PMID- 28217426
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220330
IS  - 2159-2896 (Print)
IS  - 2159-2896 (Electronic)
IS  - 2159-2896 (Linking)
VI  - 12
IP  - 1
DP  - 2017 Feb
TI  - TREATMENT OF ANTERIOR SHOULDER SUBLUXATION USING THE MULLIGAN CONCEPT AND REFLEX 
      NEUROMUSCULAR STABILIZATION: A CASE REPORT.
PG  - 155-162
AB  - BACKGROUND AND PURPOSE: Shoulder instability, a common issue among athletes who 
      engage in contact sports, may lead to recurrent subluxations, or partial 
      dislocations of the shoulder. Young athletic patients generally respond poorly to 
      the nonsurgical treatments for shoulder instability that are commonly utilized. 
      The purpose of this case report is to describe the effects of the treatment 
      guided by the Mulligan Concept (MC) coupled with reflex neuromuscular 
      stabilization (RNS) also known as reactive neuromuscular training (RNT), on an 
      adolescent football player with glenohumeral joint (GHJ) instability who 
      sustained a traumatic anterior subluxation. CASE DESCRIPTION: The MC shoulder 
      Mobilization with Movement (MWM) and RNS were applied in the treatment of an 
      anterior shoulder subluxation injury sustained by a competitive adolescent 
      football player. The Numeric Pain Rating Scale (NPRS), the Disability in the 
      Physically Active (DPA) scale, the Patient specific Functional Scale (PSFS) and 
      the Shoulder Pain and Disability Index (SPADI), were administered in order to 
      identify patient-reported outcomes. OUTCOMES: The shoulder MWM and RNS provided 
      immediate relief of all of the patient's pain and increased ROM after the first 
      treatment. The use of the coupled treatments resulted in a resolution of pain, an 
      increase in range of motion (ROM) and improvement in perceived stability. A 
      minimal clinically important difference (MCID) was reported on the NPRS and 
      minimal detectable changes (MDC) were reported on the NRS and PSFS, after the 
      first treatment. Equally important, MCIDs were reported on the DPA scale and 
      SPADI scale over the course of treatment. DISCUSSION: In this case report, the MC 
      shoulder MWM, coupled with RNS, was an effective treatment for this patient and 
      provided a short time to resolution (6 treatments; 19 days) compared to other 
      descriptions of recovery in the literature. Clinicians treating patients who 
      display anterior shoulder instability can consider this as a viable treatment 
      option. Even though current literature indicates that surgery is an optimal 
      treatment for reducing recurrent subluxations, in young athletes who participate 
      in contact sports, the effects of surgery are substantial. Therefore, the 
      consideration of the presented option for non-operative treatment is important. 
      LEVEL OF EVIDENCE: 4-Case Report.
FAU - Hudson, Robinetta A
AU  - Hudson RA
AD  - Concordia Lutheran High School, Tomball, TX, USA.
FAU - Baker, Russell T
AU  - Baker RT
AD  - University of Idaho, Moscow, ID, USA.
FAU - Nasypany, Alan
AU  - Nasypany A
AD  - University of Idaho, Moscow, ID, USA.
FAU - Reordan, Don
AU  - Reordan D
AD  - Jacksonville Physical Therapy, Jacksonville, OR, USA.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Int J Sports Phys Ther
JT  - International journal of sports physical therapy
JID - 101553140
PMC - PMC5294942
OTO - NOTNLM
OT  - Instability
OT  - Mobilization with Movement
OT  - Muscle Patterns
OT  - Nonsurgical Treatment
EDAT- 2017/02/22 06:00
MHDA- 2017/02/22 06:01
PMCR- 2017/02/01
CRDT- 2017/02/21 06:00
PHST- 2017/02/21 06:00 [entrez]
PHST- 2017/02/22 06:00 [pubmed]
PHST- 2017/02/22 06:01 [medline]
PHST- 2017/02/01 00:00 [pmc-release]
PST - ppublish
SO  - Int J Sports Phys Ther. 2017 Feb;12(1):155-162.