PTCohortJournal of physical therapy science2024

Non-invasive evaluation of autonomic responses in patients with rotator cuff tear-related nocturnal pain.

Yusuke Fukumoto, Yoshihiro Tsuji, Akihiro Kakuda and 2 others

PMID 38434993

WHAT IT FOUND

Pulse rate did not differ between groups, but patients with persistent rotator cuff tear pain showed abnormal pulse rhythm patterns before, during, and after a hand squeeze test.

Key findings

01The persistent-pain group and the improved-pain group did not differ in pulse rate before, during, or after the hand squeeze test.

02The persistent-pain group deviated from the normal pulse rhythm pattern before, during, and shortly after the hand squeeze test, unlike the improved-pain group.

03More persistent-pain patients had pulse regularity outside the normal range than improved-pain patients.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The sample was small, with 14 patients in each group. The timing of autonomic testing after the injection was not standardized. The study did not measure autonomic responses before and after injection, so it cannot show whether the injection changed them. Patients also received joint range of motion work, muscle strengthening, and physical therapy, so the contribution of any single treatment cannot be separated. The number of patients exceeding questionnaire cut-offs did not differ significantly, so questionnaire results cannot explain the autonomic differences.

Declared interests

The authors declared no funding and no conflicts of interest.

The easy way to misread this

Do not conclude that a pulse rhythm test can identify why nocturnal pain persisted or that steroid injection caused the group difference. Autonomic testing occurred after injection and rehabilitation, and the post-injection timing was not standardized, so the study cannot separate the effects of the injection, range of motion work, strengthening, and physical therapy.

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