scholarly journals Isokinetic and functional shoulder outcomes after arthroscopic capsulolabral stabilization

2021 ◽  
Author(s):  
Breborowicz Ewa ◽  
Lubiatowski Przemyslaw ◽  
Jokiel Marta ◽  
Breborowicz Maciej ◽  
Stefaniak Jakub ◽  
...  
Keyword(s):  
Shoulder Instability ◽  
Muscle Power ◽  
External Rotation ◽  
Return To Sport ◽  
Shoulder Function ◽  
Treatment Technique ◽  
Functional Evaluation ◽  
Before And After ◽  
Muscle Balance ◽  
Angular Velocities

Abstract Introduction Shoulder stability is secured by dynamic and static stabilizers. Rotator cuff is responsible for dynamic stabilization. In cases of shoulder instability their activity is disturbed. Capsulolabral repair restores mainly static stabilization. This surgery treatment technique of shoulder instability was first described by Bankart in 1923. His idea, with further modifications, is commonly used up to this day. Evaluation of muscle shoulder recovery after stabilization should be one of the important criteria to allow patient to return to sport and work. However, not much isokinetic assessment after capsulolabral repair was described. The aim of this study were the following: the comparative assessment of the shoulder rotatory strength in patients following arthroscopic capsulolabral repair of unilateral anterior traumatic instability and clinical assessment with comparison of pre and post-operative results. Material and methods Forty-five patients, 14 women and 31 men, with an average follow-up of 4.4 years were tested bilaterally for internal and external rotation strength at four angular velocities. ASES and UCLA tests were collected before and after surgery. Results The values of peak moment and muscle power parameters were slightly lower for an operated shoulder in comparison to a healthy shoulder for the external rotation. Total work parameter in external rotation was significantly lower for the operated shoulder in comparison to the non-operated side. The internal/external muscle group balance was lower for the operated shoulder in comparison to reference values in the women group. Furthermore, both ASES and UCLA scores were significantly higher after operation. Conclusions After arthroscopic capsulolabral shoulder stabilization, slight differences in isokinetic evaluation, especially in external shoulder rotation, occur. It affects rotators muscle balance. In functional evaluation significant improvement in shoulder function occurs.

scholarly journals Effectiveness of Maitland Techniques in Idiopathic Shoulder Adhesive Capsulitis

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Abhay Kumar ◽  
Suraj Kumar ◽  
Anoop Aggarwal ◽  
Ratnesh Kumar ◽  
Pooja Ghosh Das
Keyword(s):  
Statistical Analysis ◽  
External Rotation ◽  
Treatment Plan ◽  
Adhesive Capsulitis ◽  
Total Duration ◽  
Shoulder Function ◽  
Group Comparison ◽  
Before And After ◽  
Group A ◽  
Group B

Objective. To study the effectiveness of Maitland techniques in the treatment of idiopathic shoulder adhesive capsulitis. Methods. total of 40 patients diagnosed with idiopathic shoulder adhesive capsulitis were recruited and randomly allocated into two groups. In Group A () subjects were treated with Maitland mobilization technique and common supervised exercises, whereas subjects in Group B () only received common supervised exercises. Variables. Shoulder pain and disability index (SPADI), VAS and shoulder ROM (external rotation and abduction) were variables of the study. These were recorded before and after the session of the training. Total duration of the study was four weeks. Result. Statistical analysis of the data revealed that within-group comparison both groups showed significant improvement for all the parameters, whereas between-group comparison revealed higher improvement in Group A compared to the Group B. Conclusion. The study confirmed that addition of the Maitland mobilization technique with the combination of exercises have proved their efficacy in relieving pain and improving R.O.M. and shoulder function and hence should form a part of the treatment plan.

scholarly journals Failure Rates in Contact versus Non-Contact Athletes Following Arthroscopic Inferior Capsular Shift at 10-Year Follow-Up (237)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0034
Author(s):  
Kevin Plancher ◽  
Thomas Evely ◽  
Stephanie Petterson
Keyword(s):  
Bone Loss ◽  
Revision Surgery ◽  
Shoulder Instability ◽  
Functional Outcomes ◽  
External Rotation ◽  
Return To Sport ◽  
Suture Anchors ◽  
Recurrence Rates ◽  
Capsular Shift

