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Sample records for shoulder clod arm

  1. Beef customer satisfaction: factors affecting consumer evaluations of clod steaks.

    Science.gov (United States)

    Goodson, K J; Morgan, W W; Reagan, J O; Gwartney, B L; Courington, S M; Wise, J W; Savell, J W

    2002-02-01

    An in-home beef study evaluated consumer ratings of clod steaks (n = 1,264) as influenced by USDA quality grade (Top Choice, Low Choice, High Select, and Low Select), city (Chicago and Philadelphia), consumer segment (Beef Loyals, who are heavy consumers of beef; Budget Rotators, who are cost-driven and split meat consumption between beef and chicken; and Variety Rotators, who have higher incomes and education and split their meat consumption among beef, poultry, and other foods), degree of doneness, and cooking method. Consumers evaluated each steak for Overall Like, Tenderness, Juiciness, Flavor Like, and Flavor Amount using 10-point scales. Grilling was the predominant cooking method used, and steaks were cooked to medium-well and greater degrees of doneness. Interactions existed involving the consumer-controlled factors of degree of doneness and(or) cooking method for all consumer-evaluated traits for the clod steak (P affect any consumer evaluation traits or Warner-Bratzler shear force values (P > 0.05). One significant main effect, segment (P = 0.006), and one significant interaction, cooking method x city (P = 0.0407), existed for Overall Like ratings. Consumers in the Beef Loyals segment rated clod steaks higher in Overall Like than the other segments. Consumers in Chicago tended to give more uniform Overall Like ratings to clod steaks cooked by various methods; however, consumers in Philadelphia gave among the highest ratings to clod steaks that were fried and among the lowest to those that were grilled. Additionally, although clod steaks that were fried were given generally high ratings by consumers in Philadelphia, consumers in Chicago rated clod steaks cooked in this manner significantly lower than those in Philadelphia. Conversely, consumers in Chicago rated clod steaks that were grilled significantly higher than consumers in Philadelphia. Correlation and stepwise regression analyses indicated that Flavor Like was driving customer satisfaction of the

  2. 78 FR 36307 - Proposed Information Collection (Shoulder and Arm Conditions Disability Benefits Questionnaire...

    Science.gov (United States)

    2013-06-17

    ... (Shoulder and Arm Conditions Disability Benefits Questionnaire) Activity: Comment Request AGENCY: Veterans... ``OMB Control No. 2900--NEW (Shoulder and Arm Conditions Disability Benefits Questionnaire)'' in any...: Shoulder and Arm Conditions Disability Benefits Questionnaire, VA Form 21-0960M-12. OMB Control Number...

  3. 78 FR 65451 - Agency Information Collection (Shoulder and Arm Conditions Disability Benefits Questionnaire...

    Science.gov (United States)

    2013-10-31

    ... and Arm Conditions Disability Benefits Questionnaire) Activity Under OMB Review AGENCY: Veterans... Control No. 2900- NEW (Shoulder and Arm Conditions Disability Benefits Questionnaire)'' in any... Benefits Questionnaire).'' SUPPLEMENTARY INFORMATION: Title: (Shoulder and Arm Conditions Disability...

  4. How do deltoid muscle moment arms change after reverse total shoulder arthroplasty?

    Science.gov (United States)

    Walker, David R; Struk, Aimee M; Matsuki, Keisuke; Wright, Thomas W; Banks, Scott A

    2016-04-01

    Although many advantages of reverse total shoulder arthroplasty (RTSA) have been demonstrated, a variety of complications indicate there is much to learn about how RTSA modifies normal shoulder function. This study used a subject-specific computational model driven by in vivo kinematic data to assess how RTSA affects deltoid muscle moment arms after surgery. A subject-specific 12 degree-of-freedom musculoskeletal model was used to analyze the shoulders of 26 individuals (14 RTSA and 12 normal). The model was modified from the work of Holzbaur to directly input 6 degree-of-freedom humeral and scapular kinematics obtained using fluoroscopy. The moment arms of the anterior, lateral, and posterior aspects of the deltoid were significantly different when RTSA and normal cohorts were compared at different abduction angles. Anterior and lateral deltoid moment arms were significantly larger in the RTSA group at the initial elevation of the arm. The posterior deltoid was significantly larger at maximum elevation. There was large intersubject variability within the RTSA group. Placement of implant components during RTSA can directly affect the geometric relationship between the humerus and scapula and the muscle moment arms in the RTSA shoulder. RTSA shoulders maintain the same anterior and posterior deltoid muscle moment-arm patterns as healthy shoulders but show much greater intersubject variation and larger moment-arm magnitudes. These observations provide a basis for determining optimal implant configuration and surgical placement to maximize RTSA function in a patient-specific manner. Published by Elsevier Inc.

  5. Three-Dimensional Scapular Kinematics in Patients with Reverse Total Shoulder Arthroplasty during Arm Motion.

    Science.gov (United States)

    Lee, Kwang Won; Kim, Yong In; Kim, Ha Yong; Yang, Dae Suk; Lee, Gyu Sang; Choy, Won Sik

    2016-09-01

    There have been few reports on altered kinematics of the shoulder after reverse total shoulder arthroplasty (RTSA). We investigated differences in 3-dimensional (3D) scapular motions assessed using an optical tracking system between RTSA treated shoulders and asymptomatic contralateral shoulders during arm motion. Thirteen patients who underwent RTSA were assessed for active arm elevation in 2 distinct elevation planes (sagittal plane flexion and scapular plane abduction). Their mean age was 72 years (range, 69 to 79 years) and the mean follow-up was 24.4 months (range, 13 to 48 months). The dominant side was the right side in all the 13 patients, and it was also the side treated with RTSA. Scapular kinematics was recorded with an optical tracking system. The scapular kinematics and the scapulohumeral rhythm (SHR) of the RTSA shoulders and asymptomatic contralateral shoulders were recorded and analyzed during arm elevation. There were no significant differences in internal/external rotation and anterior/posterior tilting of the scapula between shoulders during arm motion (p > 0.05). However, upward rotation of the scapula differed significantly during arm motion (p = 0.035 for sagittal plane flexion; p = 0.046 for scapular plane abduction). There were significant differences in the SHR between the two shoulders (p = 0.016 for sagittal plane flexion; p = 0.021 for scapular plane abduction). The shoulder kinematics after RTSA showed significant differences from the contralateral asymptomatic shoulders. Increased upward rotation and decreased SHR after RTSA indicate that RTSA shoulders use more scapulothoracic motion and less glenohumeral motion to elevate the arm.

  6. Arm and shoulder morbidity in breast cancer patients after breast-conserving therapy versus mastectomy

    Energy Technology Data Exchange (ETDEWEB)

    Nesvold, Inger-Lise (Dept. of Cancer Rehabilitation-Physiotherapy, Rikshospitalet, Univ. of Oslo, Div. The Norwegian Radium Hospital, Montebello, Oslo (Norway)); Dahl, Alv A.; Fossaa, Sophie D. (Dept. of Clinical Cancer Research, Rikshospitalet, Univ. of Oslo: Division The Norwegian Radiumhospital, Montebello, Oslo (Norway)); Loekkevik, Erik (Dept. of Oncology, Rikshospitalet, Montebello, Oslo (Norway)); Marit Mengshoel, Anne (Inst. of Nursing and Health Sciences, Univ. of Oslo: Medical Faculty, Oslo (Norway))

    2008-06-15

    Introduction. The objective of this study was to compare the prevalence of late effects in the arm and shoulder in patients with breast cancer stage II who had radical modified mastectomy (RM) or breast-conserving therapy (BCT) followed by loco-regional adjuvant radiotherapy with or without chemotherapy/anti-oestrogen. Material and methods. All patients had axillary lymph node dissection. At a median of 47 months (range 32-87) post-surgery, 263 women (RM: n=186, BCT: n=77) were seen during an outpatient visit and had their arm and shoulder function and the presence of lymphedema assessed by a clinical examination, interview and self-rating. Volume calculation was used to measure lymphedema. Results. In the RM group 20% had developed arm lymphedema versus 8% in the BCT group (p=0.02). In multivariate analysis lymphedema was associated with a higher number of metastatic axillary lymph nodes [OR1.14, p=0.02], RM [OR 2.75, p=0.04] and increasing body mass index (BMI) [OR 1.11, p<0.01]. In the RM group 24% had a restricted range of motion in shoulder flexion compared to 7% in the BCT group (p<0.01). Shoulder pain was reported by 32% in the RM group and by 12% in the BCT group (p=0.001). Increasing observation time, RM, and increasing BMI were significantly associated with impaired arm/shoulder function. Discussion. Arm/shoulder problems including lymphedema were significantly more common after RM compared to BCT in irradiated breast cancer patients who have undergone axillary lymph node dissection. The performance of BCT should be encouraged when appropriate, to ensure a low prevalence of arm/shoulder morbidity including lymphedema

  7. Arm and shoulder morbidity in breast cancer patients after breast-conserving therapy versus mastectomy

    International Nuclear Information System (INIS)

    Nesvold, Inger-Lise; Dahl, Alv A.; Fossaa, Sophie D.; Loekkevik, Erik; Marit Mengshoel, Anne

    2008-01-01

    Introduction. The objective of this study was to compare the prevalence of late effects in the arm and shoulder in patients with breast cancer stage II who had radical modified mastectomy (RM) or breast-conserving therapy (BCT) followed by loco-regional adjuvant radiotherapy with or without chemotherapy/anti-oestrogen. Material and methods. All patients had axillary lymph node dissection. At a median of 47 months (range 32-87) post-surgery, 263 women (RM: n=186, BCT: n=77) were seen during an outpatient visit and had their arm and shoulder function and the presence of lymphedema assessed by a clinical examination, interview and self-rating. Volume calculation was used to measure lymphedema. Results. In the RM group 20% had developed arm lymphedema versus 8% in the BCT group (p=0.02). In multivariate analysis lymphedema was associated with a higher number of metastatic axillary lymph nodes [OR1.14, p=0.02], RM [OR 2.75, p=0.04] and increasing body mass index (BMI) [OR 1.11, p<0.01]. In the RM group 24% had a restricted range of motion in shoulder flexion compared to 7% in the BCT group (p<0.01). Shoulder pain was reported by 32% in the RM group and by 12% in the BCT group (p=0.001). Increasing observation time, RM, and increasing BMI were significantly associated with impaired arm/shoulder function. Discussion. Arm/shoulder problems including lymphedema were significantly more common after RM compared to BCT in irradiated breast cancer patients who have undergone axillary lymph node dissection. The performance of BCT should be encouraged when appropriate, to ensure a low prevalence of arm/shoulder morbidity including lymphedema

  8. ARMin III – Arm Therapy Exoskeleton with an Ergonomic Shoulder Actuation

    Directory of Open Access Journals (Sweden)

    Tobias Nef

    2009-01-01

    Full Text Available Rehabilitation robots have become important tools in stroke rehabilitation. Compared to manual arm training, robot-supported training can be more intensive, of longer duration and more repetitive. Therefore, robots have the potential to improve the rehabilitation process in stroke patients. Whereas a majority of previous work in upper limb rehabilitation robotics has focused on end-effector-based robots, a shift towards exoskeleton robots is taking place because they offer a better guidance of the human arm, especially for movements with a large range of motion. However, the implementation of an exoskeleton device introduces the challenge of reproducing the motion of the human shoulder, which is one of the most complex joints of the body. Thus, this paper starts with describing a simplified model of the human shoulder. On the basis of that model, a new ergonomic shoulder actuation principle that provides motion of the humerus head is proposed, and its implementation in the ARMin III arm therapy robot is described. The focus lies on the mechanics and actuation principle. The ARMin III robot provides three actuated degrees of freedom for the shoulder and one for the elbow joint. An additional module provides actuated lower arm pro/supination and wrist flexion/extension. Five ARMin III devices have been manufactured and they are currently undergoing clinical evaluation in hospitals in Switzerland and in the United States.

  9. Estimation of distal arm joint angles from EMG and shoulder orientation for transhumeral prostheses.

    Science.gov (United States)

    Akhtar, Aadeel; Aghasadeghi, Navid; Hargrove, Levi; Bretl, Timothy

    2017-08-01

    In this paper, we quantify the extent to which shoulder orientation, upper-arm electromyography (EMG), and forearm EMG are predictors of distal arm joint angles during reaching in eight subjects without disability as well as three subjects with a unilateral transhumeral amputation and targeted reinnervation. Prior studies have shown that shoulder orientation and upper-arm EMG, taken separately, are predictors of both elbow flexion/extension and forearm pronation/supination. We show that, for eight subjects without disability, shoulder orientation and upper-arm EMG together are a significantly better predictor of both elbow flexion/extension during unilateral (R 2 =0.72) and mirrored bilateral (R 2 =0.72) reaches and of forearm pronation/supination during unilateral (R 2 =0.77) and mirrored bilateral (R 2 =0.70) reaches. We also show that adding forearm EMG further improves the prediction of forearm pronation/supination during unilateral (R 2 =0.82) and mirrored bilateral (R 2 =0.75) reaches. In principle, these results provide the basis for choosing inputs for control of transhumeral prostheses, both by subjects with targeted motor reinnervation (when forearm EMG is available) and by subjects without target motor reinnervation (when forearm EMG is not available). In particular, we confirm that shoulder orientation and upper-arm EMG together best predict elbow flexion/extension (R 2 =0.72) for three subjects with unilateral transhumeral amputations and targeted motor reinnervation. However, shoulder orientation alone best predicts forearm pronation/supination (R 2 =0.88) for these subjects, a contradictory result that merits further study. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. How sensitive is the deltoid moment arm to humeral offset changes with reverse total shoulder arthroplasty?

    Science.gov (United States)

    Walker, David R; Kinney, Allison L; Wright, Thomas W; Banks, Scott A

    2016-06-01

    Reverse total shoulder arthroplasty commonly treats cuff-deficient or osteoarthritic shoulders not amenable to rotator cuff repair. This study investigates deltoid moment arm sensitivity to variations in the joint center and humeral offset of 3 representative reverse total shoulder arthroplasty subjects. We hypothesized that a superior joint implant placement may exist, indicated by muscle moment arms, compared with the current actual surgical implant configuration. Moment arms for the anterior, lateral, and posterior aspects of the deltoid muscle were determined for 1521 perturbations of the humeral offset location away from the surgical placement in a subject-specific musculoskeletal model with motion defined by subject-specific in vivo abduction kinematics. The humeral offset was varied from its surgical position ±4 mm in the anterior/posterior direction, ±12 mm in the medial/lateral direction, and -10 to 14 mm in the superior/inferior direction. The anterior deltoid moment arm varied in humeral offset and center of rotation up to 20 mm, primarily in the medial/lateral and superior/inferior directions. The lateral deltoid moment arm varied in humeral offset up to 20 mm, primarily in the medial/lateral and anterior/posterior directions. The posterior deltoid moment arm varied up to 15 mm, primarily in early abduction, and was most sensitive to humeral offset changes in the superior/inferior direction. High variations in muscle moment arms were found for all 3 deltoid components, presenting an opportunity to dramatically change the deltoid moment arms through surgical placement of the reverse shoulder components and by varying the overall offset of the humerus. Basic Science Study; Computer Modeling. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  11. Scapulohumeral rhythm in shoulders with reverse shoulder arthroplasty.

    Science.gov (United States)

    Walker, David; Matsuki, Keisuke; Struk, Aimee M; Wright, Thomas W; Banks, Scott A

    2015-07-01

    Little is known about kinematic function of reverse total shoulder arthroplasty (RTSA). Scapulohumeral rhythm (SHR) is a common metric for assessing muscle function and shoulder joint motion. The purpose of this study was to compare SHR in shoulders with RTSA to normal shoulders. Twenty-eight subjects, more than 12 months after unilateral RTSA, were recruited for an Institutional Review Board-approved study. Subjects performed arm abduction in the coronal plane with and without a 1.4-kg hand-held weight. Three-dimensional model-image registration techniques were used to measure orientation and position for the humerus and scapula from fluoroscopic images. Analysis of variance and Tukey tests were used to assess groupwise and pairwise differences. SHR in RTSA shoulders (1.3:1) was significantly lower than in normal shoulders (3:1). Below 30° abduction, RTSA and normal shoulders show a wide range of SHR (1.3:1 to 17:1). Above 30° abduction, SHR in RTSA shoulders was 1.3:1 for unweighted abduction and 1.3:1 for weighted abduction. Maximum RTSA shoulder abduction in weighted trials was lower than in unweighted trials. SHR variability in RTSA shoulders decreased with increasing arm elevation. RTSA shoulders show kinematics that are significantly different from normal shoulders. SHR in RTSA shoulders was significantly lower than in normal shoulders, indicating that RTSA shoulders use more scapulothoracic motion and less glenohumeral motion to elevate the arm. With these observations, it may be possible to improve rehabilitation protocols, with particular attention to the periscapular muscles, and implant design or placement to optimize functional outcomes in shoulders with RTSA. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  12. Experiences of employees with arm, neck or shoulder complaints: a focus group study

    NARCIS (Netherlands)

    Hutting, N.; Heerkens, Y.H.; Engels, J.A.; Staal, J.B.; Nijhuis-Van der Sanden, M.W.

    2014-01-01

    BACKGROUND: Many people suffer from complaints of the arm, neck or shoulder (CANS). CANS causes significant work problems, including absenteeism (sickness absence), presenteeism (decreased work productivity) and, ultimately, job loss. There is a need for intervention programs for people suffering

  13. Upper arm elevation and repetitive shoulder movements: a general population job exposure matrix based on expert ratings and technical measurements.

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    Dalbøge, Annett; Hansson, Gert-Åke; Frost, Poul; Andersen, Johan Hviid; Heilskov-Hansen, Thomas; Svendsen, Susanne Wulff

    2016-08-01

    We recently constructed a general population job exposure matrix (JEM), The Shoulder JEM, based on expert ratings. The overall aim of this study was to convert expert-rated job exposures for upper arm elevation and repetitive shoulder movements to measurement scales. The Shoulder JEM covers all Danish occupational titles, divided into 172 job groups. For 36 of these job groups, we obtained technical measurements (inclinometry) of upper arm elevation and repetitive shoulder movements. To validate the expert-rated job exposures against the measured job exposures, we used Spearman rank correlations and the explained variance[Formula: see text] according to linear regression analyses (36 job groups). We used the linear regression equations to convert the expert-rated job exposures for all 172 job groups into predicted measured job exposures. Bland-Altman analyses were used to assess the agreement between the predicted and measured job exposures. The Spearman rank correlations were 0.63 for upper arm elevation and 0.64 for repetitive shoulder movements. The expert-rated job exposures explained 64% and 41% of the variance of the measured job exposures, respectively. The corresponding calibration equations were y=0.5%time+0.16×expert rating and y=27°/s+0.47×expert rating. The mean differences between predicted and measured job exposures were zero due to calibration; the 95% limits of agreement were ±2.9% time for upper arm elevation >90° and ±33°/s for repetitive shoulder movements. The updated Shoulder JEM can be used to present exposure-response relationships on measurement scales. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  14. Effect of forearm axially rotated posture on shoulder load and shoulder abduction / flexion angles in one-armed arrest of forward falls.

    Science.gov (United States)

    Hsu, Hsiu-Hao; Chou, You-Li; Lou, Shu-Zon; Huang, Ming-Jer; Chou, Paul Pei-Hsi

    2011-03-01

    Falling onto the outstretched hand is the most common cause of upper extremity injury. This study develops an experimental model for evaluating the shoulder load during a simulated forward fall onto one hand with three different forearm axially rotated postures, and examines the shoulder abduction angle and shoulder flexion angle in each case. Fifteen healthy young male subjects with an average age of 23.7 years performed a series of one-armed arrests from a height of 5 cm onto a force plate. The kinematics and kinetics of the upper extremity were analyzed for three different forearm postures, namely 45° externally rotated, non-rotated, and 45° internally rotated. The shoulder joint load and shoulder abduction/flexion angles were significantly dependent on the rotational posture of the forearm. The shoulder medio-lateral shear forces in the externally rotated group were found to be 1.61 and 2.94 times higher than those in the non-rotated and internally rotated groups, respectively. The shoulder flexion angles in the externally rotated, non-rotated and internally rotated groups were 0.6°, 8.0° and 19.2°, respectively, while the corresponding shoulder abduction angles were 6.1°, 34.1° and 46.3°, respectively. In falls onto the outstretched hand, an externally rotated forearm posture should be avoided in order to reduce the medio-lateral shear force acting on the shoulder joint. In falls of this type, a 45° internally rotated forearm posture represents the most effective fall strategy in terms of minimizing the risk of upper extremity injuries. Copyright © 2010 Elsevier Ltd. All rights reserved.

