A novel manual therapy technique is effective for short-term increases in tibial internal rotation range of motion

Background: Baseball players displaying deficits in shoulder range of motion (ROM) are at increased risk of arm injury. Currently, there is a lack of consensus regarding the best available treatment options to restore shoulder ROM. Hypothesis: Instrumented manual therapy with self-stretching will result in clinically significant deficit reductions when compared with self-stretching alone. Study Design: Controlled laboratory study. Methods: Shoulder ROM and humeral torsion were assessed in 60 active baseball players (mean age, 19 ± 2 years) with ROM deficits (nondominant − dominant, ≥15°). Athletes were randomly assigned to receive a single treatment of instrumented manual therapy plus self-stretching (n = 30) or self-stretching only (n = 30). Deficits in internal rotation, horizontal adduction, and total arc of motion were compared between groups immediately before and after a single treatment session. Treatment effectiveness was determined by mean comparison data, and a number-needed-to-treat (NNT) analysis was used for assessing the presence of ROM risk factors. Results: Prior to intervention, players displayed significant ( P < 0.001) dominant-sided deficits in internal rotation (−26°), total arc of motion (−18°), and horizontal adduction (−17°). After the intervention, both groups displayed significant improvements in ROM, with the instrumented manual therapy plus self-stretching group displaying greater increases in internal rotation (+5°, P = 0.010), total arc of motion (+6°, P = 0.010), and horizontal adduction (+7°, P = 0.004) compared with self-stretching alone. For horizontal adduction deficits, the added use of instrumented manual therapy with self-stretching decreased the NNT to 2.2 (95% CI, 2.1-2.4; P = 0.010). Conclusion: Instrumented manual therapy with self-stretching significantly reduces ROM risk factors in baseball players with motion deficits when compared with stretching alone. Clinical Relevance: The added benefits of manual therapy may help to reduce ROM deficits in clinical scenarios where stretching alone is ineffective.

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Evaluating the Coupling between Foot Pronation and Tibial Internal Rotation Continuously Using Vector Coding

Journal of Applied Biomechanics ◽

10.1123/jab.2014-0067 ◽

2015 ◽

Vol 31 (2) ◽

pp. 88-94 ◽

Cited By ~ 20

Author(s):

Pedro Rodrigues ◽

Ryan Chang ◽

Trampas TenBroek ◽

Richard van Emmerik ◽

Joseph Hamill

Keyword(s):

Risk Factor ◽

Range Of Motion ◽

Internal Rotation ◽

Anterior Knee Pain ◽

Coordination Pattern ◽

Vector Coding ◽

Tibial Internal Rotation ◽

Coupling Relationship ◽

Foot Pronation ◽

Anterior Knee

Excessive pronation, because of its coupling with tibial internal rotation (TIR), has been implicated as a risk factor in the development of anterior knee pain (AKP). Traditionally, this coupling has been expressed as a ratio between the eversion range of motion and the TIR range of motion (Ev/TIR) that occurs during stance. Currently, this technique has not been used to evaluate specific injuries or the effects of sex. In addition, Ev/TIR is incapable of detecting coupling changes that occur throughout stance. Therefore, the purpose of this study was to compare the coupling between eversion and TIR in runners with (n = 19) and without AKP (n = 17) and across sex using the Ev/TIR ratio, and more continuously using vector coding. When using vector coding, significant coupling differences were noted in runners with AKP (34% to 38% stance), with runners with AKP showing relatively more TIR than eversion. Similarly significant differences were noted across sex (14%–25% and 36%–47% stance), with males transitioning from a loading to propulsive coordination pattern using a proximal to distal strategy, and female runners using a distal to proximal strategy. These differences were only detected when evaluating this coupling relationship using a continuous technique such as vector coding.