Objectives: Arthroscopic Bankart repair has become the surgical procedure of choice for many in the United States, over the Latarjet in Europe, for first time anterior shoulder instability with minimal bone loss, less than 20%. However, high recurrence rates in contact athletes have led many to proceed with open type procedures. Our purpose was to compare failure rates and functional outcomes of the arthroscopic inferior capsular shift in contact and non-contact athletes. We hypothesized that contact and non-contact athletes would exhibit excellent functional outcomes and return to sport with low recurrence rates. Methods: A consecutive series of 69 shoulders in 61 contact and non-contact athletes underwent an arthroscopic inferior capsular shift with ≥3 suture anchors by a single surgeon (1999-2018). Thirty shoulders in 26 contact athletes (6 women; 25.3±8.1 years) and 39 shoulders in 35 non-contact athletes (7 women; 34.8±10.0 years) were included. Inclusion criteria were complete anterior inferior labral detachment (6 unit hours) and ≥2-year follow-up. Exclusion criteria included multidirectional instability, engaging Hill Sachs lesion or glenoid bone loss >30%. A modified 3-portal technique utilizing the outside-in method was employed. A conservative rehabilitation program was followed with return to sport no sooner than 3 months in non-contact, 4-5 months in contact, and 9 months in throwing athletes. Functional outcomes were measured using Constant Scores, American Shoulder and Elbow Surgeons (ASES) Score, Western Ontario Shoulder Instability Index (WOSI), Melbourne Instability Shoulder Scale (MISS), and Rowe. Forward elevation, external rotation at side and 90° abduction and internal rotation range of motion (ROM) were measured. Independent samples t-tests were used to assess differences in outcomes between contact and non-contact athletes (Bonferroni correction: p<0.006). Results: Follow-up was 11.0±3.5 years (range 2-16 years) in contact athletes and 12.2±4.3 years (range 2-21 years) in non-contact athletes (p=0.264). Contact athletes were significantly younger than non-contact athletes (p<0.0001). An average of 3.9±1.7 and 3.1±1.0 suture anchors were used in contact and non-contact groups, respectively (p=0.348). There were no significant differences in post-operative functional scores (all p>0.053) or shoulder ROM (all p>0.034) between groups. Forward flexion was 163.75±16.8° pre-operatively and 168.89±13.0° post-operatively in contact athletes (p=0.212) and 162.5±13.7° preoperatively and 170±7.7° post-operatively in non-contact athletes (p=0.005). External rotation at the side was 59.04±19.4° pre-operatively and 67.9±18.6° value post-operatively in contact athletes (p=0.094) and 52.94±25.1° pre-operatively and 62.83±14.3° post-operatively in non-contact athletes (p=0.062). External rotation at 90° abduction was 92.61±20.1° pre-operatively and 93.39±12.9° post-operatively in contact athletes (p=0.867) and 88.33±21.1° pre-operatively and 87.5±8.1° post-operatively in non-contact athletes (p=0.842).Internal rotation behind the back was to an average of T11 pre-operatively and T9 post-operatively in contact athletes (p=0.004) and L1 pre-operatively and T9 post-operatively in non-contact athletes (p=0.001).In contact and non-contact athletes, respectively, Rowe scores were 65.35±17.6 and 51.25±13.2 preoperatively and 89.22±17.6 and 96.25±12.4 post-operatively (p=0.002 and p<0.001); Constant Scores were 75.69±12.6 and 61.67±11.3 pre-operatively 85.79±19.6 and 89.71±13.6 post-operatively; ASES scores were 80.40±15.3 and 62.14±22.2 pre-operatively and 93.91±9.9 and 86.06±20.7 post-operatively (p<0.001 and p<0.001); MISS scores were 59.36±12.4 and 48.39±15.5 preoperatively and 88.20±13.5 and 75.75±19.7 post-operatively (p<0.001 and p<0.001); WOSI was 3.50±1.3 and 4.55±1.4 pre-operatively and 1.70±3.0 and 2.94±2.7 post-operatively (p=0.101 and p=0.066). Overall recurrence rate was 4.3% (3/69). Two contact athletes (2/30; 6.7%) and one non-contact athlete (1/39; 2.6%) experienced a traumatic recurrent instability event requiring revision surgery (p=0.439). These three patients underwent a revision arthroscopic inferior capsular shift with an additional 3-4 plication sutures and returned to pre-injury sports including hockey, football, skiing, and tennis without recurrence of instability at greater than 7 years following the revision surgery. Conclusions: Modified arthroscopic inferior capsular shift utilizing ≥3 suture anchors with plication sutures returns contact and non-contact athletes to sports with excellent functional outcomes, low recurrence rates (3/69), and full unrestricted ROM. While loss of ROM is a concern, particularly in overhead athletes, ROM was successfully restored in all patients, most notably in external rotation at 90° abduction. We recommend a modified arthroscopic inferior capsular shift with plication sutures as the primary procedure in all athletes with anterior instability with less than 30% bone loss excluding those with high Beighton scores rather than a Latarjet.

