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Tabatabaei A, Shahsaheb S, Seyyedi A, Salehi R, Pezeshk AF, Blandford L. Observational assessment for determining shoulder fault movements before and after corrective education in participants with chronic shoulder pain: Concurrent validity study. J Hand Ther 2023:S0894-1130(23)00134-5. [PMID: 37858502 DOI: 10.1016/j.jht.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 09/19/2023] [Accepted: 09/24/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Movement faults (MF), described as the alteration of joint position and motion, are an important factor associated with developing shoulder pathologies. However, determining or predicting the exact MF in participants with shoulder pain is limited by the absence of clinical tools and poor validity. PURPOSE The aim of the study was to determine the validity of using observational assessment to MFs or controlling MFs in subjects with chronic shoulder pain during shoulder elevation and external rotation. STUDY DESIGN Concurrent validity study METHODS: Twenty-seven people with chronic shoulder pain were examined. The index test represented three observational assessments of MF during shoulder external rotation, elevation in the frontal plane, and elevation in the sagittal plane. Three-dimensional motion analysis represented the reference test. The movements of both shoulder joints were evaluated simultaneously, and the index and reference tests were performed concurrently. RESULTS The sensitivity and specificity of observational detection were good to excellent (Se: 77.5%, Sp: 81.5%) for MF and excellent (Se: 85.7%, Sp: 100%) for controlling MF. The positive and negative predictive value was (PPV: 93.9, NPV: 57.1) for MF and (PPV: 100%, NPV: 82.8%) for controlling MF. The result of the positive and negative likelihood ratio was (PLR: 5.4, NLR: 0.26) for MF and (PLR: 0, NLR: 0.18) for controlling MF. CONCLUSIONS The results revealed that the validity of the observational detection approach for identifying MFs was good to excellent. Moreover, the accuracy of this approach in detecting the control of MFs after patient education was excellent. There was good to excellent accuracy in most MFs once classified by their motion trajectories, except for scapula anterior tilt during glenohumeral joint external rotation or elevation.
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Affiliation(s)
- Abbas Tabatabaei
- Mobility and Falls Lab, Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA; Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Shahab Shahsaheb
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Aisan Seyyedi
- Department of Physiotherapy, School of Rehabilitation Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Salehi
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Farjad Pezeshk
- Associate Professor in Sport Biomechanics, Faculty of Sport Sciences, University of Birjand, Birjand, Iran
| | - Lincoln Blandford
- Faculty of Sport, Allied Health, and Performance Science, St Mary's University, Twickenham, UK; Comera Movement Science, Bristol, UK
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López-Vidriero Tejedor R, Laver L, López-Vidriero Tejedor E. Professional tennis players suffer high prevalence of shoulder alterations during the season: a possible tennis shoulder syndrome. Knee Surg Sports Traumatol Arthrosc 2023; 31:2152-2159. [PMID: 36637477 DOI: 10.1007/s00167-023-07310-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 01/02/2023] [Indexed: 01/14/2023]
Abstract
