder and scar assessment (international stay). 5. Explore, standardize, and test reliability of new ultrasound techniques for early frozen shoulder diagnosis (international stay).

Researcher(s)

• Promoter: Struyf Filip

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

The rotator cuff (RC) is a group of muscles and tendons that allows to move the shoulder, keeping the upper arm bone in the shoulder blade socket. An injury in the RC can cause swelling and irritation of these structures, making arm movements painful. This subacromial shoulder pain (SSP) can be caused by a combination of intrinsic factors (degeneration) and extrinsic factors (compression of the RC). Exercise therapy is the first choice of treatment in patients with SSP. However, it is not clear which parameters define the best exercises: e.g. the level of pain experienced by the patient during training. Our main hypothesis is that "exercising into discomfort" will give better results in terms of pain, functionality and quality of life. We therefore aim to identify the optimal dose of loading during exercise, steered by the patients' response. In this process, the Ultrasound (US) is a medical imaging modality that can give important information about tendon structural changes during treatment. This project will contribute to define: 1) the role of discomfort in exercise therapy for patients with SSP, 2) the relationship between tendon structural changes and pain, and 3) the optimal type of intervention that can improve changes in tendon structures visible by US. The final goal of this project is to develop the best evidence-based practice in the rehabilitation of SSP and to reduce its major socioeconomic burden.

Researcher(s)

• Promoter: Struyf Filip
• Fellow: Cavaggion Claudia

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

Shoulder pain is the third most common musculoskeletal disorder, with estimated lifetime prevalence around 10%. The prevalence for daily non-specific shoulder pain in the working population is around 12%, and up to 23% of the workforce seeking professional help with a shoulder related disorder have been sick-listed for at least one week. People with shoulder pain are often disabled to the point where they cannot live a normal life, suffering from sickness absence and poor quality of life. Clinically, subacromial pain is the most common form of complaint and causes a great loss of shoulder function, which accounts for 33% of all shoulder-related healthcare contacts. Previous studies have clearly shown that exercises are the preferred first choice of treatment for patients with subacromial pain. However, there are some studies supporting the benefits of using targeted strength training in patients with subacromial pain, but it is not clear what the best type of exercise combined with the patient response a health care provider should prescribe: should the patient feel pain during the performance of an exercise, or should pain be avoided? The present project aims to answer the following research questions: Which type of intervention (pain acceptance/pain avoidance) is superior to self-reported improved patient reported shoulder pain, function and quality of life? And which type of intervention (pain acceptance/pain avoidance) is superior to improved changes in the tendon structure, measured by Ultrasound? An RCT study will be conducted as a randomized, controlled, blinded multi-center trial in both public and private practice settings in Denmark, Belgium, Spain and The Netherlands with inclusion of patients from National Health Service musculoskeletal orthopedic outpatient departments and/or general practitioners. Both intervention groups will receive eccentric, concentric and isometric exercises of the same load, frequency, progression etc. However, the difference between both intervention groups will be based on the specific movement, which is either pain aggravation or not. The project is organized in cooperation between University of Antwerp (Belgium), University of Malaga (Spain), University College Rotterdam (The Netherlands) and University of Southern Denmark (Denmark). With this, the current project will have the assistance of the national and European shoulder networks in order to be sure of sufficient shoulder pain patients with different cultural backgrounds. This project will contribute to clarify the best treatment option in the management of subacromial pain. Clinicians and care providers will be benefited of this increase in the body of knowledge, in order to steer subacromial pain treatment and to improve clinical decision-making, and reducing the chronification of SPS. With this, the present project also attempt to reduce the massive economic burden of subacromial shoulder pain on society.

