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Sözlü U, Başar S, Kanatlı U. Scapular muscle endurance, shoulder pain, and functionality in patients with rotator-cuff-related shoulder pain: a matched, case-control study. Clin Shoulder Elb 2024; 27:52-58. [PMID: 38303591 PMCID: PMC10938018 DOI: 10.5397/cise.2023.00675] [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: 08/02/2023] [Revised: 10/03/2023] [Accepted: 10/11/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Deficiency in scapular muscle endurance (SME) is a risk factor for rotator-cuff-related shoulder pain (RCRSP). However, the exact relationship among SME, pain, and functionality remains unclear. This study aims to compare SME, pain, and functionality in RCRSP patients to those in age-sex-matched healthy controls. METHODS Twenty-three patients with RCRSP and 23 age-sex matched healthy controls were included in the study. SME was measured using a 1-kg dynamometer. Self-reported pain level was assessed using a visual analog scale. The Functional Impairment Test-Hand, Neck, Shoulder, and Arm (FIT-HaNSA) was also used to assess functional impairment. RESULTS The control group had higher SME and total FIT-HaNSA scores than the patient group (P<0.05). There was a statistically significant and positive correlation between SME and FIT-HaNSA scores in both groups (P<0.05). CONCLUSIONS SME was affected by RCRSP. Pain and functional impairment were correlated with low SME. Level of evidence: IV.
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Affiliation(s)
- Uğur Sözlü
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gaziosmanpasa University, Tokat, Turkey
| | - Selda Başar
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Ulunay Kanatlı
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Gazi University, Ankara, Turkey
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2
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Boulanger SM, Mahna A, Alenabi T, Gatti AA, Culig O, Hynes LM, Chopp-Hurley JN. Investigating the reliability and validity of subacromial space measurements using ultrasound and MRI. J Orthop Surg Res 2023; 18:986. [PMID: 38135882 PMCID: PMC10740303 DOI: 10.1186/s13018-023-04482-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND While ultrasound (US) measures of the subacromial space (SAS) have demonstrated excellent reliability, measurements are typically captured by experts with extensive ultrasound experience. Further, the agreement between US measured SAS width and other imaging modalities has not been explored. This research evaluated the agreement between SAS measures captured by novice and expert raters and between US and magnetic resonance imaging (MRI). This study also evaluated the effect of US transducer tilt on measured SAS. METHODS Nine men and nine women participated in this study. US images were captured by a novice and expert with the participant in both seated and supine positions. An inclinometer was fixed to the US probe to measure transducer tilt. SAS width was measured in real time from freeze framed images. MRI images were captured, and the humerus and acromion manually segmented. The SAS width was measured using a custom algorithm. RESULTS Intraclass correlation coefficients (ICCs) between novice and expert raters were 0.74 and 0.63 for seated and supine positions, respectively. Intra-rater agreement was high for both novice (ICC = 0.83-0.84) and expert (ICC ≥ 0.94) raters. Agreement between US and MRI was poor (ICC = 0.21-0.49) but linearly related. CONCLUSIONS Moderate agreement between novice and expert raters was demonstrated, while the agreement between US and MRI was poor. High intra-rater reliability within each rater suggests that US measures of the SAS may be completed by a novice with introductory training.
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Affiliation(s)
- Stephen M Boulanger
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Alexandra Mahna
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Talia Alenabi
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Anthony A Gatti
- Department of Radiology, Stanford University, Stanford, CA, USA
- NeuralSeg Ltd., Hamilton, ON, Canada
| | - Oriana Culig
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Loriann M Hynes
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Jaclyn N Chopp-Hurley
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
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Khandare S, Vidt ME. Development of a more biofidelic musculoskeletal model with humeral head translation and glenohumeral ligaments. Comput Methods Biomech Biomed Engin 2023; 26:1549-1556. [PMID: 36165581 DOI: 10.1080/10255842.2022.2127319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/30/2022] [Accepted: 09/16/2022] [Indexed: 11/03/2022]
Abstract
Computational musculoskeletal modeling is useful for understanding upper extremity biomechanics, especially when in vivo tests are unfeasible. A musculoskeletal model of the upper limb with increased biofidelity was developed by including humeral head translation (HHT) and ligaments. The model was validated and ligament contribution and effect of shoulder (thoracohumeral) elevation on HHT was evaluated. Humerus translated superiorly with increased elevation, with translations closely matching (avg. difference 2.83 mm) previous in vitro studies. HHT and ligament inclusion in the model will improve biomechanical predictions of upper extremity movements and study of conditions, like subacromial impingement, rotator cuff tear, or shoulder instability.
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Affiliation(s)
- Sujata Khandare
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
| | - Meghan E Vidt
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
- Physical Medicine & Rehabilitation, Penn State College of Medicine, Hershey, PA, USA
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Dickerson CR, McDonald AC, Chopp-Hurley JN. Between Two Rocks and in a Hard Place: Reflecting on the Biomechanical Basis of Shoulder Occupational Musculoskeletal Disorders. HUMAN FACTORS 2023; 65:879-890. [PMID: 31961724 DOI: 10.1177/0018720819896191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The aim was to review the biomechanical origins of occupational shoulder damage, while considering the complexity of shoulder mechanics and musculoskeletal consequences of diverse task demands. BACKGROUND Accessible measures of physical exposures are the primary focus of occupational shoulder assessments and analyses. This approach has led to guidelines and intervention strategies that are often inadequate for mitigating shoulder disorders amongst the complexity of modern workplace demands. Integration of complex shoulder mechanics into occupational assessments, analyses, and interventions is critical for reducing occupational shoulder injury risk. METHOD This narrative review describes shoulder biomechanics in the context of common injury mechanisms and consequent injuries, with a particular focus on subacromial impingement syndrome. Several modulators of shoulder injury risk are reviewed, including fatigue, overhead work, office ergonomics considerations, and pushing and pulling task configurations. RESULTS Relationships between work requirements, muscular demands, fatigue, and biomechanical tissue loads exist. This review highlights that consideration of specific workplace factors should be integrated with our knowledge of the intricate arrangement and interpersonal variability of the shoulder complex to proactively evaluate occupational shoulder demands and exposures. CONCLUSION A standard method for evaluating shoulder muscle exposures during workplace tasks does not exist. An integrated approach is critical for improved work design and prevention of shoulder tissue damage and accompanying disability. APPLICATION This review is particularly relevant for researchers and practitioners, providing guidance for work design and evaluation for shoulder injury prevention by understanding the importance of the unique and complex mechanics of the shoulder.
