Griffiths, S.; (2008) Investigation of trophic changes in cervical dysfunction and frozen shoulder. Masters thesis , University of London.

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Abstract

Trophic changes have been identified by several investigators and associated with visceral, articular and neural pathology. There have been claims that trophic changes can be used as clinical indicators of pathology of both visceral (Wesselmann and Lai 1997 Giamberardino et al, 2005 Vecchiet et al, 1990) and somatic structures (Gunn and Milbrandt 1978 Galletti et al, 1990), however no sensitivity analysis has been conducted in any of the studies so far to substantiate these claims. This dissertation consisted of 2 linked studies, both were non-randomized controlled studies, the first aimed to investigate the sensitivity of vasomotor, sensory and motor trophic changes using tests suitable for clinical practice in subjects with cervical sensory radiculopathy (n=31) and frozen shoulder (n=32) (control n=30). The second was a controlled study (n=30) which investigated the effect of intra-articular cortico-steroid injection on trophic changes in frozen shoulder (n=T7), before and 4 weeks after injection. The results showed that though there were significant differences between the trophic changes measured in the control and experimental groups, these were not sensitive indicators of pathology in frozen shoulder or cervical radiculopathy, (vasomotor sensitivity 0.31 and 0.06 sensory sensitivity 0.41 and 0.39 and motor sensitivity 0.25 and 0.16, for frozen shoulder and cervical radiculopathy respectively). The results of study 2 also showed that there were no significant differences in trophic changes recorded following cortico-steroid injection (P>0.05), which suggests that anti-inflammatory medication has no impact on their existence.

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