scholarly journals Level of exoskeleton support influences shoulder elevation, external rotation and forearm pronation during simulated work tasks in females

2022 ◽  
Vol 98 ◽  
pp. 103591
Author(s):  
Tasha C. McFarland ◽  
Alison C. McDonald ◽  
Rachel L. Whittaker ◽  
Jack P. Callaghan ◽  
Clark R. Dickerson
Keyword(s):  
External Rotation ◽  
Work Tasks ◽  
Shoulder Elevation

scholarly journals Clinical Predictors for Optimal Forward Elevation in Primary Reverse Total Shoulder Arthroplasty

2019 ◽  
Vol 3 ◽  
pp. 247154921983152
Author(s):  
David R Sollaccio ◽  
Joseph J King ◽  
Aimee Struk ◽  
Kevin W Farmer ◽  
Thomas W Wright
Keyword(s):  
Shoulder Arthroplasty ◽  
External Rotation ◽  
Total Shoulder Arthroplasty ◽  
Univariate Analysis ◽  
Reverse Total Shoulder Arthroplasty ◽  
Clinical Patient ◽  
Group I ◽  
Group Ii ◽  
Reverse Total Shoulder ◽  
Shoulder Elevation

Background Few studies in the literature analyze clinical factors associated with superoptimal and suboptimal forward elevation in primary reverse total shoulder arthroplasty (RTSA). We investigate the functional outcome stratified by shoulder elevation 12 months after primary RTSA and its correlation with selected clinical patient factors. Methods We analyzed prospectively collected data within a comprehensive surgical database on patients who had undergone primary RTSA between June 2004 and June 2013. Two hundred eighty-six shoulders were stratified into 2 groups: group I for shoulders that had achieved at least 145° of active forward elevation 12 months postoperatively (90th percentile of active forward elevation, 29 shoulders) and group II for shoulders that never achieved at least 90° of active forward elevation 12 months postoperatively (10th percentile of active forward elevation, 28 shoulders). Statistical analysis associated independent clinical variables with postoperative motion using univariate analysis followed by logistic regression. Results Active shoulder elevation of at least 90° was achieved 12 months postoperatively in 259 subjects (90%). Upon comparison with group II (<90° elevation), subjects in group I (≥145° elevation) were found to have improved postoperative active elevation and relatively younger age, lower American Society of Anesthesiologists score, increased preoperative active elevation, increased shoulder strength, increased passive elevation, decreased elevation lag, increased active and passive external rotation, and improved validated outcome scores. When assessing significant preoperative variables, the only independent predictor of improved postoperative forward elevation was preoperative active forward elevation. Conclusion These findings illuminate significant factors in the ability to achieve functional active shoulder elevation after primary RTSA. They may help surgeons appropriately counsel patients about anticipated functional prognosis following primary RTSA.

scholarly journals Shoulder Kinematics Is Not Influenced by External Load During Elevation in the Scapular Plane

2014 ◽  
Vol 30 (1) ◽  
pp. 66-74 ◽  
Author(s):  
Marcelo P. de Castro ◽  
Daniel Cury Ribeiro ◽  
Felipe de C. Forte ◽  
Joelly M. de Toledo ◽  
Daniela Aldabe ◽  
...  
Keyword(s):  
Repeated Measures ◽  
External Load ◽  
External Rotation ◽  
Angular Displacement ◽  
Neutral Position ◽  
Convenience Sample ◽  
Repeated Measures Design ◽  
Shoulder Kinematics ◽  
Shoulder Elevation ◽  
Scapular Plane

The current study aimed to compare the shoulder kinematics (3D scapular orientation, scapular angular displacement and scapulohumeral rhythm) of asymptomatic participants under unloaded and loaded conditions during unilateral shoulder elevation in the scapular plane. We used a repeated-measures design with a convenience sample. Eleven male participants with an age range of 21–28 years with no recent history of shoulder injury participated in the study. The participants performed isometric shoulder elevation from a neutral position to approximately 150 degrees of elevation in the scapular plane in intervals of approximately 30 degrees during unloaded and loaded conditions. Shoulder kinematic data were obtained with videogrammetry. During shoulder elevation, the scapula rotated upwardly and externally, and tilted posteriorly. The addition of an external load did not affect 3D scapular orientation, scapular angular displacement, or scapulohumeral rhythm throughout shoulder elevation (P> .05). In clinical practice, clinicians should expect to observe upward and external rotation and posterior tilt of the scapula during their assessments of shoulder elevation. Such behavior was not influenced by an external load normalized to 5% of body weight when performed in an asymptomatic population.

scholarly journals Arthroscopic Superior Capsule Reconstruction Eliminates Pseudoparalysis in Patients with Irreparable Rotator Cuff Tears