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Hui SSC, Liu J, Yang YJ, Wan JHP, Suen BKP. Yi Jin Bang exercise versus usual exercise therapy to treat subacromial pain syndrome: a pilot randomised controlled trial. Res Sports Med 2023; 31:846-858. [PMID: 35287501 DOI: 10.1080/15438627.2022.2052070] [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: 01/21/2022] [Accepted: 02/14/2022] [Indexed: 10/18/2022]
Abstract
To evaluate the effect of Yi Jin Bang (YJB) exercise on pain, disability, flexibility, and muscular endurance in individuals with subacromial pain syndrome (SAPS). Fifty-four adults with SAPS were randomly allocated into either a YJB (n = 18), a usual exercise therapy (UET; n = 18), or a control group (n = 18). YJB and UET interventions involved 10 weeks of home-based exercise training, with four sessions per week. The control group received no treatment. Outcome measures included Shoulder Pain and Disability Index (SPADI), pain at rest and during activity, flexion and abduction range of motion (ROM), back scratch test, and shoulder abduction endurance test. These measures were assessed at baseline, immediately after a single face-to-face session (acute effects), and after 10 weeks of intervention (chronic effects). For acute effects, significant group-by-time interactions were observed for flexion ROM, abduction ROM, and the back scratch test (all p < 0.05). For chronic effects, significant group-by-time interactions were found for pain during activity, the SPADI score, and the back scratch test (all p < 0.05). Home-based YJB exercise is comparable to home-based UET in reducing pain and disability and improving flexibility.
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Affiliation(s)
- Stanley Sai-Chuen Hui
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jinde Liu
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Yi-Jian Yang
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - James Ho-Pong Wan
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong
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Leung T, Eckers F, Nüesch C, Aghlmandi S, Kovacs BK, Genter J, Baumgartner D, Müller AM, Mündermann A. Load-Induced Glenohumeral Translation After Rotator Cuff Tears: Protocol for an In Vivo Study. JMIR Res Protoc 2022; 11:e43769. [PMID: 36563028 PMCID: PMC9823567 DOI: 10.2196/43769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Rotator cuff tears are a common shoulder injury, but they sometimes remain undiagnosed, as symptoms can be limited. Altered shoulder biomechanics can lead to secondary damage and degeneration. In biomechanical analyses, the shoulder (ie, the glenohumeral joint) is normally idealized as a ball-and-socket joint, even though a translation is often observed clinically. To date, no conclusive changes in glenohumeral translation have been reported in patients with rotator cuff tears, and it is unknown how an additional handheld weight that is comparable to those used during daily activities will affect glenohumeral translations in patients with rotator cuff tears. OBJECTIVE This study aims to assess the load-induced glenohumeral translation (liTr) in patients with rotator cuff tears and its association with the load-induced changes in muscle activation (liMA). METHODS Patients and asymptomatic controls will be recruited. Participants will fill out health questionnaires and perform 30° arm abduction and adduction trials, during which they will hold different handheld weights of a maximum of 4 kg while motion capture and electromyographic data are collected. In addition, fluoroscopic images of the shoulders will be taken for the same movements. Isometric shoulder muscle strength for abduction and rotation will be assessed with a dynamometer. Finally, shoulder magnetic resonance images will be acquired to assess muscle status and injury presence. The dose-response relationship between additional weight, liTr, and liMA will be evaluated. RESULTS Recruitment and data collection began in May 2021, and they will last until the recruitment target is achieved. Data collection is expected to be completed by the end of 2022. As of November 2022, data processing and analysis are in progress, and the first results are expected to be submitted for publication in 2023. CONCLUSIONS This study will aid our understanding of biological variations in liTr, the influence of disease pathology on liTr, the potential compensation of rotator cuff tears by muscle activation and size, and the association between liTr and patient outcomes. The outcomes will be relevant for diagnosis, treatment, and rehabilitation planning in patients with rotator cuff tears. TRIAL REGISTRATION ClinicalTrials.gov NCT04819724; https://clinicaltrials.gov/ct2/show/NCT04819724. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/43769.
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Affiliation(s)
| | - Franziska Eckers
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | - Corina Nüesch
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland.,Department of Clinical Research, University of Basel, Basel, Switzerland.,Department of Spine Surgery, University Hospital Basel, Basel, Switzerland
| | - Soheila Aghlmandi
- Meta-Research Centre, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
| | | | - Jeremy Genter
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland.,Institute of Mechanical Systems, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Daniel Baumgartner
- Institute of Mechanical Systems, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Andreas Marc Müller
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | - Annegret Mündermann
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland.,Department of Clinical Research, University of Basel, Basel, Switzerland.,Department of Spine Surgery, University Hospital Basel, Basel, Switzerland
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Pataky J, Engle L, Seelam V, Khandare S, Moore ZM, Armstrong AD, Vidt ME. Movement compensation is driven by the deltoid and teres minor muscles following severe rotator cuff tear. Clin Biomech (Bristol, Avon) 2022; 100:105799. [PMID: 36265254 DOI: 10.1016/j.clinbiomech.2022.105799] [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: 06/30/2022] [Revised: 10/03/2022] [Accepted: 10/07/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Rotator cuff tears are common in older adults, negatively affecting function. Previous simulation-based studies reported more posterior and superior oriented glenohumeral loading with increased cuff tear severity and task performance, although corresponding muscle compensation strategies are unclear. Our objective is to determine how shoulder muscle forces change with increased rotator cuff tear severity during functional task performance. METHODS Eight musculoskeletal models of increasing tear severity were developed to represent no rotator cuff tear to massive three-tendon tears. Simulations were performed using each combination of model and kinematics for five functional tasks. Individual muscle forces were averaged for each task and tear severity, then normalized by the sum of the muscle forces across the shoulder. Forces were compared across tear severity and muscle. FINDINGS For muscle force contribution, interactions between tear severity and muscle and a main effect of muscle were seen for all tasks (P < 0.0001). Middle deltoid increased force contribution by >10% in the greatest tear severity model compared to no cuff tear model for all tasks (all P < 0.0001). Teres minor contribution increased by 7.7%, 5.6%, and 11% in the greatest tear severity model compared to the no cuff tear model for forward reach, axilla wash, and upward reach 105° tasks, respectively (all P < 0.0001). INTERPRETATION Functional tasks elicit compensatory responses from uninjured muscles following severe cuff tears, notably in middle deltoid and teres minor, leading to posterior-superior glenohumeral loading. The muscles are potential targets for strengthening to avoid injury from sustained increased muscle force.
