Relationship between Shoulder Pain and Selected Variables in Patients with Hemiplegia

1988 ◽  
Vol 2 (2) ◽  
pp. 111-117 ◽  
Author(s):  
Richard W Bohannon

This investigation was performed to clarify the relationship between six independent variable categories and shoulder pain (SP) in hemiplegia. In this study, 30 hemiplegic patients served as subjects. The Ritchie articular index was used to measure SP. The independent variables were age, body weight, time since onset of stroke, shoulder subluxation, range of shoulder external rotation, and plegic shoulder muscle group strength. Subluxation was judged by palpation. Range of shoulder external rotation was measured goniometrically. Strength of the shoulder internal and external rotator, abductor and extensor muscles was measured with a hand-held dynamometer and normalized against body weight. A strength balance ratio of the shoulder was also determined (external rotators + abductors/internal rotators + extensors). Variables were measured on admission and prior to discharge. Spearman correlations or chi-squares were determined between the initial and final measurements of the independent variables and SP. More than 80% of the patients had SP. Correlated significantly with SP at both assessments and across time were range of shoulder external rotation (−.574 to −.797), and strength of the shoulder external rotator (−.523 to −.583) and abductor (−.375 to −.519) muscles. Correlated significantly at one or more of the assessments were body weight, time since onset and the strength of the other muscle groups (including the strength ratio). Shoulder subluxation was not correlated with SP. Patients with greater weakness may be more prone to the development of pain because their muscles lack adequate strength to move the joint enough to prevent the development of adhesive capsulitis.

2019 ◽  
Vol 27 (2) ◽  
pp. 124-128 ◽  
Author(s):  
Glauber Alvarenga ◽  
Henry Dan Kiyomoto ◽  
Emília Cardoso Martinez ◽  
Giancarlo Polesello ◽  
Vera Lúcia dos Santos Alves

ABSTRACT Objective: Hand-held dynamometry is a quantitative and accessible means of determining the isometric force of muscle groups. Methods: A total of 52 women aged 20–29 years with no complaints of hip pain who were sedentary or sporadically active and had a body mass index of 18.5–24.99 kg/m2 were included. All participants underwent bilateral assessments using hand-held dynamometry of the flexor, extensor, adductor, and abductor muscles as well as the internal and external rotator hip muscles. All hip movements were measured. All contraction data collected by the dynamometer are expressed in kilograms, normalized according to body weight, and expressed as percentages. Results: The flexor muscles exhibited an isometric muscle force of 38.54% of body weight versus a muscle force of 27.04% for the extensor muscles, 16.89% for the adductors, 16.85% for the abductors, and 17.09% for the external rotators, and 23.82% for the internal rotators. Conclusion: Standardization of isometric strength values according to body weight proved feasible. This result is important for clinical practice since it allows the establishment of patterns of normality and criteria for discharge, return to sports, or assessment of the impact of injuries in terms of loss of muscle strength. Level of evidence: III, Development of diagnostic criteria on consecutive patients (with universally applied reference “gold” standard).


2018 ◽  
Vol 20 (4) ◽  
pp. 461 ◽  
Author(s):  
Tolga Ergonenc ◽  
Serbulent Gokhan Beyaz

Aim: Pulsed radiofrequency (PRF) therapy has become increasingly popular in the treatment of chronic shoulder pain due to its long duration of action and non-destructive method. The aim of the study was to reveal the effects of PRF therapy of the suprascapular nerve (SSN) under ultrasound guidance (UG) in patients with chronic shoulder pain on both shoulder pain and function.Material and methods: This study included 74 patients diagnosed with at least one of the following: adhesive capsulitis, rotator cuff syndrome and impingement syndrome of shoulder. The PRF therapy of the SSN under UG was performed in those patients with a reduction of 50% or more Visual Analog Scale (VAS) score and those that reported healing in the active range of motion (AROM) in the diagnostic SSN block. The resting, motion and sleeping shoulder pain assessments of the patients were done with VAS score. The shoulder joint function was assessed with the Shoulder Pain and Disability Index (SPADI) questionnaire and the AROM of the joint was measured using a goniometer.Results: In 70 of the 74 patients a 50% or more reduction was found in the VAS score with diagnostic SSN block. After the PRF therapy of the SSN, the 15thday, 1st month, 3rd month, and 6th month follow-up VAS averages, SPADI averages and the flexion, internal rotation, external rotation, and abduction values were statistically significantly lower than the baseline values (p<0.05).Conclusion: This study is the largest series in the literature evaluating the efficacy of PRF therapy of the SSN under UG and has shown that pain canbe controlled quickly, for a long period of time, using ultrasound guided PRF therapy of the SSN in chronic shoulder pain.


