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Journal of Science and Medicine in Sport Jan 2018The prevalence of shoulder pain in young swimmers is high. Shoulder rotation strength and the ratio of internal to external rotation strength have been reported as... (Observational Study)
Observational Study
OBJECTIVES
The prevalence of shoulder pain in young swimmers is high. Shoulder rotation strength and the ratio of internal to external rotation strength have been reported as potential modifiable risk factors associated with shoulder pain. However, relative strength measures in elevated positions, which include flexion and extension, have not been established for the young swimmer. The aim of this study was to establish clinically useful, normative shoulder strength measures and ratios for swimmers (14-20 years) without shoulder pain.
DESIGN
Cross-sectional, observational study.
METHODS
Swimmers (N=85) without a recent history of shoulder pain underwent strength testing of shoulder flexion and extension (in 140° abduction); and internal and external rotation (in 90° abduction). Strength tests were performed in supine using a hand-held dynamometer and values normalised to body weight. Descriptive statistics were calculated for strength and strength ratios (flexion:extension and internal:external rotation). Differences between groups (based on gender, history of pain, test and arm dominance) were explored using independent and paired t tests.
RESULTS
Normative shoulder strength values and ratios were established for young swimmers. There was a significant difference (p<0.002) in relative strength between males and females for all tests with no differences in strength ratios. Relative strength of the dominant and non-dominant shoulders (except for extension); and for swimmers with and without a history of shoulder pain was not significantly different.
CONCLUSIONS
A normal shoulder strength profile for the young swimmer has been established which provides a valuable reference for the clinician assessing shoulder strength in this population.
Topics: Adolescent; Cross-Sectional Studies; Female; Humans; Male; Muscle Strength; Range of Motion, Articular; Reference Values; Rotation; Shoulder; Shoulder Pain; Swimming; Young Adult
PubMed: 28844605
DOI: 10.1016/j.jsams.2017.05.003 -
Journal of Rehabilitation Medicine Aug 2023Post-stroke shoulder pain is a serious challenge for stroke survivors. The aim of this meta-analysis was to review the literature to confirm information on structural... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Post-stroke shoulder pain is a serious challenge for stroke survivors. The aim of this meta-analysis was to review the literature to confirm information on structural changes in post-stroke shoulders detected by ultrasound examination.
METHODS
PubMed, Embase, Web of Science and ClinicalTrials.gov were searched until 7 December 2022, for studies describing shoulder sonographic findings in stroke patients. Two independent authors selected the studies, extracted the data, and performed the critical appraisal.
RESULTS
A total of 23 clinical studies were included. The most prevalent pathologies in hemiplegic shoulders pertained to the biceps long head tendon (41.4%), followed by the supraspinatus tendon (33.2%), subdeltoid bursa (29.3%), acromioclavicular joint (15.0%), and subscapularis tendon (9.2%). The common pathological findings encompassed bicipital peritendinous effusion (39.2%), biceps tendinopathy (35.5%), subdeltoid bursitis (29.3%) and supraspinatus tendinopathy (24.6%). Biceps long head tendon and supraspinatus tendon abnormalities were observed significantly more in the hemiplegic (vs contralateral) shoulders, with odds ratios of 3.814 (95% confidence interval 2.044-7.117) and 2.101 (95% confidence interval 1.257-3.512), respectively. No correlation was observed between motor function and shoulder pathology.
CONCLUSION
Ultrasonography enabled the identification of common shoulder pathologies after stroke. Further research is needed to establish the association between these changes and the clinical course of stroke patients.
Topics: Humans; Shoulder; Hemiplegia; Rotator Cuff; Tendons; Bursitis; Pain
PubMed: 37615388
DOI: 10.2340/jrm.v55.13432 -
Journal of Athletic Training Aug 2022The wall-slide exercise is commonly used in clinic and research settings. Theraband positioning variations for hip exercises have been investigated and used, but... (Randomized Controlled Trial)
Randomized Controlled Trial
CONTEXT
The wall-slide exercise is commonly used in clinic and research settings. Theraband positioning variations for hip exercises have been investigated and used, but Theraband positioning variations for upper extremity wall-slide exercises, although not commonly used, have not been examined.
OBJECTIVE
To evaluate the effect of different Theraband positions (elbow and wrist) on the activation of the scapular and shoulder muscles in wall-slide exercises and compare these variations with each other and with regular wall-slide exercises for the upper limbs.
DESIGN
Descriptive laboratory study.
SETTING
University laboratory.
