1
|
Schneider BS, Hao KA, Taylor JK, Wright JO, Wright TW, Pazik M, Schoch BS, King JJ. Influence of acromioclavicular joint arthritis on outcomes after reverse total shoulder. JSES Int 2024; 8:111-118. [PMID: 38312293 PMCID: PMC10837712 DOI: 10.1016/j.jseint.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024] Open
Abstract
Background Although substantial motion at the acromioclavicular joint (ACJ) occurs during overhead shoulder motion, the influence of ACJ arthritis on postoperative outcomes of patients undergoing reverse total shoulder arthroplasty (rTSA) is unclear. We assessed the influence of ACJ arthritis, defined by degenerative radiographic changes, and its severity on clinical outcomes after primary rTSA. Methods We conducted a retrospective review of a prospectively collected shoulder arthroplasty database of patients that underwent primary rTSA with a minimum 2-year clinical follow-up. Imaging studies of included patients were evaluated to assess ACJ arthritis classified by radiographic degenerative changes of the ACJ; severity was based upon size and location of osteophytes. Both the Petersson classification and the King classification (a modified Petersson classification addressing superior osteophytes and size of the largest osteophyte) were used to evaluate the severity of degenerative ACJ radiographic changes. Severe ACJ arthritis was characterized by large osteophytes (≥2 mm). Active range of motion (ROM) in abduction, forward elevation, and external and internal rotation as well as clinical outcome scores (American Shoulder and Elbow Surgeons Shoulder, Constant, Shoulder Pain and Disability Index, simple shoulder test, University of California, Los Angeles scores) were assessed both preoperatively and at the latest follow-up; outcomes were compared based on severity of ACJ arthritis. Multivariable linear regression models were used to determine whether increasing severity of ACJ arthritis was associated with poorer outcomes. Results A total of 341 patients were included with a mean age of 71 ± 8 years and 55% were female. The mean follow-up was 5.1 ± 2.4 years. Preoperatively, there were no differences in outcomes based on the severity of ACJ pathology. Postoperatively, there were no differences in outcomes based upon the severity of ACJ arthritis except for greater preoperative to postoperative improvement in active internal rotation in patients with normal or grade 1 ACJ arthritis vs. grade 2 and 3 (3 ± 2 vs. 1 ± 2 and 1 ± 3, P = .029). Patients with ACJ arthritis and osteophytes ≥2 mm had less favorable Shoulder Pain and Disability Index scores, corresponding to greater pain (-49.3 ± 21.5 vs. -41.3 ± 26.8, P = .015). On multivariable linear regression, increased severity of ACJ arthritis was not independently associated with poorer postoperative ROM or outcome scores. Conclusion Overall, our results demonstrate that greater ACJ arthritis severity score is not associated with poorer outcome scores and has minimal effect on ROM. However, patients with the largest osteophytes (≥2 mm) did have slightly worse pain postoperatively. Radiographic presence of high-stage ACJ arthritis should not alter the decision to undergo rTSA.
Collapse
Affiliation(s)
| | - Kevin A. Hao
- College of Medicine, University of Florida, Gainesville, FL, USA
| | - Jeremy K. Taylor
- Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USA
| | - Jonathan O. Wright
- Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USA
| | - Thomas W. Wright
- Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USA
| | - Marissa Pazik
- Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USA
| | - Bradley S. Schoch
- Department of Orthopaedic Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Joseph J. King
- Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USA
| |
Collapse
|
2
|
Perry NPJ, Omonullaeva NK, Bacevich BM, Nascimento RJ, O'Donnell EA, Price MD, Mazzocca AD. Acromioclavicular Joint Anatomy and Biomechanics: The Significance of Posterior Rotational and Translational Stability. Clin Sports Med 2023; 42:557-571. [PMID: 37716721 DOI: 10.1016/j.csm.2023.05.002] [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] [Indexed: 09/18/2023]
Abstract
The shoulder girdle extends from the sternoclavicular joint to the scapular stabilizing muscles posteriorly. It consists of 3 joints and 2 mobile regions. The shoulder girdle is statically stabilized by the acromioclavicular and coracoclavicular capsuloligamentous structures and dynamically stabilized by the trapezius, deltoid, and deltotrapezial fascia. During humerothoracic elevation, the clavicle elevates, protracts, and rotates posteriorly through the sternoclavicular joint while the scapula tilts posteriorly and rotates upward. The purpose of this article is to review the anatomy and biomechanics of the acromioclavicular joint and the shoulder girdle.