2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0027
Author(s):  
Gulcan Harput ◽  
Hande Guney ◽  
Fatma Filiz Colakoglu ◽  
Gul Baltacı

Objectives: The aim of this study was to investigate the effects of limb dominance and gender on isometric, eccentric and concentric strength of the shoulder internal and external rotator muscles in adolescent volleyball players. Methods: Forty adolescent volleyball players [Male: 23( Age: 15.5±1.4 yrs, Body weight: 72±10.2 kg, Height: 184.4±7.6 cm, BMI: 20.9±2.6 kg/m2), Female: ( Age: 16.7±0.9 yrs, Body weight: 60.7±8.2 kg, Height: 172.5±5.3 cm, BMI: 20.4±2.3 kg/m2) participated in this study. Isomed 2000 isokinetic dynamometer was used to measure muscle strength testing. Isometric strength testing of shoulder internal and external rotator muscles were performed at 90 ° shoulder abduction and external rotation position. In the same position, concentric and eccentric muscle testing was performed at 90°/s angular velocity. Strength outcomes were recorded as Nm/kg. 2-way repeated measures of ANOVA was used for statistical analysis. Results: Dominance by gender interaction was not found significant for internal rotator (IR) and external rotator (ER) muscles' strength (IR: F(1,72)=2.87, p=0.06, ER: F(1,72)=1.98, p=0.15). There was a significant strength by dominance interaction for internal rotator muscles (F(2,72)=18.52, p<0.001). Isometric strength was greater in dominant limb (p<0.001)while concentric strength was found greater in non-dominant limb(p=0.006). Eccentric strength was found similar for limbs (p=0.18). IR muscles showed greater strength during eccentric (1.03±0.05), concentric (0.76±0.03) and isometric test (0.69±0.03), respectively. On the other hand, external rotators showed greater strength during eccentric (0.49±0.4), isometric (0.40±0.3) and concentric test (0.36±0.3), respectively. There was no significant gender effect on the strength (IR: F(2,72)=0.31, p=0.73, ER: F(2,72)=0.42, p=0.66). Conclusion: The strength of shoulder internal and external rotator muscles do not differ according to gender in adolescent volleyball players. Limb dominance has an effect on the strength of internal rotator muscles while it has no effect on the strength of external rotators. Both muscle groups show greater strength during eccentric testing.


2016 ◽  
Vol 19 (03) ◽  
pp. 1650014 ◽  
Author(s):  
Y. V. Raghava Neelapala ◽  
Y Ravi Shankar Reddy ◽  
Roopa Danait

Background and objectives: Joints may have an effect on the function of the surrounding muscles through nociceptors and mechanoreceptors. Pain reduction in the shoulder might lead to improved function of the muscles surrounding the shoulder in individuals with shoulder pain. The aim of our work was to determine the acute effect of Mulligan’s posterolateral glide on shoulder rotator strength, scapular motor control, and pain in painful shoulders. Methodology: Individuals with shoulder pain were randomly assigned to a control active exercise group and an experimental Mulligan’s posterolateral glide group. VAS, scapular upward rotation and shoulder rotator strength were the outcomes measured before and after three sessions of intervention. Multivariate analysis of variance (MANOVA) was used to analyze the differences between the groups after the intervention. Results: A total of 31 subjects with shoulder pain participated in the study. After the intervention, VAS scores ([Formula: see text] (1, 29) [Formula: see text] 27, [Formula: see text]) and Shoulder external rotator strength ([Formula: see text] (1, 29) [Formula: see text] 4.6, [Formula: see text]) were statistically significantly different between both the groups as revealed by one-way MANOVA. There were no significant differences found between the groups in scapular upward rotation ([Formula: see text] (1, 29) [Formula: see text] 0.09, [Formula: see text]) and internal rotator strength ([Formula: see text] (1, 29) [Formula: see text] 0.03, [Formula: see text]) post treatment. Pain scores were lesser and the external rotation strength was higher after Mulligans’ mobilization when compared to active exercise. Conclusion: Mulligan’s mobilization with posterolateral glide was effective in reducing pain and improving external rotator strength in individuals with painful shoulders when compare to active exercise. There were no significant differences noted in shoulder internal rotator strength and scapular upward rotation.