PATIENTS OR OTHER PARTICIPANTS
A total of 20 participants (age = 23.8 ± 3 years, height = 176.5 ± 8.14 cm, mass = 75.3 ± 12.03 kg, body mass index = 24.23 ± 4.03) with healthy shoulders.
INTERVENTION(S)
Participants performed wall-slide exercises (regular and 2 variations: Theraband at the elbow and Theraband at the wrist) in randomized order.
MAIN OUTCOME MEASURE(S)
Surface electromyographic activity of the trapezius (upper trapezius [UT], middle trapezius [MT], and lower trapezius [LT]), infraspinatus, middle deltoid (MD), and serratus anterior (SA) muscles.
RESULTS
Regular wall-slide exercises elicited low activity in the MD and moderate activity in the SA muscles (32% of maximal voluntary isometric contraction [MVIC] in the SA), whereas the Theraband-at-elbow and Theraband-at-wrist variations elicited low activity in the MT, LT, infraspinatus, and MD muscles and moderate activity in the SA muscle (46% and 34% of MVIC in the SA, respectively). The UT activation was absent to minimal (classified as 0% to 15% of MVIC) in all wall-slide exercise variations. The Theraband-at-wrist variation produced lower UT:MT, UT:LT, and UT:SA levels compared with the regular wall-slide exercise and Theraband-at-elbow variation.
CONCLUSIONS
In shoulder rehabilitation, clinicians desiring to activate the scapular stabilization muscles should consider using the Theraband-at-wrist variation. Those seeking more shoulder-abduction activation and less scapular stabilization should consider using the Theraband-at-elbow variation of the upper extremity wall-slide exercise.
Topics: Adult; Humans; Young Adult; Electromyography; Exercise Therapy; Muscle, Skeletal; Scapula; Shoulder; Superficial Back Muscles
PubMed: 36356616
DOI: 10.4085/1062-6050-0305.21 -
International Orthopaedics Dec 2020Joint replacement affects the proprioception, as shown in knees, elbows, and shoulder studies.
UNLABELLED
Joint replacement affects the proprioception, as shown in knees, elbows, and shoulder studies.
AIM
The aim was to evaluate shoulder joint position sense (JPS) following reverse total shoulder arthroplasty (rTSA) for patients with cuff arthropathy.
METHODS
Twenty-nine patients that underwent unilateral rTSA (19 females, 10 males) and 31 healthy volunteers evaluated for JPS of shoulder using a dedicated high accuracy electronic goniometer. Error of active reproduction of joint position (EARJP) was assessed at the following reference positions: 30°, 60°, 90°, and 120° for forward flexion and abduction and 15°, 30°, and 45° for internal and external rotation in rTSA, contralateral non-operated, and control shoulders.
RESULTS
Results of EPRJP for rTSA, contralateral, and control (respectively) are as follows:Forward flexion: 30° = (8.0 ± 5.7, 9.8 ± 6.1, and 4.9 ± 3.0), 60° = (5.0 ± 2.8, 5.9 ± 2.7, and 5.1 ± 3.2), 90° = (3.1 ± 1.6, 5.5 ± 2.6, and 3.2 ± 1.4), and 120° = (3.4 ± 2.1, 5.6 ± 4.0, and 3.5 ± 1.7)Abduction: 30° = (5.2 ± 2.5, 9.1 ± 6.1, and 4.6 ± 2.3), 60° = (5.2 ± 3.6, 6.6 ± 4.1, and 5.3 ± 3.1), 90° = (3.8 ± 2.0; 7.4 ± 5.5, and 4.1 ± 1.9), and 120° = (5.3 ± 2.9, 7.7 ± 5.3, and 4.2 ± 1.9)Internal rotation: 15° = (4.3 ± 3.1, 6.2 ± 4.4, and 2.8 ± 1.2), 30° = (3.2 ± 1.9, 4.5 ± 2.3, and 3.3 ± 1.4), and 45° = (3.5 ± 2.0, 4.1 ± 1.8, and 2.8 ± 1.0)External rotation: 15° = (3.0 ± 1.7, 4.2 ± 2.2, and 3.6 ± 1.4) and 30° = (3.1 ± 1.5, 3.8 ± 2.6, and 3.4 ± 1.6)The results showed significantly better JPS (lower EPRJP) in shoulders following rTSA and normal control shoulders comparing with the patient's contralateral shoulder. The explanation can be that rTSA improves joint kinematics and stability, which allows better muscular performance and proprioception feedback.
CONCLUSION
Shoulders following rTSA show JPS superior to non-operated contralateral shoulders and comparable with healthy population shoulders. It seems that rTSA restores shoulder proprioception.