PURPOSE To analyze the shoulder alterations of professional tennis players during the competition season and to compare the differences between their dominant vs. non-dominant shoulders, as well as gender and age differences. METHODS Two-hundred and seventy shoulders of (78 men and 57 women) professional active tennis players were assessed during 3 ATP and WTA tournaments. MAIN VARIABLES STUDIED long head of biceps (LHB) tenderness and synovitis; glenohumeral internal rotation deficit (GIRD), total range of motion (TRM), external rotation (ER) and scapular dyskinesis (DK). Secondary variables: shoulder dominance, gender, age, training hours, ranking, type of backhand. LHB tenderness and synovitis were assessed by clinical and ultrasound examination, TRM with goniometer and DK by dynamic observation. RESULTS LHB tenderness of the dominant shoulder was present in 35% of all players, being more prevalent in women (47.4%) than men (26.9%) p = 0.023. LHB synovitis of the dominant shoulder was present in 20.2% of all players without difference between genders (n.s). High prevalence of GIRD was found in both dominant (87.4%) and non-dominant (56.3%) shoulders, being more prevalent in the dominant shoulder p = 0.00005. TRM was decreased in both dominant (144.5° ± 20.2°) and non-dominant shoulders (161.2° ± 18.9°) p = 0.00005. ER was normal in dominant (93.8° + /9.3°) and non-dominant shoulders (93.4° + /8.4°) (n.s). DK was present in 57.7% of dominant and 45.9% of non-dominant shoulders (n.s). The combination of LHB alterations, GIRD and DK in the dominant shoulder was present in 13.3% of the participants. There were no significant differences between younger (< 22 years) vs older players (≥ 22 years). CONCLUSION Professional tennis players actively playing suffer a high prevalence of LHB inflammation, GIRD, scapular dyskinesis and decreased TRM in their dominant and non-dominant shoulders. The LHB is a significant cause for anterior shoulder pain in this population. Women suffer more LHB tenderness than men. Young players are as affected as older players. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Rosa López-Vidriero Tejedor
- ISMEC (International Sports Medicine Clinic), Seville, Spain. .,Hospital Universitario Infanta Elena, Madrid, Spain. .,Mutua Madrid Open 1000 ATP/WTA Tennis Masters, Madrid, Spain.
| | - Lior Laver
- Department of Orthopaedics and Sports Medicine Unit, Hillel Yaffe Medical Center (HYMC), Hadera, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,AtrhroSport Clinic, Tel-Aviv, Israel
| | - Emilio López-Vidriero Tejedor
- ISMEC (International Sports Medicine Clinic), Seville, Spain.,Hospital Universitario Infanta Elena, Madrid, Spain.,Mutua Madrid Open 1000 ATP/WTA Tennis Masters, Madrid, Spain.,Andalusian Tennis Federation, Seville, Spain.,Orthopedic Department, Hospital Universitario Virgen Macarena, Seville, Spain
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Abass MY, Shendy W, Samir H, Sweif RE, Ahmed MA, Awad A. Assessment of shoulder proprioception in patients with chronic mechanical cervical pain: A comparative study. J Back Musculoskelet Rehabil 2023; 36:1285-1293. [PMID: 37092213 DOI: 10.3233/bmr-220173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
BACKGROUND Chronic mechanical cervical pain (CMCP) is a common disabling problem worldwide, interfering with upper extremities function. However studying the impact of CMCP on shoulder proprioception is still lacking. OBJECTIVE To investigate the impact of CMCP on shoulder proprioception in young adults compared with normal control (NC) individuals. METHODS A comparative study was conducted between two groups; 40 patients with CMCP (mean age 32.28 ± 6.586) and 40 age and sex matched NC (mean age 33.43 ± 9.021). The Biodex isokinetic dynamometer was used to assess shoulder active sense of position at 30∘ external and internal rotations. The absolute angular error was calculated for the dominant and non-dominant shoulders. RESULTS The absolute angular error was significantly increased only in the CMCP at both rotation angles for both shoulders, showing a remarkable increase on the dominant shoulder and in the external rotation range compared with NC. CONCLUSIONS CMCP can significantly impair shoulder proprioception, particularly on the dominant side and in external rotation range. This could emphasize the careful examination of shoulder proprioception for the early detection of shoulders at risk, to eliminate the possibility of shoulder instability and/or injury in young adults with CMCP.