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Affiliation(s)
- Joshua Pataky
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
| | - Lyndsay Engle
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
| | - Vijitha Seelam
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
| | - Sujata Khandare
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
| | - Zoe M Moore
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
| | - April D Armstrong
- Orthopaedics and Rehabilitation, Penn State College of Medicine, Hershey, PA, USA
| | - Meghan E Vidt
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA; Physical Medicine & Rehabilitation, Penn State College of Medicine, Hershey, PA, USA.
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8
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Reliability of the Fluoroscopic Assessment of Load-Induced Glenohumeral Translation during a 30° Shoulder Abduction Test. BIOMECHANICS 2022; 2:255-263. [PMID: 35677586 PMCID: PMC7612827 DOI: 10.3390/biomechanics2020020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Rotator cuff tears are often linked to superior translational instability, but a thorough understanding of glenohumeral motion is lacking. This study aimed to assess the reliability of fluoroscopically measured glenohumeral translation during a shoulder abduction test. Ten patients with rotator cuff tears participated in this study. Fluoroscopic images were acquired during 30° abduction and adduction in the scapular plane with and without handheld weights of 2 kg and 4 kg. Images were labelled by two raters, and inferior–superior glenohumeral translation was calculated. During abduction, glenohumeral translation (mean (standard deviation)) ranged from 3.3 (2.2) mm for 0 kg to 4.1 (1.8) mm for 4 kg, and from 2.3 (1.5) mm for 0 kg to 3.8 (2.2) mm for 4 kg for the asymptomatic and symptomatic sides, respectively. For the translation range, moderate to good interrater (intra-class correlation coefficient ICC [95% confidence interval (CI)]; abduction: 0.803 [0.691; 0.877]; adduction: 0.705 [0.551; 0.813]) and intrarater reliabilities (ICC [95% CI]; abduction: 0.817 [0.712; 0.887]; adduction: 0.688 [0.529; 0.801]) were found. Differences in the translation range between the repeated measurements were not statistically significant (mean difference, interrater: abduction, −0.1 mm, p = 0.686; adduction, −0.1 mm, p = 0.466; intrarater: abduction 0.0 mm, p = 0.888; adduction, 0.2 mm, p = 0.275). This method is suitable for measuring inferior–superior glenohumeral translation in the scapular plane.
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Pataky J, Seelam V, Engle L, Khandare S, Armstrong AD, Vidt ME. Glenohumeral joint loading is impacted by rotator cuff tear severity during functional task performance. Clin Biomech (Bristol, Avon) 2021; 90:105494. [PMID: 34634580 DOI: 10.1016/j.clinbiomech.2021.105494] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/17/2021] [Accepted: 09/21/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Rotator cuff tear is a common musculoskeletal injury, negatively affecting shoulder function. Rotator cuff tear severity ranges from small to massive tears, but it is unclear how tear severity affects glenohumeral joint loading and how changes contribute to secondary injury. This study's objective was to determine how glenohumeral joint contact force changes with tear severity during functional task performance using computational models. METHODS Eight models of increasing tear severity were developed, ranging from no rotator cuff tear to massive three-tendon tears. Simulations were performed using models representing increasing tear severity and kinematics for five functional tasks (n = 720 simulations). For each task, magnitude and orientation of peak resultant joint contact force for each tear severity was identified, then compared to the no rotator cuff tear model. FINDINGS For all tasks, compared to the no rotator cuff tear model, joint contact force magnitude decreased 9.5% on average with infraspinatus involvement, then plateaued at 20.8% average decrease with subscapularis involvement. Projected orientation of peak joint contact force vector was located more superior in the glenoid with increased tear severity, with significant changes (p < 0.0003) for all tasks with infraspinatus involvement. INTERPRETATION Decreased magnitude and superior orientation of joint contact force suggest fewer intact muscles contribute to force distribution across the joint, although more work is needed characterizing associated compensation strategies. All force vectors remained oriented within the glenoid rim for all tasks and models, suggesting the system prioritizes joint stability. This work identifies how joint contact force changes with rotator cuff tear severity.
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Affiliation(s)
- Joshua Pataky
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
| | - Vijitha Seelam
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
| | - Lyndsay Engle
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
| | - Sujata Khandare
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
| | - April D Armstrong
- Orthopaedics and Rehabilitation, Penn State College of Medicine, Hershey, PA, USA
| | - Meghan E Vidt
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA; Physical Medicine & Rehabilitation, Penn State College of Medicine, Hershey, PA, USA.
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Brown DMY, Farias Zuniga A, Mulla DM, Mendonca D, Keir PJ, Bray SR. Investigating the Effects of Mental Fatigue on Resistance Exercise Performance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6794. [PMID: 34202762 PMCID: PMC8297120 DOI: 10.3390/ijerph18136794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/14/2021] [Accepted: 06/18/2021] [Indexed: 11/16/2022]
Abstract
Mental fatigue can impart negative effects on subsequent physical performance, although the mechanisms underlying these effects are not well understood. This study examined whether mental fatigue confers negative carryover effects on the performance of a set of biceps curls, while also investigating physiological and psychological mechanisms proposed to explain the predicted effect. A randomized, cross-over design was employed. On visit 1, participants (N = 10) performed a barbell biceps curl one-repetition maximum (1RM) test. On visits 2-3, participants performed 20 biceps curls at 50% of their 1RM, followed by their respective 10 min experimental manipulation (high vs. low cognitive exertion) and then a second set of biceps curls to exhaustion. Ratings of perceived exertion and electromyography of the biceps brachii, triceps brachii, upper trapezius, thoracic erector spinae and lumbar erector spinae were recorded during the physical task. The total number of repetitions completed was similar across the conditions. Results also failed to show between-condition differences for muscle activation and perceptions of exertion. Future research is needed to build an adequate knowledge base to determine whether there is an effect of mental fatigue on dynamic resistance-based task performance and, if so, identify the mechanisms explaining how and why.
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Affiliation(s)
- Denver M. Y. Brown
- Department of Kinesiology, McMaster University, 1280 Main St. W, Hamilton, ON L8S 4L8, Canada; (A.F.Z.); (D.M.M.); (D.M.); (P.J.K.); (S.R.B.)
