ArticleProgress in rehabilitation medicine2025
Supine-induced Increase in Blood Flow Velocity in the Anterior Humeral Circumflex Artery Associates with Nocturnal Sitting-relief Shoulder Pain.
Article in Progress in rehabilitation medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: : Nocturnal pain is common in rotator cuff tears (RCTs). Among its patterns, a pain type relieved by sitting upright, referred to here as "sitting-relief pain," appears to behave differently from other nocturnal pain types. Peak systolic velocity in the anterior humeral circumflex artery (PSV-AHCA) has been suggested as a marker, but findings have varied across settings. Exploring this vascular response may help connect patients' subjective pain experiences with objective physiological data, potentially offering a bridge between symptoms and measurable signs. This study investigated the association between PSV-AHCA and nocturnal pain characteristics in patients with RCTs. Methods: : A cross-sectional study was conducted with 78 patients with RCTs. Participants were classified into three groups based on nocturnal pain characteristics: Sitting-Relief-Pain, Other-Pain, and Pain-Free. PSV-AHCA was measured in both sitting and supine positions using Doppler ultrasound. After confirming the absence of major confounders, comparisons were made across groups and positions. Results: : The Sitting-Relief-Pain group showed an increase in PSV-AHCA from sitting to supine (22.7 to 26.7 cm/s; d=0.712; P=0.001), whereas the Other-Pain and Pain-Free groups showed no significant changes. In the supine position, PSV-AHCA was higher in the Sitting-Relief-Pain group than in the Other-Pain (P=0.008) and Pain-Free (P=0.004) groups. Conclusions: : Sitting-relief pain may represent a specific pattern of nocturnal pain in RCTs, with a distinct vascular response to posture. Doppler ultrasound in physiotherapist-led assessment may assist in identifying this pattern and distinguishing it from other types of nocturnal pain.
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