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Affiliation(s)
- Mohamed Yassen Abass
- Department of Physical Therapy for Neurological Disorders, Kasr Al-Ainy Educational Hospital, Cairo, Egypt
| | - Wael Shendy
- Department of Physical Therapy for Neurology, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Hatem Samir
- Department of Neurology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Radwa E Sweif
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Mai A Ahmed
- Department for Woman and Child Health, Faculty of Physical Therapy, Beni-Suef University, Beni Suef, Egypt
| | - Amina Awad
- Department of Physical Therapy for Neurology, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
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Wang DM, Li C, Hatchard N, Chang Chien GC, Alm J. Lower trapezius muscle function in people with and without shoulder and neck pain: a systematic review. J Osteopath Med 2023; 123:73-89. [PMID: 36100364 DOI: 10.1515/jom-2022-0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 08/04/2022] [Indexed: 01/27/2023]
Abstract
CONTEXT Shoulder and neck pain are leading causes of disability worldwide. Rotator cuff pathology has strong associations with such pain and is extensively targeted by healthcare practitioners. A dysfunctional lower trapezius muscle has also been shown to contribute to neck and shoulder pain, yet it is often overlooked. OBJECTIVES This systematic review analyzes those with a history of, or who are currently managing, shoulder or neck pain to indicate differences in measures of lower trapezius function when compared to subjects without that pain. METHODS Studies with no age restrictions were included in the study. Studies could determine lower trapezius muscle function with any quantifiable measurement tool or clinical assessment. If the study included a control group (no pain) and a comparator group (pain), and if lower trapezius muscle function was assessed in both, the study was typically included. The significance of the lower trapezius muscle function change was summarized in these pain patients. From a final total of 18 studies identified, level of muscle activity, muscle activation, time to onset, muscle strength, and muscle thickness were reported. RESULTS The 18 included articles involved 485 participants with shoulder and/or neck pain and 455 without. Half of the shoulder pain studies (6/12), and all of the neck pain studies (6/6), demonstrated that the lower trapezius had a noticeable impact. The lower trapezius muscle in participants with shoulder and neck pain tended to show decreased muscle strength, and decreased time to onset/latency. CONCLUSIONS The findings from this systematic review should be taken into consideration when assessing and treating patients with shoulder and neck pain. Future studies that define the type and duration of shoulder and neck pain, as well as prospectively assessing lower trapezius muscle function in those with and without that pain, are needed.
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Affiliation(s)
- Daniel M Wang
- Kansas City University, 1750 Independence Avenue, Kansas City, MO 64106-1453, USA
| | - Crystal Li
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Nicole Hatchard
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - George C Chang Chien
- Pain Management, Ventura County Medical Center, Ventura, CA, USA.,Center for Regenerative Medicine, Southern California University of Health Sciences, Whittier, CA, USA
| | - John Alm
- Department of Rehabilitation Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
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Sousa DSF, de Farias WM, de Amorim Batista G, de Oliveira VMA, Pirauá ALT, Beltrão NB, Pitangui ACR, de Araújo RC. Activation of upper limb muscles in subjects with scapular dyskinesis during bench-press and dumbbell fly on stable and unstable surfaces. J Back Musculoskelet Rehabil 2022; 35:1289-1297. [PMID: 35599468 DOI: 10.3233/bmr-210243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Scapular dyskinesis has been associated with shoulder dysfunctions, and changes in electromyographic (EMG) activity have been reported during the execution of some exercises. OBJECTIVE To compare upper limb muscles EMG of asymptomatic subjects with and without scapular dyskinesis during bench-press and dumbbell fly exercise performed on different surface stability conditions. METHODS Twenty-eight physically active men were allocated into two groups: Control group (n= 14) and Dyskinesis group (n= 14). The participants performed six repetitions lasting three seconds of the bench press and dumbbell fly exercises with 50% of one-repetition maximum (1RM) on a bench and a Swiss ball. The EMG activity of the pectoralis major, serratus anterior, upper and lower trapezius, anterior deltoid, biceps and triceps muscles were recorded. RESULTS No differences were found between groups, regardless of exercise or surface type. Inserting the unstable surface in the supine exercise promoted a slight increase in upper trapezius EMG activity for the control [4.32 (95% CI: 1.04 to 7.60)] and dyskinesis [3.30 (95% CI: 0.34 to 6.27)] groups. CONCLUSIONS There is no difference in upper limb muscle EMG activity between subjects with and without scapular dyskinesis. In addition, inserting unstable surfaces did not modify EMG activity.