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The effects of a leg press exercise with tibial internal rotation on plantar pressure distribution during gait and knee rotational range of motion in healthy young females

Japanese Journal of Health Promotion and Physical Therapy ◽

10.9759/hppt.3.15 ◽

2013 ◽

Vol 3 (1) ◽

pp. 15-19

Author(s):

KAZUYOSHI GAMADA ◽

GENSUKE HOKAMA ◽

KAZUHIRO MITA ◽

FUTOSHI IKUTA ◽

KEI YONETA

Keyword(s):

Pressure Distribution ◽

Range Of Motion ◽

Internal Rotation ◽

Plantar Pressure ◽

Young Females ◽

Leg Press ◽

Tibial Internal Rotation ◽

Plantar Pressure Distribution

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Faculty Opinions recommendation of Short-term changes in neck pain, widespread pressure pain sensitivity, and cervical range of motion after the application of trigger point dry needling in patients with acute mechanical neck pain: a randomized clinical trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718289318.793497844 ◽

2014 ◽

Author(s):

César Fernández de las Peñas

Keyword(s):

Clinical Trial ◽

Neck Pain ◽

Range Of Motion ◽

Randomized Clinical Trial ◽

Pain Sensitivity ◽

Trigger Point ◽

Dry Needling ◽

Short Term ◽

Pressure Pain ◽

Cervical Range Of Motion

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An MRI-Based Patient-Specific Computational Framework for the Calculation of Range of Motion of Total Hip Replacements

Applied Sciences ◽

10.3390/app11062852 ◽

2021 ◽

Vol 11 (6) ◽

pp. 2852

Author(s):

Maeruan Kebbach ◽

Christian Schulze ◽

Christian Meyenburg ◽

Daniel Kluess ◽

Mevluet Sungu ◽

...

Keyword(s):

Range Of Motion ◽

Internal Rotation ◽

Computer Aided Design ◽

External Rotation ◽

Patient Specific ◽

Computational Framework ◽

Total Hip ◽

Total Hip Replacements ◽

Significant Difference ◽

Hip Replacements

The calculation of range of motion (ROM) is a key factor during preoperative planning of total hip replacements (THR), to reduce the risk of impingement and dislocation of the artificial hip joint. To support the preoperative assessment of THR, a magnetic resonance imaging (MRI)-based computational framework was generated; this enabled the estimation of patient-specific ROM and type of impingement (bone-to-bone, implant-to-bone, and implant-to-implant) postoperatively, using a three-dimensional computer-aided design (CAD) to visualize typical clinical joint movements. Hence, patient-specific CAD models from 19 patients were generated from MRI scans and a conventional total hip system (Bicontact® hip stem and Plasmacup® SC acetabular cup with a ceramic-on-ceramic bearing) was implanted virtually. As a verification of the framework, the ROM was compared between preoperatively planned and the postoperatively reconstructed situations; this was derived based on postoperative radiographs (n = 6 patients) during different clinically relevant movements. The data analysis revealed there was no significant difference between preoperatively planned and postoperatively reconstructed ROM (∆ROM) of maximum flexion (∆ROM = 0°, p = 0.854) and internal rotation (∆ROM = 1.8°, p = 0.917). Contrarily, minor differences were observed for the ROM during maximum external rotation (∆ROM = 9°, p = 0.046). Impingement, of all three types, was in good agreement with the preoperatively planned and postoperatively reconstructed scenarios during all movements. The calculated ROM reached physiological levels during flexion and internal rotation movement; however, it exceeded physiological levels during external rotation. Patients, where implant-to-implant impingement was detected, reached higher ROMs than patients with bone-to-bone impingement. The proposed framework provides the capability to predict postoperative ROM of THRs.

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Effects of Self-stretching with Mobilization on Hip Range of Motion in Individuals with Hip Internal Rotation Deficits

Korean Academy of Clinical Movement Therapy ◽

10.52901/ppms.2021.1.1.43 ◽

2021 ◽

Vol 1 (1) ◽

pp. 45-53

Author(s):

Dong-Kyu Lee ◽

In-Joon Uh

Keyword(s):

Range Of Motion ◽

Internal Rotation ◽

Hip Range Of Motion ◽

Hip Internal Rotation

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GIRD syndrome in male handball and volleyball players: Is the decrease of total range of motion the turning point to pathology?

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-191767 ◽

2021 ◽

pp. 1-8

Author(s):

Jonas Schmalzl ◽

Helen Walter ◽

Wolfram Rothfischer ◽

Sören Blaich ◽

Christian Gerhardt ◽

...