scholarly journals Effects of Repetitive Shoulder Activity on the Subacromial Space in Manual Wheelchair Users

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Yen-Sheng Lin ◽  
Michael Boninger ◽  
Lynn Worobey ◽  
Shawn Farrokhi ◽  
Alicia Koontz
Keyword(s):  
Shoulder Pain ◽  
External Rotation ◽  
Shoulder Function ◽  
Subacromial Space ◽  
Wheelchair Users ◽  
Manual Wheelchair ◽  
Before And After ◽  
Acromiohumeral Distance ◽  
The Relationship ◽  
Subject Characteristics

This study investigated (1) the effect of repetitive weight-relief raises (WR) and shoulder external rotation (ER) on the acromiohumeral distance (AHD) among manual wheelchair users (MWUs) and (2) the relationship between shoulder pain, subject characteristics, and AHD changes. Twenty-three MWUs underwent ultrasound imaging of the nondominant shoulder in an unloaded baseline position and while holding a WR position before and after the WR/ER tasks. Pairedt-tests and Spearman correlational analysis were used to assess differences in the AHD before and after each task and the relationships between pain, subject characteristics, and the AHD measures. A significant reduction in the subacromial space (P<0.01) occurred when subjects performed a WR position compared to baseline. Individuals with increased years of disability had greater AHD percentage narrowing after WR (P=0.008). Increased shoulder pain was associated with AHD percentage narrowing after ER (P≤0.007). The results support clinical practice guidelines that recommend MWUs limit WR to preserve shoulder function. The isolated repetitive shoulder activity did not contribute to the changes of subacromial space in MWUs. The ultrasonographic measurement of the AHD may be a target for identifying future interventions that prevent pain.

scholarly journals ENGARUH RANGE OF MOTION (ROM) PASIF TERHADAP KEKUATAN OTOT PADA PASIEN STROKE DENGAN PENURUNAN KESADARAN DI RUANG HCU IGD RSUD Dr. MOEWARDI DI SURAKARTA TAHUN 2012

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Sri Mulyanti
Keyword(s):  
Muscle Strength ◽  
Range Of Motion ◽  
Muscle Power ◽  
Clinical Manifestations ◽  
Critical Conditions ◽  
Power Stroke ◽  
Loss Of Consciousness ◽  
Treatment Technique ◽  
Stroke Patients ◽  
Before And After