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Affiliation(s)
| | - Wevans Monthier de Farias
- Department of Physical Education, Centro Universitário Tabosa de Almeida - Asces-Unita, Caruaru, Brazil
| | | | | | | | | | - Ana Carolina Rodarti Pitangui
- Postgraduate Program in Rehabilitation and Functional Performance, University of Pernambuco (UPE), Petrolina, Brazil
| | - Rodrigo Cappato de Araújo
- Postgraduate Program in Rehabilitation and Functional Performance, University of Pernambuco (UPE), Petrolina, Brazil
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Longo UG, De Salvatore S, Carnevale A, Tecce SM, Bandini B, Lalli A, Schena E, Denaro V. Optical Motion Capture Systems for 3D Kinematic Analysis in Patients with Shoulder Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12033. [PMID: 36231336 PMCID: PMC9566555 DOI: 10.3390/ijerph191912033] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/14/2022] [Accepted: 09/17/2022] [Indexed: 06/16/2023]
Abstract
Shoulder dysfunctions represent the third musculoskeletal disorder by frequency. However, monitoring the movement of the shoulder is particularly challenging due to the complexity of the joint kinematics. The 3D kinematic analysis with optical motion capture systems (OMCs) makes it possible to overcome clinical tests' shortcomings and obtain objective data on the characteristics and quality of movement. This systematic review aims to retrieve the current knowledge about using OMCs for 3D shoulder kinematic analysis in patients with musculoskeletal shoulder disorders and their corresponding clinical relevance. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to improve the reporting of the review. Studies employing OMCs for 3D kinematic analysis in patients with musculoskeletal shoulder disorders were retrieved. Eleven articles were considered eligible for this study. OMCs can be considered a powerful tool in orthopedic clinical research. The high costs and organizing complexities of experimental setups are likely outweighed by the impact of these systems in guiding clinical practice and patient follow-up. However, additional high-quality studies on using OMCs in clinical practice are required, with standardized protocols and methodologies to make comparing clinical trials easier.
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Affiliation(s)
- Umile Giuseppe Longo
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Sergio De Salvatore
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Arianna Carnevale
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
- Laboratory of Measurement and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy
| | - Salvatore Maria Tecce
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Benedetta Bandini
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Alberto Lalli
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Emiliano Schena
- Laboratory of Measurement and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy
| | - Vincenzo Denaro
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
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Teixeira DC, Alves L, Gutierres M. The role of scapular dyskinesis on rotator cuff tears: a narrative review of the current knowledge. EFORT Open Rev 2021; 6:932-940. [PMID: 34760292 PMCID: PMC8559559 DOI: 10.1302/2058-5241.6.210043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Scapular dyskinesis can be present in healthy individuals as in patients with shoulder pathology.Altered patterns of scapular kinematics can cause or exacerbate rotator cuff tear pathology. However, more research is needed.Regardless of the cause or the consequence of rotator cuff tear, scapular dyskinesis impairs shoulder function, worsens the symptoms, and compromises the success of clinical intervention.The available literature suggests physical therapy as the first treatment for degenerative cuff tears, and scapular dyskinesis should be addressed if present. Non-responsive cases or traumatic tears may require surgery.Postsurgical physical therapy protocols after rotator cuff repair must consider scapular dyskinesia to improve the outcomes. Cite this article: EFORT Open Rev 2021;6:932-940. DOI: 10.1302/2058-5241.6.210043.
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Affiliation(s)
- Diana Cabral Teixeira
- Faculty of Medicine, University of Porto, Porto, Portugal
- These authors contributed equally to the article and should all be considered first authors
| | - Luís Alves
- Orthopaedic and Traumatology Department, São João Hospital Center, Porto, Portugal
- These authors contributed equally to the article and should all be considered first authors
| | - Manuel Gutierres
- Orthopaedic and Traumatology Department, São João Hospital Center, Porto, Portugal
- These authors contributed equally to the article and should all be considered first authors
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