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Fulltext Sports-related shoulder dislocations: a state-hospital experience

Hazmy CHW, Parwathi A

Med J Malaysia, 2005 Jul;60 Suppl C:22-5.
PMID: 16381278

This retrospective study was conducted in a state hospital set-up and aimed at identifying the incidence of sports-related shoulder dislocations and their characteristics and the sports events involved. All patients with shoulder dislocation related to sporting activities admitted to the hospital from January 1999 to December 2002 were included in the study. There were 18 sports-related shoulder dislocations out of 106 all shoulder dislocations admitted during this 4-year period. The average age of the patients was 25.4 years. All but two were male. All were anterior dislocations. Recurrent dislocation constitutes 78% of the cases with an average of 3 times re-dislocation. Rugby and badminton were the major contributors to the injuries followed by volleyball, soccer and swimming. Conservative treatment was successfully instituted for 88% of the patients and 12% opted for surgical intervention.
Fulltext The epidemiology of shoulder dislocation in a state-hospital: a review of 106 cases

Hazmy CHW, Parwathi A

Med J Malaysia, 2005 Jul;60 Suppl C:17-21.
PMID: 16381277

This retrospective study was conducted in a state hospital set-up and aimed at identifying the magnitude of shoulder dislocations and their demographic data, characteristics of the injury, mechanism and predisposing factors, and the instituted treatment. Patients with radiographic evidence of shoulder dislocation admitted to the hospital from January 1999 to December 2002 were included. Data were recorded from the case notes. There were 105 shoulder dislocations with male predomination in 77% cases and age ranged between 11 and 90 years (average 30.9 years). The right shoulder was affected in 68% of the cases. The contributing events were fall in 37% of cases, road traffic accident 23%, sports 17% and pathological conditions 13%. Anterior dislocation occurred in 96.2% of the cases. Posterior and inferior dislocations encountered in two patients for each type. Twelve dislocations were associated fracture of the greater tuberosity, two each with humeral neck fracture and cerebral injuries. First time dislocation occurred in 73.6% of the cases. The recurrences ranged between 2 to 6 times (average 3.4 times). Closed manipulative reduction and strapping was the definitive treatment in 92.4% of the cases and the remaining needed surgical reconstruction. Four patients had open reduction and internal fixation of the associated fractures while another four had arthroscopic Bankart's repair. In conclusion, shoulder dislocation represents the most common shoulder problems. It afflicted young adults of reproductive age (21-40 years) and participation in sports was a risk factor in men. Women over 40 years and fall were at risk to develop shoulder dislocation.
Development and validation of pelvic floor muscles exercise intervention for urinary incontinence among pregnant women

Parwathi A, Sherina MS, Rampal L, Ismail SIF

Med J Malaysia, 2021 05;76(3):332-339.
PMID: 34031331

INTRODUCTION: The prevalence of urinary incontinence among pregnant women is high in Malaysia. However, healthcare providers appear to pay little attention to it along with a limited local intervention that addresses the continence health during pregnancy. This study aims to develop and validate intervention with pelvic floor muscle exercise (PFME) for pregnant women.
MATERIALS AND METHODS: The development of PFME intervention was guided by the Medical Research Council Framework for Developing and Evaluating Complex Intervention (MRC Framework). This involved four phases: identification of current research evidence, expert opinion, validation via focus group discussions with physiotherapists and pregnant women, and piloting the intervention using a single group pre-post design among 30 pregnant women at Maternity Hospital Kuala Lumpur to assess the feasibility of the intervention by evaluating changes in knowledge and attitude. The qualitative approach was used to analyse the first three phases, while non-parametric methods were used to analyse the pilot prepost test results.
RESULTS: Based on research evidence and guidelines found during the literature review, a PFME intervention was developed using a new paradigm incorporating two theories, the Health Belief Model and Motivational Interviewing that have been shown to be important in continence promotion and exercise adherence. The contribution of the panel of experts in refining the intervention to meet the local context, endorses the achievement of the intervention's content validity. While, the focus group discussion with pregnant women and physiotherapists revealed the face-validity of the intervention. The findings of the pilot pre-testing showed that PFME knowledge (p<0.001) and attitude (p=0.011) improved significantly immediately following the intervention.
CONCLUSIONS: Evidently, this is a pioneer study that illustrates the development of a Malaysian context-adapting PFME intervention on the basis of recommended steps using the MRC Framework. Incorporating a theory-based and rigorous validation approach into the development of the PFME intervention brought novel perspectives to the intervention. Given the promising preliminary results of the pre-testing pilot study, the PFME intervention could be implemented in the planned randomised control trial to validate the robustness of the results.

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