Limitation of motion and shoulder disabilities in patients with cardiac implantable electronic devices

Area of Science:

• Orthopedics
• Cardiology
• Rehabilitation Medicine

Background:

• Cardiac implantable electronic devices (CIEDs) are common treatments for cardiac arrhythmias.
• Potential side effects include upper extremity functional limitations and shoulder range of motion (ROM) deficits.
• The impact of implantation time on these deficits requires further investigation.

Purpose of the Study:

• To investigate shoulder ROM and upper extremity function in patients with CIEDs.
• To compare short-term recipients (STRs) with long-term recipients (LTRs).
• To identify factors contributing to shoulder dysfunction post-CIED implantation.

Main Methods:

• Shoulder ROM was measured using a digital goniometer, comparing the CIED side to the contralateral arm.
• Functional status was assessed using the Constant-Murler Score, Shoulder Pain Disability Index (SPDI), and Shoulder Disability Questionnaire (SDQ).
• Patients were categorized into STRs (<3 months post-implantation) and LTRs (>3 months post-implantation).

Main Results:

• Significant limitations in shoulder flexion, abduction, and internal rotation were observed on the CIED side compared to the control arm.
• STRs exhibited significant differences in shoulder flexion, abduction, and external rotation compared to LTRs.
• Shoulder disability, measured by SPDI and SDQ, was more prominent in STRs, although Constant-Murler Scores did not differ significantly between groups.

Conclusions:

• Patients with CIEDs experience shoulder ROM limitations and functional disability, more pronounced in the short term.
• Potential contributing factors include pain, CIED-pectoral muscle association, capsular pathology, and patient avoidance behaviors.
• Early assessment and management of shoulder function may be crucial for CIED recipients.