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Kim BG, Lim SK, Kong S. The Relationship between Scapular Upward Rotation and Shoulder Internal and External Rotation Isokinetic Strength in Professional Baseball Pitchers. Healthcare (Basel) 2021; 9:healthcare9060759. [PMID: 34207473 PMCID: PMC8233980 DOI: 10.3390/healthcare9060759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 12/12/2022] Open
Abstract
This study aims to assess the relationship between scapular upward rotation (SUR) across varying humeral-elevation angles (HEAs) and shoulder isokinetic strength and ratio in professional baseball pitchers. The subjects were professional baseball pitchers (n = 16) without a history of shoulder injury in the last six months. The subject’s SUR angles were measured with the humerus elevated at HEAs of 0° (at rest), 60°, 90°, and 120° to the scapular plane. Shoulder isokinetic strength was evaluated for shoulder internal rotation (IR) and external rotation (ER) strength (PT%BW and TW%BW), and the ER/IR strength ratios were determined at 60, 120 and 180°/s using an isokinetic dynamometer. The SUR angle at an HEA of 0° was positively correlated with IR strength at 120°/s (r = 0.535) and 180°/s (r = 0.522). The SUR angle at an HEA of 60° was negatively correlated with the ER/IR strength ratios at 60°/s (r = −0.505) and 120°/s (r = −0.500). The SUR angle at an HEA of 90° was negatively correlated with the ER/IR strength ratios at 60°/s (r = −0.574; r = −0.554) and 120°/s (r = −0.521; r = −0.589) as well as with ER strength at 180°/s (r = −0.591, r = −0.556). The SUR angle at an HEA of 120° was negatively correlated with ER strength at 60°/s (r = −0.558), 120°/s (r = −0.504; r = −0.524), and 180°/s (r = −0.543) and the ER/IR strength ratio at 60°/s (r = −0.517). In this study, we found that the ratio of isokinetic strength between ER and IR became closer to the normal range on increasing the SUR angle. In particular, an HEA of 90°, which resembles the pitching motion, showed a clear relationship between SUR, shoulder ER, and the ratio of ER/IR isokinetic strength in professional baseball pitchers.
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Affiliation(s)
| | - Seung Kil Lim
- Department of Exercise Prescription, Dongshin University, Naju 58245, Korea;
| | - Sunga Kong
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul 06351, Korea
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul 06351, Korea
- Correspondence: ; Tel.: +82-02-2148-9498; Fax: +82-02-3410-6639
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Electromyographic Evaluation of the Shoulder Muscle after a Fatiguing Isokinetic Protocol in Recreational Overhead Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052516. [PMID: 33802582 PMCID: PMC7967333 DOI: 10.3390/ijerph18052516] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/22/2021] [Accepted: 02/25/2021] [Indexed: 11/17/2022]
Abstract
The goal of our study was to examine the muscle activity of the shoulder girdle after isokinetic fatigue, which may simulate muscle activities commonly occurring during specific sport-related activities in recreational overhead asymptomatic athletes. We hypothesized that exercise-induced fatigue, reported after isokinetic protocols, may cause a decrease in the median frequency (MF) of the upper trapezius (UT), infraspinatus (IS), and deltoid muscles. Twenty-four male overhead volleyball (n = 8), handball (n = 8), and tennis (n = 8) athletes participated in this study. All subjects were without shoulder injury history. The surface electromyography (SEMG) was collected on the right (dominant) side of the shoulder girdle muscles in the following order: UT, IS and anterior (DA), and posterior deltoideus (DP). The fatigue protocol consisted of three sets of 32 maximum isokinetic concentric contractions while performing shoulder internal and external rotation at an isokinetic speed of 120 o/s. The resultant difference in median frequency (ΔMF) values consistently dropped after the fatiguing tasks across all recorded muscles, in terms of the initial MF (MFINI = 65.1 ± 1.1 Hz) and final MF (MFFIN = 57.9 ± 0.9 Hz), and the main effect of time was significant (F(1,22) = 43.15, p < 0.001). MF values decreased mostly for IS (ΔMFIS = −9.9 ± 1.6 Hz) and DP (ΔMFPD = −9.5 ± 1.9 Hz) muscles, while DA and UT showed smaller changes (ΔMFDA = −6.9 ± 1.5 Hz) and (ΔMFUT = −3.2 ± 1.3 Hz). The results of our study show a meaningful contribution in determining increased fatigue of the shoulder girdle muscles during repeated isokinetic internal-external rotation protocols. We have also demonstrated a significant decrease in MF in all examined muscles, especially IS and DA.
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Adamo P, Temporiti F, Natali F, Trombin S, Cescon C, Barbero M, Gatti R. Dispersion of shoulder helical axes during upper limb movements after muscle fatigue. J Biomech 2020; 113:110075. [PMID: 33142202 DOI: 10.1016/j.jbiomech.2020.110075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 10/05/2020] [Accepted: 10/16/2020] [Indexed: 10/23/2022]
Abstract
Shoulder complex control of motion is influenced by neuromuscular function and can be quantified through the analysis of helical axes (HAs) dispersion. Muscle fatigue is a variable able to influence neuromuscular control, altering muscle activation timing and proprioception. The aim of the study was to describe shoulder complex HAs dispersion after muscle fatigue during upper limb movements of young healthy subjects. Thirty healthy right-handed volunteers (age 23.2 ± 2.6 years) were asked to perform a test made up of 15 humerothoracic flexion and rotation movements using both upper limbs in two different recording sessions. After each session, muscles of the tested movement were fatigued in isometric condition at dominant side. After fatigue, subjects repeated the test. Kinematics was recorded by an optoelectronic system and HAs dispersion was computed using Mean Distance (MD) and Mean Angle (MA) for the entire Range of Motion (RoM) and in portions of RoM. After fatigue of shoulder flexion muscles, greater MD (p = 0.001) and MA (p = 0.019) were found on the dominant side. After fatigue of shoulder rotation muscles, greater MD and MA were found on the dominant (p = 0.002 for MD; p = 0.047 for MA) and non-dominant (p = 0.038 for MD; p = 0.019 for MA) sides. Independently of fatigue, greater MA was found in portions of RoM with higher external resistance torque in flexion and rotation tasks. Muscle fatigue increases shoulder complex HAs dispersion, probably due to alteration in neuromuscular control. This data should be considered when exercise involving upper arms are proposed to subjects undergoing fatigue.
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Affiliation(s)
- Paola Adamo
- Physiotherapy Unit, Humanitas Clinical and Research Center - IRCCS -, via Manzoni 56, 20089, Rozzano (Mi), Italy
| | - Federico Temporiti
- Physiotherapy Unit, Humanitas Clinical and Research Center - IRCCS -, via Manzoni 56, 20089, Rozzano (Mi), Italy; Humanitas University, Department of Biomedical Sciences, via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy
| | - Fabrizio Natali
- Physiotherapy Unit, Humanitas Clinical and Research Center - IRCCS -, via Manzoni 56, 20089, Rozzano (Mi), Italy
| | - Sara Trombin
- Humanitas University, Department of Biomedical Sciences, via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy
| | - Corrado Cescon
- Rehabilitation Research Laboratory, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Marco Barbero
- Rehabilitation Research Laboratory, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Roberto Gatti
- Physiotherapy Unit, Humanitas Clinical and Research Center - IRCCS -, via Manzoni 56, 20089, Rozzano (Mi), Italy; Humanitas University, Department of Biomedical Sciences, via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy.