2005 ◽  
Vol 33 (11) ◽  
pp. 1716-1722 ◽  
Author(s):  
Michelle B. Sabick ◽  
Young-Kyu Kim ◽  
Michael R. Torry ◽  
Michael A. Keirns ◽  
Richard J. Hawkins

Background The effects of repetitive throwing on the shoulders of developing athletes are not well understood because of the paucity of data describing the biomechanics of youth pitchers and the plasticity of the developing skeleton. Hypothesis The direction and magnitude of the stresses that exist at the proximal humeral physis during the fastball pitching motion are consistent with the development of proximal humeral epiphysiolysis (Little League shoulder) and/or humeral retrotorsion. Study Design Descriptive laboratory study. Methods A total of 14 elite youth baseball pitchers (mean age, 12.1 ± 0.4 years) were filmed from the front and dominant side while throwing fastballs in a simulated game. The net force and torque acting on the humerus throughout the throwing motion were calculated using standard biomechanical techniques. Results The external rotation torque about the long axis of the humerus reached a peak value of 17.7 ± 3.5 N.m (2.7% ± 0.3% body weight × height) just before maximum shoulder external rotation. A shoulder distraction force of 214.7 ± 47.2 N (49.8% ± 8.3% body weight) occurred at, or just after, ball release. Conclusion Shear stress arising from the high torque late in the arm-cocking phase is large enough to lead to deformation of the weak proximal humeral epiphyseal cartilage, causing either humeral retrotorsion or proximal humeral epiphysiolysis over time. The stresses generated by the external rotation torque are much greater than those caused by distraction forces generated during the pitching motion of youth baseball pitchers. Clinical Relevance The motion of throwing fastballs by youth baseball pitchers results in force components consistent with proposed mechanisms for 2 clinical entities.


2021 ◽  

Background and objective: This study aimed to assess the relationship between range of motion (ROM) and isometric strength of the shoulder joint, adjusted for humeral head retroversion angle (HHRA), in professional baseball pitchers. Material and Methods: A total of 18 pitchers from a professional baseball team were included in this study. The isometric strength of internal rotation (IR) and external rotation (ER) were measured using an isokinetic device at 85◦ and 30◦ ER, and at 25◦ IR. A linear regression analysis was then performed. Results: The HHRA of the dominant arm was approximately 7◦ greater than that of the non-dominant arm (P < 0.001). As the IR ROM increased by 1◦, the IR isometric strength at 25◦ IR was significantly increased by 0.448% body weight (P < 0.05). However, as the ROM of IR increased, the IR isometric strength at 85◦ and 30◦ ER was not significant (P > 0.05), and as the ROM of ER increased, the IR and ER isometric strength were not significant (P > 0.05). Conclusions: Thus, the increase of IR ROM in professional baseball pitchers was associated with an increase in isometric strength at 25◦ IR, after adjustments were made for HHRA.


2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Yen-Sheng Lin ◽  
Michael Boninger ◽  
Lynn Worobey ◽  
Shawn Farrokhi ◽  
Alicia Koontz

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.


2010 ◽  
Vol 45 (2) ◽  
pp. 191-197 ◽  
Author(s):  
Steve Scher ◽  
Kyle Anderson ◽  
Nick Weber ◽  
Jeff Bajorek ◽  
Kevin Rand ◽  
...  

