Força dos Músculos Rotadores do Ombro em Indivíduos Saudáveis/ Rotator Cuff Muscle Strength in Healthy Individuals

1970 ◽  
Vol 1 (1) ◽  
pp. 78-82
Author(s):  
Paulo José Oliveira Cortez ◽  
José Elias Tomazini ◽  
Mauro Gonçalves
Keyword(s):  
Rotator Cuff ◽  
Muscle Strength ◽  
Internal Rotation ◽  
Upper Limb ◽  
Statistical Difference ◽  
External Rotation ◽  
Healthy Individuals ◽  
Average Strength ◽  
Strength Tests ◽  
The Right

Introdução: A diminuição da capacidade de exercer esforços por parte dos músculos rotadores pode criar uma variedade de problemas. O conhecimento preciso do nível de força muscular de um indivíduo é importante, tanto para a avaliação da capacidade funcional ocupacional, como para uma apropriada prescrição de exercícios atléticos e de reabilitação. Percebe-se escassez de informação sobre as articulações do ombro, bem como os fatores envolvidos na força muscular dessa região. O objetivo deste estudo foi comparar a força gerada pelos músculos do manguito rotador entre o membro superior direito e o membro superior esquerdo em indivíduos saudáveis. Métodos: Participaram do estudo 22 sujeitos do sexo masculino, com idade de 18 e 19 anos, militares, saudáveis e sem história clínica de patologia ortopédica ou qualquer tipo de lesão no sistema musculoesquelético. Foram aplicados dois testes de força: Rotação Interna e Rotação Externa. Resultado : A força média de rotação interna no membro superior direito (MSD) foi maior que a força média de rotação interna no membro superior esquerdo (MSE) (p=0,723) e a força de rotação externa no MSD foi menor que a força média de rotação externa no MSE (p=0,788). Não houve diferença estatística na comparação dos valores de força de todos os testes de força isométrica. Conclusão: Para amostra estudada e metodologia utilizada na avaliação da força muscular, não houve diferença estatística na comparação da força gerada pelos músculos do manguito rotador do membro superior direito e do membro superior esquerdo.Rotator Cuff Muscle Strength in Healthy Individuals Introduction: Decreased ability to exert efforts by the rotator muscles can create a variety of problems. The precise knowledge of the level of muscular strength of an individual is important for both the functional capacity evaluation for occupational as an appropriate exercise prescription and rehabilitation of athletic. It is perceived scarcity of information on the shoulder joints as well as factors involved in muscle strength in this region. Objective: Develop a device for measuring the strength generated by the muscles of the upper limbs and the verification of efficiency and adaptability of this device through a comparative study of muscle strength in healthy subjects. Methods: The study included 22 male subjects, aged 18 and 19 years, military personnel, body mass between 57.7 and 93 kg (71.8 ± 9.45 kg) and height between 1.67 and 1.90 m (1.75 ± 0.06 m), healthy and without a history of orthopaedic disease or any kind of damage to the musculoskeletal system. Three strength tests were applied: Internal Rotation and External Rotation. For each type of effort three maximum voluntary contractions were required for 10 seconds, with an interval of 30 seconds between each contraction.  Results: Internal rotation in the right upper limb (RUL) was higher than the average strength of internal rotation in the left upper limb (LUL) (p = 0, 723) and the external rotation strength in RUL was lower than the average strength of external rotation in the LUL (p=0,788).  No statistical difference in comparing the strength values of all isometric strength tests. Conclusion: For sample and methodology used to assess muscle strength, there was no statistical difference in comparing the force generated by the muscles of the rotator cuff of the right and left upper limb.

scholarly journals Delayed Rehabilitation Protocol after Rotator Cuff Repair

Osteology ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 29-38
Author(s):  
Alessandra Berton ◽  
Sergio De Salvatore ◽  
Vincenzo Candela ◽  
Gabriele Cortina ◽  
Daniela Lo Presti ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Muscle Strength ◽  
Internal Rotation ◽  
Outcome Measures ◽  
Rotator Cuff Repair ◽  
External Rotation ◽  
Shoulder Function ◽  
Rehabilitation Protocol ◽  
Patient Reported ◽  
Cuff Repair

