Apprehension-Based Training: A Novel Treatment Concept for Anterior Shoulder Dislocation - A Case Report.
Alon Rabin, Livneh Noyman, Noa Yaakobi and 1 others
PMID 38966825WHAT IT FOUND
A single patient with recurrent shoulder dislocations completed a 13-week exercise program involving moving the arm while lying down.
He reported less fear and better function, but still dislocated once during and once after treatment.
Key findings
01The patient improved in quality of life and function beyond clinically important differences, and reduced fear of movement beyond the test's error margin.
02The patient's ability to perform the specific movement pattern used for training improved significantly, and internal rotator strength increased, but external rotator strength did not change.
03The patient experienced one dislocation during the treatment period and one immediately after, resulting in a total of two dislocations over eight months compared to his previous monthly frequency.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a single case report, so it cannot prove the treatment works or determine if results were due to the specific exercises or natural healing. The patient still experienced dislocations during and after the treatment. Fear of movement improved during treatment but returned to near-baseline levels four months later. The reliability of the modified apprehension test used in this study was not established. No interim assessments were done, so it is unclear which of the three phases contributed most to the outcome.
Declared interests
No conflicts of interest or funding sources were declared in the provided text.
The easy way to misread this
Do not assume this program prevents re-dislocation. The patient still dislocated once during the 17-week treatment and once immediately after, and his fear of movement returned to baseline levels by the four-month follow-up.