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Reproducibility and discriminant validity of the Posterior Shoulder Endurance Test in healthy and painful populations. Phys Ther Sport 2020; 47:66-71. [PMID: 33197875 DOI: 10.1016/j.ptsp.2020.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/27/2020] [Accepted: 10/30/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE This investigation measured the reproducibility and discriminant validity of the Posterior Shoulder Endurance Test (PSET) on painful and non-painful populations. DESIGN Reliability and validity study. SETTING Laboratory setting. PARTICIPANTS Thirty subjects (male = 11; female = 19). MAIN OUTCOME MEASURES Time to failure (TTF) was the primary outcome measure to determine reliability of the PSET. Discriminant validity identified with receiver operator characteristic (ROC) curves utilized TTF separately in men and women since they used different loads. RESULTS There were 25/30 subjects (painful = 12; non-painful = 13) tested a second time. ICC, SEM, and MDC90 ranged respectively from 0.77, 13.1 s, 30.6 s in the painful group to 0.85, 7.3 s, 17 s in the non-painful group. The male ROC curve AUC was 0.833 with 47 s resulting in the best combination of sensitivity = 0.833, and specificity = 0.80. The female ROC curve AUC was 0.633 with 46 s resulting in the best combination of sensitivity = 0.600 and specificity = 0.889 at 46 s. CONCLUSION The PSET is a reliable way to measure shoulder girdle muscular endurance. These data suggest that the PSET discriminates painful and non-painful individuals better in men compared to women.
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Changes in clinical measures and tissue adaptations in collegiate swimmers across a competitive season. J Shoulder Elbow Surg 2020; 29:2375-2384. [PMID: 33070869 DOI: 10.1016/j.jse.2020.03.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/23/2020] [Accepted: 03/26/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Competitive swimmers incur shoulder pain and injury. Physical characteristics such as shoulder range of motion (ROM) and endurance and tissue adaptations such as posterior capsule thickness (PCT) may be risk factors in addition to high training volume. HYPOTHESIS/PURPOSE 1) To identify the most provocative special test and prevalence of positive special tests for shoulder impingement tests in a group of collegiate swimmers, (2) to assess shoulder pain and disability, internal rotation (IR) and external rotation, and horizontal adduction (HADD) ROM and posterior shoulder endurance longitudinally over a competitive collegiate season, and (3) determine if there is a relationship between swimming yardage, supraspinatus tendon organization, and PCT. METHODS Thirty Division III swimmers were tested poolside at the beginning (T1), middle (T2), and end (T3) of their season. Dependent variables included pain and disability, shoulder ROM, Posterior Shoulder Endurance Test (PSET) value, and PCT. Analyses of variance with follow-up t tests compared measures over time, and Pearson correlation coefficients were performed. RESULTS Despite increased swimming yardage, disability was reduced from T1 to T3 (P = .003). There was a reduction in bilateral IR and HADD ROM from T1 to T3. PSET values increased on the right from T1 to T3 (P = .014). There was a significant positive correlation between swimming yardage at T1 and T2 and PCT at T3 (P = .034, P = .028). CONCLUSION A loss of shoulder IR and HADD was observed across the season concurrent with less swimming-related disability, which may indicate a favorable adaptation. Improved PSET scores over the season is consistent with prior research linking endurance and less pain and disability.
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Mulla DM, McDonald AC, Keir PJ. Joint moment trade-offs across the upper extremity and trunk during repetitive work. APPLIED ERGONOMICS 2020; 88:103142. [PMID: 32421639 DOI: 10.1016/j.apergo.2020.103142] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 04/28/2020] [Accepted: 05/01/2020] [Indexed: 06/11/2023]
Abstract
Individuals can coordinate small kinematic changes at several degrees of freedom simultaneously in the presence of fatigue, leaving it unclear how overall biomechanical demands at each joint are altered. The purpose of this study was to evaluate trade-offs in joint moments between the trunk, shoulder, and elbow during repetitive upper extremity work. Participants performed four simulated workplace tasks cyclically until meeting fatigue termination criteria. Emergent fatigue-induced adaptations to repetitive work resulted in task-dependent trade-offs in joint moments. In general, reduced shoulder moments were compensated for by increased elbow and trunk joint moment contributions. Although mean joint moment changes were modest (range: 1-3 Nm) across participants, a wide distribution of responses was observed, with standard deviations exceeding 10 Nm. Re-distributing biomechanical demands across joints may alleviate constant tissue loads and facilitate continued task performance with fatigue but may be at the expense of increasing demands at adjacent joints.
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Affiliation(s)
- Daanish M Mulla
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Alison C McDonald
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Peter J Keir
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada.
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Looft JM, Frey-Law LA. Adapting a fatigue model for shoulder flexion fatigue: Enhancing recovery rate during intermittent rest intervals. J Biomech 2020; 106:109762. [PMID: 32517992 DOI: 10.1016/j.jbiomech.2020.109762] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 03/18/2020] [Accepted: 03/18/2020] [Indexed: 12/01/2022]
Abstract
Although the rotator cuff muscles are susceptible to fatigue, shoulder fatigue studies reporting torque decline during intermittent tasks are relatively uncommon in the literature. A previous modification to the three-compartment controller (3CC) fatigue model incorporated a rest recovery multiplier (3CC-r model) to represent augmented blood flow to muscle during rest intervals (Looft et al., 2018). A rest recovery value of r = 15 was optimal for ankle, knee, and elbow joint regions, whereas r = 30 was better for hand/grip muscles. However, shoulder torque decline data was unavailable in the literature for comparison. Thus, the purpose of this study was to collect fatigue data for two different intermittent, isometric shoulder flexion fatiguing tasks and assess the 3CC-r model with r = 15 or 30 compared to the original 3CC model. Twenty healthy participants (9 M) completed two fatigue tasks: 50% maximum voluntary contraction (MVC) with 50% duty cycle (DC) and 70% MVC with 70% DC. MVCs were assessed at discrete time points (1, 3, 5, 10, and 15 min) until endurance time (MET). Mean observed percent torque decline (%TD) for the two tasks were compared to three model estimates: 3CC-r (using r = 15 and r = 30) and 3CC. Using these data, we confirmed that the addition of a rest multiplier (r = 15 somewhat better than r = 30) substantially improved predictions of shoulder fatigue using a previously validated analytical fatigue model (3CC). The relatively large reduction in model errors over the original model suggests the importance of representing augmented recovery during rest periods.
