Shoulder Kinematics and Symmetry at Different Load Intensities during Bench Press Exercise

This study aimed to analyze between-shoulder kinematics symmetry at different load intensities considering full range of movement (ROM), mean and maximum velocities (VMEAN, VMAX), and accelerations (AMEAN, AMAX) of shoulders during phases 2 (characterized by positive acceleration and negative velocity, eccentric) and 3 (characterized by positive acceleration and velocity, concentric) of bench press exercise (BP); as well as to compare unilateral kinematics variables between the different load intensity intervals. Twenty-seven participants were evaluated during phases 2 and 3 of BP at different load intervals: interval 1 (55–75% 1-repetition maximum: 1RM), interval 2 (75–85% 1RM) and interval 3 (85–100% 1RM). Kinematics variables were determined using the Xsens MVN Link System. Results showed that full ROM was higher in left than right shoulder at all intensities (p = 0.008–0.035). VMEAN, VMAX, AMEAN, and AMAX were different in both shoulders for interval 3 during phase 2 and were lower as load intensity increased in both shoulders (p = 0.001–0.029). During phase 3, only VMAX on interval 2 was different between shoulders. Moreover, VMEAN, VMAX, AMEAN, and AMAX were greater during interval 1 compared with the others in both shoulders (p = 0.001–0.029). Therefore, there exists a kinematics asymmetry between both shoulders during phases 2 and 3 of bench press, although the acceleration was similar during both phases at all load intensities. Moreover, kinematic parameters differ between loads of 55–75% RM compared to 75–100% RM loads.

Sensors for Wheelchair Tennis: Measuring Trunk and Shoulder Biomechanics and Upper Extremity Vibration during Backhand Stroke

This study was the first to compare the differences in trunk/shoulder kinematics and impact vibration of the upper extremity during backhand strokes in wheelchair tennis players and the able-bodied players relative to standing and sitting positions, adopting an electromagnetic system along with wearable tri-axial accelerometers upon target body segments. A total of 15 wheelchair tennis players and 15 able-bodied tennis players enrolled. Compared to players in standing positions, wheelchair players demonstrated significant larger forward trunk rotation in the pre-preparation, acceleration, and deceleration phase. Significant higher trunk angular velocity/acceleration and shoulder flexion/internal rotation angular velocity/acceleration were also found. When able-bodied players changed from standing to sitting positions, significant changes were observed in the degree of forward rotation of the trunk and shoulder external rotation. These indicated that when the functions of the lower limbs and trunk are lacking or cannot be used effectively, “biomechanical solutions” such as considerable reinforcing movements need to be made before the hitting movement. The differences between wheelchair tennis players and able-bodied players in sitting positions could represent the progress made as the wheelchair players evolve from novices to experts. Knowledge about how sport biomechanics change regarding specific disabilities can facilitate safe and inclusive participation in disability sports such as wheelchair tennis.

20 YEARS OF RSP – THE 5 MOST IMPORTANT LESSONS I’VE LEARNED

Introduction and aim This paper reports on 5 key aspects to consider when planning a successful RSA procedure, including patient selection, glenosphere positioning, glenoid fixation, humeral fixation, and soft tissue management/tensioning. Material, methods, results, and discussion Key in patient selection for RSA is understanding the relationship between indications, outcomes, patient mental state, and their expectations. When placing a glenosphere, prioritize sound principles of shoulder kinematics but always consider bone preservation and ease of placement. Glenoid fixation must take advantage of structural features of individual implant designs while factoring in specific-bone morphology/morphometry to optimize the resultant glenohumeral loading. For the stem, fixation prioritizes press-fit where bone quality and quantity permit. Always aim to achieve anatomical pivot point restoration with planning for stem position and avoid distalization that may lead to nerve injury and scapular spine fractures. Conclusions To increase the chances of a successful RSA procedure, a surgeon should emphasize picking the right patient, placing the implant in an optimum position, ensuring adequate glenoid and humeral fixation, and correctly balancing soft tissues. Keywords: reverse shoulder arthroplasty, surgeon education, patient optimization

Effects of Internal Fixation for Mid-Shaft Clavicle Fractures on Shoulder Kinematics During Humeral Elevations