Collapse
Affiliation(s)
- Nicholas P J Perry
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard School of Medicine, Massachusetts General Brigham, Boston, MA 02115, USA; Sports Medicine, Mass General Hospital, 175 Cambridge Street, 4th Floor, Boston, MA 02114, USA.
| | - Nozimakhon K Omonullaeva
- Sports Medicine, Mass General Hospital, 175 Cambridge Street, 4th Floor, Boston, MA 02114, USA; Nova Southeastern University, College of Osteopathic Medicine, 3301 College Avenue, Fort Lauderdale, FL 33314, USA
| | - Blake M Bacevich
- Sports Medicine, Mass General Hospital, 175 Cambridge Street, 4th Floor, Boston, MA 02114, USA; Harvard Medical School, Boston, MA 02115, USA
| | - Robert J Nascimento
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard School of Medicine, Massachusetts General Brigham, Boston, MA 02115, USA; Sports Medicine, Mass General Hospital, 175 Cambridge Street, 4th Floor, Boston, MA 02114, USA
| | - Evan A O'Donnell
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard School of Medicine, Massachusetts General Brigham, Boston, MA 02115, USA; Sports Medicine, Mass General Hospital, 175 Cambridge Street, 4th Floor, Boston, MA 02114, USA
| | - Mark D Price
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard School of Medicine, Massachusetts General Brigham, Boston, MA 02115, USA; Sports Medicine, Mass General Hospital, 175 Cambridge Street, 4th Floor, Boston, MA 02114, USA
| | - Augustus D Mazzocca
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard School of Medicine, Massachusetts General Brigham, Boston, MA 02115, USA; Sports Medicine, Mass General Hospital, 175 Cambridge Street, 4th Floor, Boston, MA 02114, USA
| |
Collapse
|
3
|
Longo UG, Risi Ambrogioni L, Candela V, Berton A, Lo Presti D, Denaro V. Scapular Kinematics and Patterns of Scapular Dyskinesis in Rotator Cuff Tears: A Prospective Cohort Study. J Clin Med 2023; 12:jcm12113841. [PMID: 37298036 DOI: 10.3390/jcm12113841] [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: 04/26/2023] [Revised: 05/28/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
Scapular dyskinesis (SD) is a condition of loss of normal mobility or function of the scapula. SD is frequently observed in patients with other shoulder disorders, such as rotator cuff (RC) tears. This study evaluates the different presentations in clinical outcomes and range of motions (ROMs) in patients suffering from RC tears with and without SD. A total of 52 patients were enrolled, of which 32 patients with RC tears and SD (group A) and 20 patients with RC tears without SD (group B). Statistically significant differences between the groups in terms of clinical outcomes were identified. There were statistically significant differences in terms of flexion (p = 0.019), extension (p = 0.015), abduction (p = 0.005), and external rotation at 90° (p = 0.003) and at 0° (p = 0.025). In conclusion, this prospective study demonstrated that SD influences the clinical presentation of patients with RC tears in terms of clinical outcomes and ROMs, apart from internal rotation. Further studies will need to show whether these differences occur regardless of SD type.