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Affiliation(s)
- John M Looft
- Minneapolis VA Health Care System, Minneapolis, MN 55417, United States; Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA 52442, United States.
| | - Laura A Frey-Law
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA 52442, United States
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Zago M, Kawczyński A, Klich S, Pietraszewski B, Galli M, Lovecchio N. Fatigue-Induced Scapular Dyskinesis in Healthy Overhead Athletes. Front Bioeng Biotechnol 2020; 8:302. [PMID: 32373599 PMCID: PMC7186350 DOI: 10.3389/fbioe.2020.00302] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 03/20/2020] [Indexed: 11/13/2022] Open
Abstract
Alterations of scapular kinematics affect the whole kinematic chain, potentially leading to the impingement syndrome. This is crucial in overhead sports, where athletes perform frequent and quick upper limb actions. In this manuscript, we aimed to assess the extent to which fatigue alters scapulo-thoracic and scapulo-humeral ranges of motion (RoM), as well as scapulo-humeral movement onset during different upper limb actions. Twenty-four young healthy males aged 22 ± 2 years (height: 1.82 ± 0.06 m, body mass: 78.0 ± 7.8 kg) performed three movements (upper limb elevation, scapular-plane abduction, and intra-extra rotation) before and after an isokinetic fatigue protocol (upper limb intra/extra rotation, 32 repetitions at 120 degrees/s). Pre vs. post fatigue RoM of humeral elevation and rotation, scapular retraction/protraction, and rotation and tilt were computed. Humerus-scapula movement delay was also determined. Humerus elevation range reduced during intra/extra humerus rotation in fatigued conditions (p = 0.006). Scapular tilt RoM increased after the fatigue protocol (p = 0.063, large effect). Humerus-scapular movement onset delay reduced in fatigued conditions of about 80 ms (p < 0.001, large effect). In sum, fatigued intra/extra upper limb rotators altered the scapulohumeral rhythm, and joints RoM in movements outside the scapular plane. Rather, movements close to the scapular plane were less prone to fatigue-induced alterations.
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Affiliation(s)
- Matteo Zago
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy.,e4Sport Laboratory, Politecnico di Milano, Italy
| | - Adam Kawczyński
- Faculty of Sport Science, University School of Physical Education, Wrocław, Poland
| | - Sebastian Klich
- Faculty of Sport Science, University School of Physical Education, Wrocław, Poland
| | - Bogdan Pietraszewski
- Faculty of Physical Education, University School of Physical Education, Wrocław, Poland
| | - Manuela Galli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy.,e4Sport Laboratory, Politecnico di Milano, Italy
| | - Nicola Lovecchio
- Department of Public Health, Experimental and Forensic Medicine, The University of Pavia, Pavia, Italy
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Jildeh TR, Okoroha KR, Tramer JS, Chahla J, Nwachukwu BU, Annin S, Moutzouros V, Bush-Joseph C, Verma N. Effect of Fatigue Protocols on Upper Extremity Neuromuscular Function and Implications for Ulnar Collateral Ligament Injury Prevention. Orthop J Sports Med 2019; 7:2325967119888876. [PMID: 31903400 PMCID: PMC6933549 DOI: 10.1177/2325967119888876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background As the incidence of overuse injuries to the medial elbow in overhead athletes continues to rise, recent evidence suggests a link between these injuries and alterations in biomechanics produced by athlete fatigue. Previous studies have evaluated the effect of fatigue on elbow injuries using a wide array of fatigue protocols/athletic tasks, and, as a consequence, the results have been heterogeneous. Purpose To determine whether there is a uniform alteration in neuromuscular function or biomechanics as the overhead athlete fatigues. Furthermore, this study sought to determine whether player fatigue should be accounted for in ulnar collateral ligament (UCL) injury prevention programs. Study Design Systematic review. Methods A systematic review of the literature using PubMed and MEDLINE databases was performed. Keywords included fatigue, upper extremity, baseball, pitcher, throwing, and muscle activity. Inclusion criteria consisted of original research articles in the English language involving healthy athletes, use of fatigue protocols, and the evaluation of at least 1 upper limb biomechanical variable. Results A total of 35 studies involving 644 athletes (90 females, 554 males; mean age, 20.2 years) met the inclusion criteria. General fatigue protocols were used in 2 investigations, peripheral protocols were used in all 35 studies, and 5 different athletic tasks were studied (simulated baseball game, overhead throwing, high-effort swimming, simulated tennis game, and overhead serving). There was a uniform decrease in muscle force production and proprioception in athletes after completing a fatigue protocol. However, there was no consistency among studies when evaluating other important upper limb biomechanical factors. The fatigue protocols did not consistently produce statistically significant changes in elbow torque, pitching biomechanics, or ball velocity. Conclusion A uniform decrease in muscle force production and proprioception was found after fatigue protocols; however, a majority of fatigue protocols published in the current literature are inconsistently measured and produce heterogeneous results. Therefore, currently, no recommendations can be made for changes in UCL injury prevention training programs to account for potential effects of fatigue. The effect of muscle force production and proprioception on upper extremity injuries should be evaluated in future studies.
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Affiliation(s)
- Toufic R Jildeh
- Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, USA
| | - Kelechi R Okoroha
- Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, USA
| | - Joseph S Tramer
- Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, USA
| | - Jorge Chahla
- Rush University Medical Center, Chicago, Illinois, USA
| | | | - Shawn Annin
- School of Medicine, Wayne State University, Detroit, Michigan, USA
| | - Vasilios Moutzouros
- Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, USA
| | | | - Nikhil Verma
- Rush University Medical Center, Chicago, Illinois, USA
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20
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Ultrasonographic and Myotonometric Evaluation of the Shoulder Girdle After an Isokinetic Muscle Fatigue Protocol. J Sport Rehabil 2019; 29:1047-1052. [PMID: 31593927 DOI: 10.1123/jsr.2019-0117] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 06/10/2019] [Accepted: 08/03/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The aim of the study was to investigate supraspinatus tendon thickness, acromiohumeral distance (AHD), and stiffness/creep measures of the shoulder girdle in overhead asymptomatic athletes in muscle fatigue conditions. DESIGN Observational, case series study. SETTING Biomechanics and motion analysis lab. PARTICIPANTS Twenty-four male overhead volleyball (n = 8), handball (n = 8), and tennis (n = 8) athletes. All subjects were without shoulder injury history. MAIN OUTCOME MEASURE The subjects were tested for supraspinatus tendon thickness (in short and long axis), AHD using ultrasound scans and stiffness/creep of upper trapezius, infraspinatus, anterior and posterior deltoid, and pectoralis major using the myotonometer device before and immediately after a fatigue protocol. INTERVENTION The fatigue protocol consisted of 3 sets of 32 maximum isokinetic concentric contractions performing shoulder internal and external rotation at isokinetic speed of 120°/s. RESULTS A significant increase in supraspinatus tendon thickness (both in short and long axis) (P = .045 and P = .01, respectively) and a reduction in AHD (P = .01) were found after an isokinetic protocol. The stiffness increased significantly in upper trapezius (P ≤ .01), infraspinatus (P = .003), posterior deltoid (P = .047), and pectoralis major (P = .01), whereas the creep showed a significant decrement for upper trapezius (P = .001) and infraspinatus (P = .003). CONCLUSION The present study has demonstrated the postexercise fatigue in overhead athletes. The increase of stiffness (reduction of muscle creep) and tendon thickness (simultaneous to the reduction of AHD) may indicate rotator cuff overloading as a primary intrinsic tendon pathology process.