  15. Early Contralateral Shoulder-Arm Morbidity in Breast Cancer Patients Enrolled in a Randomized Trial of Post-Surgery Radiation Therapy

    Directory of Open Access Journals (Sweden)

    Nele Adriaenssens

    2012-01-01

    Full Text Available Introduction Shoulder/arm morbidity is a common complication of breast cancer surgery and radiotherapy (RT, but little is known about acute contralateral morbidity. Methods Patients were 118 women enrolled in a RT trial. Arm volume and shoulder mobility were assessed before and 1–3 months after RT. Correlations and linear regression were used to analyze changes affecting ipsilateral and contralateral arms, and changes affecting relative interlimb differences (RID. Results Changes affecting one limb correlated with changes affecting the other limb. Arm volume between the two limbs correlated (R = 0.57. Risk factors were weight increase and axillary dissection. Contralateral and ipsilateral loss of abduction strongly correlated (R = 0.78. Changes of combined RID exceeding 10% affected the ipsilateral limb in 25% of patients, and the contralateral limb in 18%. Aromatase inhibitor therapy was significantly associated with contralateral loss of abduction. Conclusions High incidence of early contralateral arm morbidity warrants further investigations.

  16. The Duration of computer use as risk for hand-arm and neck-shoulder symptoms

    NARCIS (Netherlands)

    IJmker, S.; Huysmans, M.A.; Blatter, B.M.; Beek, A. J. van der; Mechelen, W. van; Bongers, P.M.

    2006-01-01

    Worldwide, millions of office workers use a computer. This systematic review sum marizes the evidence for a relation between the duration of computer use and the incidence of hand-arm and neck- shoulder symptoms and disorders. The strength of the evidence was based on methodological quality and

  17. Treatment related impairments in arm and shoulder in patients with breast cancer: a systematic review

    NARCIS (Netherlands)

    Hidding, J.T.; Beurskens, C.H.G.; Wees, P.J. van der; Laarhoven, H.W.M. van; Nijhuis-Van der Sanden, M.W.

    2014-01-01

    BACKGROUND: Breast cancer is the most common type of cancer in women in the developed world. As a result of breast cancer treatment, many patients suffer from serious complaints in their arm and shoulder, leading to limitations in activities of daily living and participation. In this systematic

  18. Treatment related impairments in arm and shoulder in patients with breast cancer: a systematic review

    NARCIS (Netherlands)

    Hidding, Janine T.; Beurskens, Carien H. G.; van der Wees, Philip J.; van Laarhoven, Hanneke W. M.; Nijhuis-van der Sanden, Maria W. G.

    2014-01-01

    Breast cancer is the most common type of cancer in women in the developed world. As a result of breast cancer treatment, many patients suffer from serious complaints in their arm and shoulder, leading to limitations in activities of daily living and participation. In this systematic literature

  19. Using your shoulder after surgery

    Science.gov (United States)

    Shoulder surgery - using your shoulder; Shoulder surgery - after ... rotator cuff surgery or other ligament or labral surgery, you need to be careful with your shoulder. Ask the surgeon what arm movements are safe ...

  20. Influence of adjuvant irradiation on the development of late arm lymphedema and impaired shoulder mobility after mastectomy for carcinoma of the breast

    International Nuclear Information System (INIS)

    Ryttov, N.; Holm, N.V.; Qvist, N.; Blichert-Toft, M.; Odense Univ. Hospital

    1988-01-01

    The influence of postoperative radiation therapy on development of late arm lymphedema and shoulder joint disability following mastectomy was evaluated from a series of 57 women with operable carcinoma of the breast. The patients were divided into three groups. Common for all three groups was mastectomy and partial axillary dissection. In addition one group received postoperative irradiation plus systemic therapy and another group systemic therapy alone. The incidence of late arm lymphedema/impaired shoulder mobility was 11%/4% in the group of patients undergoing surgery alone, 46%/38% in the group of patients receiving adjuvant irradiation and 6%/12% in the group of patients receiving adjuvant systemic therapy. It is concluded that adjuvant irradiation to the axilla in patients with metastatic lymph nodes highly increases the risk of late physical sequelae following modified radical mastectomy. Adjuvant systemic therapy can be administered to high risk patients without increasing the risk of late arm lymphedema and shoulder disability. (orig.)

  1. Lasting effects of workplace strength training for neck/shoulder/arm pain among laboratory technicians

    DEFF Research Database (Denmark)

    Mortensen, Peter; Larsen, Anders I; Zebis, Mette Kreutzfeldt

    2014-01-01

    Objectives. This study investigated long-term effects and implementation processes of workplace strength training for musculoskeletal disorders. Methods. 333 and 140 laboratory technicians from private and public sector companies, respectively, replied to a 3-year follow-up questionnaire subseque...... be implemented successfully at different companies during working hours on a long-term basis with lasting effects on pain in neck, shoulder, and arm....

  2. Treatment related impairments in arm and shoulder in patients with breast cancer: a systematic review.

    Directory of Open Access Journals (Sweden)

    Janine T Hidding

    Full Text Available BACKGROUND: Breast cancer is the most common type of cancer in women in the developed world. As a result of breast cancer treatment, many patients suffer from serious complaints in their arm and shoulder, leading to limitations in activities of daily living and participation. In this systematic literature review we present an overview of the adverse effects of the integrated breast cancer treatment related to impairment in functions and structures in the upper extremity and upper body and limitations in daily activities. Patients at highest risk were defined. METHODS AND FINDINGS: We conducted a systematic literature search using the databases of PubMed, Embase, CINAHL and Cochrane from 2000 to October 2012, according to the PRISMA guidelines. Included were studies with patients with stage I-III breast cancer, treated with surgery and additional treatments (radiotherapy, chemotherapy and hormonal therapy. The following health outcomes were extracted: reduced joint mobility, reduced muscle strength, pain, lymphedema and limitations in daily activities. Outcomes were divided in within the first 12 months and >12 months post-operatively. Patients treated with ALND are at the highest risk of developing impairments of the arm and shoulder. Reduced ROM and muscle strength, pain, lymphedema and decreased degree of activities in daily living were reported most frequently in relation to ALND. Lumpectomy was related to a decline in the level of activities of daily living. Radiotherapy and hormonal therapy were the main risk factors for pain. CONCLUSIONS: Patients treated with ALND require special attention to detect and consequently address impairments in the arm and shoulder. Patients with pain should be monitored carefully, because pain limits the degree of daily activities. Future research has to describe a complete overview of the medical treatment and analyze outcome in relation to the treatment. Utilization of uniform validated measurement

  3. Treatment related impairments in arm and shoulder in patients with breast cancer: a systematic review.

    Science.gov (United States)

    Hidding, Janine T; Beurskens, Carien H G; van der Wees, Philip J; van Laarhoven, Hanneke W M; Nijhuis-van der Sanden, Maria W G

    2014-01-01

    Breast cancer is the most common type of cancer in women in the developed world. As a result of breast cancer treatment, many patients suffer from serious complaints in their arm and shoulder, leading to limitations in activities of daily living and participation. In this systematic literature review we present an overview of the adverse effects of the integrated breast cancer treatment related to impairment in functions and structures in the upper extremity and upper body and limitations in daily activities. Patients at highest risk were defined. We conducted a systematic literature search using the databases of PubMed, Embase, CINAHL and Cochrane from 2000 to October 2012, according to the PRISMA guidelines. Included were studies with patients with stage I-III breast cancer, treated with surgery and additional treatments (radiotherapy, chemotherapy and hormonal therapy). The following health outcomes were extracted: reduced joint mobility, reduced muscle strength, pain, lymphedema and limitations in daily activities. Outcomes were divided in within the first 12 months and >12 months post-operatively. Patients treated with ALND are at the highest risk of developing impairments of the arm and shoulder. Reduced ROM and muscle strength, pain, lymphedema and decreased degree of activities in daily living were reported most frequently in relation to ALND. Lumpectomy was related to a decline in the level of activities of daily living. Radiotherapy and hormonal therapy were the main risk factors for pain. Patients treated with ALND require special attention to detect and consequently address impairments in the arm and shoulder. Patients with pain should be monitored carefully, because pain limits the degree of daily activities. Future research has to describe a complete overview of the medical treatment and analyze outcome in relation to the treatment. Utilization of uniform validated measurement instruments has to be encouraged.

  4. Kinematic analysis of dynamic shoulder motion in patients with reverse total shoulder arthroplasty.

    Science.gov (United States)

    Kwon, Young W; Pinto, Vivek J; Yoon, Jangwhon; Frankle, Mark A; Dunning, Page E; Sheikhzadeh, Ali

    2012-09-01

    Reverse total shoulder arthroplasty (rTSA) has been used to treat patients with irreparable rotator cuff dysfunction. Despite the proven clinical efficacy, there is minimal information regarding the underlying changes to the shoulder kinematics associated with this construct. Therefore, we sought to examine the kinematics of dynamic shoulder motion in patients with well-functioning rTSA. We tested 12 healthy subjects and 17 patients with rTSA. All rTSA patients were able to elevate their arms to at least 90° and received the implant as the primary arthroplasty at least 6 months before testing. On average, the rTSA patients elevated their arms to 112° ± 12° (mean ± SD) and reported an American Shoulder and Elbow Surgeons outcome score of 90.6 ± 6.3. A 3-dimensional electromagnetic motion capture device was used to detect the dynamic motion of the trunk, scapula, and humerus during bilateral active shoulder elevation along the sagittal, scapular, and coronal planes. In both healthy and rTSA shoulders, the majority of the humeral-thoracic motion was provided by the glenohumeral motion. Therefore, the ratio of glenohumeral to scapulothoracic (ST) motion was always greater than 1.62 during elevation along the scapular plane. In comparison to healthy subjects, however, the contribution of ST motion to overall shoulder motion was significantly increased in the rTSA shoulders. This increased contribution was noted in all planes of shoulder elevation and was maintained when weights were attached to the arm. Kinematics of the rTSA shoulders are significantly altered, and more ST motion is used to achieve shoulder elevation. Copyright © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  5. Loss of productivity due to neck/shoulder symptoms and hand/arm symptoms: Results from the PROMO-study

    NARCIS (Netherlands)

    Heuvel, S.G. van den; IJmker, S.; Blatter, B.M.; Korte, E.M. de

    2007-01-01

    Introduction: The objective of the present study is to describe the extent of productivity loss among computer workers with neck/shoulder symptoms and hand/arm symptoms, and to examine associations between pain intensity, various physical and psychosocial factors and productivity loss in computer

  6. Prevalence of complaints of arm, neck and shoulder among computer office workers and psychometric evaluation of a risk factor questionnaire

    Directory of Open Access Journals (Sweden)

    Kennes Janneke

    2007-07-01

    Full Text Available Abstract Background Complaints of Arm Neck and Shoulder (CANS represent a wide range of complaints, which can differ in severity from mild, periodic symptoms to severe, chronic and debilitating conditions. They are thought to be associated with both physical and psychosocial risk factors. The measurement and identification of the various risk factors for these complaints is an important step towards recognizing (a high risk subgroups that are relevant in profiling CANS; and (b also for developing targeted and effective intervention plans for treatment. The purpose of the present study was to investigate the prevalence of CANS in a Dutch population of computer workers and to develop a questionnaire aimed at measuring workplace physical and psychosocial risk factors for the presence of these complaints. Methods To examine potential workplace risk factors for the presence of CANS, the Maastricht Upper Extremity Questionnaire (MUEQ, a structured questionnaire, was developed and tested among 264 computer office workers of a branch office of the national social security institution in the Netherlands. The MUEQ holds 95 items covering demographic characteristics, in addition to seven main domains assessing potential risk factors with regard to (1 work station, (2 posture during work, (3 quality of break time, (4 job demands, (5 job control, and (6 social support. The MUEQ further contained some additional questions about the quality of the work environment and the presence of complaints in the neck, shoulder, upper and lower arm, elbow, hand and wrist. The prevalence rates of CANS in the past year were computed. Further, we investigated the psychometric properties of the MUEQ (i.e. factor structure and reliability. Results The one-year prevalence rate of CANS indicated that 54% of the respondents reported at least one complaint in the arm, neck and/or shoulder. The highest prevalence rates were found for neck and shoulder symptoms (33% and 31

  7. Disability Trajectories in Patients With Complaints of Arm, Neck, and Shoulder (CANS) in Primary Care : Prospective Cohort Study

    NARCIS (Netherlands)

    Miedema, Harald S; Feleus, Anita; Bierma-Zeinstra, Sita M. A.; Hoekstra, T.; Burdorf, Alex; Koes, Bart W

    BACKGROUND: Nontraumatic complaints of arm, neck, and shoulder (CANS) represent an important health issue, with a high prevalence in the general working age population and huge economic impact. Nevertheless, only few prospective cohort studies for the outcome of CANS are available. OBJECTIVES: The

  8. Rotator cuff degeneration of the healthy shoulder in patients with unilateral arm amputation is not worsened by overuse.

    Science.gov (United States)

    Gumina, S; Candela, V; Mariani, L; Venditto, T; Catalano, C; Castellano, S; Santilli, V; Giannicola, G; Castagna, A

    2018-01-01

    In order to evaluate whether overuse has a significant role in rotator cuff tear (RCT) aetiology, we evaluated both shoulders of patients with old unilateral arm amputation expecting a higher rate of RC degeneration in the healthy side. Nineteen males and six females (mean age: 57.3 ± 10.1) with an old (>20 years) unilateral arm amputation were submitted to an MRI of both shoulders. Tendon status and muscle tropism were evaluated according to Sugaya and Fuchs classifications, respectively; the acromion humeral distance was measured. Statistical analysis was performed to verify the prevalence of Sugaya and Fuchs categories in each sides. A significant prevalence of Sugaya type II in the amputated side (p = 0.02) and of type I in the healthy side (p Rotator cuff was healthy in 28 and 52% of amputated and non-amputated side, respectively. The mean acromio-humeral distances of the amputated and healthy side were 0.8 cm (SD: 0.1) and 0.9 cm (SD: 0.1), respectively, (p = 0.02). A significant prevalence of Fuchs type II category in the healthy side (p Cuff tear prevalence in not amputated shoulders, inevitably submitted to functional overload, was not higher than that of coetaneous subjects with two functional upper limbs. Shoulder non-use is a risk factor for rotator cuff tear. As the prevalence of rotator cuff degeneration/tear is higher in the amputee side, non-use is a more relevant risk factor than overuse. In the daily clinical practice, patients with rotator cuff tear should be encouraged to shoulder movement because rotator cuff tendon status could be worsened by disuse. III.

  9. Optimal Design of a Bio-Inspired Anthropocentric Shoulder Rehabilitator

    Directory of Open Access Journals (Sweden)

    S. K. Mustafa

    2006-01-01

    Full Text Available This paper presents the design of a bio-inspired anthropocentric 7-DOF wearable robotic arm for the purpose of stroke rehabilitation. The proposed arm rehabilitator synergistically utilizes the human arm structure with non-invasive kinematically under-deterministic cable-driven mechanisms to form a completely deterministic structure. It offers the advantages of being lightweight and having high dexterity. Adopting an anthropocentric design concept also allows it to conform to the human anatomical structure. The focus of this paper is on the analysis and design of the 3-DOF-shoulder module, called the shoulder rehabilitator. The design methodology is divided into three main steps: (1 performance evaluation of the cable-driven shoulder rehabilitator, (2 performance requirements of the shoulder joint based on its physiological characteristics and (3 design optimization of the shoulder rehabilitator based on shoulder joint physiological limitations. The aim is to determine a suitable configuration for the development of a shoulder rehabilitator prototype.

  10. Biomechanical comparison of reverse total shoulder arthroplasty systems in soft tissue-constrained shoulders.

    Science.gov (United States)

    Henninger, Heath B; King, Frank K; Tashjian, Robert Z; Burks, Robert T

    2014-05-01

    Numerous studies have examined the biomechanics of isolated variables in reverse total shoulder arthroplasty. This study directly compared the composite performance of two reverse total shoulder arthroplasty systems; each system was designed around either a medialized or a lateralized glenohumeral center of rotation. Seven pairs of shoulders were tested on a biomechanical simulator. Center of rotation, position of the humerus, passive and active range of motion, and force to abduct the arm were quantified. Native arms were tested, implanted with a Tornier Aequalis or DJO Surgical Reverse Shoulder Prosthesis (RSP), and then retested. Differences from the native state were then documented. Both systems shifted the center of rotation medially and inferiorly relative to native. Medial shifts were greater in the Aequalis implant (P .05). Both reverse total shoulder arthroplasty systems exhibited adduction deficits, but the RSP implant deficit was smaller (P = .046 between implants). Both systems reduced forces to abduct the arm compared with native, although the Aequalis required more force to initiate motion from the resting position (P = .022). Given the differences in system designs and configurations, outcome variables were generally comparable. The RSP implant allowed slightly more adduction, had a more lateralized humeral position, and required less force to initiate elevation. These factors may play roles in limiting scapular notching, improving active external rotation by normalizing the residual rotator cuff length, and limiting excessive stress on the deltoid. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  11. Late normal tissue effects in the arm and shoulder following lymphatic radiotherapy: Results from the UK START (Standardisation of Breast Radiotherapy) trials.

    Science.gov (United States)

    Haviland, Joanne S; Mannino, Mariella; Griffin, Clare; Porta, Nuria; Sydenham, Mark; Bliss, Judith M; Yarnold, John R

    2018-01-01

    Adjuvant lymphatic radiotherapy (LNRT) is recommended for selected axillary node positive women with early breast cancer. We investigated whether hypofractionated LNRT is safe combined with similarly-hypofractionated breast/chest wall radiotherapy (RT). The Standardisation of Breast Radiotherapy (START) pilot, A and B trials randomised women with early breast cancer to schedules of 2.67-3.3 Gy versus 2.0 Gy fractions (control). RT adverse effects were assessed by patients using the EORTC QLQ-BR23 and protocol-specific questions, and by physicians. Rates of arm/shoulder effects were compared between schedules for patients given LNRT. 864/5861 (14.7%) patients received LNRT (385 START-pilot, 318 START-A, 161 START-B). Prevalences of moderate/marked arm/shoulder effects were low up to 10 years. There were no significant differences between the hypofractionated and control groups for patient- and physician-assessed symptoms in START-A or START-B. In START-pilot, adverse effect rates were higher after 13 fractions of 3.3 Gy, consistent with effects reported in the breast/chest wall (significant for shoulder stiffness, HR 3.07, 95%CI 1.62-5.83, p = 0.001). The START trial results suggest that appropriately-dosed hypofractionated LNRT is safe in the long-term, according to patient and physician-assessed arm and shoulder symptoms. These findings are consistent with those reported after the same schedules delivered to the breast/chest wall. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  12. A longitudinal study of shoulder and arm morbidity in breast cancer survivors 7 years after sentinel lymph node biopsy or axillary lymph node dissection

    NARCIS (Netherlands)

    Kootstra, J.J.; Dijkstra, P.U.; Rietman, Johan Swanik; de Vries, J.; Baas, P.C.; Geertzen, J.H.B.; Hoekstra, H.J.; Hoekstra-Weebers, J.E.

    2013-01-01

    Knowledge about long-term consequences of breast cancer treatment on shoulder and arm function and volume in stages I–II breast cancer survivors is limited. The effects of shoulder–arm function shortly after surgery on long-term function are unknown. One hundred and ninety-four women were examined

  13. Arm Pain

    Science.gov (United States)

    ... be a sign of a heart attack. Seek emergency treatment if you have: Arm, shoulder or back ... http://www.mayoclinic.org/symptoms/arm-pain/basics/definition/SYM-20050870 . Mayo Clinic Footer Legal Conditions and ...

  14. Arm Care. Relief and Prevention for Shoulder Tendonitis, Tennis Elbow, Bursitis and Wrist Sprain in Athletics and Other Activities.

    Science.gov (United States)

    Nirschl, Robert P.

    The book provides a practical and meaningful treatment program for athletes involved in sports which injure the arm or shoulder to a high degree, such as tennis, baseball, swimming, raquetball, pole vaulting, javelin throwing, and weight training. The book's chapters present information on: (1) symptoms of injury; (2) the anatomy of injury; (3)…

  15. Lasting Effects of Workplace Strength Training for Neck/Shoulder/Arm Pain among Laboratory Technicians: Natural Experiment with 3-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Peter Mortensen

    2014-01-01

    Full Text Available Objectives. This study investigated long-term effects and implementation processes of workplace strength training for musculoskeletal disorders. Methods. 333 and 140 laboratory technicians from private and public sector companies, respectively, replied to a 3-year follow-up questionnaire subsequent to a 1-year randomized controlled trial (RCT with high-intensity strength training for prevention and treatment of neck, shoulder, and arm pain. Being a natural experiment, the two participating companies implemented and modified the initial training program in different ways during the subsequent 2 years after the RCT. Results. At 3-year follow-up the pain reduction in neck, shoulder, elbow, and wrist achieved during the first year was largely maintained at both companies. However, the private sector company was rated significantly better than the public sector company in (1 training adherence, (2 training culture, that is, relatively more employees trained at the workplace and with colleagues, (3 self-reported health changes, and (4 prevention of neck and wrist pain development among initially pain-free employees. Conclusions. This natural experiment shows that strength training can be implemented successfully at different companies during working hours on a long-term basis with lasting effects on pain in neck, shoulder, and arm.

  16. Lasting Effects of Workplace Strength Training for Neck/Shoulder/Arm Pain among Laboratory Technicians: Natural Experiment with 3-Year Follow-Up

    Science.gov (United States)

    Larsen, Anders I.; Zebis, Mette K.; Pedersen, Mogens T.; Sjøgaard, Gisela; Andersen, Lars L.