Collapse
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
| | - Laura Risi Ambrogioni
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
| | - Vincenzo Candela
- 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
| | - Alessandra Berton
- 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
| | - Daniela Lo Presti
- Unit of Measurements and Biomedical Instrumentation, Campus Bio-Medico University, Via Alvaro del Portillo, 21, 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
| |
Collapse
|
4
|
Daher B, Hunter J, Athwal GS, Lalone EA. How does computed tomography inform our understanding of shoulder kinematics? A structured review. Med Biol Eng Comput 2023; 61:967-989. [PMID: 36692800 DOI: 10.1007/s11517-022-02755-1] [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: 09/01/2021] [Accepted: 12/22/2022] [Indexed: 01/25/2023]
Abstract
The objective of this structured review was to review how computed tomography (CT) scanning has been used to measure the kinematics of the shoulder. A literature search was conducted using Evidence-based Medicine Reviews (Embase) and PubMed. In total, 29 articles were included in the data extraction process. Forty percent of the studies evaluated healthy participants' shoulder kinematics. The glenohumeral joint was the most studied, followed by the scapulothoracic, acromioclavicular, and sternoclavicular joints. Three-dimensional computed tomography (3DCT) and 3DCT with biplane fluoroscopy are the two primary imaging techniques that have been used to measure shoulder joints' motion under different conditions. Finally, many discrepancies in the reporting of the examined motions were found. Different authors used different perspectives and planes to report similar motions, which results in confusion and misunderstanding of the actual examined motion. The use of 3DCT has been widely used in the examination of shoulder kinematics in a variety of populations with varying methods employed. Future work is needed to extend these methodologies to include more diverse populations, to examine the shoulder complex as a whole, and to standardize their reporting of motion examined to make study to study comparisons possible.
Collapse
Affiliation(s)
- Baraa Daher
- Faculty of Engineering, School of Biomedical Engineering, Western University, London, Canada.,Department of Mechanical and Materials Engineering, The University of Western Ontario, Thompson Engineering Building, Room 353, London, ON, N6A 5B9, Canada.,Bone and Joint Institute, Western University, London, Canada
| | - James Hunter
- Faculty of Engineering, School of Biomedical Engineering, Western University, London, Canada.,Department of Mechanical and Materials Engineering, The University of Western Ontario, Thompson Engineering Building, Room 353, London, ON, N6A 5B9, Canada
| | - George S Athwal
- Bone and Joint Institute, Western University, London, Canada.,Department of Surgery, Western University, London, Canada.,Roth
- McFarlane Hand and Upper Limb Centre, St. Joseph's Health Care, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada
| | - Emily A Lalone
- Faculty of Engineering, School of Biomedical Engineering, Western University, London, Canada. .,Department of Mechanical and Materials Engineering, The University of Western Ontario, Thompson Engineering Building, Room 353, London, ON, N6A 5B9, Canada. .,Bone and Joint Institute, Western University, London, Canada. .,Department of Surgery, Western University, London, Canada. .,Roth
- McFarlane Hand and Upper Limb Centre, St. Joseph's Health Care, London, ON, Canada. .,Lawson Health Research Institute, London, ON, Canada.
| |
Collapse
|
5
|
Sulkar HJ, Knighton TW, Amoafo L, Aliaj K, Kolz CW, Zhang Y, Hermans T, Henninger HB. In Vitro Simulation of Shoulder Motion Driven by Three-Dimensional Scapular and Humeral Kinematics. J Biomech Eng 2022; 144:051008. [PMID: 34817051 PMCID: PMC8822462 DOI: 10.1115/1.4053099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/12/2021] [Indexed: 11/08/2022]
Abstract
In vitro simulation of three-dimensional (3D) shoulder motion using in vivo kinematics obtained from human subjects allows investigation of clinical conditions in the context of physiologically relevant biomechanics. Herein, we present a framework for laboratory simulation of subject-specific kinematics that combines individual 3D scapular and humeral control in cadavers. The objectives were to: (1) robotically simulate seven healthy subject-specific 3D scapulothoracic and glenohumeral kinematic trajectories in six cadavers, (2) characterize system performance using kinematic orientation accuracy and repeatability, and muscle force repeatability metrics, and (3) analyze effects of input kinematics and cadaver specimen variability. Using an industrial robot to orient the scapula range of motion (ROM), errors with repeatability of ±0.1 mm and <0.5 deg were achieved. Using a custom robot and a trajectory prediction algorithm to orient the humerus relative to the scapula, orientation accuracy for glenohumeral elevation, plane of elevation, and axial rotation of <3 deg mean absolute error (MAE) was achieved. Kinematic accuracy was not affected by varying input kinematics or cadaver specimens. Muscle forces over five repeated setups showed variability typically <33% relative to the overall simulations. Varying cadaver specimens and subject-specific human motions showed effects on muscle forces, illustrating that the system was capable of differentiating changes in forces due to input conditions. The anterior and middle deltoid, specifically, showed notable variations in patterns across the ROM that were affected by subject-specific motion. This machine provides a platform for future laboratory studies to investigate shoulder biomechanics and consider the impacts of variable input kinematics from populations of interest, as they can significantly impact study outputs and resultant conclusions.