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21
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Flores-Hernandez C, Eskinazi I, Hoenecke HR, D'Lima DD. Scapulothoracic rhythm affects glenohumeral joint force. JSES OPEN ACCESS 2019; 3:77-82. [PMID: 31334433 PMCID: PMC6620199 DOI: 10.1016/j.jses.2019.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Hypothesis Musculoskeletal computer models provide valuable insights into shoulder biomechanics. The shoulder is a complex joint composed of glenohumeral, scapulothoracic, acromioclavicular, and sternoclavicular articulations, whose function is largely dependent on the many muscles spanning these joints. However, the range of patient-to-patient variability in shoulder function is largely unknown. We therefore assessed the sensitivity of glenohumeral forces to population-based model input parameters that were likely to influence shoulder function. Methods We constructed musculoskeletal models of the shoulder in the AnyBody Modeling System (AnyBody Technology, Aalborg, Denmark). We used inverse dynamics and static optimization to solve for glenohumeral joint forces during a simulated shoulder elevation. We generated 1000 AnyBody models by uniformly distributing the following input parameters: subject height, scapulohumeral rhythm, humeral head radius, and acromiohumeral interval. Results Increasing body height increased glenohumeral joint forces. Increasing the ratio of scapulothoracic to glenohumeral elevation also increased forces. Increasing humeral head radius and acromiohumeral interval decreased forces. The relative sensitivity of glenohumeral joint forces to input parameters was dependent on the angle of shoulder elevation. We developed an efficient method of generating and simulating musculoskeletal models representing a large population of shoulder arthroplasty patients. We found that scapulohumeral rhythm had a significant influence on glenohumeral joint force. Conclusions This finding underscores the importance of more accurately measuring and simulating scapulothoracic motion rather than using fixed ratios or average scapulothoracic motion. This modeling approach can be used to generate virtual populations for conducting efficient simulations and generating statistical conclusions.
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Affiliation(s)
| | - Ilan Eskinazi
- Shiley Center for Orthopaedic Research & Education at Scripps Clinic, La Jolla, CA, USA
| | - Heinz R Hoenecke
- Shiley Center for Orthopaedic Research & Education at Scripps Clinic, La Jolla, CA, USA
| | - Darryl D D'Lima
- Shiley Center for Orthopaedic Research & Education at Scripps Clinic, La Jolla, CA, USA
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22
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Khandare S, Arce RA, Vidt ME. Muscle compensation strategies to maintain glenohumeral joint stability with increased rotator cuff tear severity: A simulation study. J Electromyogr Kinesiol 2019; 62:102335. [DOI: 10.1016/j.jelekin.2019.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 06/24/2019] [Accepted: 07/08/2019] [Indexed: 11/26/2022] Open
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McDonald AC, Mulla DM, Keir PJ. Muscular and kinematic adaptations to fatiguing repetitive upper extremity work. APPLIED ERGONOMICS 2019; 75:250-256. [PMID: 30509533 DOI: 10.1016/j.apergo.2018.11.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 10/31/2018] [Accepted: 11/01/2018] [Indexed: 06/09/2023]
Abstract
Repetitive work is common in the modern workplace and the effects are often studied using fatigue protocols; however, there is evidence that the manner in which fatigue develops impacts the kinematic and muscular response to reduced physical capacity. The purpose of this study was to simultaneously evaluate muscular and kinematic adaptations during fatiguing, repetitive work until exhaustion. We measured muscle activity in 13 muscles in the shoulder and trunk, and captured full body kinematics while participants completed simulated, repetitive work tasks. Every 12 min, reference data were collected to quantify fatigue. This sequence continued until they reached the termination criteria. Participants displayed significant signs of muscle fatigue, loss of strength and increased perceived fatigue (p < 0.05). Analysis revealed a significant effect of time on posture and muscle activity that was both task and time dependent, and variable both between and within individuals. Participants were able to compensate for reduced physical capacity and maintain task performance through coordinated compensation strategies.
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Affiliation(s)
- Alison C McDonald
- Occupational Biomechanics Laboratory, Department of Kinesiology, McMaster University, Hamilton, ON, Canada, L8S 4K1
| | - Daanish M Mulla
- Occupational Biomechanics Laboratory, Department of Kinesiology, McMaster University, Hamilton, ON, Canada, L8S 4K1
| | - Peter J Keir
- Occupational Biomechanics Laboratory, Department of Kinesiology, McMaster University, Hamilton, ON, Canada, L8S 4K1.
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Vidt ME, Santago AC, Marsh AP, Hegedus EJ, Tuohy CJ, Poehling GG, Freehill MT, Miller ME, Saul KR. Modeling a rotator cuff tear: Individualized shoulder muscle forces influence glenohumeral joint contact force predictions. Clin Biomech (Bristol, Avon) 2018; 60:20-29. [PMID: 30308434 PMCID: PMC6252115 DOI: 10.1016/j.clinbiomech.2018.10.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/31/2018] [Accepted: 10/03/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Rotator cuff tears in older individuals may result in decreased muscle forces and changes to force distribution across the glenohumeral joint. Reduced muscle forces may impact functional task performance, altering glenohumeral joint contact forces, potentially contributing to instability or joint damage risk. Our objective was to evaluate the influence of rotator cuff muscle force distribution on glenohumeral joint contact force during functional pull and axilla wash tasks using individualized computational models. METHODS Fourteen older individuals (age 63.4 yrs. (SD 1.8)) were studied; 7 with rotator cuff tear, 7 matched controls. Muscle volume measurements were used to scale a nominal upper limb model's muscle forces to develop individualized models and perform dynamic simulations of movement tracking participant-derived kinematics. Peak resultant glenohumeral joint contact force, and direction and magnitude of force components were compared between groups using ANCOVA. FINDINGS Results show individualized muscle force distributions for rotator cuff tear participants had reduced peak resultant joint contact force for pull and axilla wash (P ≤ 0.0456), with smaller compressive components of peak resultant force for pull (P = 0.0248). Peak forces for pull were within the glenoid. For axilla wash, peak joint contact was directed near/outside the glenoid rim for three participants; predictions required individualized muscle forces since nominal muscle forces did not affect joint force location. INTERPRETATION Older adults with rotator cuff tear had smaller peak resultant and compressive forces, possibly indicating increased instability or secondary joint damage risk. Outcomes suggest predicted joint contact force following rotator cuff tear is sensitive to including individualized muscle forces.