Keyword(s):

Range Of Motion ◽

Internal Rotation ◽

Turning Point ◽

External Rotation ◽

Constant Score ◽

High Rate ◽

Overhead Athletes ◽

Glenohumeral Internal Rotation Deficit ◽

Total Range ◽

Volleyball Players

BACKGROUND: Adaptations in glenohumeral range of motion may affect overhead athletes and lead to shoulder pathologies. OBJECTIVE: The purpose of this study was to evaluate glenohumeral internal rotation deficit (GIRD) and postero-superior impingement among male handball and volleyball players and the relationship between these pathologies and training level (amateur vs. professional), position (attack vs. no attack), experience (> 5 years vs. < 5 years) and sports. METHODS: Sixty-seven handball players and 67 volleyball players with a mean age of 25 [± 5] years were included. The range of motion including external and internal rotation in 90∘ abduction of the dominant and non-dominant shoulder was measured of each examined athlete. Visual analogue scale, disabilities of the shoulder and hand score, constant score and subjective shoulder value were recorded. The athletes were examined for postero-superior impingement and abduction force was measured with an isokinetic dynamometer. RESULTS: Internal rotation was significantly lower and external rotation was significantly greater in the dominant arm for both sports. 72% presented with GIRD. GIRD was more prevalent in athletes active for > 5 years (odds ratio (OR) 3), in those training > 3 times per week (OR 1.4) and in handball players (OR 2.7). 24% presented with postero-superior impingement. Players active for > 5 years (OR 1.22), professionals (OR 1.14), volleyball players (OR 1.19), offensive players (OR 2.2) and athletes with GIRD > 10∘ (OR 1.5) showed a higher prevalence of postero-superior impingement. CONCLUSION: GIRD is a common phenomenon in handball and volleyball players. Offensive players are frequently suffering from postero-superior impingement. GIRD > 10∘ leads in nearly 75% of the athletes to a decrease of total range of motion and a high rate of postero-superior impingement. Thus, a decreased range of motion seems to be the turning point from adaptation to pathology. Therefore, regular controls of range of motion and countermeasures by means of stretching the posterior shoulder joint should be integrated in the training content.

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Total versus hemiarthroplasty for glenohumeral arthritis according to preoperative glenoid erosion

Orthopedic Reviews ◽

10.4081/or.2015.5923 ◽

2015 ◽

Vol 7 (2) ◽

Cited By ~ 3

Author(s):

Marc-Frederic Pastor ◽

Melena Kaufmann ◽

Andre Gettmann ◽

Mathias Wellmann ◽

Tomas Smith

Keyword(s):

Pain Relief ◽

Clinical Outcome ◽

Internal Rotation ◽

Constant Score ◽

Total Shoulder Arthroplasty ◽

Short Term ◽

Simple Shoulder Test ◽

Lower Pain ◽

Glenoid Erosion

Clinical studies on primary osteoarthritis have shown better results of total shoulder arthroplasty (TSA) compared to hemiarthroplasty (HA) regarding the function, revision rate and postoperative pain relief. However, a clear recommendation for implantation of TSA or HA, depending on the glenoid type of erosion, does not exist. The aim of the study was to compare the results of TSA and HA with respect to the preoperative glenoid type. In this study, 41 patients were examined retrospectively; among them, 25 patients were treated with stemmed anatomic TSA and 16 with stemmed anatomic HA. The degree of osteoarthritis was determined according to Samilson and the glenoid erosion was classified according to Walch. The clinical outcome of the patients was determined by using the Constant Score (CS) and the Simple Shoulder Test at final follow-up. Patients after TSA demonstrated a significantly improved internal rotation compared to HA patients. Patients with preoperative B1 glenoid showed better pain relief after TSA compared to HA. For patients with preoperative type A2 glenoid a significantly higher CS was found after TSA compared to HA. We were able to show good short-term results after TSA and HA. Our findings suggest a better internal rotation for TSA compared to HA, superior clinical outcome for patients with preoperative A2 glenoid and lower pain level for patients with a preoperative B1 glenoid. However, these results need to be confirmed by further studies.

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