AbstractIntroduction: Each year, approximately 15 million people worldwide have a stroke. In Indonesia based on the census of population and demography Indonesia (SKDI) in 2010 as many as 3.6 million per year with a prevalence of 8.3 per 1,000 population. Stroke is a neurological disease that appeared suddenly in a short time. One of the clinical manifestations of the most common is hemiparese. Complications hemiparese in muscles and joints is muscle atrophy and joint contractures. One treatment technique to prevent these complications is the Range Of Motion (ROM) passive exercise.Objective: (1) Identify the characteristics of stroke patients with loss of consciousness (2) Identify the muscle power stroke patients with loss of consciousness (3) to analyze the influence Range Of Motion (ROM) of the passive muscle strength in stroke patients with loss of consciousness. Method: This research is quasy experiment with design one-group pretestposttest design. The population in this study were 13 stroke patients with critical conditions in Space High Care Unit Hospital Dr Moewardi in Surakarta. Samples were taken by sampling saturated. Data were analyzed with the Wilcoxon or Z test using SPSS for windows 16 series.Result: (1) The muscle strength before passive ROM was 11 people (68.8%) is trace, 5 people (31.2%) is poor, and of zero muscle strength, fair, good, and normally does not exist. (2) Muscle strength stroke after passive ROM is 7 (43.8%) of respondents with poor muscle strength scale, 9 people (56.2%) fair, and scale of zero muscle strength, trace, good, and normally there is not exist(0%). (3) The results of the statistical Wilcoxon or Z test significance value (p) of 0000 which means that there are differences in muscle strength scale before and after passive Range Of Motion. (ROM) patients with loss of consciousness. Conclusion: Range Of Motion (ROM) is effective for improving muscle strength for stroke patients with loss of consciousness in H ospital Dr Moewardi Surakarta Keywords: Stroke, Hemiparese, Range Of Motion

scholarly journals Shoulder Rotator Muscle Dynamometry Characteristics: Side Asymmetry and Correlations with Ball-Throwing Speed in Adolescent Handball Players

2014 ◽  
Vol 42 (1) ◽  
pp. 41-50 ◽  
Author(s):  
Inese Pontaga ◽  
Janis Zidens
Keyword(s):  
Muscle Power ◽  
External Rotation ◽  
Body Height ◽  
Average Power ◽  
Power Ratio ◽  
Concentric Contractions ◽  
Maximal Speed ◽  
Angular Velocities ◽  
External Rotator ◽  
Side Asymmetry

Abstract The aim of the investigation was to: 1) compare shoulder external/internal rotator muscles’ peak torques and average power values and their ratios in the dominant and non-dominant arm; 2) determine correlations between shoulder rotator muscles’ peak torques, average power and ball-throwing speed in handball players. Fourteen 14 to 15- year-old male athletes with injury-free shoulders participated in the study (body height: 176 ± 7 cm, body mass 63 ± 9 kg). The tests were carried out by an isokinetic dynamometer system in the shoulder internal and external rotation movements at angular velocities of 60°/s, 90°/s and 240°/s during concentric contractions. The eccentric external- concentric internal rotator muscle contractions were performed at the velocity of 90°/s. The player threw a ball at maximal speed keeping both feet on the floor. The speed was recorded with reflected light rays. Training in handball does not cause significant side asymmetry in shoulder external/internal rotator muscle peak torques or the average power ratio. Positive correlations between isokinetic characteristics of the shoulder internal and external rotator muscles and ball-throwing speed were determined. The power produced by internal rotator muscles during concentric contractions after eccentric contractions of external rotator muscles was significantly greater in the dominant than in the non-dominant arm. Thus, it may be concluded that the shoulder eccentric external/concentric internal rotator muscle power ratio is significantly greater than this ratio in the concentric contractions of these muscles

scholarly journals The Immediate Effects of Kinesiotm Taping on Shoulder External Rotation in People with Shoulder Pain

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0017
Author(s):  
Arman Gözbek ◽  
Elif Üstün ◽  
Habibe Serap İnal
Keyword(s):  
Lower Extremity ◽  
Muscle Power ◽  
External Rotation ◽  
Dynamic Balance ◽  
Pearson Correlation ◽  
American Football ◽  
Mean Velocity ◽  
Before And After ◽  
The University ◽  
Sedentary Subjects