Rotator cuff tears are a frequent cause of shoulder pain that often require arthroscopic repair. After surgery an intense and well-studied rehabilitation protocol is needed to obtain the complete recovery of shoulder function. Fifty patients, who sustained arthroscopic rotator cuff repair for symptomatic, atraumatic and full-thickness supraspinatus tendon tear, were involved. According to our rehabilitation protocol, during the first four postoperative weeks, the arm was supported with an abduction sling pillow, and pendulum exercises, table slide and active elbow extension and flexion were conceded. Outcome measures (Oxford shoulder score (OSS), simple shoulder test (SST), patient-reported satisfaction), shoulder function (range of motion (ROM) and muscle strength), and MRI examination were evaluated. The mean OSS score and SST score increased from 16 to 30.2 and from 5.3 to 11.4, respectively. Patient-reported satisfaction was 96%. At 12 months, patients improved ROM and muscle strength. Postoperative passive anterior elevation was 176; external rotation averaged 47; internal rotation was 90. Postoperative muscle strength during anterior elevation was 8.3 ± 2.2 kg, internal rotation 6.8 ± 3 kg, external rotation 5.5 ± 2.3 kg. Five out of seven patients with recurrent tears evaluated their results as satisfactory. They reported improvements in terms of OSS and SST mean scores despite recurrent tears; therefore, they did not undergo revision surgery. The delayed postoperative physical therapy protocol was associated with improvements in the outcome measures and shoulder function compared to the preoperatory state and rotator cuff healing demonstrated by MRI.

scholarly journals Comparison Between Strength of Muscles Rotating the Knee in Healthy Individuals and Patients one Year after an ACL Reconstruction

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0014
Author(s):  
Marcın Popieluch ◽  
Robert Śmigıelski ◽  
Darıusz Straszewski ◽  
Marcın Plenzler ◽  
Mıchał Stanıszewski
Keyword(s):  
Muscle Strength ◽  
Internal Rotation ◽  
Acl Reconstruction ◽  
Lower Leg ◽  
Control Group ◽  
Special Device ◽  
Healthy Individuals ◽  
Static State ◽  
Significant Difference ◽  
The Right

Objectives: In this study we have made an attempt to establish torque value of the muscles rotating the knee of patients who had ruptured their ACLs during an amateur football practise on an artificial turf. In this study we presented biomechanical research on torques of muscles responsible for internal and external rotation of the lower leg. We presented a method whereby it is possible to measure the muscle strength before and after the ACL rupture but also during the process of rehabilitation and after its finish. The available literature on measurements of torque of the knee is quite extensive though it mainly describes torques of muscles flexing and extending the joint. In Polish literature there is scarcity of studies focused on torques of muscles rotating the knee. In foreign literature there is an increasing emphasis on the role of lower leg rotation, as the element greatly impacting, for instance, the position of the foot. Methods: The study presents results of 22 patients and 50 healthy individuals (not practising any particular sport regularly) being the control group. All patients had their ACLs reconstructed using the double-bundle technique. The material for the graft was obtained from the hamstrings. The aim was to measure the maximal torque of the muscles responsible for external and internal rotation of the knee (lower leg in a static state using a special device). The device allowed measurement of the torque of muscles rotating the lower leg in its axis by stabilizing the ankle with special emphasis on foot mounting (stabilization of footwear). The special device was connected to a PC with CPS/HMF software. The software enabled observation and recording of increase in the value of the torque until it reached its maximum. The measurements were taken in two knee positions: 30 degrees and 90 degrees flexion. Results: The result were analyzed statistically, means and SDs were calculated. Only right-legged subjects were included in the analysis. The Shapiro-Wilk test was used to test normality of the distribution. Some of the data did not have a normal distribution so in order to compare results of different groups a non-parametric Mann–Whitney U test was used. The groups differed significantly in terms of age (p=0.001), did not differ in terms of body height (p=0.529) or mass (p=0.233). Statistically significant differences (p<0.001) were marked by an asterix symbol (*). Each measurement of the left and right leg was also compared between the groups. The Kruskal–Wallis one-way analysis of variance by ranks was used and significant differences were those with p<0.001. When analyzing it has been noted that there was a statistically significant difference (p<0.001) between the torque value of muscles responsible for internal rotation (S40) when examining the right limb (after ACL reconstruction) in both groups. Significant differences were observed in all starting positions, as well as in both degrees of flexion – 30 and 900. Deficit of muscle strength on the right side – the injured one – when compared to the left was sometimes as high as 30%. Conclusion: 1. Near 30% deficit of strength of muscles responsible for internal rotation of the knee indicates that the knee is rotationally unstable after a year from the surgery. 2. Based on the fact that using the hamstrings tendons – responsible for internal rotation of the knee – in order to reconstruct the ACL, poses a risk of rotational instability of the joint for as long as a year after the procedure, the rehabilitation protocol for such patients should be adjusted or completely changed.