    2014-01-01

    Objectives. This study investigated long-term effects and implementation processes of workplace strength training for musculoskeletal disorders. Methods. 333 and 140 laboratory technicians from private and public sector companies, respectively, replied to a 3-year follow-up questionnaire subsequent to a 1-year randomized controlled trial (RCT) with high-intensity strength training for prevention and treatment of neck, shoulder, and arm pain. Being a natural experiment, the two participating companies implemented and modified the initial training program in different ways during the subsequent 2 years after the RCT. Results. At 3-year follow-up the pain reduction in neck, shoulder, elbow, and wrist achieved during the first year was largely maintained at both companies. However, the private sector company was rated significantly better than the public sector company in (1) training adherence, (2) training culture, that is, relatively more employees trained at the workplace and with colleagues, (3) self-reported health changes, and (4) prevention of neck and wrist pain development among initially pain-free employees. Conclusions. This natural experiment shows that strength training can be implemented successfully at different companies during working hours on a long-term basis with lasting effects on pain in neck, shoulder, and arm. PMID:24734247

  17. Shoulder Impingement Treatment

    Science.gov (United States)

    ... trunk is crucial for maximizing arm strength and power with throwing or tennis. This part of rehabilitation can usually take place while shoulder pain is subsiding. IV Restore function Resume overhead motion ...

  18. Clinical and radiological outcome of the Total Evolutive Shoulder System (TESS®) reverse shoulder arthroplasty: a prospective comparative non-randomised study.

    Science.gov (United States)

    Kadum, Bakir; Mukka, Sebastian; Englund, Erling; Sayed-Noor, Arkan; Sjödén, Göran

    2014-05-01

    The aims of this study were to assess the function and quality of life after the Total Evolutive Shoulder System (TESS) reverse shoulder arthroplasty (RSA), to evaluate the radiological stability of the stemless version and to address the effect of arm lengthening and scapular notching (SN) on the outcome. This was a prospective comparative non-randomised study. A total of 37 consecutive patients (40 shoulders) underwent TESS RSA between October 2007 and January 2012; 16 were stemless and 26 were stemmed. At a mean follow-up of 39 months (15-66), we evaluated range of motion (ROM), pain and functional outcome with QuickDASH and quality of life with EQ-5D score. Radiologically, component positioning, signs of loosening, SN and arm length difference were documented. We found a significant improvement in functional outcome and reduction of pain in both stemmed and stemless groups. No humeral loosening was evident, but there were four glenoid loosenings. In 12 shoulders that developed SN, seven already had scapular bone impression (SBI) evident on initial post-operative radiographs. Glenoid overhang seemed to decrease the risk of SN. Arm lengthening was associated with better EQ-5D but did not influence ROM or functional outcome. Reverse shoulder arthroplasty markedly improved shoulder function. SN is of concern in RSA, but proper positioning of the glenoid component may prevent its development.

  19. Cortical activation pattern during shoulder simple versus vibration exercises: a functional near infrared spectroscopy study.

    Science.gov (United States)

    Jang, Sung Ho; Yeo, Sang Seok; Lee, Seung Hyun; Jin, Sang Hyun; Lee, Mi Young

    2017-08-01

    To date, the cortical effect of exercise has not been fully elucidated. Using the functional near infrared spectroscopy, we attempted to compare the cortical effect between shoulder vibration exercise and shoulder simple exercise. Eight healthy subjects were recruited for this study. Two different exercise tasks (shoulder vibration exercise using the flexible pole and shoulder simple exercise) were performed using a block paradigm. We measured the values of oxygenated hemoglobin in the four regions of interest: the primary sensory-motor cortex (SM1 total, arm somatotopy, and leg and trunk somatotopy), the premotor cortex, the supplementary motor area, and the prefrontal cortex. During shoulder vibration exercise and shoulder simple exercise, cortical activation was observed in SM1 (total, arm somatotopy, and leg and trunk somatotopy), premotor cortex, supplementary motor area, and prefrontal cortex. Higher oxygenated hemoglobin values were also observed in the areas of arm somatotopy of SM1 compared with those of other regions of interest. However, no significant difference in the arm somatotopy of SM1 was observed between the two exercises. By contrast, in the leg and trunk somatotopy of SM1, shoulder vibration exercise led to a significantly higher oxy-hemoglobin value than shoulder simple exercise. These two exercises may result in cortical activation effects for the motor areas relevant to the shoulder exercise, especially in the arm somatotopy of SM1. However, shoulder vibration exercise has an additional cortical activation effect for the leg and trunk somatotopy of SM1.

  20. Cortical activation pattern during shoulder simple versus vibration exercises: a functional near infrared spectroscopy study

    Directory of Open Access Journals (Sweden)

    Sung Ho Jang

    2017-01-01

    Full Text Available To date, the cortical effect of exercise has not been fully elucidated. Using the functional near infrared spectroscopy, we attempted to compare the cortical effect between shoulder vibration exercise and shoulder simple exercise. Eight healthy subjects were recruited for this study. Two different exercise tasks (shoulder vibration exercise using the flexible pole and shoulder simple exercise were performed using a block paradigm. We measured the values of oxygenated hemoglobin in the four regions of interest: the primary sensory-motor cortex (SM1 total, arm somatotopy, and leg and trunk somatotopy, the premotor cortex, the supplementary motor area, and the prefrontal cortex. During shoulder vibration exercise and shoulder simple exercise, cortical activation was observed in SM1 (total, arm somatotopy, and leg and trunk somatotopy, premotor cortex, supplementary motor area, and prefrontal cortex. Higher oxygenated hemoglobin values were also observed in the areas of arm somatotopy of SM1 compared with those of other regions of interest. However, no significant difference in the arm somatotopy of SM1 was observed between the two exercises. By contrast, in the leg and trunk somatotopy of SM1, shoulder vibration exercise led to a significantly higher oxy-hemoglobin value than shoulder simple exercise. These two exercises may result in cortical activation effects for the motor areas relevant to the shoulder exercise, especially in the arm somatotopy of SM1. However, shoulder vibration exercise has an additional cortical activation effect for the leg and trunk somatotopy of SM1.

  1. Sonographic assessment of the subscapularis after reverse shoulder arthroplasty: impact of tendon integrity on shoulder function.

    Science.gov (United States)

    Dedy, Nicolas J; Gouk, Conor J; Taylor, Fraser J; Thomas, Michael; Tan, S L Ezekiel

    2018-06-01

    The deltopectoral approach for reverse shoulder arthroplasty (RSA) requires subscapularis tenotomy or lesser tuberosity osteotomy. Whether the subscapularis should be repaired at the conclusion of the procedure remains controversial. The present study sonographically assessed the subscapularis after RSA and evaluated the effect of tendon integrity on functional outcome. All patients who had undergone RSA in the Gold Coast University Hospital between 2005 and 2016 were included. Sonography was performed by a blinded examiner. Function was assessed using the Disabilities of the Arm, Shoulder and Hand, the Constant-Murley, and Oxford Shoulder scores. Internal rotation ability was recorded on a 6-point scale. The study included 43 patients (48 shoulders). Median length of follow-up was 19 months (range, 4-132 months). On sonography, the subscapularis was graded intact in 6 shoulders (13%), intact with mild attenuation in 16 (33%), severely attenuated in 15 (31%), and not intact or absent in 11 (23%). Differences in Disabilities of the Arm, Shoulder and Hand, Constant-Murley, or Oxford Shoulder scores between intact and attenuated or absent subscapularis shoulders were not significant. Internal rotation scores were significantly higher in the intact and mildly attenuated tendon group than in the absent tendon group (U = 1.0, P = .001 and U = 28.5, P = .007, respectively). The present work is the first long-term outcome study of RSA using sonography to assess the subscapularis. Subscapularis integrity did not appear to have a measurable effect on patient outcome as measured by standard scores but was important for internal rotation ability after RSA. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.

  2. Assessing physical function in adult acquired major upper-limb amputees by combining the Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Questionnaire and clinical examination.

    Science.gov (United States)

    Ostlie, Kristin; Franklin, Rosemary J; Skjeldal, Ola H; Skrondal, Anders; Magnus, Per

    2011-10-01

    To describe physical function in adult acquired major upper-limb amputees (ULAs) by combining self-assessed arm function and physical measures obtained by clinical examinations; to estimate associations between background factors and self-assessed arm function in ULAs; and to assess whether clinical examination findings may be used to detect reduced arm function in unilateral ULAs. postal questionnaires and clinical examinations. Norwegian ULA population. Clinical examinations performed at 3 clinics. Questionnaires: population-based sample (n=224; 57.4% response rate). Clinical examinations: combined referred sample and convenience sample of questionnaire responders (n=70; 83.3% of those invited). SURVEY inclusion criteria: adult acquired major upper-limb amputation, resident in Norway, mastering of spoken and written Norwegian. Not applicable. The Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Questionnaire, and clinical examination of joint motion and muscle strength with and without prostheses. Mean DASH score was 22.7 (95% confidence interval [CI], 20.3-25.0); in bilateral amputees, 35.7 (95% CI, 23.0-48.4); and in unilateral amputees, 22.1 (95% CI, 19.8-24.5). A lower unilateral DASH score (better function) was associated with paid employment (vs not in paid employment: adjusted regression coefficient [aB]=-5.40, P=.033; vs students: aB=-13.88, P=.022), increasing postamputation time (aB=-.27, P=.001), and Norwegian ethnicity (aB=-14.45, P<.001). At clinical examination, we found a high frequency of impaired neck mobility and varying frequencies of impaired joint motion and strength at the shoulder, elbow, and forearm level. Prosthesis wear was associated with impaired joint motion in all upper-limb joints (P<.006) and with reduced shoulder abduction strength (P=.002). Impaired without-prosthesis joint motion in shoulder flexion (ipsilateral: aB=12.19, P=.001) and shoulder abduction (ipsilateral: aB=12.01, P=.005; contralateral: aB=28.82, P=.004

  3. Impact of fatigue on the position of the release arm and shoulder girdle over a longer shooting distance for an elite basketball player.

    Science.gov (United States)

    Erculj, Frane; Supej, Matej

    2009-05-01

    The purpose of this case study is to establish how a gradual increase in fatigue affects the position of the arms and shoulders during a long shot in a basketball game. For this purpose, Primoz Brezec, an elite National Basketball Association player, performed a total of 7 series of 20 shots from a distance of 7.24 m. The subject performed a special basketball motor task between individual series' of shots. The fatigue gradually increased with each motor task, and in the meantime, the subject's heart rate (HR) and blood lactate concentration (LA) were measured. The height of each jump during the shot at the basket was measured, and all shots were recorded using a system of 3 digital cameras operating at a frequency of 50 Hz. Thereafter, a kinematic analysis was applied to calculate the height of the shoulder and wrist of the release arm, as well as the elbow and upper arm angles, with regard to the vertical line. The study results reveal statistically significant differences (p basketball coaches and basketball conditioning coaches to include moderate- and high-intensity exercise in their shooting practice sessions.

  4. Video Analysis of Primary Shoulder Dislocations in Rugby Tackles.

    Science.gov (United States)

    Maki, Nobukazu; Kawasaki, Takayuki; Mochizuki, Tomoyuki; Ota, Chihiro; Yoneda, Takeshi; Urayama, Shingo; Kaneko, Kazuo

    2017-06-01

    Characteristics of rugby tackles that lead to primary anterior shoulder dislocation remain unclear. To clarify the characteristics of tackling that lead to shoulder dislocation and to assess the correlation between the mechanism of injury and morphological damage of the glenoid. Case series; Level of evidence, 4. Eleven elite rugby players who sustained primary anterior shoulder dislocation due to one-on-one tackling between 2001 and 2014 were included. Using an assessment system, the tackler's movement, posture, and shoulder and head position were evaluated in each phase of tackling. Based on 3-dimensional computed tomography, the glenoid of the affected shoulder was classified into 3 types: intact, erosion, and bone defect. Orientation of the glenoid defect and presence of Hill-Sachs lesion were also evaluated. Eleven tackles that led to primary shoulder dislocation were divided into hand, arm, and shoulder tackle types based on the site at which the tackler contacted the ball carrier initially. In hand and arm tackles, the tackler's shoulder joint was forcibly moved to horizontal abduction by the impact of his upper limb, which appeared to result from an inappropriate approach to the ball carrier. In shoulder tackles, the tackler's head was lowered and was in front of the ball carrier at impact. There was no significant correlation between tackle types and the characteristics of bony lesions of the shoulder. Although the precise mechanism of primary anterior shoulder dislocation could not be estimated from this single-view analysis, failure of individual tackling leading to injury is not uniform and can be caused by 2 main factors: failure of approach followed by an extended arm position or inappropriate posture of the tackler at impact, such as a lowered head in front of the opponent. These findings indicate that injury mechanisms should be assessed for each type of tackle, as it is unknown whether external force to the glenoid is different in each mechanism

  5. Work related shoulder disorders

    DEFF Research Database (Denmark)

    Svendsen, Susanne Wulff; Bonde, Jens Peter; Mathiassen, S.E.

    2004-01-01

    and symptoms. Data were analysed by generalised estimating equation and multiple logistic regression with adjustment for potential confounders. Results: For current upper arm elevation above 90°, a duration increment of 1% of the daily working hours was associated with odds ratios of 1.23 (95% CI 1.10 to 1......Aims: To determine quantitative exposure-response relations between work with highly elevated arms and supraspinatus tendinitis, shoulder pain with disability, and shoulder pain without disability. Methods: A cross sectional study was conducted in a historical cohort of 1886 males from three...... occupational groups. Exposure measurements were performed for four consecutive working days in a random sample of 72 currently employed subjects. Individual work histories were obtained by questionnaire and register data. Health status was ascertained by physical examination blinded towards exposure...

  6. Comparison of self-report and interview administration methods based on the Brazilian versions of the Western Ontario Rotator Cuff Index and Disabilities of the Arm, Shoulder and Hand Questionnaire in patients with rotator cuff disorders

    Directory of Open Access Journals (Sweden)

    Andréa Diniz Lopes

    2009-02-01

    Full Text Available OBJECTIVE: The purpose of the present study was to compare self-report and interview administration methods using the Western Ontario Rotator Cuff Index (WORC and Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH in patients with rotator cuff disorders. METHODS: Thirty male and female patients over 18 years of age with rotator cuff disorders (tendinopathy or rotator cuff tear and Brazilian Portuguese as their primary language were recruited for assessment via administration of the Western Ontario Rotator Cuff Index and and Disabilities of the Arm, Shoulder and Hand Questionnaire. A randomization method was used to determine whether the questionnaires would be self-reported (n=15 or administered by an interviewer (n=15. Pearson correlation coefficients were used to evaluate the correlation between the Western Ontario Rotator Cuff Index and and Disabilities of the Arm, Shoulder and Hand Questionnaire in each group. The t-test was used to determine whether the difference in mean questionnaire scores and administration time was statistically significant. For statistical analysis, the level of significance was set at 5%. RESULTS: The mean subject age was 55.07 years, ranging from 27 to 74 years. Most patients had a diagnosis of tendinopathy (n=21. With regard to level of schooling, the majority (n=26 of subjects had completed a college degree or higher. The mean questionnaire scores and administration times did not significantly differ between the two groups (p>0.05. There were statistically significant correlations (p<0.05 between Western Ontario Rotator Cuff Index and and Disabilities of the Arm, Shoulder and Hand Questionnaire, and strong correlations were found between the questionnaires in both groups. CONCLUSION: There are no differences between the Western Ontario Rotator Cuff Index and Disabilities of the Arm, Shoulder and Hand Questionnaire administration methods with regard to administration time or correlations between the

  7. DASH (disabilities of the arm, shoulder, and hand) evaluation of QOL for carpal tunnel syndrome

    International Nuclear Information System (INIS)

    Morita, Akimasa; Kawamoto, Masataka; Fujisawa, Kouzou; Tsujii, Masaya; Hirata, Hitoshi

    2006-01-01

    The questionnaire on the disabilities of the arm, shoulder, and hand is a region-specific, self-administered outcome instrument that is developed as a measure of self-rate upper extremity disability and symptoms. Last year, the Japanese version of disabilities of the arm, shoulder and hand (DASH) was cross-culturally adapted. The main purpose of this study is to analyze the relationship between DASH and clinical assessment (findings of MRI and electrodiagnostic parameters). The subjects comprised 41 patients (6 males and 35 females) with carpal tunnel syndrome (CTS), except for cases with other upper extremity disorders. These subjects prospectively completed DASH 1 (disability module), DASH 2 (symptom module), and DASH (disability and symptom module) before the release of the open carpal tunnel. The patients were divided into 3 groups based on the symptom duration (A: shorter than 3 months, B: 4-11 months, C: longer than 12 months). All patients were preoperatively assessed with regard to sensory conduction velocity (SCV) and compound muscle action potential (CMAP). In addition, all patients underwent MRI in order to evaluate the flexor tenosynovial swelling represented by palmar bowing of the flexor retinaculum (PBFR). The relationships were estimated using the Spearman rank score, unpaired t tests, and Bonferroni tests. DASH 2 scores indicated greater responsiveness than DASH 1, which reflected the character of CTS. DASH 1 scores were higher in patients who were affected in their dominant hand than in those whose nondominant hand was affected. The DASH scores decreased significantly in groups A and B, with the exception of C. However, DASH did not show any correlation either with the parameters, age, or MRI assessment. DASH can be used for the research of preoperative outcomes related to CTS. It also has the advantage of being useful in assessing and comparing the outcome for various other hand disorders. (author)

  8. Shoulder range of motion measures as risk factors for shoulder and elbow injuries in high school softball and baseball players.

    Science.gov (United States)

    Shanley, Ellen; Rauh, Mitchell J; Michener, Lori A; Ellenbecker, Todd S; Garrison, J Craig; Thigpen, Charles A

    2011-09-01

    Range of motion deficits in shoulder external rotation (ER), internal rotation (IR), total rotation range of motion (ER + IR), and horizontal adduction (HA) have been retrospectively associated with overhand athletes' arm injuries. The authors expected the incidence of upper extremity injury in high school softball and baseball players with side-to-side shoulder range of motion deficits to be greater than the incidence of upper extremity injury in players with normal shoulder range of motion. Cohort study (prognosis); Level of evidence, 2. High school softball and baseball players (N = 246) participated. Before the start of the season, passive shoulder ER, IR, and HA were assessed at 90° of abduction with the scapula stabilized. Relative risk (RR) was calculated to examine range of motion measure, by categorical criteria, and risk of upper extremity injury. Twenty-seven shoulder and elbow injuries (9 softball, 18 baseball) were observed during the season. The dominant shoulder of all injured players and baseball players displayed a significant decrease in HA (P = .05) and IR (P = .04). The dominant shoulder total rotation of injured baseball players displayed a significant decrease (mean difference = 8.0° ± 0.1°; P = .05) as compared with the dominant shoulder of uninjured baseball players. Players who displayed a decrease of ≥25° of IR in the dominant shoulder were at 4 times greater risk of upper extremity injury compared with players with a .05). There are large mean deficits in shoulder IR and HA between injured and noninjured players, but not in ER or total rotation. Passive shoulder IR loss ≥25° as compared bilaterally was predictive of arm injury. Shoulder range of motion deficits differed between sports and appeared more predictive of injury for baseball players.

  9. Measurement of shoulder motion fraction and motion ratio

    International Nuclear Information System (INIS)

    Kang, Yeong Han

    2006-01-01

    This study was to understand about the measurement of shoulder motion fraction and motion ratio. We proposed the radiological criterior of glenohumeral and scapulothoracic movement ratio. We measured the motion fraction of the glenohumeral and scapulothoracic movement using CR (computed radiological system) of arm elevation at neutral, 90 degree, full elevation. Central ray was 15 .deg., 19 .deg., 22 .deg. to the cephald for the parallel scapular spine, and the tilting of torso was external oblique 40 .deg., 36 .deg., 22 .deg. for perpendicular to glenohumeral surface. Healthful donor of 100 was divided 5 groups by age (20, 30, 40, 50, 60). The angle of glenohumeral motion and scapulothoracic motion could be taken from gross arm angle and radiological arm angle. We acquired 3 images at neutral, 90 .deg. and full elevation position and measured radiographic angle of glenoheumeral, scapulothoracic movement respectively. While the arm elevation was 90 .deg., the shoulder motion fraction was 1.22 (M), 1.70 (W) in right arm and 1.31, 1.54 in left. In full elevation, Right arm fraction was 1.63, 1.84 and left was 1.57, 1.32. In right dominant arm (78%), 90 .deg. and Full motion fraction was 1.58, 1.43, in left (22%) 1.82, 1.94. In generation 20, 90 .deg. and Full motion fraction was 1.56, 1.52, 30' was 1.82, 1.43, 40' was 1.23, 1.16, 50' was 1.80, 1.28,60' was 1.24, 1.75. There was not significantly by gender, dominant arm and age. The criteria of motion fraction was useful reference for clinical diagnosis the shoulder instability

  10. A STUDY ON MANAGEMENT OF ADHESIVE CAPSULITIS (FROZEN SHOULDER BY HYDRODILATATION METHOD

    Directory of Open Access Journals (Sweden)

    S. Lakshmi Narayana

    2016-08-01

    Full Text Available AIMS AND OBJECTIVES To study the efficacy of hydraulic distension under local anaesthesia in the management of frozen shoulder. To study the age and sex distribution of frozen shoulder. MATERIALS AND METHODS 50 Patients with 54 shoulders of frozen shoulder syndrome, 4 cases with bilateral shoulder involvement were studied. A detailed history was elicited with particular reference to frozen shoulder (as shown in the proforma. A preliminary general physical examination was done. RESULTS Fifty patients with 54 shoulders of frozen shoulder syndrome were treated with hydraulic distension under local anaesthesia. The maximum and minimum age in this study was found to be 85 years and 41 years respectively. The average age of the patients in this study was calculated as 54.16 years. Out of 50 patients followed up, 32 were females and 18 were males. The Female: Male ratio was 1.77:1. In this series, 4 patients had bilateral involvement. In 17 patients, side involved was the dominant that is right arm. In 29 cases, the left arm that is non-dominant arm was involved. Associated conditions in this series are 7 patients had diabetes mellitus, 4 patients had hypertension, 5 patients had osteoarthritis of knee, 2 had peptic ulcer, 1 pulmonary Koch’s and 1 had bilateral cataract. CONCLUSION Concomitant home exercises program is a must and is the hallmark of success following hydraulic distension. Hydraulic distension is a safe, reliable, cost effective without requiring specialised equipment in the management of frozen shoulder.