2017 ◽  
Vol 5 (3_suppl3) ◽  
pp. 2325967117S0011 ◽  
Author(s):  
Teruhisa Mihata ◽  
Thay Q. Lee ◽  
AKIHIKO HASEGAWA ◽  
Takeshi Kawakami ◽  
Kunimoto Fukunishi ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Healing Rate ◽  
External Rotation ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Shoulder Stiffness ◽  
Graft Healing ◽  
Acromiohumeral Distance ◽  
Tear Size ◽  
Shoulder Elevation

Objectives: We have developed the superior capsule reconstruction (SCR) technique for surgical treatment of irreparable rotator cuff tears. In these patients, SCR restores shoulder stability and muscle balance, consequently improving shoulder function—particularly deltoid muscle function—and relieving pain. In this study, we evaluated whether arthroscopic SCR reversed preoperative pseudoparalysis in patients with irreparable rotator cuff tears. Methods: A series of 100 consecutive patients with irreparable rotator cuff tears that had failed conservative treatment underwent arthroscopic SCR using fascia lata autografts; 7 patients with deltoid weakness due to cervical or axillary nerve palsy and 3 patients with severe shoulder stiffness (passive shoulder elevation, less than 90°) before surgery were excluded from the study population. The remaining 90 patients were allocated into 3 groups according to their preoperative active shoulder elevation: (1) no pseudoparalysis: more than 90° of active shoulder elevation (48 patients; mean age, 66.3 years; mean tear size in anterioposterior direction, 3.5 cm); (2) moderate pseudoparalysis: no shoulder stiffness, less than 90° of active shoulder elevation, patients maintained more than 90° elevation once the shoulder was elevated passively (27 patients; mean age, 68.1 years, mean tear size, 3.5 cm); and (3) severe pseudoparalysis: no shoulder stiffness, less than 90° of active shoulder elevation, patients had a positive drop-arm sign (15 patients; mean age, 62.3 years, mean tear size, 4.9 cm). Physical examination, radiography, and magnetic resonance imaging were performed before surgery; at 3, 6, and 12 months after surgery; and yearly thereafter. The American Shoulder and Elbow Surgeons (ASES) score, active shoulder range of motion, acromiohumeral distance, and healing rate were compared between patients with and without pseudoparalysis as well as between before surgery and at the final follow-up (mean, 48 months; range, 24 to 88 months) by using the t and chi-square tests. A significant difference was defined as P < 0.05. Results: ASES score, active elevation, active external rotation, and acromiohumeral distance increased significantly after arthroscopic SCR in patients with no pseudoparalysis, moderate pseudoparalysis, or severe pseudoparalysis. The graft healing rate was 96% (43 of 45) in patients with no pseudoparalysis, 96% (26 of 27) in those with moderate pseudoparalysis, and 87% (13 of 15) in the severe pseudoparalysis group. Postoperative ASES score, active elevation, active external rotation, acromiohumeral distance, and healing rate did not differ among the 3 patient groups. Pseudoparalysis was reversed in 96% (26 of 27) of patients with moderate pseudoparalysis and in 93% (14 of 15) patients with severe pseudoparalysis. Patients with residual moderate or severe pseudoparalysis had graft tears postoperatively. Conclusion: Arthroscopic SCR improved shoulder function and achieved superior stability in patients with previously irreparable rotator cuff tears both with and without pseudoparalysis. Providing that the graft did not tear postoperatively, arthroscopic SCR reversed preoperative pseudoparalysis. The graft healing rate after arthroscopic SCR did not differ between patients with and without pseudoparalysis.

scholarly journals Assessing Shoulder Biomechanics of Healthy Elderly Individuals During Activities of Daily Living Using Inertial Measurement Units: High Maximum Elevation Is Achievable but Rarely Used

2019 ◽  
Vol 141 (4) ◽  
Author(s):  
Ryan M. Chapman ◽  
Michael T. Torchia ◽  
John-Erik Bell ◽  
Douglas W. Van Citters
Keyword(s):  
External Rotation ◽  
Shoulder Function ◽  
Measurement Unit ◽  
Clinical Settings ◽  
Healthy Individuals ◽  
Inertial Measurement ◽  
Healthy Elderly ◽  
Maximum Elevation ◽  
Measurement Units ◽  
Shoulder Elevation