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Affiliation(s)
- Meghan E Vidt
- Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences, Wake Forest Baptist Health, Biomedical Engineering, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
| | - Anthony C Santago
- Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences, Wake Forest Baptist Health, Biomedical Engineering, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Anthony P Marsh
- Department of Health and Exercise Science, Wake Forest University, PO Box 7868, Winston-Salem, NC 27109, USA
| | - Eric J Hegedus
- Department of Physical Therapy, High Point University, One University Parkway, High Point, NC 27268, USA
| | - Christopher J Tuohy
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Gary G Poehling
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Michael T Freehill
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Michael E Miller
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Katherine R Saul
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Engineering Building 3, Campus Box 7910, 911 Oval Drive, Raleigh, NC 27695-7910, USA
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25
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Upper body kinematic and muscular variability in response to targeted rotator cuff fatigue. Hum Mov Sci 2018; 59:121-133. [DOI: 10.1016/j.humov.2018.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 04/01/2018] [Accepted: 04/02/2018] [Indexed: 11/23/2022]
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Gaudet S, Tremblay J, Dal Maso F. Evolution of muscular fatigue in periscapular and rotator cuff muscles during isokinetic shoulder rotations. J Sports Sci 2018; 36:2121-2128. [PMID: 29447092 DOI: 10.1080/02640414.2018.1440513] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
To this day, how shoulder muscles react to a strong fatigue stimulus during dynamic shoulder rotations remains unknown. The aims of this study were to assess the effect of repeated maximal internal-external isokinetic shoulder rotations on shoulder strength and muscle activity. Twenty-four individuals completed a 50-repetition fatiguing isokinetic protocol while electromyography was recorded on eleven muscles of the shoulder girdle. Time-frequency transformation and an ANOVA model using statistical parametric mapping methods were used to analyze shifts in instantaneous median frequency (MDF) between each 10-repetition Blocks. Peak torques decreased in both internal and external rotation (P < 0.01) by 24.8% on average which indicated the presence of fatigue. Significant decrease in MDF (P < 0.01) was observed for pectoralis, middle deltoid, upper, middle and lower trapezius, infraspinatus and subscapularis muscles. The observed fatigue to the periscapular and rotator cuff muscles suggests that shoulder stability could be compromised during repeated shoulder rotations, which could underlie the increased risk of scapular dyskinesis and shoulder impingement during fatiguing tasks. The present study provides a deeper understanding on the manifestations of fatigue within muscles of the shoulder girdle and the results could be applied toward improvements in athlete shoulder injury prevention and rehabilitation programs.
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Affiliation(s)
- Sylvain Gaudet
- a Département de Kinésiologie , Université de Montréal , Montréal , Canada
| | - Jonathan Tremblay
- a Département de Kinésiologie , Université de Montréal , Montréal , Canada
| | - Fabien Dal Maso
- a Département de Kinésiologie , Université de Montréal , Montréal , Canada
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Alizadehkhaiyat O, Roebuck MM, Makki AT, Frostick SP. Subacromial impingement syndrome: An electromyographic study of shoulder girdle muscle fatigue. J Electromyogr Kinesiol 2017; 38:136-142. [PMID: 29245114 DOI: 10.1016/j.jelekin.2017.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 11/21/2017] [Accepted: 12/06/2017] [Indexed: 11/30/2022] Open
Abstract
Muscle fatigue affecting glenohumeral and/or scapular muscles is suggested as one of the contributing factors to the development of subacromial impingement syndrome (SAIS). Nonetheless, the fatigability of shoulder girdle muscles in association with the pathomechanics of SAIS has not been reported. This study aimed to measure and compare fatigue progression within the shoulder girdle musculature of patients and healthy controls. 75 participants including 39 patients (20 females; 19 males) and 36 healthy controls (15 females; 21 males) participated in the study. Study evaluated the progression of muscle fatigue in 15 shoulder girdle muscles by means of surface and fine-wire EMG during submaximal contraction of four distinct movements (abduction, flexion, internal and external rotation). Shoulder strength, subjective pain experience (McGill Pain Questionnaire), and psychological status (Hospital Anxiety and Depression Scale) were also assessed. The results were compared between patient and control groups according to the gender. Despite marked fatigue observed in the majority of muscles particularly during flexion and abduction at 90°, overall results indicated a lower tendency of fatigue progression in the impingement group across the tests (p < 0.05 - p < 0.001). Shoulder Strength, pain experience, and psychological status were significantly different between the two groups (P < .05). Lower tendency to fatigue progression in the impingement group can be attributed to the presence of fear avoidance and pain-related muscle inhibition, which in turn lead to adaptations in motor programme to reduce muscle recruitment and activation. The significantly higher levels of pain experience and anxiety/depression in the impingement group further support this proposition.
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Affiliation(s)
- Omid Alizadehkhaiyat
- School of Health Sciences (Sport and Exercise Science), Liverpool Hope University, Liverpool, UK.
| | - Margaret M Roebuck
- Musculoskeletal Science Research Group, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Ahmed T Makki
- Musculoskeletal Science Research Group, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Simon P Frostick
- Musculoskeletal Science Research Group, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
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A probabilistic orthopaedic population model to predict fatigue-related subacromial geometric variability. J Biomech 2016; 49:543-9. [DOI: 10.1016/j.jbiomech.2015.12.049] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 11/13/2015] [Accepted: 12/28/2015] [Indexed: 11/20/2022]
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Dickerson CR, Cutti AG. The translational value of shoulder biomechanics research. J Electromyogr Kinesiol 2016; 29:1-3. [PMID: 26792417 DOI: 10.1016/j.jelekin.2015.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Clark R Dickerson
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
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