Comparison of shoulder internal rotation passive range of motion in various positions in nonathletic persons and the establishment of normative values for the sidelying position

Correlation of Glenohumeral Internal Rotation Deficit With Shoulder Pain in Elite Table Tennis Players

OBJECTIVES

The aims of the study were (1) to investigate glenohumeral internal rotation deficit (a difference in internal rotation of 15.6 degrees or more between dominant and nondominant shoulders) and its correlation with self-reported shoulder pain in table tennis players and (2) to find the optimal cutoff point for the difference in the internal rotation range of motion between dominant and nondominant shoulders of self-reported shoulder pain.

DESIGN

The internal rotation range of motion of both shoulders of 46 table tennis players was measured in the supine and side-lying positions, and the external rotation range of motion was measured in the supine position.

RESULTS

Significant differences existed in internal rotation range of motion between the two sides in the supine ( z = 6.53, P < 0.001) and side-lying positions ( z = 5.67, P < 0.001). Self-reported shoulder pain was associated with glenohumeral internal rotation deficit (odds ratio = 6.86, 95% confidence interval = 1.752-26.832, P = 0.006). The cutoff points for the difference in internal rotation range of motion between the sides of self-reported shoulder pain were 17.9 degrees in the supine position and 11.1 degrees in the side-lying position.

CONCLUSIONS

Table tennis players exhibited glenohumeral internal rotation deficit. There was a correlation between glenohumeral internal rotation deficit and self-reported shoulder pain in the past year; therefore, glenohumeral internal rotation deficit may be a risk factor for shoulder pain in table tennis players.

The relationship between scapular position and glenohumeral rotational range of motion in high school baseball players

BACKGROUND

Past research indicated that scapular malposition is related to the glenohumeral internal rotation deficit (GIRD). However, there is no research examining the effect of throwing-related pain on this relationship. This study investigated the relationship between scapular position and range of motion (ROM) and compared the difference in this relationship between with and without throwing-related pain.

METHODS

Forty male baseball players in high school were recruited for this study. The existence and degree of throwing-related pain were obtained from a questionnaire. Participants were divided into 2 groups according to the presence or absence of the pain. Glenohumeral internal and external rotation ROM (abduction internal rotation angle and abduction external rotation angle [ABER], respectively) were measured using a digital inclinometer. The pectoralis minor muscle length was measured using a vernier caliper and scapula index, which indicated the scapular position, measured using a measuring tape. All these measurements were taken on both dominant and nondominant sides. The GIRD and total motion arc (TMA) deficit were calculated from the ROM measurements. Groups were compared using a mixed-model analysis of variance.

RESULTS

There was a significant interaction between group and ABER dominance. Other variables were not seen as the interaction effect. There was a significant positive correlation between the scapula index and TMA (r = 0.47, P = .02) and a negative correlation between the scapula index and GIRD (r = -0.65, P < .01) in the dominant side of the pain group. In addition, in the nondominant side of the pain group, the scapula index and ABER were significantly correlated (r = 0.43, P = .04).

CONCLUSIONS

The results of this study indicate that the scapular position is associated with the glenohumeral ROM in high school baseball players. In addition, this study demonstrated that the scapular internally rotated position was correlated with the GIRD and TMA deficit in high school baseball players who had throwing-related pain. On the other hand, the scapular externally rotated position was correlated with increased ABER, mainly in the pain-free baseball players or on the nondominant side. These results indicated that the scapular position might affect the glenohumeral rotational ROM in high school baseball players.

Inclinometer Reliability for Shoulder Ranges of Motion in Individuals With Subacromial Impingement Syndrome

OBJECTIVE

This study aimed to determine the intra- and interrater reliability of active and passive range of motion in the shoulders of individuals with subacromial impingement syndrome using a digital inclinometer.

METHODS

The raters evaluated active and passive range of motion in the shoulder of 50 individuals with unilateral subacromial impingement syndrome in movements including flexion, abduction, extension, external rotation in a neutral position, external rotation with the arm at 90° of abduction, and internal rotation with the arm at 90° of abduction. The tests were performed by 2 examiners on the same day, with a 10-minute interval, and were repeated by 1 examiner after a 2- to 4-day interval. Reliability was analyzed using the intraclass correlation coefficient (ICC_2,3).

RESULTS

There was moderate to excellent interrater (ICC_2,3 = 0.50-0.95) and intrarater (ICC_2,3 = 0.74-0.94) reliability. In the interrater analysis, the standard error of measurement (SEM) ranged from 4.1° to 10°, the percentage SEM (%SEM) ranged from 2% to 17%, and the minimum detectable change ranged from 9.5° to 23.4°. In the intrarater analysis, the SEM ranged from 4° to 9.2°, %SEM ranged from 3% to 14%, and the minimum detectable change ranged from 9.3° to 21.4°.

CONCLUSION

The digital inclinometer showed moderate to excellent reliability for measuring active and passive range of motion in shoulders with unilateral subacromial impingement syndrome.

How internal rotation is measured in reverse total shoulder arthroplasty: a systematic review of the literature

Background

Reverse total shoulder arthroplasty (RTSA) can lead to limited postoperative internal rotation (IR). We assessed how IR is measured and reported in the RTSA literature and examined the relationships between these measures and patient-reported ability to perform activities of daily living.

Methods

We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials for articles published in English from January 2000 through September 2018 that reported clinical outcomes after RTSA (minimum 12-month follow-up). We included studies reporting IR range of motion (ROM) and/or patient-reported functional outcomes related to IR. We identified 255 studies, 35% of which were excluded because they reported no IR outcome measures, leaving 165 studies for analysis.

Results

Studies reported 3 methods of measuring IR ROM: (1) vertebral level (VL) method (ie, the most proximal VL reached by the extended thumb with the arm behind the back), (2) degrees of IR with the arm abducted to 90°, and (3) degrees of IR with the arm in a neutral position. The VL measurement was reported in 89% of studies, but the methods of reporting this measure varied. Only 9% of studies reported functional outcomes related to IR. No study correlated clinical measurements of IR ROM with functional outcomes.

Conclusions

Measures and reporting of shoulder IR after RTSA varied widely. This variability makes it difficult to assess associations between postoperativce IR limitation and functional abilities. Standardization of IR measures and reporting is needed to allow meta-analysis of data related to this important outcome.