BackgroundMid-shaft clavicle fractures account for 35 to 44% of injuries to the shoulder girdle. There is increasing evidence to support surgical repair, but poor functional outcomes have been reported, and associated factors remain unclear.MethodsThe three-dimensional poses of the shoulder bones during arm elevations were measured in 15 patients treated for mid-shaft clavicle fractures by open reduction and internal fixation, and in 15 healthy controls.Results and ConclusionNo significant between-side differences were found in the clavicle length after surgery (p > 0.05). The patients showed increased scapular protraction at lower elevation angles and reduced scapular retraction at higher elevation angles during frontal-plane elevations, with significantly reduced clavicle retraction (p < 0.05), with unaltered scapular rotation and tilt. The ranges of the observed changes were reduced to arm elevations at 60° and 90° in the scapular and sagittal planes. Similar changes were also found on the unaffected side, suggesting symmetrical bilateral compensation. The results suggest that shoulder kinematics in multi-plane arm elevations should be monitored for any signs of compromised bone motions following surgical treatment, and that rehabilitative training may be needed on both sides to improve the bilateral movement control of the shoulder complex.

Effect of Handrail Height and Age on Trunk and Shoulder Kinematics Following Perturbation-Evoked Grasping Reactions During Gait

Objective To characterize the effect of handrail height and age on trunk and shoulder kinematics, and concomitant handrail forces, on balance recovery reactions during gait. Background Falls are the leading cause of unintentional injury in adults in North America. Handrails can significantly enhance balance recovery and help individuals to avoid falls, provided that their design allows users across the lifespan to reach and grasp the rail after balance loss, and control their trunk by applying hand-contact forces to the rail. However, the effect of handrail height and age on trunk and shoulder kinematics when recovering from perturbations during gait is unknown. Method Fourteen younger and 13 older adults experienced balance loss (sudden platform translations) while walking beside a height-adjustable handrail. Handrail height was varied from 30 to 44 inches (76 to 112 cm). Trunk and shoulder kinematics were measured via 3D motion capture; applied handrail forces were collected from load cells mounted to the rail. Results As handrail height increased (up to 42 inches/107 cm), peak trunk angular displacement and velocity generally decreased, while shoulder elevation angles during reaching and peak handrail forces did not differ significantly between 36 and 42 inches (91 and 107 cm). Age was associated with reduced peak trunk angular displacements, but did not affect applied handrail forces. Conclusion Higher handrails (up to 42 inches) may be advantageous for trunk control when recovering from destabilizations during gait. Application Our results can inform building codes, workplace safety standards, and accessibility standards, for safer handrail design.

Design and Preliminary Evaluation of a Wearable Passive Cam-Based Shoulder Exoskeleton

BackgroundMechanically passive (i.e. spring-powered) exoskeletons may be a practical and affordable solution to meet a growing clinical need for continuous, home-based movement assistance. We designed, fabricated, and preliminarily evaluated the performance of a wearable, passive, cam-driven shoulder exoskeleton (WPCSE) prototype. MethodsThe novel feature of the WPCSE is a modular spring-cam-wheel module, which generates an assistive force that can be customized to compensate for any proportion of the shoulder elevation moment due to gravity. We performed a benchtop experiment to validate the mechanical output of the WPCSE against our theoretical model. We also conducted a pilot biomechanics study (four able-bodied subjects) to quantify the effect of a WPCSE prototype on muscle activity and shoulder kinematics during three one-degree-of-freedom shoulder movements. ResultsThe shoulder elevation moment produced by the spring-cam-wheel module alone closely matched the desired, theoretical moment. However, when measured from the full WPCSE prototype, the moment was lower (up to 30%) during positive shoulder elevation and higher (up to 120%) during negative shoulder elevation compared to the theoretical moment, due primarily to friction. Even so, a WPCSE prototype, compensating for about 25% of the shoulder elevation moment due to gravity, showed a trend of reducing root mean square (up to 50%) and peak (up to 53%) electromyogram magnitudes of several muscles crossing the shoulder during shoulder elevation and horizontal adduction/abduction movements. Subjects verbally reported that the WPCSE did not physically constrain them during the tested movements. ConclusionThe results provide proof-of-concept evidence that our WPCSE can potentially assist shoulder movements. The proposed WPCSE, once refined, could provide clinical and home-based rehabilitation for patients with shoulder disability.