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°.

Chronic Adaptations of the Posterior Rotator Cuff in Professional Pitchers

2021 ◽  
pp. 036354652098868
Author(s):  
Stephen J. Thomas ◽  
Justin Cobb ◽  
Scott Sheridan ◽  
Joseph Rauch ◽  
Ryan W. Paul
Keyword(s):  
Soft Tissue ◽  
Rotator Cuff ◽  
Internal Rotation ◽  
External Rotation ◽  
Negative Relationship ◽  
Muscle Thickness ◽  
Pennation Angle ◽  
Muscle Architecture ◽  
Infraspinatus Muscle ◽  
Teres Minor

Background: Because of the large forces and high frequency of throwing, the upper extremity experiences repetitive stresses that lead to acute and chronic adaptations. While the importance of pennation angle and muscle thickness as predictors of muscle force production has been shown in other populations and other joints, there has been little research done that examines these variables in the shoulders of baseball players. Purpose: (1) To examine the chronic effect pitching has on the rotator cuff muscle architecture (pennation angle and muscle thickness) in healthy professional baseball pitchers, and (2) to examine the correlation between muscle architecture and clinical measures of strength and range of motion (ROM). Study Design: Cross-sectional study; Level of evidence, 3. Methods: Twenty-eight healthy professional pitchers were recruited during the 2019 spring training. Internal rotation (IR) and external rotation (ER) strength were measured with a handheld dynamometer and IR and ER ROM were measured with an inclinometer. A diagnostic ultrasound machine was utilized to capture images of humeral retroversion, as well as the pennation angle and muscle thickness of the infraspinatus and teres minor muscles. ImageJ software was used to quantify the pennation angle and muscle thickness. Results: There were no significant differences between the dominant and nondominant arms for ER or IR strength. Also, no pennation angle and muscle thickness differences were found between the dominant and nondominant arms. A weak positive relationship between infraspinatus muscle thickness (superficial and total) and ER strength ( P = .016, R = 0.287 and P = .009, R = 0.316) and a moderate negative relationship between soft tissue glenohumeral internal rotation deficit (GIRD) and the bilateral difference of the teres minor deep pennation angle ( R = −0.477, P = .008) were observed. No other significant relationships were noted. Conclusion: Our results are contrary to current literature as we expected to see a stronger dominant arm, with a larger pennation angle and greater muscle thickness. Interestingly, we found that ER strength was positively related to only the thickness of the infraspinatus muscle, and that soft tissue GIRD was positively related to only the side-to-side adaptation of the pennation angle within the deep portion of the teres minor. This suggests that when posterior shoulder tightness occurs, specifically the architecture of the teres minor muscle is involved. However, the organization to which these players belonged has a very extensive training protocol throughout the year that emphasizes bilateral training during a large majority of the exercises. Therefore, the results may not be generalizable to all professional players.

Rotator Cuff Training for Pitchers

1998 ◽  
Vol 7 (4) ◽  
pp. 285-299 ◽  
Author(s):  
Michael E. Powers
Keyword(s):  
Rotator Cuff ◽  
Internal Rotation ◽  
High Speed ◽  
External Rotation ◽  
Shoulder Abduction ◽  
Muscular Endurance ◽  
Shoulder Injuries ◽  
Three Stages ◽  
Two Stages

This paper reviews the role of the rotator cuff during two key phases of the pitching sequence and presents a training program for these muscles. The program uses a periodization design consisting of three stages, beginning with a high-resistance/low-repetition eccentric strengthening stage. This is followed by a low-resistance/high-repetition stage for training muscular endurance. The core exercises for these two stages are prone external rotation in the 90/90 position, prone horizontal abduction, side-lying D2 flexion pattern, supine internal rotation in the 90/90 position, prone elevation with 100° of shoulder abduction and external rotation, and standing scapular plane elevation. The final stage of the program uses high-speed functional exercises: 90/90 external rotation, 90/90 internal rotation, D2 PNF flexion pattern, D2 PNF extension pattern, supine plyometric 90/90 internal rotation with a medicine ball, and the “arm whip” through the D2 PNF flexion pattern. The goal of this program is to prepare the muscles for the stresses of pitching and prevent shoulder injuries.