  11. Estimation of Human Arm Joints Using Two Wireless Sensors in Robotic Rehabilitation Tasks

    Directory of Open Access Journals (Sweden)

    Arturo Bertomeu-Motos

    2015-12-01

    Full Text Available This paper presents a novel kinematic reconstruction of the human arm chain with five degrees of freedom and the estimation of the shoulder location during rehabilitation therapy assisted by end-effector robotic devices. This algorithm is based on the pseudoinverse of the Jacobian through the acceleration of the upper arm, measured using an accelerometer, and the orientation of the shoulder, estimated with a magnetic angular rate and gravity (MARG device. The results show a high accuracy in terms of arm joints and shoulder movement with respect to the real arm measured through an optoelectronic system. Furthermore, the range of motion (ROM of 50 healthy subjects is studied from two different trials, one trying to avoid shoulder movements and the second one forcing them. Moreover, the shoulder movement in the second trial is also estimated accurately. Besides the fact that the posture of the patient can be corrected during the exercise, the therapist could use the presented algorithm as an objective assessment tool. In conclusion, the joints’ estimation enables a better adjustment of the therapy, taking into account the needs of the patient, and consequently, the arm motion improves faster.

  12. Shoulder injuries in elite rugby union football matches: Epidemiology and mechanisms.

    Science.gov (United States)

    Usman, Juliana; McIntosh, Andrew S; Quarrie, Kenneth; Targett, Stephen

    2015-09-01

    Shoulder injuries in rugby union football have been the focus of few in-depth studies, despite their frequency and severity. The study's objective was to describe the incidence, patterns and mechanisms of shoulder injuries in rugby. Prospective cohort study of shoulder injury incidence and retrospective case-series study of shoulder injury mechanisms. Data were collected from Super Rugby matches from 2005 to 2010 involving elite level adult male rugby players. 7920 player participation hours and 100 shoulder injuries were recorded during 397 Super Rugby matches. The shoulder injury incidence rate was 13 per 1000 player hours (95% confidence interval 10-16). The mean number of days unavailable for selection due to these injuries was 37 (95% confidence interval 25-54). Tacklers sustained shoulder injuries at a higher rate than ball carriers (Rate Ratio=1.7 (95% confidence interval 0.5-5.3)). The most frequently reported injuries were those to the acromio-clavicular joint; dislocations resulted in the greatest amount of missed play. Using video analysis, 47 of the 100 shoulder injury events were successfully identified and analyzed. The main mechanisms of shoulder injury were contact with the ground with the shoulder/arm in horizontal adduction, flexion, and internal rotation; and impact to the lateral aspect of the shoulder with the elbow flexed and arm at the side. Direct impact to the shoulder, either through player-to-player contact or contact with the ground, is the main cause of shoulder injury. Methods to reduce injury risk, such as shoulder pads and tackle skills, require consideration. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  13. C-arm flat-panel CT arthrography of the shoulder: Radiation dose considerations and preliminary data on diagnostic performance

    International Nuclear Information System (INIS)

    Guggenberger, Roman; Ulbrich, Erika J.; Kaelin, Pascal; Pfammatter, Thomas; Alkadhi, Hatem; Andreisek, Gustav; Dietrich, Tobias J.; Scholz, Rosemarie; Koehler, Christoph; Elsaesser, Thilo; Le Corroller, Thomas

    2017-01-01

    To investigate radiation dose and diagnostic performance of C-arm flat-panel CT (FPCT) versus standard multi-detector CT (MDCT) shoulder arthrography using MRI-arthrography as reference standard. Radiation dose of two different FPCT acquisitions (5 and 20 s) and standard MDCT of the shoulder were assessed using phantoms and thermoluminescence dosimetry. FPCT arthrographies were performed in 34 patients (mean age 44 ± 15 years). Different joint structures were quantitatively and qualitatively assessed by two independent radiologists. Inter-reader agreement and diagnostic performance were calculated. Effective radiation dose was markedly lower in FPCT 5 s (0.6 mSv) compared to MDCT (1.7 mSv) and FPCT 20 s (3.4 mSv). Contrast-to-noise ratios (CNRs) were significantly (p < 0.05) higher in FPCT 20-s versus 5-s protocols. Inter-reader agreements of qualitative ratings ranged between κ = 0.47-1.0. Sensitivities for cartilage and rotator cuff pathologies were low for FPCT 5-s (40 % and 20 %) and moderate for FPCT 20-s protocols (75 % and 73 %). FPCT showed high sensitivity (81-86 % and 89-99 %) for bone and acromioclavicular-joint pathologies. Using a 5-s protocol FPCT shoulder arthrography provides lower radiation dose compared to MDCT but poor sensitivity for cartilage and rotator cuff pathologies. FPCT 20-s protocol is moderately sensitive for cartilage and rotator cuff tendon pathology with markedly higher radiation dose compared to MDCT. (orig.)

  14. C-arm flat-panel CT arthrography of the shoulder: Radiation dose considerations and preliminary data on diagnostic performance

    Energy Technology Data Exchange (ETDEWEB)

    Guggenberger, Roman; Ulbrich, Erika J.; Kaelin, Pascal; Pfammatter, Thomas; Alkadhi, Hatem; Andreisek, Gustav [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zuerich (Switzerland); Dietrich, Tobias J. [Balgrist University Hospital, Department of Radiology, Zurich (Switzerland); Scholz, Rosemarie; Koehler, Christoph; Elsaesser, Thilo [Siemens Healthcare GmbH, Business Area Advanced Therapies, Forchheim (Germany); Le Corroller, Thomas [Aix-Marseille Universite, CNRS, ISM UMR 7287, Marseille (France); Radiology Department, APHM, Marseille (France)

    2017-02-15

    To investigate radiation dose and diagnostic performance of C-arm flat-panel CT (FPCT) versus standard multi-detector CT (MDCT) shoulder arthrography using MRI-arthrography as reference standard. Radiation dose of two different FPCT acquisitions (5 and 20 s) and standard MDCT of the shoulder were assessed using phantoms and thermoluminescence dosimetry. FPCT arthrographies were performed in 34 patients (mean age 44 ± 15 years). Different joint structures were quantitatively and qualitatively assessed by two independent radiologists. Inter-reader agreement and diagnostic performance were calculated. Effective radiation dose was markedly lower in FPCT 5 s (0.6 mSv) compared to MDCT (1.7 mSv) and FPCT 20 s (3.4 mSv). Contrast-to-noise ratios (CNRs) were significantly (p < 0.05) higher in FPCT 20-s versus 5-s protocols. Inter-reader agreements of qualitative ratings ranged between κ = 0.47-1.0. Sensitivities for cartilage and rotator cuff pathologies were low for FPCT 5-s (40 % and 20 %) and moderate for FPCT 20-s protocols (75 % and 73 %). FPCT showed high sensitivity (81-86 % and 89-99 %) for bone and acromioclavicular-joint pathologies. Using a 5-s protocol FPCT shoulder arthrography provides lower radiation dose compared to MDCT but poor sensitivity for cartilage and rotator cuff pathologies. FPCT 20-s protocol is moderately sensitive for cartilage and rotator cuff tendon pathology with markedly higher radiation dose compared to MDCT. (orig.)

  15. Conservative treatment and rehabilitation of shoulder problems

    International Nuclear Information System (INIS)

    Paternostro-Sluga, T.; Zoech, C.

    2004-01-01

    The shoulder joint has an important influence on arm- and handfunction. Therefore, activities of daily living, working and leisure time can be negatively influenced by diseases of the shoulder joint. Problems of the shoulder joint can be induced by muscular dysbalance and poor body posture. There is a strong relationship between shoulder function and body posture. Conservative treatment and rehabilitation of the shoulder joint aims at improving the local dysfunction of the shoulder joint as well as at improving function and social participation. Antiinflammatory and pain medication, exercise, occupational, electro-, ultrasound and shock wave therapy, massage, thermotherapy and pulsed electromagnetic fields are used as conservative treatments. Exercise therapy aims at improving muscular performance, joint mobility and body posture. Occupational therapy aims at improving functional movements for daily living and work. Electrotherapy is primarily used to relieve pain. Shock wave and ultrasound therapy proved to be an effective treatment for patients with calcific tendinitis. The subacromial impingement syndrome can be effectively treated by conservative therapy. (orig.) [de

  16. Relationship between isometric shoulder strength and arms-only swimming power among male collegiate swimmers: study of valid clinical assessment methods.

    Science.gov (United States)

    Awatani, Takenori; Morikita, Ikuhiro; Mori, Seigo; Shinohara, Junji; Tatsumi, Yasutaka

    2018-04-01

    [Purpose] The purpose of the present study was to confirm the relationships between shoulder strength (extensor strength and internal rotator strength) of the abducted position and swimming power during arm-only swimming. [Subjects and Methods] Fourteen healthy male collegiate swimmers participated in the study. Main measures were shoulder strength (strength using torque that was calculated from the upper extremity length and the isometric force of the abducted position) and swimming power. [Results] Internal rotation torque of the dominant side in the abducted external rotated position (r=0.85) was significantly correlated with maximum swimming power. The rate of bilateral difference in extension torque in the maximum abducted position (r=-0.728) was significantly correlated with the swimming velocity-to-swimming power ratio. [Conclusion] The results of this study suggest that internal rotator strength measurement in the abducted external rotated position and extensor strength measurement in the maximum abducted position are valid assessment methods for swimmers.

  17. Neonatal morbidity associated with shoulder dystocia maneuvers.

    Science.gov (United States)

    Spain, Janine E; Frey, Heather A; Tuuli, Methodius G; Colvin, Ryan; Macones, George A; Cahill, Alison G

    2015-03-01

    We sought to examine neonatal morbidity associated with different maneuvers used among term patients who experience a shoulder dystocia. We conducted a retrospective cohort study of all women who experienced a clinically diagnosed shoulder dystocia at term requiring obstetric maneuvers at a single tertiary care hospital from 2005 through 2008. We excluded women with major fetal anomaly, intrauterine death, multiple gestation, and preterm. Women exposed to Rubin maneuver, Wood's screw maneuver, or delivery of the posterior arm were compared to women delivered by McRoberts/suprapubic pressure only, which served as the reference group. The primary outcome was a composite morbidity of neonatal injury (defined as clavicular or humeral fracture or brachial plexus injury) and neonatal depression (defined as Apgar dystocia, defined as time from delivery of fetal head to delivery of shoulders. Among the 231 women who met inclusion criteria, 135 were delivered by McRoberts/suprapubic pressure alone (57.9%), 83 women were exposed to Rubin maneuver, 53 women were exposed to Wood's screw, and 36 women were exposed to delivery of posterior arm. Individual maneuvers were not associated with composite morbidity, neonatal injury, or neonatal depression after adjusting for nulliparity and duration of shoulder dystocia. We found no association between shoulder dystocia maneuvers and neonatal morbidity after adjusting for duration, a surrogate for severity. Our results demonstrate that clinicians should utilize the maneuver most likely to result in successful delivery. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Hemiplegic shoulder pain: implications for occupational therapy treatment.

    Science.gov (United States)

    Gilmore, Paula E; Spaulding, Sandi J; Vandervoort, Anthony A

    2004-02-01

    Hemiplegic shoulder pain is common after stroke causing hemiplegia. It adversely affects the recovery of arm function and independence in activities of daily living. Subluxation, abnormal tone and limited range of motion or capsular constrictions have been reported as potential causes. Other factors such as rotator cuff tears, brachial plexus injury, shoulder-hand syndrome and other pre-existing pathological conditions may also be associated with hemiplegic shoulder pain. The etiology remains unclear, but hemiplegic shoulder pain may result from a combination of the above factors. This literature review examines the possible causes of hemiplegic shoulder pain and discusses the implications for occupational therapy treatment. Occupational therapy interventions include proper positioning, facilitation of movement through purposeful therapeutic activities, increasing passive range of motion, implementation of external supports and treatment of shoulder-hand syndrome. Understanding the processes involved will assist with effective assessment, treatment and prevention of hemiplegic shoulder pain. This will facilitate clients' participation in rehabilitation programs and move them towards attainment of optimal function.

  19. Isometric shoulder strength in young swimmers.

    Science.gov (United States)

    McLaine, Sally J; Ginn, Karen A; Fell, James W; Bird, Marie-Louise

    2018-01-01

    The prevalence of shoulder pain in young swimmers is high. Shoulder rotation strength and the ratio of internal to external rotation strength have been reported as potential modifiable risk factors associated with shoulder pain. However, relative strength measures in elevated positions, which include flexion and extension, have not been established for the young swimmer. The aim of this study was to establish clinically useful, normative shoulder strength measures and ratios for swimmers (14-20 years) without shoulder pain. Cross-sectional, observational study. Swimmers (N=85) without a recent history of shoulder pain underwent strength testing of shoulder flexion and extension (in 140° abduction); and internal and external rotation (in 90° abduction). Strength tests were performed in supine using a hand-held dynamometer and values normalised to body weight. Descriptive statistics were calculated for strength and strength ratios (flexion:extension and internal:external rotation). Differences between groups (based on gender, history of pain, test and arm dominance) were explored using independent and paired t tests. Normative shoulder strength values and ratios were established for young swimmers. There was a significant difference (pdifferences in strength ratios. Relative strength of the dominant and non-dominant shoulders (except for extension); and for swimmers with and without a history of shoulder pain was not significantly different. A normal shoulder strength profile for the young swimmer has been established which provides a valuable reference for the clinician assessing shoulder strength in this population. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  20. Unusual inferior dislocation of shoulder: reduction by two-step maneuver: a case report

    Directory of Open Access Journals (Sweden)

    Patro Dilip K

    2009-11-01

    Full Text Available Abstract Dislocation of the shoulder is the commonest of all large joint dislocations. Inferior dislocation constitutes 0.5% of all shoulder dislocations. It characteristically presents with overhead abduction of the arm, the humerus being parallel to the spine of scapula. We present an unusual case of recurrent luxatio erecta in which the arm transformed later into an adducted position resembling the more common anterior shoulder dislocation. Such a case has not been described before in English literature. Closed reduction by the two-step maneuver was successful with a single attempt. MRI revealed posterior labral tear and a Hill-Sachs variant lesion on the superolateral aspect of humeral head. Immobilisation in a chest-arm bandage followed by physiotherapy yielded excellent results. The case is first of its kind; the unusual mechanism, unique radiological findings and alternate method of treatment are discussed.

  1. Comfort and acceptability of various immobilization positions using a shoulder external rotation and abduction brace.

    Science.gov (United States)

    Hatta, Taku; Yamamoto, Nobuyuki; Sano, Hirotaka; Itoi, Eiji

    2017-03-01

    Immobilization with shoulder braces is used for conservative treatment of an initial shoulder dislocation. Various arm positions have been investigated to determine optimal position in terms of the anatomical reduction of the Bankart lesion. Recently, the effect of immobilization in shoulder abduction as well as in external rotation has been reported. However, there are few studies assessing subjects' acceptability of the brace in various arm positions. We hypothesized that a certain arm position regarding abduction or external rotation for immobilization would induce significant discomfort during activities of daily living. A dominant arm of 20 healthy participants was immobilized with a shoulder brace in 4 different positions; adduction and internal rotation (Add-IR), adduction and external rotation (Add-ER), 30° of abduction and 30° of external rotation (Abd-30ER), and 30° of abduction and 60° of external rotation (Abd-60ER). After completing immobilization for 24 h, subjects were asked to assess the discomfort of bracing for overall and individual activities, using a visual analogue scale. Data were compared among the four positions. For overall activities and several activities (eating, reading books, and removing and putting on pants), Abd-60ER was significantly more uncomfortable than adducted arm positions. Abd-30ER did not show any differences compared to the other arm positions. Immobilization in abduction and external rotation seems to be acceptable although the arm position in 30° of abduction and 60° of external rotation is less comfortable than the others. Our results might be useful in determining and developing the ideal shoulder brace which could keep patients' compliance and improve their outcomes. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  2. ADAPTATION OF DASH OUTCOME MEASURES TO SLOVENIAN POPULATION - FUNCTIONALITY OF ARM, SHOULDER AND HAND

    Directory of Open Access Journals (Sweden)

    Katja Semprimožnik

    2015-04-01

    Full Text Available  ABSTRACT BackgroundIn Slovenia, there is no test for upper limb function, which would be uniform for all institutions and would allow comparison of results of the therapy and upper limb rehabilitation with medical centers. MethodsAfter reviewing the existing hand function tests and current literature we decided to translate the DASH test - Disabilities of arm, shoulder and hand. Adaptation was tested on patient population in outpatient hand clinic, General hospital Celje and showed good validity, reliability and responsiveness. Results and discussionAdaptation of DASH test to Slovene population is a procedure, where language and cultural differences must be considered. Testing the adapted DASH in the general population shows good validity, reliability and responsiveness of adapted test. ConclusionTranslations DASH test, QuickDASH test and instructions for scoring the DASH outcome measures are approved by the Institute for Work and Health. Translations are published on their site and available for use.

  3. Validity of ultrasonography and measures of adult shoulder function and reliability of ultrasonography in detecting shoulder synovitis in patients with rheumatoid arthritis using magnetic resonance imaging as a gold standard.

    LENUS (Irish Health Repository)

    Bruyn, G A W

    2010-08-01

    To assess the intra- and interobserver reproducibility of musculoskeletal ultrasonography (US) in detecting inflammatory shoulder changes in patients with rheumatoid arthritis, and to determine the agreement between US and the Shoulder Pain and Disability Index (SPADI) and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, using magnetic resonance imaging (MRI) as a gold standard.

  4. Mechanisms of traumatic shoulder injury in elite rugby players

    Science.gov (United States)

    Crichton, James; Jones, Doug R; Funk, Lennard

    2012-01-01

    Background Shoulder injuries in rugby players are common, but the mechanisms of injury are less well understood. This study aims to elucidate common mechanisms of injury and identify the patterns of injury they produce. Materials and methods Twenty-four elite rugby players, referred to the senior author for diagnosis and management of shoulder injuries, were selected. Videos of the injuries were independently reviewed by rugby-medical experts to describe the mechanisms of injury. The mechanisms reported were collated and analysed to determine the level of agreement between reviewers and conclude an overall description of injury mechanisms. Results The authors identified three mechanisms of shoulder injury from the video analysis. These are the ‘Try-Scorer’, characterised by hyperflexion of the outstretched arm such as when scoring a try; the ‘Tackler’, extension of the abducted arm behind the player while tackling; and the ‘Direct Impact’, a direct blow to the arm or shoulder when held by the side in neutral or slight adduction. The Try Scorer and Tackler mechanisms both involve a levering force on the glenohumeral joint (GHJ). These mechanisms predominantly cause GHJ dislocation, with Bankart, reverse Bankart and superior labrum anterior–posterior tears. The Try-Scorer Mechanism also caused the majority (83%) of rotator cuff tears. The Direct Hit mechanism resulted in GHJ dislocation and labral injury in 37.5% of players and was most likely to cause acromioclavicular joint dislocation and scapula fractures, injuries that were not seen with the other mechanisms. Conclusion Greater understanding of the mechanisms involved in rugby shoulder injury is useful in understanding the pathological injuries, guiding treatment and rehabilitation and aiding the development of injury-prevention methods. PMID:22510645

  5. Intra-articular elastofibroma of the shoulder joint

    International Nuclear Information System (INIS)

    Bae, Sang-Jin; Shin, Myung Jin; Kim, Sung Moon; Cho, Kyung-Ja

    2002-01-01

    A 19-year-old man presented with an elastofibroma in his left shoulder joint. The patient had had limitation of motion in his left arm for 3 years, especially when rotating internally. Radiography of his left shoulder showed bone erosion in the neck of the humerus. On MR imaging, a soft tissue mass was noted in the shoulder joint eroding bone. The mass showed similar signal intensity to that of surrounding muscles on T1- and T2-weighted images. At surgery, a soft, encapsulated mass was found attached to the subscapularis muscle. It was pathologically confirmed as an elastofibroma. This unusual manifestation of an elastofibroma is discussed. (orig.)

