Shoulder Strength Requirements for Upper Limb Functional Tasks: Do Age and Rotator Cuff Tear Status Matter?

2017 ◽  
Vol 33 (6) ◽  
pp. 446-452 ◽  
Author(s):  
Anthony C. Santago ◽  
Meghan E. Vidt ◽  
Xiaotong Li ◽  
Christopher J. Tuohy ◽  
Gary G. Poehling ◽  
...  
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Upper Limb ◽  
External Rotation ◽  
Strength Loss ◽  
Cuff Tear ◽  
Supraspinatus Tear ◽  
Shoulder Strength

Understanding upper limb strength requirements for daily tasks is imperative for early detection of strength loss that may progress to disability due to age or rotator cuff tear. We quantified shoulder strength requirements for 5 upper limb tasks performed by 3 groups: uninjured young adults and older adults, and older adults with a degenerative supraspinatus tear prior to repair. Musculoskeletal models were developed for each group representing age, sex, and tear-related strength losses. Percentage of available strength used was quantified for the subset of tasks requiring the largest amount of shoulder strength. Significant differences in strength requirements existed across tasks: upward reach 105° required the largest average strength; axilla wash required the largest peak strength. However, there were limited differences across participant groups. Older adults with and without a tear used a larger percentage of their shoulder elevation (p < .001,p < .001) and external rotation (p < .001,p = .017) strength than the young adults, respectively. Presence of a tear significantly increased percentage of internal rotation strength compared to young (p < .001) and uninjured older adults (p = .008). Marked differences in strength demand across tasks indicate the need for evaluating a diversity of functional tasks to effectively detect early strength loss, which may lead to disability.

scholarly journals Shoulder Function and Fatty Infiltration on MRI in Older Adults During Rehabilitation for Rotator Cuff Tear

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 960-960
Author(s):  
Derik Davis ◽  
Ranyah Almardawi ◽  
Omer Awan ◽  
Lawrence Lo ◽  
Sagheer Ahmed ◽  
...  
Keyword(s):  
Older Adults ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Fatty Infiltration ◽  
Shoulder Function ◽  
Control Cohort ◽  
Cuff Tear ◽  
Supraspinatus Tear ◽  
Cohort Groups ◽  
Over Time

Abstract Rotator cuff tear is highly prevalent in older adults, with supraspinatus tendon tear (STT) the most common. Shoulder rehabilitation is a major treatment strategy, but supraspinatus-muscle-fatty infiltration (FI) and shoulder function in older adults with rotator cuff tear primarily managed by physical therapy (PT) is inadequately documented. We tested the hypothesis that older adults receiving usual-care PT when stratified by supraspinatus tear-status differ in supraspinatus FI [by quantitative Dixon fat fraction (FF) and semi-quantitative Goutallier grade (GG) on MRI] and shoulder function [by the American Shoulder and Elbow Surgeons score (ASES-score)] over time. Longitudinal cohort study (pilot): adults 60-85 years, PT-cohort (n=15) and control-cohort (n=25). Participants completed both shoulder MRI and ASES survey at baseline and follow-up visits. Kruskal-Wallis test compared within cohort among 3 groups: no tear (no-STT), partial-thickness tear (pt-STT), full-thickness tear (ft-STT). Mann-Whitney U test compared equivalent groups between cohorts. Baseline PT-cohort groups differed for GG (p=0.033) [no tear, 0.50±0.50;pt-STT, 1.11±0.22;ft-STT, 1.50±0.50] without difference in age, BMI, comorbidity, or ASES-score. Baseline control-cohort groups differed for FF (p=0.034) [no-tear, 5.77%±1.16%;pt-STT, 7.14%±6.26%;ft-STT, 21.44%±10.44%], without difference in age, BMI, comorbidity, or ASES-score. Baseline no-tear groups for ASES-score (p=0.049) differed between cohorts: PT-cohort (58.87±8.21) versus control-cohort (83.98±21.89). Both cohorts showed no difference in Δ-FF or Δ-GG over time. PT-cohort groups differed for Δ-ASES-score over time (p=0.042)[no-tear, 16.65±4.69;pt-STT, -7.24±0.94;ft-STT, 4.48±3.45], but control-cohort groups did not (p&gt;0.050). Our results suggest differences exist for supraspinatus FI and self-reported shoulder function among older adults receiving PT for rotator cuff tear when stratified by supraspinatus tear-status.

