Shoulder Elevation
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2022 ◽  
Vol 98 ◽  
pp. 103591
Tasha C. McFarland ◽  
Alison C. McDonald ◽  
Rachel L. Whittaker ◽  
Jack P. Callaghan ◽  
Clark R. Dickerson

Akira Sugi ◽  
Keisuke Matsuki ◽  
Ryunosuke Fukushi ◽  
Takeshi Shimoto ◽  
Toshiaki Hirose ◽  

2021 ◽  
Vol 9 (8) ◽  
pp. 232596712098520
Cetin Sayaca ◽  
Miray Unal ◽  
Mahmut Calik ◽  
Filiz Erdem Eyuboglu ◽  
Defne Kaya ◽  

Background: Scapular kinesia is an important component of glenohumeral rhythm and shoulder stability. No studies have evaluated scapular dyskinesis and its relationship to shoulder proprioception in patients who have undergone arthroscopic Bankart repair (ABR). Purpose: To investigate scapular dyskinesis, proprioception, and functional level after ABR. Study Design: Cohort study; Level of evidence, 3. Methods: This study included 13 male patients who underwent ABR (ABR group; mean age, 30 years; range, 24-36 years) and 13 sex- and age-matched healthy individuals (control group). The age, height, weight, and dominant side of all participants were collected. Scapular dyskinesis was evaluated using the lateral scapular slide test and the scapular dyskinesis test; proprioception was measured by the active angle reproduction test using a smartphone goniometer application, and functional level was assessed using the upper-quarter Y-balance test for dynamic stability as well as the Rowe score and Walch-Duplay score for quality of life and return to activities of daily living. Results: The presence of static scapular dyskinesis in the neutral position, at 45° of abduction, and at 90° of abduction as well as the presence of dynamic scapular dyskinesis was higher in the ABR group compared with the control group ( P ≤ .04 for all). Shoulder joint position sense (absolute error) at 40° and 100° of shoulder elevation and shoulder functional level according to the Rowe score were worse in the ABR patients compared with the healthy controls ( P ≤ .02 for all). Dynamic scapular dyskinesis was negatively related to shoulder joint position sense at 40° of shoulder elevation ( r = –0.64; P = .01). Static scapular movement as measured on the lateral scapular slide test was moderately related to the Rowe score ( r = 0.58; P = .03). Conclusion: Scapular kinematics and proprioception should be evaluated after ABR. Treatment approaches to improve scapular control and proprioceptive sense should be included in the rehabilitation program for patients after ABR.

2021 ◽  
Morteza Asgari ◽  
Elizabeth A. Phillips ◽  
Britt M. Dalton ◽  
Jennifer L. Rudl ◽  
Dustin L. Crouch

Abstract 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.

2021 ◽  
Vol 14 (3) ◽  
pp. e240234
Satoshi Oki ◽  
Ryogo Furuhata ◽  
Yusuke Sakamoto ◽  
Shohei Iwabu

A 44-year-old woman with distal clavicular malunion and scapular dyskinesis, causing limited shoulder elevation, underwent clavicular osteotomy 2 years postinjury. We used three-dimensional (3D) surface data from both injured and intact sides for correction of the distal clavicular shape by closing wedge osteotomy. The plate position and screw directions were decided preoperatively. Surgery was performed with reference to a 3D-printed, reduced model. Range of shoulder motion and scapular dyskinesis improved by 1 year postoperatively. Precise corrective osteotomy for distal clavicular malunion, referencing a 3D-printed, reduced model, improved scapular dyskinesis and range of shoulder motion 2 years postinjury.