Collapse
Affiliation(s)
- Hema J. Sulkar
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108; Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112
| | - Tyler W. Knighton
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108; Department of Mechanical Engineering, University of Utah, Salt Lake City, UT 84112
| | - Linda Amoafo
- Department of Epidemiology, University of Utah, Salt Lake City, UT 84132
| | - Klevis Aliaj
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108; Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112
| | - Christopher W. Kolz
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108; Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112
| | - Yue Zhang
- Department of Epidemiology, University of Utah, Salt Lake City, UT 84132
| | - Tucker Hermans
- Department of Mechanical Engineering, University of Utah, Salt Lake City, UT 84112; Robotics Center and School of Computing, University of Utah, Salt Lake City, UT 84112
| | - Heath B. Henninger
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108; Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112; Department of Mechanical Engineering, University of Utah, Salt Lake City, UT 84112
| |
Collapse
|
6
|
Guerrero-Henriquez J, Oyarce-Mella M, Reyes Rocabado J, Olivares-Ponce D, Olivares-Lee O, Pérez-Pasten S, Vargas-Matamala M. Inter-rater reliability of scapular dyskinesis classification in overhead athletes by entry-level physical therapy students. J Man Manip Ther 2021; 30:56-60. [PMID: 34460354 DOI: 10.1080/10669817.2021.1972653] [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] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Scapular dyskinesis (SD) is a dysfunction associated with shoulder pathologies in overhead athletes and its classification is highly complex, especially in entry-level physical therapy students. OBJECTIVE This research aimed to determine the effect of a video training method on inter-rater reliability of physical therapy entry-level students with no clinical experience while performing SD ratings under 4-type, severity, and 'yes or no' criteria in overhead athletes. METHODS A total of 49 overhead athletes were evaluated by video recordings in posterior view of lifting tasks. Two entry-level students without clinical experience performed SD classifications according to previously mentioned criteria on both scapula in two separate sessions, with 1 week of difference. Data analysis was conducted based on the kappa coefficient (k) and its confidence intervals (CI). RESULTS The 'yes or no' criteria present better results than the 4-type and severity criteria. In addition, a better inter-rater agreement is evidenced in the second measurement compared to the first one. Furthermore, the k coefficients reach values like those achieved by experienced evaluators. CONCLUSION Video training settings for scapular dyskinesis rating in entry-level physical therapist students with no clinical experience allows better inter-rater reliability values.