  6. Assessing the influence of a passive, upper extremity exoskeletal vest for tasks requiring arm elevation: Part I - "Expected" effects on discomfort, shoulder muscle activity, and work task performance.

    Science.gov (United States)

    Kim, Sunwook; Nussbaum, Maury A; Mokhlespour Esfahani, Mohammad Iman; Alemi, Mohammad Mehdi; Alabdulkarim, Saad; Rashedi, Ehsan

    2018-03-07

    Use of exoskeletal vests (designed to support overhead work) can be an effective intervention approach for tasks involving arm elevation, yet little is known on the potential beneficial impacts of their use on physical demands and task performance. This laboratory study (n = 12) evaluated the effects of a prototype exoskeletal vest during simulated repetitive overhead drilling and light assembly tasks. Anticipated or expected benefits were assessed, in terms of perceived discomfort, shoulder muscle activity, and task performance. Using the exoskeletal vest did not substantially influence perceived discomfort, but did decrease normalized shoulder muscle activity levels (e.g., ≤ 45% reduction in peak activity). Drilling task completion time decreased by nearly 20% with the vest, but the number of errors increased. Overall, exoskeletal vest use has the potential to be a new intervention for work requiring arm elevation; however, additional investigations are needed regarding potential unexpected or adverse influences (see Part II). Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. Isokinetic strength of shoulder internal and external rotators in cricket bowlers

    Directory of Open Access Journals (Sweden)

    X.M. Mabasa

    2002-02-01

    Full Text Available The strength of the shoulder internal and external rotators incricket bowlers, may not be sufficient to cope with the demands of bowling.As very little research has been done on cricketers, this study was done to establish the isokinetic strength profile of the shoulder internal andexternal rotators in cricket bowlers.Isokinetic, shoulder rotational strength was evaluated in thirty malecricket volunteers with a mean age of 23.9 years and mean body weight of 70.3 kgs. The Cybex 340 dynamometer multi joint system was used to collect data on shoulder rotation strength in a standing neutral position. Data were collected at four different speeds (60,90,180 and 300deg/sec and were computed for peak torque values for internal and external ratios for both dominant and non dominant shoulders.The results showed no statistically significant difference in the mean shoulder rotational torque between the bowlingand non-bowling shoulders for external rotation (p>0.05, and indicated statistically significant differences in themean shoulder rotational torque between the bowling and non-bowling shoulders for internal rotation (p<0.05. Therewas a significant decrease in isokinetic peak torque production for the external/internal rotator muscles as the speedof contraction increased (p<0.05. The peak torque ratio for the external/internal rotator muscles of the bowling armwere significantly less than of the non-bowling arm (p<0.05. These findings suggest that the strength ratios of thebowling arm need to be considered when managing young cricketers and their injuries.

  8. Preliminary results of training with gravity compensation of the arm in chronic stroke survivors

    NARCIS (Netherlands)

    van der Kooij, Herman; Prange, Grada Berendina; Prange, G.B.; Krabben, T.; Krabben, T.; Renzenbrink, G.H.; Boer, J.; Hermens, Hermanus J.; Jannink, M.J.A.

    2009-01-01

    After stroke, arm function can be limited by a reduction in the selectivity of movements, due to involuntary coupling of shoulder abduction and elbow flexion, limiting the ability to reach. Gravity compensation of the arm reduces the required active shoulder abduction torques, which results in a

  9. Are professional handball players at risk for developing a glenohumeral internal rotation deficit in their dominant arm?

    Science.gov (United States)

    Seabra, Pedro; Van Eck, Carola F; Sá, Márcia; Torres, João

    2017-05-01

    Overhead athletes, such as baseball players, have been shown to have adaptive changes in the shoulder range of motion (ROM) of their dominant arm. Professional handball players are a unique subtype of overhead athletes with very different demands from baseball players. The aim of this study was to determine if professional handball players demonstrate differences in shoulder ROM between their dominant and non-dominant arm and try to relate them with new variables. Fifty professional male handball players were included and completed a questionnaire regarding age at which they started to play, number of hours they practice a week, field position and arm dominance. ROM measurements were performed including forward flexion (FF), external rotation with the shoulder in abduction (ABER) and with adducted arm (ADER) and internal rotation with shoulder in abduction (IR). Statistical analysis was performed to determine differences in ROM between the dominant and non-dominant shoulder and if there is a relationship between these differences and shoulder load or field position. The dominant arm showed decreased internal rotation (47 vs. 56 degrees, p handball players with a first line position have a significant risk for developing a glenohumeral internal rotation deficit, similar to the phenomenon seen in baseball pitchers.

  10. A soft wearable robot for the shoulder: Design, characterization, and preliminary testing.

    Science.gov (United States)

    O'Neill, Ciaran T; Phipps, Nathan S; Cappello, Leonardo; Paganoni, Sabrina; Walsh, Conor J

    2017-07-01

    In this paper, we present a soft wearable robot for the shoulder which has the potential to assist individuals suffering from a range of neuromuscular conditions affecting the shoulder to perform activities of daily living. This wearable robot combines two types of soft textile pneumatic actuators which were custom developed for this particular application to support the upper arm through shoulder abduction and horizontal flexion/extension. The advantage of a textile-based approach is that the robot can be lightweight, low-profile, comfortable and non-restrictive to the wearer, and easy to don like an item of clothing. The actuator's ability to fold flat when not in use allows the robot to be almost invisible under clothing, potentially allowing the user to avoid any stigma associated with using assistive devices in public. To abduct the arm, a textilebased pneumatic actuator was developed to fit within the axilla to push the arm upwards, while a pair of smaller actuators pivot the abduction actuator to allow for horizontal extension and flexion. The individual textile actuators were experimentally evaluated before being integrated into a wearable garment. Human subject testing was performed to evaluate the ability of the robot to assist the arm by monitoring changes in biological muscle activity when comparing the robot powered on and off. Preliminary results show large reductions in muscular effort in targeted muscles, demonstrating the feasibility and promise of such a soft wearable robot for the shoulder.

  11. Overhead work and shoulder-neck pain in orchard farmers harvesting pears and apples.

    Science.gov (United States)

    Sakakibara, H; Miyao, M; Kondo, T; Yamada, S

    1995-04-01

    The effects of overhead work were studied by comparing orchard farmers' musculoskeletal symptoms while bagging pears with those same symptoms while bagging apples. The subjects were 52 Japanese female farmers, who were examined twice an evening in late June for bagging pears, and during another evening of late July for bagging apples, when each task had been almost finished. They were questioned about musculoskeletal complaints of stiffness and pain during each job, and examined for muscle tenderness and pain from joint movement. Arm elevation angles during the work were measured for each type of bagging. The prevalence of stiffness and pain in the neck and shoulder, muscle tenderness in the shoulder regions, and pain in neck motion were found to be significantly higher when bagging pears than apples. Musculoskeletal symptoms of parts other than the neck and shoulder did not differ between the two types of bagging. The working posture of elevating the arm more than 90 degrees was assumed to account for 75% of the time bagging pears, against 40% for bagging apples. Overhead work requiring arm elevation and head extension was considered to be closely related with shoulder-neck disorders among farmers.

  12. Influence of frequency and duration of strength training for effective management of neck and shoulder pain

    DEFF Research Database (Denmark)

    Andersen, Christoffer H; Andersen, Lars Louis; Gram, Bibi

    2012-01-01

    training (REF). Primary outcome was self-reported neck and shoulder pain (scale 0-9) and secondary outcome work disability (Disability in Arms, Shoulders and Hands (DASH)). RESULTS: The intention-to-treat analysis showed reduced neck and right shoulder pain in the training groups after 20 weeks compared...

  13. [Stability versus mobility of the shoulder. Biomechanical aspects in athletes].

    Science.gov (United States)

    Pastor, M F; Smith, T; Struck, M; Wellmann, M

    2014-03-01

    The demand profile of athletes shoulders is high. On the one hand the shoulder has to provide a maximum active range of motion that allows rapid movements of the arm and on the other hand it has to be sufficiently stabilized to decelerate rapid movements and to neutralize the resulting translational forces. Two general types of instability can be differentiated in athletes shoulders: the macroinstability typically occurring in athletes involved in contact sports and the microinstability occurring in athletes involved in overhead sports.Repetitive abduction and external rotation movements of athletes involved in overhead sports lead to adaptation of the glenohumeral joint capsule and ligaments. The anterior capsule becomes stretched while the posterior capsule develops tightness. These adaptations can result in an anterior microinstability as well as posterosuperior impingement (PSI) which implicates a pathological contact of the posterosuperior rotator cuff with the posterior glenoid and which is also associated with SLAP lesions. In contrast the shoulders of swimmers are prone to anterosuperior impingement because the arm stroke involves a forceful combined anteflexion, adduction and internal rotation of the arm.The macroinstability of contact athletes is caused by sufficient trauma and characterized by a structural lesion of capsulolabral or bony lesion. While the empirical recurrence risk of young contact athletes is already high, it can be further impaired by bony defects of the glenoid. In suspected cases, critical glenoid defects should be quantified by computed tomography (CT) scans and treated by bony augmentation of the glenoid.

  14. Quasi-static analysis of muscle forces in the shoulder mechanism during wheelchair propulsion

    NARCIS (Netherlands)

    van der Helm, Frans C T; Veeger, H. E J

    During wheelchair propulsion the largest net joint moments and net joint powers are generated around the shoulder. The analysis of the contribution of arm- and shoulder muscles to the joint moments could explain the low efficiency of wheelchair propulsion. Basically, it is assumed that a large

  15. Abduction and external rotation (ABER) MR arthrography of the shoulder. Benefits and limitations

    International Nuclear Information System (INIS)

    Mostafa, A.; Gokan, Takehiko; Munechika, Hirotsugu; Ogawa, Takashi; El-Feky, A.A.

    2001-01-01

    The purpose of this study was to show the benefits and limitations of using abduction and external rotation (ABER) positions of the arm during MR arthrography of the shoulder in the evaluation of the rotator-cuff tendon, the capsulolabral complex and the shoulder joint after surgery. Forty-seven patients complaining of either shoulder instability, chronic shoulder pain, pain of unknown cause or pain following shoulder surgery were studied using the direct MR arthrography technique in both the standard neutral position with the arm adducted as well as with the arm in the ABER position. A correlation was obtained between the MR arthrography findings and the surgical findings in 10 reports and clinical presentations of the examined patients. Three patients [6%] were unable to perform ABER positioning. ABER oblique axial images were better than standard oblique coronal images in revealing undersurface tears of the rotator cuff particularly of the grade I type. Four tears were missed in standard images. Oblique axial images were better than standard axial images in demonstrating non-displaced anterior labral tears. One tear was missed and two tears were suspected in the standard images. Oblique axial images were less sensitive than oblique coronal images in the diagnosis of superior labral tears. Two tears were missed in ABER images. The ABER oblique axial MR arthrogram is a useful adjunct to the standard axial and oblique coronal MR arthrograms for assessment of capsulolabral abnormalities and rotator-cuff tendon tears despite some limitations. (author)

  16. Trunk Muscle Activation at the Initiation and Braking of Bilateral Shoulder Flexion Movements of Different Amplitudes.

    Directory of Open Access Journals (Sweden)

    M Eriksson Crommert

    Full Text Available The aim of this study was to investigate if trunk muscle activation patterns during rapid bilateral shoulder flexions are affected by movement amplitude. Eleven healthy males performed shoulder flexion movements starting from a position with arms along sides (0° to either 45°, 90° or 180°. EMG was measured bilaterally from transversus abdominis (TrA, obliquus internus (OI with intra-muscular electrodes, and from rectus abdominis (RA, erector spinae (ES and deltoideus with surface electrodes. 3D kinematics was recorded and inverse dynamics was used to calculate the reactive linear forces and torque about the shoulders and the linear and angular impulses. The sequencing of trunk muscle onsets at the initiation of arm movements was the same across movement amplitudes with ES as the first muscle activated, followed by TrA, RA and OI. All arm movements induced a flexion angular impulse about the shoulders during acceleration that was reversed during deceleration. Increased movement amplitude led to shortened onset latencies of the abdominal muscles and increased level of activation in TrA and ES. The activation magnitude of TrA was similar in acceleration and deceleration where the other muscles were specific to acceleration or deceleration. The findings show that arm movements need to be standardized when used as a method to evaluate trunk muscle activation patterns and that inclusion of the deceleration of the arms in the analysis allow the study of the relationship between trunk muscle activation and direction of perturbing torque during one and the same arm movement.

  17. Two-Armed, Mobile, Sensate Research Robot

    Science.gov (United States)

    Engelberger, J. F.; Roberts, W. Nelson; Ryan, David J.; Silverthorne, Andrew

    2004-01-01

    The Anthropomorphic Robotic Testbed (ART) is an experimental prototype of a partly anthropomorphic, humanoid-size, mobile robot. The basic ART design concept provides for a combination of two-armed coordination, tactility, stereoscopic vision, mobility with navigation and avoidance of obstacles, and natural-language communication, so that the ART could emulate humans in many activities. The ART could be developed into a variety of highly capable robotic assistants for general or specific applications. There is especially great potential for the development of ART-based robots as substitutes for live-in health-care aides for home-bound persons who are aged, infirm, or physically handicapped; these robots could greatly reduce the cost of home health care and extend the term of independent living. The ART is a fully autonomous and untethered system. It includes a mobile base on which is mounted an extensible torso topped by a head, shoulders, and two arms. All subsystems of the ART are powered by a rechargeable, removable battery pack. The mobile base is a differentially- driven, nonholonomic vehicle capable of a speed >1 m/s and can handle a payload >100 kg. The base can be controlled manually, in forward/backward and/or simultaneous rotational motion, by use of a joystick. Alternatively, the motion of the base can be controlled autonomously by an onboard navigational computer. By retraction or extension of the torso, the head height of the ART can be adjusted from 5 ft (1.5 m) to 6 1/2 ft (2 m), so that the arms can reach either the floor or high shelves, or some ceilings. The arms are symmetrical. Each arm (including the wrist) has a total of six rotary axes like those of the human shoulder, elbow, and wrist joints. The arms are actuated by electric motors in combination with brakes and gas-spring assists on the shoulder and elbow joints. The arms are operated under closed-loop digital control. A receptacle for an end effector is mounted on the tip of the wrist and

  18. [The painful hemiplegic shoulder: effects of exercises program according to Bobath].

    Science.gov (United States)

    Gialanella, B; Benvenuti, P; Santoro, R

    2004-01-01

    To verify whether a shoulder exercises program according to Bobath reduced the shoulder pain in hemiplegic patients. We studied a total of 20 patients with pain shoulder. Ten patients are assigned to group R (submitted to rehabilitation) and ten to group R+E (submitted to rehabilitation and shoulder exercises program according to Bobath). Shoulder exercises program was self-performed by the patients after training in occupational rehabilitation unit. The assessment of patients was performed at admission to hospital, at discharge and three months after discharge. Shoulder pain (VAS), shoulder range of motion, disability (FIM), motor function (Fugl-Meyer scale) and spasticity (Ashworth scale) of paretic arm were evaluated in all patients. VAS was similar in both groups at admission and decreased in group R+E at discharge without reaching significant differences (p=0.253). On the contrary, VAS and Shoulder range of motion improved statistically in group R+E (p=0.0001, pBobath reduces shoulder pain of patients with hemiplegia if it is performed daily and for a long period of time.

  19. Effects of practice variability on unimanual arm rotation.

    Science.gov (United States)

    James, Eric G; Conatser, Phillip

    2014-01-01

    High variability practice has been found to lead to a higher rate of motor learning than low variability practice in sports tasks. The authors compared the effects of low and high levels of practice variability on a simple unimanual arm rotation task. Participants performed rhythmic unimanual internal-external arm rotation as smoothly as possible before and after 2 weeks of low (LV) or high (HV) variability practice and after a 2-week retention interval. Compared to the pretest, the HV group significantly decreased hand, radioulnar, and shoulder rotation jerk on the retention test and shoulder jerk on the posttest. After training the LV group had lower radioulnar and shoulder jerk on the posttest but not the retention test. The results supported the hypothesis that high variability practice would lead to greater learning and reminiscence than low variability practice and the theoretical prediction of a bifurcation in the motor learning dynamics.

  20. Effect of pitching consecutive days in youth softball tournaments on objective shoulder strength and subjective shoulder symptoms

    Science.gov (United States)

    Skillington, S. Andrew; Brophy, Robert H.; Wright, Rick W.; Smith, Matthew V.

    2017-01-01

    Background The windmill pitching motion has been associated with risk for shoulder injury. Since there are no pitching limits on youth fast-pitch softball pitchers, these athletes often pitch multiple games across consecutive days. Strength changes, fatigue levels, and shoulder pain that develop among female fast-pitch pitchers over the course of consecutive days of pitching have not been investigated. Hypothesis Over the course of 2 and 3-day fast-pitch softball tournaments, pitchers will develop progressive objective weakness and increased subjective shoulder fatigue and pain without complete recovery between days. Study Design Cross-Sectional Study. Methods Female fast-pitch softball pitchers between the ages of 14 and 18 who were pitching in 2 and 3-day tournaments were recruited for study participation. At the beginning and end of each day of tournament play, pitchers were asked to quantify shoulder fatigue and shoulder pain levels of their dominant throwing arm using a 10-point visual analog scale (VAS). Shoulder abduction, flexion, external rotation, internal rotation, elbow flexion, and elbow extension strength measurements were gathered using a hand-held dynamometer. Results Over the course of an average single day of tournament participation, pitchers developed significant increases in VAS shoulder fatigue (2.0, 95% CI: 1.3 to 3.0), and pain (1.3, 95% CI: 0.5 to 2.3) and significant strength loss in all tested motions. Pitchers also developed significant increases in VAS shoulder fatigue (3.5, 95% CI: 1.5 to 5.5), VAS shoulder pain (2.5, 95% CI: 1.0 to 4.5) and strength loss in all tested motions over the entire tournament. Shoulder pain, fatigue, and strength do not fully recover between days. The accumulation of subjective shoulder pain and fatigue over the course of tournament play were closely correlated. Conclusion Among youth female fast-pitch softball pitchers, there is a progressive increase in shoulder fatigue, pain, and weakness over the course

  1. Measurement and Quantification of Gross Human Shoulder Motion

    Directory of Open Access Journals (Sweden)

    Jeremy T. Newkirk

    2013-01-01

    Full Text Available The shoulder girdle plays an important role in the large pointing workspace that humans enjoy. The goal of this work was to characterize the human shoulder girdle motion in relation to the arm. The overall motion of the human shoulder girdle was characterized based on motion studies completed on test subjects during voluntary (natural/unforced motion. The collected data from the experiments were used to develop surface fit equations that represent the position and orientation of the glenohumeral joint for a given humeral pointing direction. These equations completely quantify gross human shoulder girdle motion relative to the humerus. The equations are presented along with goodness-of-fit results that indicate the equations well approximate the motion of the human glenohumeral joint. This is the first time the motion has been quantified for the entire workspace, and the equations provide a reference against which to compare future work.

  2. Sensory-Feedback Exoskeletal Arm Controller

    Science.gov (United States)

    An, Bin; Massie, Thomas H.; Vayner, Vladimir

    2004-01-01

    An electromechanical exoskeletal arm apparatus has been designed for use in controlling a remote robotic manipulator arm. The apparatus, called a force-feedback exoskeleton arm master (F-EAM) is comfortable to wear and easy to don and doff. It provides control signals from the wearer s arm to a robot arm or a computer simulator (e.g., a virtual-reality system); it also provides force and torque feedback from sensors on the robot arm or from the computer simulator to the wearer s arm. The F-EAM enables the wearer to make the robot arm gently touch objects and finely manipulate them without exerting excessive forces. The F-EAM features a lightweight design in which the motors and gear heads that generate force and torque feedback are made smaller than they ordinarily would be: this is achieved by driving the motors to power levels greater than would ordinarily be used in order to obtain higher torques, and by providing active liquid cooling of the motors to prevent overheating at the high drive levels. The F-EAM (see figure) includes an assembly that resembles a backpack and is worn like a backpack, plus an exoskeletal arm mechanism. The FEAM has five degrees of freedom (DOFs) that correspond to those of the human arm: 1. The first DOF is that of the side-to-side rotation of the upper arm about the shoulder (rotation about axis 1). The reflected torque for this DOF is provided by motor 1 via drum 1 and a planar four-bar linkage. 2. The second DOF is that of the up-and-down rotation of the arm about the shoulder. The reflected torque for this DOF is provided by motor 2 via drum 2. 3. The third DOF is that of twisting of the upper arm about its longitudinal axis. This DOF is implemented in a cable remote-center mechanism (CRCM). The reflected torque for this DOF is provided by motor 3, which drives the upper-arm cuff and the mechanism below it. A bladder inflatable by gas or liquid is placed between the cuff and the wearer s upper arm to compensate for misalignment

  3. At-home resistance tubing strength training increases shoulder strength in the trained and untrained limb.

    Science.gov (United States)

    Magnus, C R A; Boychuk, K; Kim, S Y; Farthing, J P

    2014-06-01

    The purpose was to determine if an at-home resistance tubing strength training program on one shoulder (that is commonly used in rehabilitation settings) would produce increases in strength in the trained and untrained shoulders via cross-education. Twenty-three participants were randomized to TRAIN (strength-trained one shoulder; n = 13) or CONTROL (no intervention; n = 10). Strength training was completed at home using resistance tubing and consisted of maximal shoulder external rotation, internal rotation, scaption, retraction, and flexion 3 days/week for 4 weeks. Strength was measured via handheld dynamometry and muscle size measured via ultrasound. For external rotation strength, the trained (10.9 ± 10.9%) and untrained (12.7 ± 9.6%) arm of TRAIN was significantly different than CONTROL (1.6 ± 13.2%; -2.7 ± 12.3%; pooled across arm; P tubing training program on one limb can produce increases in strength in both limbs, and has implications for rehabilitation after unilateral shoulder injuries. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Stochastic estimation of human shoulder impedance with robots: an experimental design.