Topics: Arthroplasty, Replacement, Shoulder; Female; Humans; Male; Proprioception; Range of Motion, Articular; Shoulder; Shoulder Joint
PubMed: 32803357
DOI: 10.1007/s00264-020-04756-x -
Journal of Obstetrics and Gynaecology... Jul 2016
Topics: Delivery, Obstetric; Dystocia; Female; Humans; Pregnancy; Shoulder; Standard of Care
PubMed: 27591350
DOI: 10.1016/j.jogc.2016.03.012 -
La Revue de Medecine Interne Jul 2020
Topics: Aged, 80 and over; Cardiovascular Abnormalities; Collateral Circulation; Female; Humans; Shoulder; Veins
PubMed: 31883836
DOI: 10.1016/j.revmed.2019.12.010 -
European Review For Medical and... Mar 2022The purpose of this study was to evaluate whether there was a difference in shoulder morphology and hand dominance between a healthy shoulder and a shoulder with rotator...
OBJECTIVE
The purpose of this study was to evaluate whether there was a difference in shoulder morphology and hand dominance between a healthy shoulder and a shoulder with rotator cuff tear (RCT) in the same patient.
PATIENTS AND METHODS
Between 2015 and 2020, 120 shoulders from 60 patients with complete RCT and contralateral intact rotator cuffs were enrolled in this retrospective analysis. Physical examinations, shoulder radiographs, and magnetic resonance imaging (MRI) pictures of the patients were reviewed. On radiographs, the AT, CSA, LAA, and AI values were compared between shoulders with complete RCT and contralateral healthy shoulders from the same individuals. Additionally, the association between hand dominance and RCT was evaluated.
RESULTS
This study enrolled 60 patients. 59.17% of the participants are female, and 40.83% are male. The mean age of the patients was 54.5±7.1 years. There were statistically significant differences in AI, CSA, and LAA measurements between the study group (RCT group) and the control group. There was no significant difference in AT between the two groups.
CONCLUSIONS
There are morphological differences between a healthy shoulder and a shoulder with an RCT in the same patient, and these differences (LAA/CSA/AI/AT) may have an effect on the prevalence of RCT.
Topics: Acromion; Female; Humans; Male; Middle Aged; Risk Factors; Rotator Cuff Injuries; Shoulder; Shoulder Joint
PubMed: 35302201
DOI: 10.26355/eurrev_202203_28222 -
BMC Musculoskeletal Disorders Jun 2022The aim of this study is to evaluate both the utility of MRI scans and reports used in the current practice routine of shoulder surgeons and their surgical...
BACKGROUND
The aim of this study is to evaluate both the utility of MRI scans and reports used in the current practice routine of shoulder surgeons and their surgical decision-making process.
METHODS
Ninety-three shoulder-specialised orthopaedic surgeons of the Canadian Shoulder and Elbow Society (CSES) Orthopaedic Association were surveyed in 2020 anonymously online to help identify the use of MR-imaging and reports in managing shoulder disorders and surgical decision process.
RESULTS
Thirty out of 93 (32.25%) CSES fellowship-trained orthopaedic surgeons participated. Respondents request MRI scans in about 55% of rotator cuff (RC) pathology and 48% of shoulder instability cases. Fifty percent of patients with potential RC pathology arrive with a completed MRI scan prior first orthopaedic consult. Their surgical decision is primarily based on patient history (45-55%) and physical examination (23-42%) followed by MRI scan review (2.6-18%), reading MRI reports (0-1.6%) or viewing other imaging (3-23%) depending on the shoulder disease. Ninety percent of surgeons would not decide on surgery in ambiguous cases unless the MR-images were personally reviewed. Respondents stated that shoulder MRI scans are ordered too frequently prior specialist visit as identified in more than 50% of cases depending on pathology.
CONCLUSIONS
The decision-making process for shoulder surgery depends on the underlying pathology and patient history. The results demonstrate that orthopaedic surgeons are comfortable reviewing shoulder MRI scans without necessarily reading the MRI report prior to a surgical decision. MRI scans are becoming an increasingly important part of surgical management in shoulder pathologies but should not be used without assessment of patient history and or physical examination.