Collapse
Affiliation(s)
- Juan Guerrero-Henriquez
- Rehabilitation and Human Movement Sciences Department, Faculty of Health Sciences, University of Antofagasta, Antofagasta, Chile
| | - Mauricio Oyarce-Mella
- Biomedical Department, Faculty of Health Sciences, University of Antofagasta, Antofagasta, Chile
| | - Jimmy Reyes Rocabado
- Mathematics Department, Faculty of Basics Sciences, University of Antofagasta, Antofagasta, Chile
| | - David Olivares-Ponce
- Kinesiology, Faculty of Health Sciences, University of Antofagasta, Antofagasta, Chile
| | - Omar Olivares-Lee
- Kinesiology, Faculty of Health Sciences, University of Antofagasta, Antofagasta, Chile
| | - Stefano Pérez-Pasten
- Kinesiology, Faculty of Health Sciences, University of Antofagasta, Antofagasta, Chile
| | - Martin Vargas-Matamala
- Rehabilitation and Human Movement Sciences Department, Faculty of Health Sciences, University of Antofagasta, Antofagasta, Chile
| |
Collapse
|
7
|
Giuseppe LU, Laura RA, Berton A, Candela V, Massaroni C, Carnevale A, Stelitano G, Schena E, Nazarian A, DeAngelis J, Denaro V. Scapular Dyskinesis: From Basic Science to Ultimate Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082974. [PMID: 32344746 PMCID: PMC7215460 DOI: 10.3390/ijerph17082974] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 04/16/2020] [Accepted: 04/22/2020] [Indexed: 01/05/2023]
Abstract
Background: This study intends to summarize the causes, clinical examination, and treatments of scapular dyskinesis (SD) and to briefly investigate whether alteration can be managed by a precision rehabilitation protocol planned on the basis of features derived from clinical tests. Methods: We performed a comprehensive search of PubMed, Cochrane, CINAHL and EMBASE databases using various combinations of the keywords “Rotator cuff”, “Scapula”, “Scapular Dyskinesis”, “Shoulder”, “Biomechanics” and “Arthroscopy”. Results: SD incidence is growing in patients with shoulder pathologies, even if it is not a specific injury or directly related to a particular injury. SD can be caused by multiple factors or can be the trigger of shoulder-degenerative pathologies. In both cases, SD results in a protracted scapula with the arm at rest or in motion. Conclusions: A clinical evaluation of altered shoulder kinematics is still complicated. Limitations in observing scapular motion are mainly related to the anatomical position and function of the scapula itself and the absence of a tool for quantitative SD clinical assessment. High-quality clinical trials are needed to establish whether there is a possible correlation between SD patterns and the specific findings of shoulder pathologies with altered scapular kinematics.
Collapse
Affiliation(s)
- Longo Umile Giuseppe
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, Trigoria 200, 00128 Rome, Italy; (R.A.L.); (A.B.); (V.C.); (A.C.); (G.S.)
- Correspondence: ; Tel.: +39-062-2541-1613; Fax: +39-0622-5411
| | - Risi Ambrogioni Laura
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, Trigoria 200, 00128 Rome, Italy; (R.A.L.); (A.B.); (V.C.); (A.C.); (G.S.)
| | - Alessandra Berton
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, Trigoria 200, 00128 Rome, Italy; (R.A.L.); (A.B.); (V.C.); (A.C.); (G.S.)
| | - Vincenzo Candela
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, Trigoria 200, 00128 Rome, Italy; (R.A.L.); (A.B.); (V.C.); (A.C.); (G.S.)
| | - Carlo Massaroni
- Laboratory of Measurement and Biomedical Instrumentation, Campus Bio-Medico University, Via Alvaro del Portillo 200, 00128 Rome, Italy; (C.M.); (E.S.)
| | - Arianna Carnevale
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, Trigoria 200, 00128 Rome, Italy; (R.A.L.); (A.B.); (V.C.); (A.C.); (G.S.)
- Laboratory of Measurement and Biomedical Instrumentation, Campus Bio-Medico University, Via Alvaro del Portillo 200, 00128 Rome, Italy; (C.M.); (E.S.)
| | - Giovanna Stelitano
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, Trigoria 200, 00128 Rome, Italy; (R.A.L.); (A.B.); (V.C.); (A.C.); (G.S.)
| | - Emiliano Schena
- Laboratory of Measurement and Biomedical Instrumentation, Campus Bio-Medico University, Via Alvaro del Portillo 200, 00128 Rome, Italy; (C.M.); (E.S.)
| | - Ara Nazarian
- Carl J. Shapiro Department of Orthopaedic Surgery and Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 20115, USA; (A.N.); (J.D.)
| | - Joseph DeAngelis
- Carl J. Shapiro Department of Orthopaedic Surgery and Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 20115, USA; (A.N.); (J.D.)
| | - Vincenzo Denaro
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, Trigoria 200, 00128 Rome, Italy; (R.A.L.); (A.B.); (V.C.); (A.C.); (G.S.)
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|