scholarly journals Adhesive Capsulitis of the Shoulder in Patients with Diabetes

2014 ◽  
Vol 4 (1) ◽  
pp. 24-26
Keyword(s):  
Rotator Cuff ◽  
Internal Rotation ◽  
Adhesive Capsulitis ◽  
Symptomatic Improvement ◽  
Diabetic Patients ◽  
Imaging Studies ◽  
Level Of Evidence ◽  
Forward Flexion ◽  
Patients With Diabetes ◽  
The Right

ABSTRACT Background Adhesive capsulitis of the shoulder is common in patients with diabetes. The exact etiology is unknown. The aim of this study is to evaluate the results of subacromial bursal corticosteroid injections and a home program of Codman's exercises in a cohort of diabetic patients with adhesive capsulitis. Materials and methods Twelve diabetic patients with adhesive capsulitis treated from November, 2011 to February, 2013 in an outpatient clinic were evaluated. The age range was 40 to 64 years with a mean age of 52. There were six males and six females. Six patients had involvement of the right shoulder, four had involvement of the left and two patients had bilateral shoulder involvement. The dominate upper extremity was affected in nine patients. There were 11 patients with type 2 diabetes and one with type 1 diabetes. All patients had an insidious onset of pain and stiffness in the affected shoulder. There was poorly localized tenderness about the shoulder with restricted abduction, forward flexion and internal rotation limited to the level of the buttocks or below. There were abnormal imaging studies in seven of the 12 patients. Five patients did not have imaging studies. Edema and thickening of rotator cuff tissue was the most frequent finding on magnetic resonance imaging (MRI). There was one small rotator cuff tear and one small labral tear. Patients were treated with a subacromial bursal space injection with 2 to 3 ml of 2% lidocaine and one milliliter of betamethasone sodium phosphate and sodium acetate (6 mg/ ml). Following the injection, passive stretching of the involved shoulder was done for a few minutes. The patients were instructed in Codman's exercises and wall climbing. Results Good pain relief was experienced by 11 patients with only fair relief in one. The average range of motion post-treatment was greater than 110° forward flexion and greater than 140° abduction. Internal rotation was possible to the L3 level. Two patients had a recurrence of symptoms at 6 and 12 months, and both were treated with reinjection and subsequent symptomatic improvement. There were no complications, though some patients had a transient rise in their blood sugar following injection. Conclusion Subacromial bursal injections coupled with Codman's exercises are effective in treating adhesive capsulitis of the shoulder in diabetic patients. Level of evidence IV Nasca RJ. Adhesive Capsulitis of the Shoulder in Patients with Diabetes. The Duke Orthop J 2014;4(1):24-26.

scholarly journals Comparison of Shoulder Functions Between Workers With and Without Shoulder Impingement Syndrome

2020 ◽  
Author(s):  
Jun-hee Kim ◽  
Oh-yun Kwon ◽  
Chung-hwi Yi ◽  
Hye-seon Jeon ◽  
Woo-chol Joseph Choi ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Internal Rotation ◽  
External Rotation ◽  
Impingement Syndrome ◽  
Shoulder Abduction ◽  
Shoulder Impingement Syndrome ◽  
Asymmetry Ratio ◽  
Shoulder Injuries ◽  
Shoulder Impingement ◽  
The Asymmetry