Current shoulder clinical range of motion (ROM) assessments (e.g., goniometric ROM) may not adequately represent shoulder function beyond controlled clinical settings. Relative inertial measurement unit (IMU) motion quantifies ROM precisely and can be used outside of clinic settings capturing “real-world” shoulder function. A novel IMU-based shoulder elevation quantification method was developed via IMUs affixed to the sternum/humerus, respectively. This system was then compared to in-laboratory motion capture (MOCAP) during prescribed motions (flexion, abduction, scaption, and internal/external rotation). MOCAP/IMU elevation were equivalent during flexion (R2 = 0.96, μError = 1.7 deg), abduction (R2 = 0.96, μError = 2.9 deg), scaption (R2 = 0.98, μError = −0.3 deg), and internal/external rotation (R2 = 0.90, μError = 0.4 deg). When combined across movements, MOCAP/IMU elevation were equal (R2 = 0.98, μError = 1.4 deg). Following validation, the IMU-based system was deployed prospectively capturing continuous shoulder elevation in 10 healthy individuals (4 M, 69 ± 20 years) without shoulder pathology for seven consecutive days (13.5 ± 2.9 h/day). Elevation was calculated continuously daily and outcome metrics included percent spent in discrete ROM (e.g., 0–5 deg and 5–10 deg), repeated maximum elevation (i.e., >10 occurrences), and maximum/average elevation. Average elevation was 40 ± 6 deg. Maximum with >10 occurrences and maximum were on average 145–150 deg and 169 ± 8 deg, respectively. Subjects spent the vast majority of the day (97%) below 90 deg of elevation, with the most time spent in the 25–30 deg range (9.7%). This study demonstrates that individuals have the ability to achieve large ROMs but do not frequently do so. These results are consistent with the previously established lab-based measures. Moreover, they further inform how healthy individuals utilize their shoulders and may provide clinicians a reference for postsurgical ROM.

scholarly journals Scapular Kinematics and Shoulder Elevation in a Traditional Push-Up

2013 ◽  
Vol 48 (6) ◽  
pp. 826-835 ◽  
Author(s):  
David N. Suprak ◽  
Jennifer Bohannon ◽  
Gabriel Morales ◽  
Joseph Stroschein ◽  
Jun G. San Juan
Keyword(s):  
Upper Extremity ◽  
External Rotation ◽  
The Self ◽  
Spine Injury ◽  
Elbow Extension ◽  
Scapular Kinematics ◽  
Posterior Tilt ◽  
Shoulder Position ◽  
Shoulder Elevation ◽  
Push Up

Context: Proper scapulothoracic motion is critical for the health and function of the shoulder and represents a principal focus in the rehabilitation setting. Variants of the traditional push-up are used frequently to help restore proper scapular kinematics. To date, substantial research has focused on muscle activation levels of rotator cuff and scapular-stabilizing musculature, whereas a dearth of literature exists regarding scapular kinematics during push-up variants. Objective: To examine the effect of shoulder position on scapular kinematics across the range of motion (ROM) of a traditional push-up. Design: Cross-sectional study. Setting: University laboratory. Patients or Other Participants: Sixteen healthy participants without a history of upper extremity or spine injury requiring rehabilitation or surgery. Intervention(s): Participants performed a traditional push-up while kinematic measurements were acquired from multiple upper extremity segments. The 3 shoulder position conditions were (1) self-selected position, (2) shoulder adducted upon ascent (at side), and (3) shoulder elevated to approximately 90°. Main Outcome Measure(s): Scapular posterior tilt, upward rotation, and external rotation were examined across elbow-extension ROM and compared across conditions. Results: Posterior tilt was greater in the self-selected and at-side conditions than in the elevated condition and increased linearly with elbow extension. External rotation was greater in the self-selected and at-side conditions compared with that in the elevated condition. In the at-side condition, upward rotation began lower than in the other conditions at the start of the concentric phase but increased above the others soon after the elbow started to extend. Conclusions: Performing a traditional push-up with the shoulders elevated may place the scapula in a position of impingement. Clinicians should be cognizant of shoulder elevation when prescribing and monitoring exercise progression. The results of this study will provide further direction for clinicians in prescribing rehabilitation exercises for the upper extremity, especially closed chain exercises for shoulder conditions.

scholarly journals Association of Shoulder Dysfunction with Mobility Limitation in Older Adults of the BLSA

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 936-937
Author(s):  
Derik Davis ◽  
Kai Sun ◽  
Laurence Magder ◽  
Eleanor Simonsick
Keyword(s):  
Older Adults ◽  
Lower Extremity ◽  
External Rotation ◽  
Mobility Limitation ◽  
Shoulder Dysfunction ◽  
Shoulder Range Of Motion ◽  
Shoulder External Rotation ◽  
The Impact ◽  
Shoulder Elevation ◽  
Walking Endurance