Objectives: Observing the immediate effect of KinesioTMTaping(KT) on dynamic balance(DB) and acceleration(ACC) of athletes and sedentary subjects. Methods: The mean ages of athletes(n=25) and sedentary(n=25) were 21,36±2,07 and 21,64±1,62 years, weight 82,36±1,75 and 79,48±7,41kg, height 1,81±0,65 and 1,77±0,56cm, and body mass index were 24,99±4,07 and 25,20±2,12kg/cm2, respectively. They were all male and students of Yeditepe University. The athletes were in the soccer and American football teams of the university. All gave their own written consent to participate in the test protocols of the study voluntarily.Their lower extremity (LE) muscle power (JTech Myometry), and the flexibility of the LE antigravity muscles were assessed before. Their DB (Prokin PK 200) of both sides, speed and acceleration in 30m sprint (Research Tracker RT6) were assessed as before and after the KT applications on both calves to observe their immediate effects on the gastrosoleus group of muscles (p<0.05). The Y shaped KT were used starting from Achilles tendon as one piece and ending over medial and lateral heads of M.Gastrocnemius. Descriptive statistics were used to understand the physical properties of the participants. Wilcoxon and Mann-Whitney-U tests were used for the significance (p< 0.05) of the data and Pearson Correlation was used to understand the relation between the data. Results: Athletes’ lower extremity muscles were stronger (p< 0.05) than the sedentary, except the M.Gluteus maximus and ankle invertors. They achieved higher performance in 30m sprint and in DB tests than the sedentary. KT on gastrosoleus group improved the DB of both sides as perimeter length(°) of the centre of pressure (COP) and the area covered (%) by COP (p< 0.05) of the athletes, but not in the ML and AP displacements (°) of COP. The athletes forward (X) and resultant (XYZ) ACC and velocity (m/sec) were significantly higher after KT application (p<0.01). The soleus, ankle invertors-evertors were effective on the forward (X) ACC, but invertors were also effective on mean velocity of the athletes, compared to sedentary. Conclusion: The athletes benefited from the immediate effects of KT application during sprinting. It increased the ability of athletes to control the movements of COP in shorter distance and smaller area compared to sedentary. Since there is no difference in AP-ML displacement of COP of both groups, we can conclude that KT does not have immediate effect on ankle strategy for DB.

Nerve graft versus nerve transfer for neonatal brachial plexus: shoulder outcomes

2021 ◽  
Vol 27 (1) ◽  
pp. 87-92
Author(s):  
Brandon W. Smith ◽  
Kate W. C. Chang ◽  
Sravanthi Koduri ◽  
Lynda J. S. Yang
Keyword(s):  
Brachial Plexus ◽  
Clinical Data ◽  
External Rotation ◽  
Nerve Transfer ◽  
Shoulder Function ◽  
Nerve Transfers ◽  
Shoulder Flexion ◽  
Significant Difference ◽  
Transfer Strategies ◽  
Shoulder External Rotation

OBJECTIVEThe decision-making in neonatal brachial plexus palsy (NBPP) treatment continues to have many areas in need of clarification. Graft repair was the gold standard until the introduction of nerve transfer strategies. Currently, there is conflicting evidence regarding outcomes in patients with nerve grafts versus nerve transfers in relation to shoulder function. The objective of this study was to further define the outcomes for reconstruction strategies in NBPP with a specific focus on the shoulder.METHODSA cohort of patients with NBPP and surgical repairs from a single center were reviewed. Demographic and standard clinical data, including imaging and electrodiagnostics, were gathered from a clinical database. Clinical data from physical therapy evaluations, including active and passive range of motion, were examined. Statistical analysis was performed on the available data.RESULTSForty-five patients met the inclusion criteria for this study, 19 with graft repair and 26 with nerve transfers. There were no significant differences in demographics between the two groups. Understandably, there were no patients in the nerve grafting group with preganglionic lesions, resulting in a difference in lesion type between the cohorts. There were no differences in preoperative shoulder function between the cohorts. Both groups reached statistically significant improvements in shoulder flexion and shoulder abduction. The nerve transfer group experienced a significant improvement in shoulder external rotation, from −78° to −28° (p = 0.0001), whereas a significant difference was not reached in the graft group. When compared between groups, there appeared to be a trend favoring nerve transfer in shoulder external rotation, with the graft patients improving by 17° and the transfer patients improving by 49° (p = 0.07).CONCLUSIONSIn NBPP, patients with shoulder weakness experience statistically significant improvements in shoulder flexion and abduction after graft repair or nerve transfer, and patients with nerve transfers additionally experience significant improvement in external rotation. With regard to shoulder external rotation, there appear to be some data supporting the use of nerve transfers.

