Electromyographic analysis of the infraspinatus and scapular stabilizing muscles during isometric shoulder external rotation at various shoulder elevation angles

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.

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Electromyographic Analysis of the Rotator Cuff and Deltoid Musculature During Common Shoulder External Rotation Exercises

Journal of Orthopaedic and Sports Physical Therapy ◽

10.2519/jospt.2004.34.7.385 ◽

2004 ◽

Vol 34 (7) ◽

pp. 385-394 ◽

Cited By ~ 201

Author(s):

Michael M. Reinold ◽

Kevin E. Wilk ◽

Glenn S. Fleisig ◽

Nigel Zheng ◽

Steven W. Barrentine ◽

...

Keyword(s):

Rotator Cuff ◽

External Rotation ◽

Shoulder External Rotation ◽

Electromyographic Analysis

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Electromyographic Analysis and Phase Definition of the Overhead Football Throw

The American Journal of Sports Medicine ◽

10.1177/03635465020300061401 ◽

2002 ◽

Vol 30 (6) ◽

pp. 837-844 ◽

Cited By ~ 52

Author(s):

Bryan T. Kelly ◽

Sherry I. Backus ◽

Russell F. Warren ◽

Riley J. Williams

Keyword(s):

Internal Rotation ◽

Motion Analysis ◽

Muscle Activation ◽

External Rotation ◽

Shoulder Abduction ◽

Activation Patterns ◽

Muscle Activation Patterns ◽

Ball Release ◽

Shoulder External Rotation ◽

Electromyographic Analysis

Background The phases of the football throw need definition so that muscle activation patterns during the overhead football throw can be fully described. Hypothesis Electromyographic analysis of shoulder musculature can better define muscle activation patterns during the football throw. Study Design Descriptive anatomic study. Methods Videos of 20 elite-level quarterbacks were reviewed to define phases of the overhead football throw; 14 recreational male athletes underwent electromyography and motion analysis testing. Results Four sequential phases of the football throw were consistently observed. Early cocking (49% ± 11% of throw) was initiated at rear foot plant and continued to maximal shoulder abduction and internal rotation. Late cocking (20% ± 6%) started at maximal shoulder abduction and internal rotation and ended with maximal shoulder external rotation. The acceleration phase (15% ± 4%) began with maximal shoulder external rotation and ended with ball release. Follow-through (16% ± 5%) was defined as the phase from ball release to maximal horizontal adduction (across the body). Conclusion The four phases demonstrated little variation in motion analysis and electromyographic activation between subjects and were associated with muscle activation patterns consistent with upper extremity movements. Clinical Relevance A clearer understanding of muscle activation patterns may help to explain patterns of muscle injury and improve rehabilitation protocols in football-throwing athletes.

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ELECTROMYOGRAPHIC ANALYSIS OF SHOULDER MUSCLES DURING SHOULDER EXTERNAL ROTATION WITH REFERENCE TO LOAD MAGNITUDE

Japanese Journal of Physical Fitness and Sports Medicine ◽

10.7600/jspfsm1949.49.481 ◽

2000 ◽

Vol 49 (4) ◽

pp. 481-493 ◽

Cited By ~ 2

Author(s):

NORITOSHI SUZUKI ◽

TOMOHIRO KIZUKA ◽

HIROSHI NOGUCHI ◽

SHINOBU TANAKA ◽

HITOSHI SHIMOJO ◽

...

Keyword(s):

External Rotation ◽

Shoulder Muscles ◽

Shoulder External Rotation ◽

Electromyographic Analysis

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

Journal of Neurosurgery Pediatrics ◽

10.3171/2020.6.peds2027 ◽

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.

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Nerve Transfer Is Superior to Nerve Grafting for Suprascapular Nerve Reconstruction in Obstetrical Brachial Plexus Birth Injury: A Meta-Analysis

Hand ◽

10.1177/15589447211030691 ◽

2021 ◽

pp. 155894472110306

Author(s):

Kevin J. Nickel ◽

Alexander Morzycki ◽

Ralph Hsiao ◽

Michael J. Morhart ◽

Jaret L. Olson

Keyword(s):