    Science.gov (United States)

    Park, Kyungbin; Chang, Pyung Hun

    2011-01-01

    Previous studies assumed the shoulder as a hinge joint during human arm impedance measurement. This is obviously a vast simplification since the shoulder is a complex of several joints with multiple degrees of freedom. In the present work, a practical methodology for more general and realistic estimation of human shoulder impedance is proposed and validated with a spring array. It includes a gravity compensation scheme, which is developed and used for the experiments with a spatial three degrees of freedom PUMA-type robot. The experimental results were accurate and reliable, and thus it has shown a strong potential of the proposed methodology in the estimation of human shoulder impedance. © 2011 IEEE

  5. The radiographic acromiohumeral interval is affected by arm and radiographic beam position

    Energy Technology Data Exchange (ETDEWEB)

    Fehringer, Edward V.; Rosipal, Charles E.; Rhodes, David A.; Lauder, Anthony J.; Feschuk, Connie A.; Mormino, Matthew A.; Hartigan, David E. [University of Nebraska Medical Center, Department of Orthopaedic Surgery and Rehabilitation, Omaha, NE (United States); Puumala, Susan E. [Nebraska Medical Center, Department of Preventive and Societal Medicine, Omaha, NE (United States)

    2008-06-15

    The objective was to determine whether arm and radiographic beam positional changes affect the acromiohumeral interval (AHI) in radiographs of healthy shoulders. Controlling for participant's height and position as well as radiographic beam height and angle, from 30 right shoulders of right-handed males without shoulder problems four antero-posterior (AP) radiographic views each were obtained in defined positions. Three independent, blinded physicians measured the AHI to the nearest millimeter in 120 randomized radiographs. Mean differences between measurements were calculated, along with a 95% confidence interval. Controlling for observer effect, there was a significant difference between AHI measurements on different views (p<0.01). All pair-wise differences were statistically significant after adjusting for multiple comparisons (all p values <0.01). Even in healthy shoulders, small changes in arm position and radiographic beam orientation affect the AHI in radiographs. (orig.)

  6. Simultaneous and Continuous Estimation of Shoulder and Elbow Kinematics from Surface EMG Signals

    Directory of Open Access Journals (Sweden)

    Qin Zhang

    2017-05-01

    Full Text Available In this paper, we present a simultaneous and continuous kinematics estimation method for multiple DoFs across shoulder and elbow joint. Although simultaneous and continuous kinematics estimation from surface electromyography (EMG is a feasible way to achieve natural and intuitive human-machine interaction, few works investigated multi-DoF estimation across the significant joints of upper limb, shoulder and elbow joints. This paper evaluates the feasibility to estimate 4-DoF kinematics at shoulder and elbow during coordinated arm movements. Considering the potential applications of this method in exoskeleton, prosthetics and other arm rehabilitation techniques, the estimation performance is presented with different muscle activity decomposition and learning strategies. Principle component analysis (PCA and independent component analysis (ICA are respectively employed for EMG mode decomposition with artificial neural network (ANN for learning the electromechanical association. Four joint angles across shoulder and elbow are simultaneously and continuously estimated from EMG in four coordinated arm movements. By using ICA (PCA and single ANN, the average estimation accuracy 91.12% (90.23% is obtained in 70-s intra-cross validation and 87.00% (86.30% is obtained in 2-min inter-cross validation. This result suggests it is feasible and effective to use ICA (PCA with single ANN for multi-joint kinematics estimation in variant application conditions.

  7. The efficacy of physiotherapy upon shoulder function following axillary dissection in breast cancer, a randomized controlled study

    Directory of Open Access Journals (Sweden)

    Oostendorp Rob AB

    2007-08-01

    Full Text Available Abstract Background Many patients suffer from severe shoulder complaints after breast cancer surgery and axillary lymph node dissection. Physiotherapy has been clinically observed to improve treatment of these patients. However, it is not a standard treatment regime. The purpose of this study is to investigate the efficacy of physiotherapy treatment of shoulder function, pain and quality of life in patients who have undergone breast cancer surgery and axillary lymph node dissection. Methods Thirty patients following breast cancer surgery and axillary lymph node dissection were included in a randomised controlled study. Assessments were made at baseline and after three and six months. The treatment group received standardised physiotherapy treatment of advice and exercises for the arm and shoulder for three months; the control group received a leaflet containing advice and exercises. If necessary soft tissue massage to the surgical scar was applied. Primary outcome variables were amount of pain in the shoulder/arm recorded on the Visual Analogue Scale, and shoulder mobility (flexion, abduction measured using a digital inclinometer under standardized conditions. Secondary outcome measures were shoulder disabilities during daily activities, edema, grip strength of both hands and quality of life. The researcher was blinded to treatment allocation. Results All thirty patients completed the trial. After three and six months the treatment group showed a significant improvement in shoulder mobility and had significantly less pain than the control group. Quality of life improved significantly, however, handgrip strength and arm volume did not alter significantly. Conclusion Physiotherapy reduces pain and improves shoulder function and quality of life following axillary dissection after breast cancer. Trial registration ISRCTN31186536

  8. [Management of shoulder dystocia].

    Science.gov (United States)

    Le Ray, C; Oury, J-F

    2015-12-01

    The objective of this review is to propose recommendations on the management of shoulder dystocia. The PubMed database, the Cochrane Library and the recommendations from the foreign obstetrical societies or colleges have been consulted. In case of shoulder dystocia, if the obstetrician is not present at delivery, he should be systematically informed as quickly as possible (professional consensus). A third person should also be called for help in order to realize McRoberts maneuver (professional consensus). The patient has to be properly installed in gynecological position (professional consensus). It is recommended not to pull excessively on the fetal head (grade C), do not perform uterine expression (grade C) and do not realize inverse rotation of the fetal head (professional consensus). McRoberts maneuver, with or without a suprapubic pressure, is simple to perform, effective and associated with low morbidity, thus, it is recommended in the first line (grade C). Regarding the maneuvers of the second line, the available data do not suggest the superiority of one maneuver in relation to another (grade C). We proposed an algorithm; however, management should be adapted to the experience of the operator. If the posterior shoulder is engaged, Wood's maneuver should be performed preferentially; if the posterior shoulder is not engaged, delivery of the posterior arm should be performed preferentially (professional consensus). Routine episiotomy is not recommended in shoulder dystocia (professional consensus). Other second intention maneuvers are described. It seems necessary to know at least two maneuvers to perform in case of shoulder dystocia unresolved by the maneuver McRoberts (professional consensus). All physicians and midwives should know and perform obstetric maneuvers if needed quickly but without precipitation. Copyright © 2015. Published by Elsevier Masson SAS.

  9. Reverse shoulder arthroplasty leads to significant biomechanical changes in the remaining rotator cuff

    Directory of Open Access Journals (Sweden)

    Perka Carsten

    2011-08-01

    Full Text Available Abstract Objective After reverse shoulder arthroplasty (RSA external and internal rotation will often remain restricted. A postoperative alteration of the biomechanics in the remaining cuff is discussed as a contributing factor to these functional deficits. Methods In this study, muscle moment arms as well as origin-to-insertion distance (OID were calculated using three-dimensional models of the shoulder derived from CT scans of seven cadaveric specimens. Results Moment arms for humeral rotation are significantly smaller for the cranial segments of SSC and all segments of TMIN in abduction angles of 30 degrees and above (p ≤ 0.05. Abduction moment arms were significantly decreased for all segments (p ≤ 0.002. OID was significantly smaller for all muscles at the 15 degree position (p ≤ 0.005, apart from the cranial SSC segment. Conclusions Reduced rotational moment arms in conjunction with the decrease of OID may be a possible explanation for the clinically observed impaired external and internal rotation.

  10. Change in neck circumference after shoulder arthroscopy: An observational study

    Directory of Open Access Journals (Sweden)

    Shrividya Chellam

    2015-01-01

    Full Text Available Background and Aims: Shoulder arthroscopy requires fluid irrigation, which causes soft-tissue oedema around chest, neck, and arm intraoperatively, leading to postoperative airway complications. We decided to study the incidence of increase in the neck circumference in shoulder arthroscopy and its effects on the airway. Methods: We studied 32 cases of shoulder arthroscopies over a period of 1-year, performed under general anaesthesia with interscalene block. The neck circumference of patients before and after the procedure was measured along with other parameters. The endotracheal tube cuff was deflated at the end of surgery to determine air leak around the tube. The negative leak test suggested airway oedema. Results: Thirty out of 32 patients showed positive air leak test. The average change in neck circumference was 1.17 ± 1.16 cm and all could be extubated uneventfully. Two showed negative leak test with an increase in neck circumference by 4.5 and 6.4 cm and were not extubated. Multiple regression analysis for risk factors showed intraoperative hypertension as a single predictor for an increase in neck circumference. Conclusion: Change in the neck circumference beyond 4 cm may suggest airway compromise and below 4 cm, airway compromise is unlikely even in the presence of extensive soft-tissue oedema around the shoulder, upper arm and chest.

  11. Effect of Pitching Consecutive Days in Youth Fast-Pitch Softball Tournaments on Objective Shoulder Strength and Subjective Shoulder Symptoms.

    Science.gov (United States)

    Skillington, S Andrew; Brophy, Robert H; Wright, Rick W; Smith, Matthew V

    2017-05-01

    The windmill pitching motion has been associated with risk for shoulder injury. Because there are no pitching limits on youth fast-pitch softball pitchers, these athletes often pitch multiple games across consecutive days. Strength changes, fatigue levels, and shoulder pain that develop among female fast-pitch pitchers over the course of consecutive days of pitching have not been investigated. Over the course of 2- and 3-day fast-pitch softball tournaments, pitchers will develop progressive objective weakness and increased subjective shoulder fatigue and pain without complete recovery between days. Cross-sectional study; Level of evidence, 3. Fourteen female fast-pitch softball pitchers between the ages of 14 and 18 years were evaluated for strength and fatigue changes across 2- and 3-day tournaments. At the beginning and end of each day of tournament play, pitchers were asked to quantify shoulder fatigue and shoulder pain levels of their dominant throwing arm using a 10-point visual analog scale (VAS). Shoulder abduction, flexion, external rotation, internal rotation, elbow flexion, and elbow extension strength measurements were gathered using a handheld dynamometer. Over the course of an average single day of tournament participation, pitchers developed significant increases in VAS scores for shoulder fatigue (median, 2.0; 95% CI, 1.3-3.0) and pain (median, 1.3; 95% CI, 0.5-2.3) and significant strength loss in all tested motions. Pitchers also developed significant increases in VAS shoulder fatigue (median, 3.5; 95% CI, 1.5-5.5), VAS shoulder pain (median, 2.5; 95% CI, 1.0-4.5), and strength loss in all tested motions over the entire tournament. Shoulder pain, fatigue, and strength do not fully recover between days. The accumulation of subjective shoulder pain and fatigue over the course of tournament play were closely correlated. Among youth female fast-pitch softball pitchers, there is a progressive increase in shoulder fatigue, pain, and weakness over the

  12. Evaluation of Arm and Shoulder Mobility and Strength after Modified Radical Mastectomy and Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Blomqvist, Lennart; Stark, Birgit; Engler, Natacha; Malm, Maj [Karolinska Inst., Stockholm (Sweden). Dept. of Physiotherapy Center for Surgical Sciences

    2004-04-01

    Seventy-five women, of whom 30 had received postoperative radiotherapy, were tested for range of motion (ROM) and shoulder strength with a goniometer and an isokinetic device (Orthotron II), respectively. On the individual level, irradiated patients exhibited significantly reduced range of motion (varying from p<0.05 to p<0.001) for all movements compared with the non-operated side. In contrast, in the non-irradiated patients only flexion was significantly reduced (p<0.05). The same individual pattern was evident for shoulder strength where all movements except external rotation were significantly reduced in irradiated patients (varying from p<0.05 to p<0.001). Non-irradiated patients exhibited a significant reduction in shoulder strength for flexion and abduction (p<0.05), whereas other movements were less affected. The observed differences in ROM and strength were less pronounced when analyzed on a group level, but were still significant for ROM (p<0.001) for flexion and abduction. Group level analysis also showed reduced shoulder strength for all movements but only rotation was significantly (p<0.01) impaired.

  13. Evaluation of Arm and Shoulder Mobility and Strength after Modified Radical Mastectomy and Radiotherapy

    International Nuclear Information System (INIS)

    Blomqvist, Lennart; Stark, Birgit; Engler, Natacha; Malm, Maj

    2004-01-01

    Seventy-five women, of whom 30 had received postoperative radiotherapy, were tested for range of motion (ROM) and shoulder strength with a goniometer and an isokinetic device (Orthotron II), respectively. On the individual level, irradiated patients exhibited significantly reduced range of motion (varying from p<0.05 to p<0.001) for all movements compared with the non-operated side. In contrast, in the non-irradiated patients only flexion was significantly reduced (p<0.05). The same individual pattern was evident for shoulder strength where all movements except external rotation were significantly reduced in irradiated patients (varying from p<0.05 to p<0.001). Non-irradiated patients exhibited a significant reduction in shoulder strength for flexion and abduction (p<0.05), whereas other movements were less affected. The observed differences in ROM and strength were less pronounced when analyzed on a group level, but were still significant for ROM (p<0.001) for flexion and abduction. Group level analysis also showed reduced shoulder strength for all movements but only rotation was significantly (p<0.01) impaired

  14. The Influence of Surgical Stabilization on Glenohumeral Abduction Using 3-Dimensional Computed Tomography in Patients With Shoulder Instability.

    Science.gov (United States)

    Bakshi, Neil K; Jameel, Omar F; Merrill, Zachary F; Debski, Richard E; Sekiya, Jon K

    2016-08-01

    This study compared the amount of glenohumeral abduction during arm abduction in the affected and unaffected shoulders of 3 groups of patients with shoulder instability: failed surgical stabilization, successful surgical stabilization, and unstable shoulder with no prior surgical intervention. All patients underwent bilateral shoulder computed tomography scans in 3 positions: 0° of abduction and 0° of external rotation (0-0 position), 30° of abduction and 30° of external rotation (30-30 position), and arms maximally abducted (overhead position). Three-dimensional computed tomography reconstruction was performed for both shoulders in all 3 positions. A specialized coordinate system marked specific points and directions on the humerus and glenoid of each model. These coordinates were used to calculate the glenohumeral abduction for the normal and affected sides in the 0-0, 30-30, and overhead positions. Thirty-nine patients with shoulder instability were included, of whom 14 had failed surgical repairs, 10 had successful surgical repairs, and 15 had unstable shoulders with no prior surgical intervention. In the overhead position, patients with failed surgical intervention had significantly less glenohumeral abduction in the failed shoulder (95.6° ± 12.7°) compared with the normal shoulder (101.5° ± 12.4°, P = .02). Patients with successfully stabilized shoulders had significantly less glenohumeral abduction in the successfully stabilized shoulder (93.6° ± 10.8°) compared with the normal shoulder (102.1° ± 12.5°, P = .03). Unstable shoulders with no prior surgical intervention (102.1° ± 10.3°) did not differ when compared with the normal shoulders (101.9° ± 10.9°, P = .95). Surgical intervention, regardless of its success, limits the amount of abduction at the glenohumeral joint. Level III, retrospective comparative study. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  15. Development of a 3D workspace shoulder assessment tool incorporating electromyography and an inertial measurement unit-a preliminary study.

    Science.gov (United States)

    Aslani, Navid; Noroozi, Siamak; Davenport, Philip; Hartley, Richard; Dupac, Mihai; Sewell, Philip

    2018-06-01

    Traditional shoulder range of movement (ROM) measurement tools suffer from inaccuracy or from long experimental setup times. Recently, it has been demonstrated that relatively low-cost wearable inertial measurement unit (IMU) sensors can overcome many of the limitations of traditional motion tracking systems. The aim of this study is to develop and evaluate a single IMU combined with an electromyography (EMG) sensor to monitor the 3D reachable workspace with simultaneous measurement of deltoid muscle activity across the shoulder ROM. Six volunteer subjects with healthy shoulders and one participant with a 'frozen' shoulder were recruited to the study. Arm movement in 3D space was plotted in spherical coordinates while the relative EMG intensity of any arm position is presented graphically. The results showed that there was an average ROM surface area of 27291 ± 538 deg 2 among all six healthy individuals and a ROM surface area of 13571 ± 308 deg 2 for the subject with frozen shoulder. All three sections of the deltoid show greater EMG activity at higher elevation angles. Using such tools enables individuals, surgeons and physiotherapists to measure the maximum envelope of motion in conjunction with muscle activity in order to provide an objective assessment of shoulder performance in the voluntary 3D workspace. Graphical abstract The aim of this study is to develop and evaluate a single IMU combined with an electromyography (EMG) sensor to monitor the 3D reachable workspace with simultaneous measurement of deltoid muscle activity across the shoulder ROM. The assessment tool consists of an IMU sensor, an EMG sensor, a microcontroller and a Bluetooth module. The assessment tool was attached to subjects arm. Individuals were instructed to move their arms with the elbow fully extended. They were then asked to provide the maximal voluntary elevation envelope of the arm in 3D space in multiple attempts starting from a small movement envelope going to the biggest

  16. Irreducible Traumatic Posterior Shoulder Dislocation

    Directory of Open Access Journals (Sweden)

    Blake Collier

    2017-01-01

    Full Text Available History of present illness: A 22-year-old male presented to the Emergency Department complaining of right shoulder pain after a motocross accident. He was traveling at approximately 10 mph around a turn when he lost control and was thrown over the handlebars, landing directly on his right shoulder. On arrival, he was holding his arm in adduction and internal rotation. An area of swelling was noted over his anterior shoulder. He was unable to abduct his shoulder. No humeral gapping was noted. He had normal neuro-vascular status distal to the injury. Significant findings: Radiographs demonstrated posterior displacement of the humeral head on the “Y” view (see white arrow and widening of the glenohumeral joint space on anterior-posterior view (see red arrow. The findings were consistent with posterior dislocation and a Hill-Sachs type deformity. Sedation was performed and reduction was attempted using external rotation, traction counter-traction. An immediate “pop” was felt during the procedure. Post-procedure radiographs revealed a persistent posterior subluxation with interlocking at posterior glenoid. CT revealed posterior dislocation with acute depressed impaction deformity medial to the biceps groove with the humeral head perched on the posterior glenoid, interlocked at reverse Hill-Sachs deformity (see blue arrow. Discussion: Posterior shoulder dislocations are rare and represent only 2% of all shoulder dislocations. Posterior shoulder dislocations are missed on initial diagnosis in more than 60% of cases.1 Posterior shoulder dislocations result from axial loading of the adducted and internally rotated shoulder, violent muscle contractions (resulting from seizures or electrocution, a direct posterior force applied to the anterior shoulder.1 Physical findings include decreased anterior prominence of the humeral head, increased palpable posterior prominence of the humeral head below the acromion, increased palpable prominence of the

  17. Measurement and description of three-dimensional shoulder range of motion with degrees of freedom interactions.

    Science.gov (United States)

    Haering, Diane; Raison, Maxime; Begon, Mickael

    2014-08-01

    The shoulder is the most mobile joint of the human body due to bony constraint scarcity and soft tissue function unlocking several degrees of freedom (DOF). Clinical evaluation of the shoulder range of motion (RoM) is often limited to a few monoplanar measurements where each DOF varies independently. The main objective of this study was to provide a method and its experimental approach to assess shoulder 3D RoM with DOF interactions. Sixteen participants performed four series of active arm movements with maximal amplitude consisting in (1) elevations with fixed arm axial rotations (elevation series), (2) axial rotations at different elevations (rotation series), both in five planes of elevation, (3) free arm movements with the instruction to fill the largest volume in space while varying hand orientation (random series), and (4) a combination of elevation and rotation series (overall series). A motion analysis system combined with an upper limb kinematic model was used to estimate the 3D joint kinematics. Thoracohumeral Euler angles with correction were chosen to represent rotations. The angle-time-histories were treated altogether to analyze their 3D interaction. Then, all 3D angular poses were included into a nonconvex hull representing the RoM space accounting for DOF interactions. The effect of series of movements (n = 4) on RoM volumes was tested with a one-way repeated-measures ANOVA followed by Bonferroni posthoc analysis. A normalized 3D RoM space was defined by including 3D poses common to a maximal number of participants into a hull of average volume. A significant effect of the series of movements (p measured the largest RoM with an average volume of 3.46 ± 0.89 million cubic degrees. The main difference between the series of movements was due to axial rotation. A normalized RoM hull with average volume was found by encompassing arm poses common to more than 50% of the participants. In general, the results confirmed and characterized the complex 3D