Topics: Canada; Decision Making; Humans; Joint Instability; Magnetic Resonance Imaging; Rotator Cuff Injuries; Shoulder; Shoulder Joint
PubMed: 35717178
DOI: 10.1186/s12891-022-05541-0 -
Acta Orthopaedica Et Traumatologica... Nov 2019The present study aimed to compare the isometric strength and endurance of shoulder abduction and internal and external rotation between operated shoulders and... (Comparative Study)
Comparative Study
OBJECTIVE
The present study aimed to compare the isometric strength and endurance of shoulder abduction and internal and external rotation between operated shoulders and nonoperated, contralateral shoulders of patients who underwent reverse shoulder replacement due to unilateral rotator cuff tear arthropathy.
PATIENTS AND METHODS
With a diagnosis of cuff tear arthropathy, 41 consecutive patients (mean age of 70.8 years; age range, 57 to 84; 36 females, 5 males) who underwent unilateral reverse shoulder arthroplasty were reviewed based on functional and radiological data. In all cases, cuff tear arthropathy was unilateral and contralateral shoulder was asymptomatic, with normal shoulder function. The average length of follow-up was 34 months (range of 12-67). To assess patients' functional level, the Constant score and the Disabilities of the Arm, Shoulder, and Hand (the Quick-DASH) outcome measure were used preoperatively and at the final examination. The primary outcomes of the present study were measurement of isokinetic strength and endurance of shoulder abduction and internal and external rotation using an isokinetic evaluator.
RESULTS
Patients exhibited marked improvement in functional level as reflected by a significant increase in the mean Constant score from 38 preoperatively to 65 at the final follow-up (p = 0.03). The functional improvement was supported by a decrease in the mean Quick-DASH from 64 preoperatively to 26 at the final follow-up (p = 0.018). In the comparison of the isokinetic strength and endurance of shoulder abduction, no statistical difference was observed between operated shoulders and contralateral shoulders (p > 0.05). However; the strength and endurance of internal and external rotation were lower in operated shoulders than in contralateral shoulders (p < 0.05). Similarly, there was no statistically significant difference in comparisons of the durability of abduction (p > 0.05); however, the durability of internal and external rotation were significantly lower in operated shoulders (p < 0.05).
CONCLUSION
In terms of durability and strength of abduction, similar results with the unaffected shoulder may be accomplished; nonetheless, the surgeon should be aware that durability and strength of rotation would be weak.
LEVEL OF EVIDENCE
Level III, Therapeutic Study.
Topics: Aged; Aged, 80 and over; Arthroplasty, Replacement, Shoulder; Female; Humans; Male; Middle Aged; Radiography; Range of Motion, Articular; Rotator Cuff Tear Arthropathy; Shoulder; Shoulder Joint
PubMed: 31439480
DOI: 10.1016/j.aott.2019.08.001 -
The Iowa Orthopaedic Journal Jun 2022Research has shown that postoperative shoulder imbalance is a common problem after spinal fusion in adolescent idiopathic scoliosis (AIS). The best radiographic...
BACKGROUND
Research has shown that postoperative shoulder imbalance is a common problem after spinal fusion in adolescent idiopathic scoliosis (AIS). The best radiographic predictor has not yet been determined and results are inconsistent. This study was to investigate whether using medial and lateral shoulder parameters can effectively achieve postoperative shoulder balance.
METHODS
A prospective database of AIS undergoing posterior spinal fusion were reviewed. Patient demographics and radiological parameters including radiographic shoulder height (RSH), clavicle angle, T1-tilt and first-rib angle at baseline, 6 weeks and last minimal follow up of 2 years were recorded. Correlations between radiological parameters were assessed using Pearson's correlation coefficients. Multivariable linear models identified predictors associated with increased RSH.
RESULTS
219 patients (mean age:13.7 years; 81.7% female) were included. The mean follow-up time was 2.8 years (range:2.0-7.0). The mean RSH at baseline, 6 weeks and last follow up was improved significantly at 95.8%. Preoperative (r=0.8; p<0.001) and post-operative measurements of RSH at 6-week (r=0.9; p<0.001) and last follow up (r=0.9; p<0.001) correlated strongly with clavicle angle measured at respective time-points. In a multivariable linear model, we noted marginal increase in clavicle angle (+4.3°; p<0.001) to be associated with increased RSH. On the contrary, first rib angle and T1-tilt demonstrated moderate to weak correlation with RSH.
CONCLUSION
Clavicle angle is strongly consistent with RSH. First rib angle and T1-tilt as demonstrate medial shoulder balance are moderate to weak correlation. Leveling T1 tilt and first rib angle do not guarantee the postoperative shoulder balance. .
Topics: Adolescent; Female; Humans; Kyphosis; Male; Radiography; Scoliosis; Shoulder; Thoracic Vertebrae
PubMed: 35821947
DOI: No ID Found