The occurrence of shoulder impingement syndrome (SIS) is associated with the frequent handling and lifting of heavy loads and excessive repetitive work above the shoulder level. Thus, assembly workers have a high prevalence of shoulder injuries, including SIS. The purpose of this study was to investigate differences in shoulder ROM, muscle strength, asymmetry ratio, function, productivity, and depression between workers with and without SIS.Sixty-seven assembly line male workers (35 workers with SIS and 32 workers without SIS) participated in this study. The four shoulder ROMs and the five muscle strengths were measured using a Smart KEMA system. The asymmetry ratios were calculated using the asymmetry ratio formula; shoulder functions were measured using the shoulder pain and disability index (SPADI), disabilities of the arm, shoulder, and hand (DASH), and visual analogue scale (VAS); and Endicott work productivity scale (EWPS). Severity of depression was measured using the Beck depression inventory (BDI). Independent t-tests were performed for statistical analysis.The SPADI, DASH, and VAS values of workers with SIS were significantly higher than those of workers without SIS. Also, workers with SIS had significantly smaller shoulder internal rotation and shoulder abduction compared to workers without SIS. In addition, workers with SIS exhibited significantly lower SIR muscle strength than workers without SIS. Workers with SIS had significantly higher asymmetry ratios in shoulder internal rotation, shoulder external rotation, and elbow flexion muscle strength than workers without SIS.The SPADI and DASH scores, which indicate shoulder function, were higher, and the intensity of self-aware pain was higher in workers with SIS. Also, workers with SIS exhibited reduced SIR and SAB ROMs; decreased SIR muscle strength. Particularly, the asymmetry ratios of SIR, SER, EF muscle strength are good comparable factors for workers with and without SIS. In addition, the asymmetry ratios of shoulder muscle strengths could provide an important baseline comparison for the workers with SIS.

scholarly journals The immediate effect of ipsilateral and contralateral sacroiliac joint manipulation on the hip range of motion and kicking velocity in soccer players

2015 ◽  
Author(s):  
◽  
Zia ul Mustafa Rehman
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Sacroiliac Joint ◽  
Ordinal Data ◽  
External Rotation ◽  
Intervention Group ◽  
Soccer Players ◽  
Hip Range Of Motion ◽  
Flexion Extension ◽  
The Right

Background There is a close biomechanical relationship that exists between the sacroiliac and hip joints. It is essential to have optimum hip range of motion originating from the pelvis in both the kicking and support limbs as both limbs play a role in achieving a high speed kicking velocity. Due to the strenuous activity of soccer players, both hip ranges of motion may be decreased, thus predisposing the player to injuries. This may also affect the kicking velocity. The effects of sacroiliac joint manipulation on hip range of motion and kicking velocity were investigated. Objectives The objective of this study was to determine the effect of ipsilateral sacroiliac joint manipulation versus contralateral sacroiliac joint manipulation on bilateral hip range of motion and kicking velocity. Methods There were three groups of twenty soccer players. The ipsilateral sacroiliac joint manipulation group, the contralateral sacroiliac joint manipulation group, and the sham laser intervention group. The case history, physical, regional, lumbar and hip exams were done in the Chiropractic Day Clinic. The hip ranges of motion were measured pre- and post- Chiropractic manipulation in all three groups on both limbs in the Fred Crookes Sports Centre (Durban University of Technology). Hip ranges of motion were measured by the Saunders (The Saunders Group, Chaska, MN) digital inclinometer. The kicking velocity of all players were measured pre- and post- manipulation by a speed sport radar gun (Bushnell Speedster Speed Gun; Bushnell Inc, Lenexa, KS). This was a purposive, investigational study trial where the data was reduced and analysed with the help of a statistician, using the statistical software SPSS version 20.0.The statistical aspect of the research encompassed the following: descriptive statistics used Fischer values, Eta tests, frequency, cross-tabulation tables and various types of graphs (bar charts, scatter graphs etc.); Inferential statistics used Pearson’s and/or Spearman’s correlations at a significance level of 0.05; testing of hypotheses used chi-square tests for nominal data and ordinal data at a level of significance of 0.05. Results The ipsilateral group showed statistically significant results for the right hip in flexion, extension, internal rotation and external rotation, as well as for extension, internal rotation and external rotation in the left hip. The contralateral group showed statistically significant results for the right hip in extension, internal rotation and external rotation, as well as for extension and internal rotation in the left hip. There was a statistically significant improvement in the kicking velocity of the ipsilateral and contralateral group after treatment. There was a strong association between the perception changes to the actual kicking velocity in the soccer players. There was a correlation between the change in hip range of motion and change in kicking velocity, however statistically it was not significant. Conclusion The manipulation of ipsilateral or contralateral sacroiliac joint has an effect on the right and left hip range of motion

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 Evaluation of rotator cuff muscle strength in healthy individuals

2015 ◽  
Vol 23 (3) ◽  
pp. 142-145
Author(s):  
Paulo José Oliveira Cortez ◽  
José Elias Tomazini
Keyword(s):  
Rotator Cuff ◽  
Muscle Strength ◽  
Healthy Individuals ◽  
Rotator Cuff Muscle
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