  18. Effects of external rotation on anteroposterior translations in the shoulder: a pilot study.

    Science.gov (United States)

    Brown, Andrew J; Debski, Richard E; Voycheck, Carrie A; McMahon, Patrick J

    2014-08-01

    Using physical examination to make the diagnosis of shoulder instability can be difficult, because typical examination maneuvers are qualitative, difficult to standardize, and not reproducible. Measuring shoulder translation is especially difficult, which is a particular problem, because measuring it inaccurately may result in improper treatment of instability. The objective of this study was to use a magnetic motion tracking system to quantify the effects of external rotation of the abducted shoulder on a simulated simple translation test in healthy subjects. Specifically, we hypothesized that (1) increasing external rotation of the abducted shoulder would result in decreasing translation; (2) intraobserver repeatability would be less than 2 mm at all external rotation positions; and (3) mean side-to-side differences would be less than 2 mm at all external rotation positions. The intraobserver repeatability and side-to-side differences of AP translation were quantified with a noninvasive magnetic motion tracking system and automated data analysis routine in nine healthy subjects at four positions of external rotation with the arm abducted. A shoulder positioning apparatus was used to maintain the desired arm position. No differences in translations between the positions of external rotation were found (p = 0.48). Intraobserver repeatability was 1.1 mm (SD, 0.8 mm) and mean side-to-side differences were small: 2.7 mm (SD, 2.8 mm), 2.8 mm (SD, 1.8 mm), 2.5 mm (SD, 1.8 mm), and 4.0 mm (SD, 2.6 mm) at 0°, 20°, 40°, and 60° of external rotation, respectively. The intraobserver repeatability was strong and the side-to-side differences in translation were small with the magnetic motion tracking system, which is encouraging for development of an improved quantitative test to assess shoulder translation for fast and low-cost diagnosis of shoulder instability. Clinicians may not have to position the contralateral, normal, abducted shoulder in precisely the same position

  19. A Bioinspired 10 DOF Wearable Powered Arm Exoskeleton for Rehabilitation

    Directory of Open Access Journals (Sweden)

    Soumya Kanti Manna

    2013-01-01

    Full Text Available The developed exoskeleton device (Exorn has ten degrees of freedom to control joints starting from shoulder griddle to wrist to provide better redundancy, portability, and flexibility to the human arm motion. A 3D conceptual model is being designed to make the system wearable by human arm. All the joints are simple revolute joints with desired motion limit. A Simulink model of the human arm is being developed with proper mass and length to determine proper torque required for actuating those joints. Forward kinematics of the whole system has been formulated for getting desired dexterous workspace. A proper and simple Graphical User Interface (GUI and the required embedded system have been designed for providing physiotherapy lessons to the patients. In the literature review it has been found that researchers have generally ignored the motion of shoulder griddle. Here we have implemented those motions in our design. It has also been found that people have taken elbow pronation and supination motion as a part of shoulder internal and external rotation though both motions are quite different. A predefined resolved motion rate control structure with independent joint control is used so that all movements can be controlled in a predefined way.

  20. A randomized controlled trial of a modified wheelchair arm-support to reduce shoulder pain in stroke patients.

    Science.gov (United States)

    Pan, Ruihuan; Zhou, Mingchao; Cai, Hao; Guo, Youhua; Zhan, Lechang; Li, Mei; Yang, Zhijing; Zhu, Leying; Zhan, Jie; Chen, Hongxia

    2018-01-01

    To evaluate the effect of modified wheelchair arm-support to mitigate hemiplegic shoulder pain and reduce pain frequency in stroke patients. A single-blind randomized controlled trial using computer-generated simple randomization. Participants recruited from inpatients at the Guangdong Provincial Hospital of Chinese Medicine. A total of 120 patients with stroke were divided into two groups. All subjects underwent basic rehabilitation training and wheelchair assistance with eight weeks follow-up period. Patients in the treatment group additionally received modified wheelchair arm-support for at least 60 minutes a day, six days a week, for four weeks. Primary outcome was measured by the Visual Analogue Pain Scale or Numeric Pain Rating Scale. Secondary outcome was measured using the Upper Extremity Fugl-Meyer Assessment scale, Modified Barthel Index and Quality of Life Index. Measurements were made at 4 weeks and 12 weeks, following the intervention. Patients age from 21 to 83 years (mean ± SD = 62.41 ± 12.26). The average duration of disease was 1.9 ± 1.3 months. At four weeks, the median of pain intensity was higher in the control group (median, interquartile range = 3, 5.75 vs. 2, 3.75; P = 0.059). At 12 weeks, the median of pain intensity was higher in the control group (median, interquartile range = 3, 5.00 vs. 0, 1.00; P vs. 1; P stroke patients. It may also improve the patients' quality of life.

  1. Intraarticular findings in the chronically painful shoulder. A study of 32 posttraumatic cases

    DEFF Research Database (Denmark)

    Suder, P.A.; Hougaard, K.; Frich, Lars Henrik

    1994-01-01

    the head activities. Symptoms of a "dead arm" and instability were also present. Patients with previous dislocations, traumas or radiographic signs of degenerative shoulder lesions were excluded. The patients had a decreased active range of motion and positive signs of apprehension and impingement......32 consecutive patients suffering from chronic shoulder pain for more than 6 months after a single, nondislocating shoulder trauma were examined clinically and by special radiographs, dynamic sonography, MRI and arthroscopy. Typical complaints were pain during loading, especially during over......, but only 4 had clinical signs of shoulder instability. Diagnostic evaluation identified labral tears, partial and total rotator cuff lesions with subacromial impingement and tendinitis of the biceps tendon. Surgery was performed in 24 patients, using capsulolabral and rotator cuff reconstruction...

  2. Shoulder Dynamic Control Ratio and Rotation Range of Motion in Female Junior Elite Handball Players and Controls.

    Science.gov (United States)

    van Cingel, Robert; Habets, Bas; Willemsen, Linn; Staal, Bart

    2018-03-01

    To compare glenohumeral range of motion and shoulder rotator muscle strength in healthy female junior elite handball players and controls. Cross-sectional case-control study. Sports medical center. Forty elite female handball players and 30 controls active in nonoverhead sports participated in this study. Passive external rotator (ER), internal rotator (IR), and total range of motion (TROM) of the dominant and nondominant arm were examined with a goniometer. An isokinetic dynamometer was used to evaluate concentric and eccentric rotator muscle strength at 60 and 120 degrees/s with dynamic control ratio (DCR = ERecc:IRcon) as the main outcome parameter. Except for the ER range of motion in the nondominant arm, no significant differences were found between groups for IR, ER of the dominant arm, and the TROM. Within the handball group, the side-to-side difference for IR of the dominant arm was -1.4 degrees. The ER and the TROM of the dominant arm were significantly larger, 6.3 and 4.9 degrees, respectively. For both groups, the DCR values were above 1 and no significant differences were found between the dominant and nondominant arm. The DCR values in the handball group were significantly lower than in the control group. Based on the adopted definitions for muscle imbalance, glenohumeral internal range of motion deficit and TROM deficit our elite female handball players seem not at risk for shoulder injuries. Prospective studies are needed to support the belief that a DCR below 1 places the shoulder at risk for injury.

  3. Shoulder injuries in provincial male fast bowlers — predisposing ...

    African Journals Online (AJOL)

    Enrique

    sule and by the rotator cuff muscles. The external rotator strength has been reported to be around 65% of internal rotator strength.17. During bowling in cricket, the internal shoulder rotators are involved in the acceleration phase of the arm through concentric contractions, while the external rotators are involved during the ...

  4. Clinical outcomes after arthroscopic release for recalcitrant frozen shoulder.

    Science.gov (United States)

    Ebrahimzadeh, Mohammad H; Moradi, Ali; Pour, Mostafa Khalili; Moghadam, Mohammad Hallaj; Kachooei, Amir Reza

    2014-09-01

    To explain the role of arthroscopic release in intractable frozen shoulders. We used different questionnaires and measuring tools to understand whether arthroscopic release is the superior modality to treat patients with intractable frozen shoulders. Between 2007 and 2013, in a prospective study, we enrolled 80 patients (52 females and 28 males) with recalcitrant frozen shoulder, who underwent arthroscopic release at Ghaem Hospital, a tertiary referral center, in Mashhad, Iran. Before operation, all patients filled out the Disability of Arm, Shoulder and Hand (DASH), Constant, University of California Los Angeles (UCLA), ROWE and Visual Analogue Scale (VAS) for pain questionnaires. We measured the difference in range of motion between both the normal and the frozen shoulders in each patient. The average age of the patients was 50.8±7.1 years. In 49 patients, the right shoulder was affected and in the remaining 31 the left side was affected. Before surgery, the patients were suffering from this disease on average for 11.7±10.3 months. The average time to follow-up was 47.2±6.8 months (14 to 60 months). Diabetes mellitus (38%) and history of shoulder trauma (23%) were the most common comorbidities in our patients. We did not find any significant differences between baseline characteristics of diabetics patients with non-diabetics ones. After surgery, the average time to achieve maximum pain improvement and range of motion were 3.6±2.1 and 3.6±2 months, respectively. The VAS score, constant shoulder score, Rowe score, UCLA shoulder score, and DASH score showed significant improvement in shoulder function after surgery, and shoulder range of motion improved in all directions compared to pre-operation range of motion. According to our results, arthroscopic release of recalcitrant frozen shoulder is a valuable modality in treating this disease. This method could decrease pain and improve both subjective and objective mid-term outcomes.

  5. Clinical Outcomes after Arthroscopic Release for Recalcitrant Frozen Shoulder

    Directory of Open Access Journals (Sweden)

    Mohammad Hosein Ebrahimzadeh

    2014-09-01

    Full Text Available Background: To explain the role of arthroscopic release in intractable frozen shoulders. We used different questionnaires and measuring tools to understand whether arthroscopic release is the superior modality to treat patients with intractable frozen shoulders. Methods: Between 2007 and 2013, in a prospective study, we enrolled 80 patients (52 females and 28 males with recalcitrant frozen shoulder, who underwent arthroscopic release at Ghaem Hospital, a tertiary referral center, in Mashhad, Iran. Before operation, all patients filled out the Disability of Arm, Shoulder and Hand (DASH, Constant, University of California Los Angeles (UCLA, ROWE and Visual Analogue Scale (VAS for pain questionnaires. We measured the difference in range of motion between both the normal and the frozen shoulders in each patient. Results: The average age of the patients was 50.8±7.1 years. In 49 patients, the right shoulder was affected and in the remaining 31 the left side was affected. Before surgery, the patients were suffering from this disease on average for 11.7±10.3 months.  The average time to follow-up was 47.2±6.8 months (14 to 60 months. Diabetes mellitus (38% and history of shoulder trauma (23% were the most common comorbidities in our patients. We did not find any significant differences between baseline characteristics of diabetics patients with non-diabetics ones. After surgery, the average time to achieve maximum pain improvement and range of motion were 3.6±2.1 and 3.6±2 months, respectively. The VAS score, constant shoulder score, Rowe score, UCLA shoulder score, and DASH score showed significant improvement in shoulder function after surgery, and shoulder range of motion improved in all directions compared to pre-operation range of motion. Conclusions: According to our results, arthroscopic release of recalcitrant frozen shoulder is a valuable modality in treating this disease. This method could decrease pain and improve both subjective and

  6. Obesity-Related Adipokines Predict Patient-Reported Shoulder Pain

    Directory of Open Access Journals (Sweden)

    Rajiv Gandhi

    2013-12-01

    Full Text Available Background/Aims: Increasingly, an inflammatory modulating effect of adipokines within synovial joints is being recognized. To date, there has been no work examining a potential association between the presence of adipokines in the shoulder and patient-reported outcomes. This study undertakes an investigation assessing these potential links. Methods: 50 osteoarthritis patients scheduled for shoulder surgery completed a pre-surgery questionnaire capturing demographic information including validated, patient-reported function (Disabilities of the Arm, Shoulder, and Hand questionnaire and pain (Short Form McGill Pain Questionnaire measures. Synovial fluid (SF samples were analyzed for leptin, adiponectin, and resistin levels using Milliplex MAP assays. Linear regression modeling was used to assess the association between adipokine levels and patient-reported outcomes, adjusted for age, sex, BMI, and disease severity. Results: 54% of the cohort was female (n = 27. The mean age (SD of the sample was 62.9 (9.9 years and the mean BMI (SD was 28.1 (5.4 kg/m2. From regression analyses, greater SF leptin and adiponectin levels, but not regarding resistin, were found to be associated with greater pain (p Conclusions: The identified association between shoulder-derived SF leptin and adiponectin and shoulder pain is likely explained by the pro-inflammatory characteristics of the adipokines and represents potentially important therapeutic targets.

  7. Obesity-related adipokines predict patient-reported shoulder pain.

    Science.gov (United States)

    Gandhi, Rajiv; Perruccio, Anthony V; Rizek, Randy; Dessouki, Omar; Evans, Heather M K; Mahomed, Nizar N

    2013-01-01

    Increasingly, an inflammatory modulating effect of adipokines within synovial joints is being recognized. To date, there has been no work examining a potential association between the presence of adipokines in the shoulder and patient-reported outcomes. This study undertakes an investigation assessing these potential links. 50 osteoarthritis patients scheduled for shoulder surgery completed a pre-surgery questionnaire capturing demographic information including validated, patient-reported function (Disabilities of the Arm, Shoulder, and Hand questionnaire) and pain (Short Form McGill Pain Questionnaire) measures. Synovial fluid (SF) samples were analyzed for leptin, adiponectin, and resistin levels using Milliplex MAP assays. Linear regression modeling was used to assess the association between adipokine levels and patient-reported outcomes, adjusted for age, sex, BMI, and disease severity. 54% of the cohort was female (n = 27). The mean age (SD) of the sample was 62.9 (9.9) years and the mean BMI (SD) was 28.1 (5.4) kg/m(2). From regression analyses, greater SF leptin and adiponectin levels, but not regarding resistin, were found to be associated with greater pain (p < 0.05). Adipokine levels were not associated with functional outcome scores. The identified association between shoulder-derived SF leptin and adiponectin and shoulder pain is likely explained by the pro-inflammatory characteristics of the adipokines and represents potentially important therapeutic targets. © 2013 S. Karger GmbH, Freiburg.

  8. Intraarticular findings in the chronically painful shoulder. A study of 32 posttraumatic cases

    DEFF Research Database (Denmark)

    Suder, P.A.; Hougaard, K.; Frich, Lars Henrik

    1994-01-01

    the head activities. Symptoms of a "dead arm" and instability were also present. Patients with previous dislocations, traumas or radiographic signs of degenerative shoulder lesions were excluded. The patients had a decreased active range of motion and positive signs of apprehension and impingement......, arthroscopic labral resection and open subacromial decompression. In conclusion, patients with chronic posttraumatic shoulder pain have intraarticular injuries, especially tears of the glenoid labrum. History, clinical findings, radiography and sonography are seldom diagnostic. MRI is valuable, particularly...

  9. Conservative treatment and rehabilitation of shoulder problems; Konservative Therapie und Rehabilitation von Schulterbeschwerden

    Energy Technology Data Exchange (ETDEWEB)

    Paternostro-Sluga, T.; Zoech, C. [Klinik fuer Physikalische Medizin und Rehabilitation, Allgemeines Krankenhaus der Medizinischen Universitaet Wien (Austria)

    2004-06-01

    The shoulder joint has an important influence on arm- and handfunction. Therefore, activities of daily living, working and leisure time can be negatively influenced by diseases of the shoulder joint. Problems of the shoulder joint can be induced by muscular dysbalance and poor body posture. There is a strong relationship between shoulder function and body posture. Conservative treatment and rehabilitation of the shoulder joint aims at improving the local dysfunction of the shoulder joint as well as at improving function and social participation. Antiinflammatory and pain medication, exercise, occupational, electro-, ultrasound and shock wave therapy, massage, thermotherapy and pulsed electromagnetic fields are used as conservative treatments. Exercise therapy aims at improving muscular performance, joint mobility and body posture. Occupational therapy aims at improving functional movements for daily living and work. Electrotherapy is primarily used to relieve pain. Shock wave and ultrasound therapy proved to be an effective treatment for patients with calcific tendinitis. The subacromial impingement syndrome can be effectively treated by conservative therapy. (orig.) [German] Aufgrund der zentralen Rolle des Schultergelenks fuer die Arm- und Handfunktion koennen Erkrankungen des Schultergelenks zu einer erheblichen Beeintraechtigung in Alltag, Beruf und Freizeit fuehren. Muskulaere Dysbalancen und Fehlhaltungen sind haeufige Ursachen fuer Schulterbeschwerden. Es besteht eine enge Beziehung zwischen Schulterfunktion und Koerperhaltung. Therapieziele in der konservativen Behandlung und Rehabilitation sind neben der Verbesserung der lokalen Situation das Wiedererlangen der Funktion und sozialen Partizipation. Zu den konservativen Therapiemassnahmen zaehlen medikamentoese, Bewegungs-, Ergo-, Elektro-, Ultraschall- und Stosswellentherapie, Massage, Thermo- und Magnetfeldtherapie. Muskulaere Dysbalancen und Fehlhaltungen sind durch bewegungstherapeutische Massnahmen gut

  10. Shoulder Rotator Muscle Dynamometry Characteristics: Side Asymmetry and Correlations with Ball-Throwing Speed in Adolescent Handball Players

    Science.gov (United States)

    Pontaga, Inese; Zidens, Janis

    2014-01-01

    The aim of the investigation was to: 1) compare shoulder external/internal rotator muscles’ peak torques and average power values and their ratios in the dominant and non-dominant arm; 2) determine correlations between shoulder rotator muscles’ peak torques, average power and ball-throwing speed in handball players. Fourteen 14 to 15-year-old male athletes with injury-free shoulders participated in the study (body height: 176 ± 7 cm, body mass 63 ± 9 kg). The tests were carried out by an isokinetic dynamometer system in the shoulder internal and external rotation movements at angular velocities of 60°/s, 90°/s and 240°/s during concentric contractions. The eccentric external– concentric internal rotator muscle contractions were performed at the velocity of 90°/s. The player threw a ball at maximal speed keeping both feet on the floor. The speed was recorded with reflected light rays. Training in handball does not cause significant side asymmetry in shoulder external/internal rotator muscle peak torques or the average power ratio. Positive correlations between isokinetic characteristics of the shoulder internal and external rotator muscles and ball-throwing speed were determined. The power produced by internal rotator muscles during concentric contractions after eccentric contractions of external rotator muscles was significantly greater in the dominant than in the non-dominant arm. Thus, it may be concluded that the shoulder eccentric external/concentric internal rotator muscle power ratio is significantly greater than this ratio in the concentric contractions of these muscles. PMID:25414738

  11. Shoulder Rotator Muscle Dynamometry Characteristics: Side Asymmetry and Correlations with Ball-Throwing Speed in Adolescent Handball Players

    Directory of Open Access Journals (Sweden)

    Pontaga Inese

    2014-10-01

    Full Text Available The aim of the investigation was to: 1 compare shoulder external/internal rotator muscles’ peak torques and average power values and their ratios in the dominant and non-dominant arm; 2 determine correlations between shoulder rotator muscles’ peak torques, average power and ball-throwing speed in handball players. Fourteen 14 to 15- year-old male athletes with injury-free shoulders participated in the study (body height: 176 ± 7 cm, body mass 63 ± 9 kg. The tests were carried out by an isokinetic dynamometer system in the shoulder internal and external rotation movements at angular velocities of 60°/s, 90°/s and 240°/s during concentric contractions. The eccentric external- concentric internal rotator muscle contractions were performed at the velocity of 90°/s. The player threw a ball at maximal speed keeping both feet on the floor. The speed was recorded with reflected light rays. Training in handball does not cause significant side asymmetry in shoulder external/internal rotator muscle peak torques or the average power ratio. Positive correlations between isokinetic characteristics of the shoulder internal and external rotator muscles and ball-throwing speed were determined. The power produced by internal rotator muscles during concentric contractions after eccentric contractions of external rotator muscles was significantly greater in the dominant than in the non-dominant arm. Thus, it may be concluded that the shoulder eccentric external/concentric internal rotator muscle power ratio is significantly greater than this ratio in the concentric contractions of these muscles

  12. What is the effect of a shoulder-strengthening program to prevent shoulder pain among junior female team handball players?