Researcher(s)

• Promoter: Struyf Filip
• Fellow: Cavaggion Claudia

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

Subacromial pain syndrome is the most common cause of shoulder pain, accounting for 50% of all shoulder pain cases. Scapular dyskinesis has shown to be a key factor associated with many shoulder disorders, such as the subacromial pain syndrome and glenohumeral shoulder instability. Two Master students product development have created (and privately defended) a basic prototype of an orthopaedic device that is aimed at correcting the scapular position. The current project proposal is aimed at bringing this product to the market. First, the prototype will be further developed and adapted with confirmation of its efficacy, i.e. the apparatus can indeed correct scapular position. Second, this improved prototype will be used within a smallscale clinical study to demonstrate that the apparatus can reduce pain in patients with subacromial pain syndrome. At the same time, a trajectory of valorization will be developed to investigate the possibilities of bringing the product to the market.

Researcher(s)

• Promoter: Struyf Filip
• Co-promoter: Truijen Steven
• Co-promoter: Verwulgen Stijn

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

The main aim of the project is to study the importance of acromiohumeral distance (AHD) and coracohumeral distance (CHD) in patients with chronic shoulder pain, and establish a comparison with people free of chronic shoulder pain. Shoulder impingement syndrome (SIS) is frequently related to a decrease of acromio-humeral distance (AHD), known like one of the extrinsic factor presented as possible cause for Shoulder Pain Syndrome (SPS). The evaluation of subacromial space has been traditionally carried out by magnetic resonance imaging, although in the last years ultrasonography has appeared as a more accessible, non-invasive and non-ionizing tool to measure this space. Quantifying this space in people suffering from chronic shoulder pain is challenging. If there is any relationship between changes in AHD and shoulder pain-function and range of movement (ROM) is still unknown. On the other hand, coracohumeral distance has been also considered as a possible risk factor for people suffering for anterior shoulder pain, being measured at the moment by MRI and CT (computed tomography). If a standard method could be develop to measure both spaces, and to determine the normative values and the relationship between these quantitative measures and shoulder pain-function and mobility, it could be of help to identify, in one hand, people at risk of perpetuating chronic shoulder pain and, on the other hand, steer treatments, contributing to increase the body of knowledge of the field. Hence, the aim of this project will be to determine the association between AHD-CHD and chronic shoulder pain and function, in addition to ROM-free of pain, and how AHD-CHD can be affected after the application of a multimodal physiotherapy program.

Researcher(s)

• Promoter: Struyf Filip
• Fellow: Navarro Ledesma Santiago

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

;Neck pain is one of the three most commonly reported musculoskeletal complaints, with point prevalence's varying between 10% and 22%. The lifetime prevalence has been estimated to be between 67% and 71% indicating that approximately two-thirds of all individuals will experience an episode of neck pain at some time during life. Several alterations in scapulothoracic muscle activity has been reported in patients with neck pain. In addition, there is clinical evidence that scapular position at rest and scapular motion during elevation of the upper limb may be altered in individuals with neck pain when compared to a healthy population. However, the literature clearly lacks a comprehensive studying of this relationship between scapular dysfunctions and neck pain. These insights may contribute to the rationale for the development of new therapeutic and/or preventive interventions. Therefore, the general purpose of this study is to obtain an understanding in the movement of the scapula in patients with neck pain in comparison to healthy controls. This leads to the following research questions: Do subjects with neck pain have a different movement pattern of the scapula compared to asymptomatic control subjects? and which variables affect scapular movement in neck pain patients? Consequently, patients with grade II neck pain according to the Classification of The Bone and Joint Task Force on Neck Pain and matched controls will be enrolled in this study. Pain and function will be evaluated with a Visual Analogue Scale, Neck Disability Index, Neck Bournemouth Questionnaire and CROM for cervical range of motion. The movement of the scapula will measured with the Polhemus 3SPACE FASTRAK, in order to register three scapular motions: posterior tilting (X-axis), upward rotation (Y-axis) and external/internal rotation (Z-axis).

Researcher(s)

• Promoter: Struyf Filip
• Co-promoter: De Hertogh Willem

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

The following study proposal concerns a prospective longitudinal study design in order to assess central sensitization and metabolic characteristics relative to the patients' pain, mobility and functioning in patients with adhesive capsulitis of the shoulder.

Researcher(s)

• Promoter: Struyf Filip
• Co-promoter: Meeus Mira

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project