scholarly journals The effects of a rotator cuff tear on activities of daily living in older adults: A kinematic analysis

2016 ◽  
Vol 49 (4) ◽  
pp. 611-617 ◽  
Author(s):  
Meghan E. Vidt ◽  
Anthony C. Santago ◽  
Anthony P. Marsh ◽  
Eric J. Hegedus ◽  
Christopher J. Tuohy ◽  
...  
Keyword(s):  
Older Adults ◽  
Rotator Cuff ◽  
Activities Of Daily Living ◽  
Rotator Cuff Tear ◽  
Kinematic Analysis ◽  
Daily Living ◽  
Cuff Tear

scholarly journals Reverse Shoulder Prosthesis With a Lateralized Glenosphere: Early Results of a Prospective Multicenter Study Stratified by Diagnosis

2019 ◽  
Vol 3 ◽  
pp. 247154921984404 ◽  
Author(s):  
Samer S Hasan ◽  
Jonathan C Levy ◽  
Zachary R Leitze ◽  
Avinash G Kumar ◽  
Gary D Harter ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Multicenter Study ◽  
Shoulder Arthroplasty ◽  
External Rotation ◽  
Reverse Shoulder Arthroplasty ◽  
Design Team ◽  
Scapular Notching ◽  
Cuff Tear ◽  
Glenohumeral Arthritis

Background We report here on the results, stratified by diagnosis, of a multicenter prospective study by surgeons unaffiliated with the design team of reverse shoulder arthroplasty (RSA) performed using a lateralized glenosphere. We hypothesized that outcomes would be comparable to those reported previously.Methods: A total of 245 patients underwent RSA for cuff tear arthropathy or glenohumeral arthritis with rotator cuff tear, rotator cuff tear with instability or escape and without glenohumeral arthritis, or failed shoulder arthroplasty. Clinical, radiographic, and self-assessed outcome measures were obtained preoperatively and at standardized time points postoperatively. At 2 years, 173 patients were available as 23 patients were deceased, 12 had undergone revision, and 37 were unavailable.Results: Range of motion and outcomes improved, irrespective of diagnosis. Active forward flexion, abduction, and external rotation improved (73°–127°, 65°–109°, and 24°–37°, respectively, P < .0001 for all). Simple Shoulder Test (3.2–8.5) and American Shoulder and Elbow Surgeons scores (45–86) also improved. Scapular notching occurred in 13.3%; scapular spine/acromial fractures in 6.5%. Patients undergoing revision shoulder arthroplasty improved more modestly.Conclusion: In this multicenter study, surgeons unaffiliated with the design team obtained clinical improvements comparable to those reported previously and that exceeded minimal clinically important differences for RSA. Improvements in external rotation and low scapular notching rates potentially relate to the lateralized design.

scholarly journals Can self-report instruments of shoulder function capture functional differences in older adults with and without a rotator cuff tear?

2016 ◽  
Vol 29 ◽  
pp. 90-99 ◽  
Author(s):  
Meghan E. Vidt ◽  
Anthony C. Santago ◽  
Eric J. Hegedus ◽  
Anthony P. Marsh ◽  
Christopher J. Tuohy ◽  
...  
Keyword(s):  
Older Adults ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Shoulder Function ◽  
Self Report ◽  
Cuff Tear ◽  
Functional Differences

scholarly journals Two-year results of double row repair for medium sized rotator cuff tear in elderly patients

2019 ◽  
Vol 6 (2) ◽  
pp. 423
Author(s):  
Afsar T. Ozkut
Keyword(s):  
Rotator Cuff ◽  
Internal Rotation ◽  
Rotator Cuff Tear ◽  
External Rotation ◽  
Constant Score ◽  
Rotator Cuff Tears ◽  
Double Row ◽  
Cuff Tear ◽  
Forward Flexion