Abstract Context: The overhead throwing motion is complex, and restrictions in range of motion (ROM) at the hip may place additional demands on the shoulder that lead to injury. However, the relationship between hip and shoulder ROM in athletes with and without a history of shoulder injury is unknown. Objective: To (1) determine if differences exist in hip and shoulder ROM between professional baseball players with a history of shoulder injury and those with no history of shoulder injury and (2) assess relationships between hip and shoulder ROM in these players. Design: Cross-sectional study. Patients or Other Participants: Fifty-seven professional baseball players. Main Outcome Measure(s): Outcome measures consisted of hip extension and internal rotation, shoulder internal and external rotation, glenohumeral internal-rotation deficit, and history of shoulder injury. Differences in shoulder and hip ROM were assessed with a 1-way analysis of variance. Associations between hip and shoulder ROM were assessed with linear regression. Results: Nonpitchers with a history of shoulder injury had more external rotation and less internal rotation of the shoulder than nonpitchers with no history of shoulder injury. Glenohumeral internal-rotation deficit was greater in both pitchers and nonpitchers with a history of shoulder injury. The relationship between dominant hip extension and shoulder external rotation was significant for pitchers with a history of shoulder injury and nonpitchers with a history of shoulder injury. Conclusions: Shoulder injury may be associated with specific measures of hip and shoulder ROM, and hip extension and shoulder external rotation may be related in baseball players with a history of shoulder injury. Additional research is necessary to understand the specific mechanisms of shoulder injury in the throwing athlete.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Fatih Özden ◽  
Nazan Tuğay ◽  
Özgür Nadiye Karaman ◽  
Cem Yalın Kilinç ◽  
Baki Umut Tuğay

Abstract Background The pain, fear of movement, and disability are interrelated parameters that may adversely affect the individual in terms of medical and social aspects. This relationship has not been well studied in shoulder pathologies. We carried out a single-center cross-sectional study in the Orthopaedics and Traumatology Clinic. The aim of the study was to investigate the relationship between pain, function range of motion (ROM), and fear of movement in patients with shoulder pain. Results The mean age of the participants was 53.7 ± 11.2 years. Symptom duration was 11.65 ± 23.39 months. Most of the subjects (66.7%) had impingement syndrome. There was a weak to moderate negative correlation between both visual analog scale (VAS) and Oxford Shoulder Score (OSS) with flexion, abduction, external rotation ROM values (r1 = − 0.293, r2 = − 0.348, r3 = − 0.330, p < 0.001). In addition, there was a weak negative correlation between Tampa Kinesiophobia Score (TKS) and ROM values of abduction, internal rotation, and external rotation (r1 = − 0.273, r2 = − 0.207, r3 = − 0.250, p < 0.05). Pain was weakly and positively correlated with OSS (r = 0.209, p < 0.05). Conclusions According to our results, shoulder pain was associated with functionality, but fear of movement was not associated with shoulder pain or functionality. ROM was associated with both pain, functionality, and fear of movement.


2017 ◽  
Vol 9 (4) ◽  
pp. 292-298 ◽  
Author(s):  
Michael Bryant ◽  
Andrew Gough ◽  
James Selfe ◽  
Jim Richards ◽  
Elizabeth Burgess

Background Evidence for optimal non-operative treatment of frozen shoulder is lacking. The present study aimed to evaluate a treatment strategy for stage II to III frozen shoulder provided by the current primary care musculoskeletal service. Methods General practioner referrals of shoulder pain to the musculoskeletal service diagnosed with stage II to III frozen shoulder and who opted for a treatment strategy of hydrodistension and guided physiotherapy exercise programme over a 12-month period were evaluated for 6 months. Thirty-three patients were diagnosed with stage II to III frozen shoulder by specialist physiotherapists and opted for the treatment strategy. Outcome measures included Shoulder Pain Disability Index (SPADI) and Shortened Disabilities of the Arm, Shoulder and Hand (QuickDASH), pain score and range of movement. Data were collected at baseline, as well as at 6 weeks, 12 weeks and 6 months. Results All patients significantly improved in shoulder symptoms on the SPADI and QuickDASH scores ( p < 0.001). Pain scores and range of shoulder movement flexion, abduction, external rotation showed significant improvement at all time points ( p < 0.001). Conclusions This service evaluation demonstrates that management of frozen shoulder stage II to III, as conducted by physiotherapists in a primary care setting utilizing hydrodistension and a guided exercise programme, represents an effective non-operative treatment strategy.


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