EFEITOS DO DEEP RUNNING SOBRE A AMPLITUDE DE MOVIMENTO E A CAPACIDADE FUNCIONAL DOS MEMBROS SUPERIORES DE MULHERES MASTECTOMIZADAS: RELATO DE CASOS

2019 ◽  
pp. 121-131
Keyword(s):  
Range Of Motion ◽  
Upper Limb ◽  
Functional Capacity ◽  
External Rotation ◽  
Treatment Protocol ◽  
Range Of Movement ◽  
Flexion Extension ◽  
Before And After ◽  
In The Beginning ◽  
And Function

Introduction: Breast cancer is the most common type of cancer among women in Brazil and in the worl. The surgical treatment procedure may cause severe morbidity in the upper limb homolateral to surgery, including the reduction of the range of motion, with consequent impairment of function. A physiotherapeutic approach has an important role in the recover range of motion and the functionality of these women, guaranteeing the occupational, domestestic, familiar and conjugated activities, and, in this way, also improving the quality of life. Objectives: To analyse chances in the shoulder's range of motion and the functional capacity of the upper limbs, promoted by the deep running procedure in women with late postoperative mastectomy. Methods: All the patients were submitted to an evaluation in the beginning and end of the treatment, including: goniometry of flexion, extension, abduction, adduction, internal and external rotation of the shoulder joint; and function capacity analysis in activities that involve the upper members by DASH questionnaire. The treatment protocol includes twelve sessions of deep running, realized twice a week, in deep pool, for 20-minute during six weeks. Results: Were submitted to treatment a total of 4 patients. Despite the improvement in the numerical values, statistically significant differences were not found on the range of movements and in the functional capacity of upper members before and after the deep running sessions in post-mastectomy women. Conclusion: Deep running had effects on the numerical values of range of movement and upper limb functionality in women in the late postoperative period of the mastectomy procedure, but without statistically significant differences.

scholarly journals Open Capsulorrhaphy for Recurrent Multidirectional Instability of the Shoulder

2021 ◽  
Vol 1 (3) ◽  
pp. 263502542110071
Author(s):  
Ioanna K. Bolia ◽  
Rebecca Griffith ◽  
Nickolas Fretes ◽  
Frank A. Petrigliano
Keyword(s):  
Shoulder Instability ◽  
Return To Sport ◽  
Young Female ◽  
Subscapularis Tendon ◽  
Shoulder Stabilization ◽  
Ehlers Danlos Syndrome ◽  
Physically Active ◽  
Recurrent Shoulder Instability ◽  
Multidirectional Instability

Background: The management of multidirectional instability (MDI) of the shoulder remains challenging, especially in athletes who participate in sports and may require multiple surgical procedures to achieve shoulder stabilization. Open or arthroscopic procedures can be performed to address shoulder MDI. Indications: Open capsulorrhaphy is preferred in patients with underlying tissue hyperlaxity and who had 1 or more, previously failed, arthroscopic shoulder stabilization procedures. Technique Description: With the patient in the beach-chair position (45°), tissue dissection is performed to the level of subscapularis tendon via the deltopectoral approach. The subscapularis tenotomy is performed in an L-shaped fashion, and the subscapularis tendon is tagged with multiple sutures and mobilized. Careful separation of the subscapularis tendon from the underlying capsular tissue is critical. Capsulotomy is performed, consisting of a vertical limb and an inferior limb that extends to the 5 o’clock position on the humeral neck (right shoulder). After evaluating the integrity of the labrum, the capsule is shifted superiorly and laterally, and repaired using 4 to 5 suture anchors. The redundant capsule is excised, and the subscapularis tendon is repaired in a side-to-side fashion, augmented by transosseous equivalent repair using the capsular sutures. Results: Adequate shoulder stabilization was achieved following open capsulorrhaphy in a young female athlete with tissue hyperlaxity and history of a previously failed arthroscopic soft tissue stabilization surgery of the shoulder. The athlete returned to sport at 6 months postoperatively and did not experience recurrent shoulder instability episodes at midterm follow-up. Discussion/Conclusion: Based on the existing literature, 82% to 97% of patients who underwent open capsulorrhaphy for MDI had no recurrent shoulder instability episodes at midterm follow-up. One study reported 64% return-to-sport rate following open capsulorrhaphy in 15 adolescent athletes with Ehlers-Danlos syndrome, but more research is necessary to better define the indications and outcomes of this procedure in physically active patients.

Sign in / Sign up

Export Citation Format

Share Document