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Related Experiment Video

Updated: Jan 30, 2026

Reverse Total Shoulder Arthroplasty
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Shoulder apprehension: A multifactorial approach.

Alexandre Lädermann1,2, Jérome Tirefort3, Davide Zanchi4

  • 1Division of Orthopaedics and Trauma Surgery, Department of Surgery, University Hospitals of Geneva, Switzerland.

EFORT Open Reviews
|January 22, 2019
PubMed
Summary
This summary is machine-generated.

Shoulder apprehension stems from brain network changes due to instability and nerve damage. A multimodal approach combining physical therapy, proprioception, and surgery can improve outcomes and prevent long-term joint issues.

Keywords:
anteroinferior glenohumeral dislocationapprehensionshoulder instability

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Area of Science:

  • Orthopedic Surgery
  • Neuroscience
  • Sports Medicine

Background:

  • Shoulder apprehension is linked to functional brain network alterations following dislocations.
  • Peripheral neuromuscular lesions and persistent glenohumeral instability contribute to micro-motion.
  • Identifying osseous, soft-tissue, and neurologic damage is crucial for effective patient treatment.

Purpose of the Study:

  • To review the relationship between shoulder apprehension and neurological/biomechanical factors.
  • To explore the efficacy of a multimodal treatment approach for shoulder instability.
  • To highlight methods for improving patient outcomes and preventing long-term complications.

Main Methods:

  • Literature review focusing on shoulder instability, neurological impact, and treatment strategies.
  • Analysis of evidence supporting a multimodal approach including "reafferentation" techniques.
  • Examination of surgical stabilization and physical therapy in managing micro-motion.

Main Results:

  • Shoulder apprehension is associated with changes in cerebral networks and persistent instability.
  • A multimodal strategy integrating proprioception, mirror therapy, cognitive behavioral approaches, surgery, and physical therapy shows promise.
  • Minimizing micro-motion is key to promoting brain healing and functional recovery.

Conclusions:

  • Comprehensive identification of all contributing factors (osseous, soft-tissue, neurologic) is essential.
  • A global multimodal approach offers a promising strategy for managing shoulder apprehension.
  • This integrated management can enhance return to sport and mitigate the risk of arthropathy.