2021 ◽  
pp. 003151252199304
David Phillips ◽  
Albena Zahariev ◽  
Andrew Karduna

Joint position sense (JPS) is commonly evaluated using an angle replication protocol with vision occluded. However, multiple sources of sensory information are integrated when moving limbs accurately, not just proprioception. The purpose of this study was to examine different availability of vision during an active JPS protocol at the shoulder. Specifically, the effects of four conditions of vision availability were examined for three target shoulder elevation angles (50°, 70° & 90°): vision occluded continuously (P-P); vision available continuously (VP-VP); vision occluded only during target memorization (P-VP); and vision occluded only during target position replication (VP-P). There were 18 participants ( M age = 21, SD = 1 years). We used separate repeated ANOVAs to examine the effect of condition and target angle on participants’ absolute error (AE, a measure of accuracy) and constant error (CE, a measure of directional bias). We found a significant main effect for condition and angle for both dependent variables ( p < 0.01), and follow-up analysis indicated that participants were most accurate in the VP-VP condition and least accurate in the P-VP condition. Further follow-up analysis showed that accuracy improved with higher target elevation angles, consistent with previous research findings. Constant error results were similar, as there was a prominent tendency to overshoot the target. Unsurprisingly, participants performed best at the angle replication protocol with their eyes open. However, while accuracy was reduced when vision was occluded during target memorization, it was restored during target replication. This finding may have indicated an accuracy cost due to introduced noise when transforming sensory information from a proprioceptive reference frame into a visual reference frame.

2020 ◽  
Vol 80 ◽  
pp. 105160
Hiroki Miyamoto ◽  
Kota Watanabe ◽  
Atsushi Teramoto ◽  
Naoya Iida ◽  
Tatsuya Taniguchi ◽  

2020 ◽  
Vol 8 ◽  
Mike Murray ◽  
Britt Lange ◽  
Karen Søgaard ◽  
Gisela Sjøgaard

Introduction: This study presents secondary outcome analyses, in terms of muscle function [i.e., maximal voluntary contraction (MVC) and rate of torque development (RTD)] from a parallel group, single blinded, randomized controlled trial introducing a physical exercise training intervention aiming to reduce neck pain among military helicopter pilots and crew-members.Methods: Participants (50 pilots, 58 crew-members) were recruited from the Royal Danish Air Force and randomized to either an exercise-training-group (ETG; n = 35) or a reference-group (REF; n = 34). Participants in ETG received 20 weeks of self-administered exercise training specifically tailored to target the neck and shoulder muscles. REF received no training. Outcome: (1) MVC was measured for cervical extension and flexion as well as shoulder elevation and abduction, (2) RTD was measured for cervical extension and flexion. Adherence to training was self-reported and categorized as regular if performed at least once a week.Results: MVC for cervical extension was significantly increased at follow-up in ETG (37.5 ± 11.2 Nm at baseline, change: 2.1 ± 8.3 Nm) compared to REF (38.1 ± 10.7 Nm at baseline, change: −2.4 ± 6.8 Nm) according to intension-to-treat analysis (p = 0.018). Likewise, RTD was significantly increased in ETG for cervical extension (149.6 ± 63.3 Nm/s at baseline, change: 14.7 ± 49.0 Nm/s) compared to REF (165.4 ± 84.7 Nm/s at baseline, change: −16.9±70.9 Nm/s) (p = 0.034). The cervical extension/flexion MVC-ratio was significantly different at follow-up (p = 0.039) between ETG (1.5 ± 0.5 at baseline, change: −0.0 ± 0.3) compared to REF (1.5 ± 0.5 at baseline, change: −0.2 ± 0.4). Per-protocol analysis of MVC, including only participants in ETG with regular training adherence (n = 10), showed a significant increase for cervical extension (33.2 ± 7.3 Nm at baseline, change: 6.0 ± 5.4 Nm) and shoulder elevation right side (143.0 ± 25.8 Nm at baseline, change: 15.8 ± 18.1 Nm).Conclusion: Physical exercise training significantly improved MVC and RTD in the upper neck extensors. Only approximately 1/3 of participants in ETG adhered to training regularly, which likely attenuated the effectiveness of the training intervention on neck and shoulder muscle function. Future studies should focus on the practical implementation of self-administered exercise training to improve adherence.

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