Brachial Plexus ◽

Brachial Plexus Injury ◽

External Rotation ◽

Nerve Transfer ◽

Suprascapular Nerve ◽

Cochrane Library ◽

Nerve Grafting ◽

Level Of Evidence ◽

Optimal Method ◽

Shoulder External Rotation

Background Restoration of shoulder function in obstetrical brachial plexus injury is paramount. There remains debate as to the optimal method of upper trunk reconstruction. The purpose of this study was to test the hypothesis that spinal accessory nerve to suprascapular nerve transfer leads to improved shoulder external rotation relative to sural nerve grafting. Methods A systematic review of Medline, EMBASE, EBSCO CINAHL, SCOPUS, Cochrane Library, and TRIP Pro from inception was conducted. Our primary outcome was shoulder external rotation. Results Four studies were included. Nerve transfer was associated with greater shoulder external rotation relative to nerve grafting (mean difference: 0.82 AMS 95% confidence interval [CI]: 0.27-1.36, P < .005). Patients undergoing nerve grafting were more likely to undergo a secondary shoulder stabilizing procedure (odds ratio [OR]: 1.27, 95% CI: 0.8376-1.9268). Conclusion In obstetrical brachial plexus injury, nerve transfer is associated with improved shoulder external rotation and a lower rate of secondary shoulder surgery. Level of Evidence Level III; Therapeutic

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

Journal of Shoulder and Elbow Arthroplasty ◽

10.1177/2471549219831527 ◽

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.

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Kinematic determinants of performance parameters during golf swing

Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine ◽

10.1177/0954411919838643 ◽

2019 ◽

Vol 233 (5) ◽

pp. 554-561 ◽

Cited By ~ 2

Author(s):

Batbayar Khuyagbaatar ◽

Tserenchimed Purevsuren ◽

Yoon Hyuk Kim

Keyword(s):

External Rotation ◽

Three Dimensional ◽

Left Knee ◽

Performance Parameters ◽

Joint Angles ◽

Lower Trunk ◽

Left Elbow ◽

Posterior Tilt ◽

Shoulder External Rotation ◽

Measures Of Performance

In golf, the trunk and pelvis kinematic variables are often related to measures of performance due to the highly complex and multi-joint movements involved in swings. However, it is unclear how specific body segments or joints contributed to the golf performance parameters. Therefore, the purpose of this study was to identify the key joints, including those of the upper and lower trunk, that are associated with golf performance parameters, such as X-Factor and pelvis motion. A motion capture system was used to obtain three-dimensional kinematics of golf swings performed by 10 low handicap male golfers. Based on regression analysis, right knee adduction, right shoulder external rotation and left elbow extension in ball address to top of the backswing and left knee adduction and lower trunk right bending with left rotation in top of the backswing to end of follow-through were presented as predictor variables for the X-Factor. For pelvis movement, a greater number of joint angles were associated with pelvis posterior tilt during backswing and pelvis motion to target with right rotation during downswing/follow-through. This study provides fundamental details of the movement mechanisms of major joints, as well as their relationships with performance parameters. Such understanding can be combined with training to improve the golfing skill and prevent possible injuries.

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Latissimus Dorsi Transfer for External Rotation Weakness of the Shoulder in Obstetric Brachial Plexus Palsy

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(02)00393-5 ◽

2003 ◽

Vol 28 (5) ◽

pp. 405-408 ◽

Cited By ~ 14

Author(s):

M. M. Al-QATTAN

Keyword(s):

Brachial Plexus ◽

Latissimus Dorsi ◽

External Rotation ◽

Skeletal Development ◽

Shoulder Abduction ◽

Brachial Plexus Palsy ◽

Obstetric Brachial Plexus Palsy ◽

Latissimus Dorsi Transfer ◽

Obstetric Brachial Plexus ◽

Shoulder External Rotation

This report describes the results of latissimus dorsi transfer for weakness of shoulder external rotation in 12 children with obstetric brachial plexus palsy. Selection criteria for the muscle transfer procedure included good passive external rotation of the shoulder, normal skeletal development of the shoulder joint, and adequate power of the deltoid. In addition to measuring the ranges of motion of joints before and after surgery, a modified Mallet grading system was utilized for the functional assessment of shoulder external rotation. At a mean follow-up of 4 years, two of the 12 children had recurrence of the shoulder deformity. In the remaining 10 children, the mean active external rotation was 30° (range, 20–60°), mean shoulder abduction was 140° (range, 90–170°), and all children had achieved a modified Mallet score of 4.

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