Abstract Mobility limitation affects one-third of older adults; yet, the impact of shoulder dysfunction which effects roughly 20%, is inadequately documented. As arm swing is a fundamental component of ambulation, we investigated the cross-sectional association between shoulder range of motion (ROM) and walking endurance using time to walk 400m as quickly as possible and lower extremity performance using the expanded Short Physical Performance Battery (e-SPPB). Data are from 614 men (50.5%) and women aged ≥ 60 years (mean 71.8 ±8 years) in the Baltimore Longitudinal Study of Aging (BLSA) who performed bilateral shoulder elevation and/or bilateral shoulder external rotation (ER) during nurse-administered physical examination. We examined odds of poor 400m-walk and e-SPPB performance defined as the worst quartile associated with abnormal shoulder elevation (≤9%) relative to bilateral normal shoulder elevation and abnormal shoulder external rotation (≤5%) relative to bilateral normal shoulder external rotation (ER) in separate analyses. Analyses were adjusted for age, sex, weight and height. Adjusted odds (95% confidence interval) of poor 400m-walk performance associated with abnormal shoulder elevation (N=254) were 4.7 (1.1-19.5;p=0.035) and with abnormal shoulder ER (n=401) were 4.8 (1.4-16.7;p=0.010). Adjusted odds of poor e-SPPB performance associated with abnormal shoulder elevation (N=462) were 3.5 (1.6-7.7;p=0.002) and with abnormal shoulder ER (n=457) were 2.9 (1.1-7.4;p=0.030). Results suggest abnormal shoulder ROM is associated with poorer walking endurance capacity and lower-extremity functional performance in the relatively healthy older adults. Future research is warranted to develop novel screening paradigms that mitigate mobility limitation and functional decline in older adults with shoulder dysfunction.

Legal Update: North Dakota Supreme Court: Third Edition of Guides is “Most Current”

1999 ◽  
Vol 4 (1) ◽  
pp. 6-7
Author(s):  
James J. Mangraviti
Keyword(s):  
Internal Rotation ◽  
External Rotation ◽  
Measurement Techniques ◽  
Fourth Edition ◽  
Hip Motion ◽  
The Difference ◽  
The Right ◽  
Hip Flexion ◽  
Hip Rotation ◽  
Hip Extension

Abstract The accurate measurement of hip motion is critical when one rates impairments of this joint, makes an initial diagnosis, assesses progression over time, and evaluates treatment outcome. The hip permits all motions typical of a ball-and-socket joint. The hip sacrifices some motion but gains stability and strength. Figures 52 to 54 in AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, illustrate techniques for measuring hip flexion, loss of extension, abduction, adduction, and external and internal rotation. Figure 53 in the AMA Guides, Fourth Edition, illustrates neutral, abducted, and adducted positions of the hip and proper alignment of the goniometer arms, and Figure 52 illustrates use of a goniometer to measure flexion of the right hip. In terms of impairment rating, hip extension (at least any beyond neutral) is irrelevant, and the AMA Guides contains no figures describing its measurement. Figure 54, Measuring Internal and External Hip Rotation, demonstrates proper positioning and measurement techniques for rotary movements of this joint. The difference between measured and actual hip rotation probably is minimal and is irrelevant for impairment rating. The normal internal rotation varies from 30° to 40°, and the external rotation ranges from 40° to 60°.

Clinical Update: Measuring Shoulder Joint Motion

1998 ◽  
Vol 3 (5) ◽  
pp. 4-5
Author(s):  
Christopher R. Brigham
Keyword(s):  
External Rotation ◽  
Joint Motion ◽  
Fourth Edition ◽  
Single Plane ◽  
Reconstructive Procedures ◽  
Results Of Treatment ◽  
Shoulder Disorders ◽  
Shoulder Motion ◽  
Motion Measurements ◽  
Upper Extremity Impairment

Abstract Accurate measurement of shoulder motion is critical in assessing impairment following shoulder disorders. To this end, measuring and recording joint motion are important steps in diagnosing, determining the severity and progression of a disorder, assessing the results of treatment, and evaluating impairment. Shoulder movement usually is composite rather than in a single plane, so isolating single movements is challenging. Universal goniometers with long arms are used to measure shoulder motion, and testing must be performed and recorded consistently. Passive motion may be carried out cautiously by the examiner; two measurements of the same patient by the same examiner should lie within 10° of each other. Shoulder extension and flexion are illustrated. Maximal flexion of the shoulder also includes slight external rotation and abduction, and controlling or eliminating these components during evaluation is challenging. Abduction and adduction are illustrated. Deficits in external rotation may occur in patients who have undergone reconstructive procedures with an anterior approach; deficits in internal rotation may result from issues with shoulder instability. The authors recommend recording the shoulder's range of motion measurements according to the Upper Extremity Impairment Evaluation Record in the AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition.

The effects of personality type and stress on muscle activity during simulated work tasks

2003 ◽  
Author(s):  
Naomi F. Glasscock ◽  
Gary A. Mirka ◽  
Carolyn M. Sommerich ◽  
Katherine W. Klein
Keyword(s):  
Muscle Activity ◽  
Personality Type ◽  
Work Tasks
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