Background: Rotator cuff tears are treated surgically when conservative treatment methods fail. Since osteoporosis is common and the cuff is degenerative in nature, it may be a challenge to treat the tears surgically in the elderly. The objective of this study was to evaluate the results rotator cuff repair with double row two anchors (one medial and one lateral) for middle sized tears in patients over 65years old.Methods: 18 patients who are over 65years old treated arthroscopically for medium sized rotator cuff tear were included in the study. Inclusion criteria were patients with MR findings and physical findings consistent with medium sized (1-3cm) rotator cuff tears, patients with follow up period of at least 2years. All of the patients were repaired using (two anchors, one medially and one laterally placed) double row technique arthroscopically.  The patients were evaluated with constant Murley score and ASES scores. All these measurements (both ROM and functional tests) were performed preoperatively and at postoperative third sixth months, first year and after second year.Results: Mean age of the patients was 69.3 (±2.6). The mean follows up period was 34months (±4.1) Preoperative mean forward flexion and external rotation were 127.3±25.3º and 48.9±14.6º respectively. The preoperative mean internal rotation was 9.1±6.9º. Preoperative mean ASES score was 59.1º (±9.6) and mean constant score was 53.7º (±11.2). At the last follow up mean forward flexion was 158.3º (±17.9), external rotation was 63.2º (±11.4) and internal rotation was 9.3º (±7.3).  Mean ASES score and constant score of the patients were 84.3 (±9.1) and 77.3 (±10.8) in the last follow up.Conclusions: It is possible to obtain good results in medium sized rotator cuff tears in patients over 65years old particularly if fatty degeneration over grade II has not prevailed.

Effects of Supraspinatus Tear and Repair on Glenohumeral Joint Biomechanics

2002 ◽  
Author(s):  
Michelle H. McGarry ◽  
Jennifer L. Bissell ◽  
Bruce Y. Yang ◽  
Ranjan Gupta ◽  
Thay Q. Lee
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Glenohumeral Joint ◽  
Rotator Cuff Tears ◽  
Patient Factors ◽  
Subacromial Decompression ◽  
Orthopaedic Surgeons ◽  
Cuff Tear ◽  
Supraspinatus Tear ◽  
Joint Biomechanics

Rotator cuff tears are common injuries seen by orthopaedic surgeons. Management may vary depending on patient factors, size and location of tear, and severity of symptoms. Treatment for symptomatic rotator cuff tear often includes subacromial decompression, debridement, and/or repair. The objective of this study was to determine the change in glenohumeral joint (GHJ) forces after repair of pathologic supraspinatus tears.

The relationship between rotator cuff tear and four acromion types: cross-sectional study based on shoulder magnetic resonance imaging in 227 patients

2018 ◽  
Vol 60 (5) ◽  
pp. 608-614 ◽  
Author(s):  
Jong Moon Kim ◽  
Yong Wook Kim ◽  
Hyoung Seop Kim ◽  
Sang Chul Lee ◽  
Yong Min Chun ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Supraspinatus Tendon ◽  
Cross Sectional ◽  
Partial Tear ◽  
Cuff Tear ◽  
Supraspinatus Tear ◽  
Number Of Patients ◽  
The Relationship

Background Rotator cuff tear (RCT) has been believed to be related to specific types of the acromion. However, most of the studies were performed on a small number of patients with surgical findings not considering the severity of RCT. Purpose To analyze the relationship between age, gender, the side of the shoulder, the acromion type, and the severity of RCT using shoulder magnetic resonance arthrography (MRA). Material and Methods A total of 277 shoulder MRA findings were analyzed by a radiologist specializing in the musculoskeletal system. The relationship between variables (age, gender, side of the shoulder, and acromion type) and the injury of the supraspinatus (no rupture, partial rupture, full rupture, complete rupture) was confirmed. The partial tear of the supraspinatus tendon was divided into bursal and articular side tear in order to investigate the damage caused by the anatomical difference of the acromion. We also confirmed the differences between single supraspinatus injury and multiple RCTs. Results The severity of supraspinatus tear and multiple RCTs were statistically significant with the old age and the right side of the shoulder, but not with a specific acromion type. In supraspinatus partial tear, there was no statistical difference between bursal and articular side tears. Conclusion Our study revealed that the age at which degeneration could occur also was associated with multiple RCTs and is considered to be the most important factor in RCT, not anatomical structures such as acromion type.

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