title: Patient Participation Approach to Reduction of Anterior Shoulder Dislocation: P-R-I-M/O-Y-E-S.
abstract: A variety of successful techniques are available for reduction of shoulder dislocation; none have been shown to be clearly superior to another. Analgesic methods vary as well from none to deep sedation-analgesia. The literature hints at the importance of optimal muscle relaxation as a factor of success. Yet, the literature describes only cursorily the means by which muscle relaxation is optimized. Patient-centered participation and relaxation methods have been used in other contexts to reduce pain, anxiety, and muscle tension. This article proposes to integrate a patient-centered participation approach to the reduction of anterior shoulder dislocation as a way to optimize muscular relaxation nonpharmacologically. It can be used in the field in combination with the practitioner's reduction technique of choice. It minimizes risks because it entails no deep pharmacological sedation. The mnemonic P-R-I-M/O-Y-E-S is used to respectively represent the four phases: Preparation, Rehearsal, Intervention, and Mobilization as well as the 4 repeated steps in each phase of the procedure: Observe, Yield control, Explain, and Support. The focus is on (1) securing optimal patient participation within a patient-centered approach and (2) achieving nonpharmacological muscular relaxation through a simple relaxation routine. More studies are needed to identify the factors that determine success and guide the practitioner's choice among available options in shoulder dislocation reductions.
authors.affiliation: *Centre Intégré de Santé et de Services Sociaux de Laval, Hôpital Cité de la Santé, Laval, Quebec, Canada; †Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Quebec, Canada; ‡Department of Psychology, McGill University, Montreal, Quebec, Canada; and §Department of Educational Psychology and Neuropsychology, Université du Québec à Montréal (UQAM), Montreal, Quebec, Canada.
authors.forename: Paul-André
authors.initials: PA
authors.lastname: Lachance
authors.forename: Catherine Isabelle
authors.initials: CI
authors.lastname: Taieb-Lachance
mesh_terms: D003142:Communication; D006801:Humans; D008349:Manipulation, Orthopedic / Q000379:methods*; D009126:Muscle Relaxation; D010358:Patient Participation; D010817:Physician-Patient Relations; D012783:Shoulder Dislocation / Q000628:therapy*; D020069:Shoulder Pain / Q000628:therapy