    Directory of Open Access Journals (Sweden)

    Sommervold M

    2017-03-01

    Full Text Available Maria Sommervold, Håvard Østerås Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU, Trondheim, Norway Background: Excessively high stresses are applied to the shoulder joint of handball players, mainly caused by overhead throwing. Shoulder pain is a significant problem among junior female team handball players and both male and female top-level team handball players in Norway.Method: A randomized selection was performed among the best female junior teams (J 16 in the Trøndelag region of Norway in the 2014–2015 season. Three teams were randomized to the intervention group and three teams to the control group. Players in the intervention group (n=53 participated in a seven-month, three-times-a-week shoulder-muscle strength-training program, while those in the control group (n=53 participated in a comparable handball training, but did not conduct any specific strength training during the season. Results: A strength-training program had no effect on the prevention of shoulder pain. Overall, the players reported shoulder pain, but graded the pain low on visual analog scale (VAS. Both the intervention group and the control group reported pain under 1 on VAS at baseline and posttest, and there was no significant difference within or between the groups when it came to the intensity of pain reported on VAS. A significant difference (p<0.048 was found between the groups on the sport-specific part of the quick-Disability of the Arm, Shoulder and Hand (DASH form, but it did not fulfill the minimal demand to change and the players scored it low, something that indicates little functional problems when it comes to team handball. The intervention group was significantly stronger (p<0.008 on the push-ups test compared to the control group on the posttest. The intervention group increased the number of push-ups from 3.1 to 6.4, while the control group went from 2.3 to 3.6. Aside from this, there were no

  13. Effectiveness of a Multidisciplinary Rehabilitation Program Following Shoulder Injury

    Directory of Open Access Journals (Sweden)

    Andrea Bean

    2017-07-01

    Full Text Available Background: Shoulder injuries in working age adults result in a major cost to the health care system. The purpose of this study was to examine the effectiveness of a new multidisciplinary rehabilitation program and to explore factors that affected a successful return to work (RTW in injured workers with shoulder problems who received this program. Methods: This was a prospective longitudinal study. The patient-oriented outcome measures were the Numeric Pain Rating Scale (NPRS and the Disabilities of the Arm, Shoulder, and Hand (DASH. Range of motion (ROM in flexion, abduction, and external rotation and strength in lifting and push/pull were documented. All outcomes were measured before and at the completion of the program. Results: Data of 68 patients were used for analysis. All outcomes showed a statistically significant improvement over time. Conclusions: Multidisciplinary rehabilitation programs help to improve pain, disability, ROM, strength, and facilitate RTW. Higher stress and a fast-paced work environment increased the risk of not progressing in work status.

  14. Effects of non-paretic arm exercises using a tubing band on abdominal muscle activity in stroke patients.

    Science.gov (United States)

    Lee, Dong-Kyu; Kang, Min-Hyeok; Kim, Ji-Won; Kim, Yang-Gon; Park, Ji-Hyuk; Oh, Jae-Seop

    2013-01-01

    Abdominal strengthening exercises are important for stroke patients; however, there is a lack of research on therapeutic exercises for increasing abdominal muscle activity in stroke patients. We investigated the effects of non-paretic arm exercises using a tubing band on abdominal muscle activity in stroke patients. In total, 18 hemiplegic subjects (13 males, 5 females) were recruited. All subjects performed non-paretic arm exercises involving three different shoulder movements (extension, flexion, and horizontal abduction) using an elastic tubing band. Surface electromyography (EMG) signals were recorded from the rectus abdominis (RA), external oblique (EO), and internal oblique (IO) muscles bilaterally during non-paretic arm exercises. EMG activities of abdominal muscles during non-paretic arm extension and horizontal abduction were increased significantly versus shoulder flexion when subjects performed the arm exercise in a seated position. Muscle activity of the EO was significantly greater in the paretic than the non-paretic side during non-paretic arm extension and horizontal abduction. We suggest that non-paretic arm extension and horizontal abduction exercises using an elastic tubing band may be effective in increasing abdominal muscle activity.

  15. Shoulder fusion in two patients with a long-standing proximal humerus resection

    NARCIS (Netherlands)

    Kager, J.; Marti, R. K.; Raaymakers, E. L. F. B.

    2011-01-01

    With a "headless" humerus active abduction and elevation of the arm are hardly possible. Especially if the humeral head was removed because of an infection, shoulder fusion is often the only safe solution for this disabling condition. Large corticocancellous, autologous bone grafts are interposed

  16. Control of leg movements driven by EMG activity of shoulder muscles

    Directory of Open Access Journals (Sweden)

    Valentina eLa Scaleia

    2014-10-01

    Full Text Available During human walking there exists a functional neural coupling between arms and legs, and between cervical and lumbosacral pattern generators. Here we present a novel approach for associating the electromyographic (EMG activity from upper limb muscles with leg kinematics. Our methodology takes advantage of the high involvement of shoulder muscles in most locomotor-related movements and of the natural coordination between arms and legs. Nine healthy subjects were asked to walk at different constant and variable speeds (3-5 km/h, while EMG activity of shoulder (deltoid muscles and the kinematics of walking were recorded. To ensure a high level of EMG activity in deltoid, the subjects performed slightly larger arm swinging than they usually do. The temporal structure of the burst-like EMG activity was used to predict the spatiotemporal kinematic pattern of the forthcoming step. A comparison of actual and predicted stride leg kinematics showed a high degree of correspondence (r>0.9. This algorithm has been also implemented in pilot experiments for controlling avatar walking in a virtual reality setup and an exoskeleton during overground stepping. The proposed approach may have important implications for the design of human-machine interfaces and neuroprosthetic technologies such as those of assistive lower limb exoskeletons.

  17. Development of a non-expert risk assessment method for hand-arm related tasks (HARM)

    NARCIS (Netherlands)

    Douwes, M.; Kraker, H. de

    2014-01-01

    To support health and safety practitioners in their obligation of risk assessment the 'Hand Arm Risk Assessment Method' (HARM) was developed. This tool can be used by any type of company for risk assessment of developing arm, neck or shoulders symptoms (pain) resulting from light manual tasks.This

  18. Shoulder injuries in professional rugby: a retrospective analysis.

    Science.gov (United States)

    Horsley, Ian G; Fowler, Elizabeth M; Rolf, Christer G

    2013-04-26

    In the literature, little is known about the level and pattern of rugby injuries. Of the shoulder injuries reported, 51% of these are caused during a tackle, and 65% of all match injuries affected the shoulder. The study aims to describe a sport-specific unique intra-articular shoulder pathology of professional rugby players, who presented with persistent pain and dysfunction despite physiotherapeutic treatment and rest. This study is a retrospective analysis set at a university sports medicine clinic. Eighty-seven professional rugby players, referred by their professional medical team since they could no longer play, underwent shoulder arthroscopy between June 2001 and October 2007 due to persistent shoulder pain and dysfunction. All were full-time professional male rugby union and rugby league players. They all had failed conservative treatment for their complaint, and the diagnosis was unclear. Arthroscopic findings were used as a measure of main outcome. The primary mechanism of injury was reported as direct tackling (56%; n = 49) followed in succession by falling onto the arm (10%; n = 8). However, in 30% of the cases, no definite injury could be recalled. The main operative finding was that most patients exhibited multiple shoulder pathologies, with 75% of cases presenting with two or more pathologies. A superior labrum anterior to posterior (SLAP) lesion was evident at arthroscopy in 72 of the 87 cases (83%), while rotator cuff tears were evident in 43% of cases (n = 37). One-third of all cases had a Bankart tear (n = 29), despite none of them reporting previous dislocations, while other labral tears, excluding SLAP tears, to the inferior or posterior labrum were present in 34% (n = 30) of the cohort. Repeated tackling, which is clearly rugby specific, is most likely to be responsible for most of these shoulder injuries, which upon arthroscopic examination, showed signs of mixed pathology. We suggest that an early arthroscopic investigation is valuable in

  19. Arthroscopic treatment of secondary rotator cuff damage after shoulder hemiarthroplasty (case report

    Directory of Open Access Journals (Sweden)

    S. Y. Dokolin

    2015-01-01

    Full Text Available Anatomical shoulder arthroplasty is an effective treatment for patients with primary deforming arthritis, rheumatoid arthritis and aseptic necrosis of the humeral head. However this kind of surgery is associated with high risk of complications, and within five-year follow-up the incidence of complications increases. The authors described a clinical case illustrating one of these complications - secondary rotator cuff damage after shoulder hemiarthroplasty. The tear was verified using radiological methods and arthroscopy. They performed arthroscopic rotator cuff repair using suture anchors in order to alleviate pain and preserve shoulder functions. If there are no signs of endoprosthetic instability and coracoacromial ligament is preserved, arthroscopic treatment of such damages extends the time of limb function preserving the endoprosthesis. Patients should not raise their arms above the horizontal level.

  20. Kinesthetically guided reaching accuracy in individuals with a history of traumatic anterior shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Hung Y

    2013-05-01

    Full Text Available You-jou Hung,1 Warren G Darling2 1Doctor of Physical Therapy Program, Department of Nursing and Rehabilitation Sciences, Angelo State University, San Angelo, TX, USA; 2Department of Health and Human Physiology, The University of Iowa, Iowa City, IA, USA Background: The purpose of the study was to investigate whether individuals with a history of traumatic anterior shoulder dislocation show larger reaching errors than those with healthy shoulders and to determine if they implement different reaching strategies to protect the injured shoulder. Methods: Ten people with a history of traumatic anterior shoulder dislocation and 15 with healthy shoulders volunteered for this study. After viewing targets in space, participants pointed with the unconstrained arm to remembered target locations in space without visual guidance. Nine different targets were located in various planes and heights. Endpoint reaching errors were determined by comparing the finger endpoint position without visual guidance to the target location. Shoulder rotation angle at the endpoint was also compared between groups. Results: Participants with injured shoulders were able to point voluntarily to visually specified targets as accurately as participants with healthy shoulders (1 cm difference. However, participants with injured shoulders showed less shoulder external rotation (average 12° difference at the target location when compared with healthy shoulders. This difference was consistent over a large range of target locations. Conclusion: Individuals with a history of traumatic anterior shoulder dislocation have sufficient kinesthetic information about their upper limb orientation to point accurately to visually specified targets in space. However, individuals with injured shoulders acquired a new motor strategy to reach with less shoulder external rotation, presumably to protect the injured shoulder from recurrent injuries. Keywords: shoulder injuries, physiotherapy, shoulder

  1. Responsiveness of two Persian-versions of shoulder outcome measures following physiotherapy intervention in patients with shoulder disorders.

    Science.gov (United States)

    Negahban, Hossein; Behtash, Zeinab; Sohani, Soheil Mansour; Salehi, Reza

    2015-01-01

    To identify the ability of the Persian-version of the Shoulder Pain and Disability Index (SPADI) and the Disabilities of the Arm, Shoulder, and Hand (DASH) to detect changes in shoulder function following physiotherapy intervention (i.e. responsiveness) and to determine the change score that indicates a meaningful change in functional ability of the patient (i.e. Minimally Clinically Important Difference (MCID)). A convenient sample of 200 Persian-speaking patients with shoulder disorders completed the SPADI and the DASH at baseline and then again 4 weeks after physiotherapy intervention. Furthermore, patients were asked to rate their global rating of shoulder function at follow-up. The responsiveness was evaluated using two methods: the receiver operating characteristics (ROC) method and the correlation analysis. Two useful statistics extracted from the ROC method are the area under curve (AUC) and the optimal cutoff point called as MCID. Both the SPADI and the DASH showed the AUC of greater than 0.70 (AUC ranges = 0.77-0.82). The best cutoff points (or change scores) for the SPADI-total, SPADI-pain, SPADI-disability and the DASH were 14.88, 26.36, 23.86, and 25.41, respectively. Additionally, moderate to good correlations (Gamma = -0.51 to -0.58) were found between the changes in SPADI/DASH and changes in global rating scale. The Persian SPADI and DASH have adequate responsiveness to clinical changes in patients with shoulder disorders. Moreover, the MCIDs obtained in this study will help the clinicians and researchers to determine if a Persian-speaking patient with shoulder disorder has experienced a true change following a physiotherapy intervention. Implications for Rehabilitation Responsiveness was evaluated using two methods; the receiver operating characteristics (ROC) method and the correlation analysis. The Persian SPADI and DASH can be used as two responsive instruments in both clinical practice and research settings. The MCIDs of 14.88 and 25

  2. Diagnostic imaging of shoulder impingement

    International Nuclear Information System (INIS)

    Merl, T.; Weinhardt, H.; Oettl, G.; Lenz, M.; Riel, K.A.

    1996-01-01

    Magnetic resonance imaging is a method that has been advancing in the last few years to the modality of choice for diagnostic evaluation of the bone joints, as the method is capable of imaging not only the ossous but also the soft tissue components of the joint. MRI likewise has become an accepted method for diagnostic evaluation of syndromes of the shoulder, with high diagnostic accuracy in detecting rotator cuff lesions, or as an efficient MRI arthrography for evaluation of the instability or lesions of the labrocapsular complex. In the evaluation of early stages of shoulder impingement, the conventional MRI technique as a static technique yields indirect signs which in many cases do not provide the diagnostic certainty required in order to do justice to the functional nature of the syndrome. In these cases, functional MRI for imaging of the arm in abducted position and in rotational movement may offer a chance to early detect impingement and thus identify patients who will profit from treatment at an early stage [de

  3. Shoulder Dislocation in the course of Revenue Collection: A Need to ...

    African Journals Online (AJOL)

    Alasia Datonye

    Revenue collection. Correspondence: R.C. Echem and extension by a fall onto an outstretched arm or by direct force applied to the posterior aspect of the humeral ... utilization of tax consultant and revenue agents. This paper aims to report a case of shoulder dislocation that occurred in the course of revenue collection and.

  4. Shoulder replacement - discharge

    Science.gov (United States)

    Total shoulder arthroplasty - discharge; Endoprosthetic shoulder replacement - discharge; Partial shoulder replacement - discharge; Partial shoulder arthroplasty - discharge; Replacement - shoulder - discharge; Arthroplasty - shoulder - discharge

  5. Shoulder pain

    Science.gov (United States)

    ... exercises Rotator cuff - self-care Shoulder replacement - discharge Shoulder surgery - discharge Using your shoulder after replacement surgery Using your shoulder after surgery Images Impingement syndrome Rotator cuff muscles Heart attack ...

  6. Frozen shoulder

    Science.gov (United States)

    ... your hormones, such as during menopause Shoulder injury Shoulder surgery Open heart surgery Cervical disk disease of the ... Instructions Rotator cuff exercises Rotator cuff - self-care Shoulder surgery - discharge Images Shoulder joint inflammation References Finnoff JT. ...

  7. Open inferior capsular shift for multidirectional shoulder instability in adolescents with generalized ligamentous hyperlaxity or Ehlers-Danlos syndrome.

    Science.gov (United States)

    Vavken, Patrick; Tepolt, Frances A; Kocher, Mininder S

    2016-06-01

    The objective of this study was to assess the outcome of open inferior capsular shift for multidirectional shoulder instability in patients with generalized ligamentous hyperlaxity or Ehlers-Danlos syndrome. Data were obtained for 18 open inferior capsular shift surgeries in 15 adolescent patients with generalized ligamentous hyperlaxity or Ehlers-Danlos syndrome with a mean follow-up of 7.5 years. End points were subjective clinical outcome (pain, stability, satisfaction, return to sport), objective clinical outcome (recurrence, complications), and functional outcome scores (American Shoulder and Elbow Surgeons, 11-item version of the Disabilities of Arm, Shoulder and Hand). Thirteen patients (87%) reported improved pain and stability and were satisfied with the procedure. Nine patients (64%) were able to return to sports. One patient (7%) was dissatisfied with continuous pain and recurrent instability and considered a surgical failure. Seven patients (47%) reported no further episodes of instability. The mean American Shoulder and Elbow Surgeons score at a mean of 7.5 years of follow-up was 88 ± 10 points, and the mean score for the 11-item version of the Disabilities of Arm, Shoulder and Hand was 14 ± 14 points. The management of multidirectional shoulder instability in adolescent patients with generalized ligamentous hyperlaxity or Ehlers-Danlos syndrome is challenging. Open inferior capsular shift results in improvement in subjective and objective shoulder function and stability in adolescent patients with ligamentous hyperlaxity or Ehlers-Danlos who have failed nonoperative treatment. We found no effect of the recalled number of prior dislocations, laterality, and type of hyperlaxity on subjective and objective clinical outcomes. Level IV; Case Series; Treatment Study. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  8. Experiences of employees with arm, neck or shoulder complaints: a focus group study.

    Science.gov (United States)

    Hutting, Nathan; Heerkens, Yvonne F; Engels, Josephine A; Staal, J Bart; Nijhuis-van der Sanden, Maria W G

    2014-04-29

    Many people suffer from complaints of the arm, neck or shoulder (CANS). CANS causes significant work problems, including absenteeism (sickness absence), presenteeism (decreased work productivity) and, ultimately, job loss. There is a need for intervention programs for people suffering from CANS. Management of symptoms and workload, and improving the workstyle, could be important factors in the strategy to deal with CANS. The objective of this study is to evaluate the experienced problems of employees with CANS, as a first step in an intervention mapping process aimed at adaptation of an existing self-management program to the characteristics of employees suffering from CANS. A qualitative study comprising three focus group meetings with 15 employees suffering from CANS. Based on a question guide, participants were asked about experiences in relation to continuing work despite their complaints. Data were analysed using content analysis with an open-coding system. During selective coding, general themes and patterns were identified and relationships between the codes were examined. Participants suffering from CANS often have to deal with pain, disability, fatigue, misunderstanding and stress at work. Some needs of the participants were identified, i.e. disease-specific information, exercises, muscle relaxation, working with pain, influence of the work and/or social environment, and personal factors (including workstyle). Employees suffering from CANS search for ways to deal with their complaints in daily life and at work. This study reveals several recurring problems and the results endorse the multi-factorial origin of CANS. Participants generally experience problems similar to those of employees with other types of complaints or chronic diseases, e.g. related to their illness, insufficient communication, working together with healthcare professionals, colleagues and management, and workplace adaptations. These topics will be addressed in the adaptation of an

  9. The globe system : An unambiguous description of shoulder positions in daily life movements

    NARCIS (Netherlands)

    Doorenbosch, C.A.M.; Harlaar, J.; Veeger, D.J.

    2003-01-01

    Positions of the shoulder joint are commonly described in terms of degrees of humeral elevation in the principal planes. This approach is inadequate for an accurate and unambiguous description of functional arm movements that are not confined to these planes. In this paper, a general unambiguous

  10. The Effects of Shoulder Slings on Balance in Patients With Hemiplegic Stroke

    Science.gov (United States)

    Sohn, Min Kyun; Jee, Sung Ju; Hwang, Pyoungsik; Jeon, Yumi

    2015-01-01

    Objective To investigate the effects of a shoulder sling on balance in patients with hemiplegia. Methods Twenty-seven hemiplegic stroke patients (right 13, left 14) were enrolled in this study. The subjects' movement in their centers of gravity (COGs) during their static and dynamic balance tests was measured with their eyes open in each sling condition-without a sling, with Bobath's axillary support (Bobath sling), and with a simple arm sling. The percent times in quadrant, overall, anterior/posterior, and medial/lateral stability indexes were measured using a posturography platform (Biodex Balance System SD). Functional balance was evaluated using the Berg Balance Scale and the Trunk Impairment Scale. All balance tests were performed with each sling in random order. Results The COGs of right hemiplegic stroke patients and all hemiplegic stroke patients shifted to, respectively, the right and posterior quadrants during the static balance test without a sling (pBobath or the simple arm sling. There was no significant improvement in any stability index during either the static or the dynamic balance tests in any sling condition. Conclusion The right and posterior deviations of the hemiplegic stroke patients' COGs were maintained during the application of the shoulder slings, and there were no significant effects of the shoulder slings on the patients' balance in the standing still position. PMID:26798614

  11. Office work and complaints of the arms, neck and shoulders: the role of job characteristics, muscular tension and need for recovery.

    Science.gov (United States)

    Gawke, Jason C; Gorgievski, Marjan J; van der Linden, Dimitri

    2012-01-01

    This study investigated physical, psychological and social job characteristics as potential risk factors for complaints of the arms, neck and shoulders (CANS) and mediating effects of muscular tension and need for recovery. Data were collected among 105 computer workers using questionnaires and electromyography (EMG), and were analyzed with linear regression analyses. Task interdependence, information processing and lower social support predicted more CANS. Physical job demands had no predictive power over and above psychological and social Stressors. Both muscular tension and need for recovery partially mediated the job characteristics-CANS relationships. Occupational health professionals should not neglect psychological and social job characteristics as potentially important predictors of CANS in specific occupational groups, such as office workers. Our findings imply that CANS interventions should not be restricted to ergonomic improvements, but should be accompanied by improvement of the job design from a psychological and social perspective and reactive intervention aimed at decreasing short-term physical strain (muscular tension) and mental strain (need for recovery).

  12. Alterations in strength of the shoulder rotators in young elite swimmers

    Directory of Open Access Journals (Sweden)

    Gustavo Antonio Meliscki

    Full Text Available Abstract Introduction: Shoulder muscle strength imbalance is considered a risk factor for shoulder injuries in athletes, especially in sports involving arm movements above the head. Objective: To assess the strength of the external rotators (ER and internal rotators (IR of the shoulder in elite swimmers, to determine possible differences between the dominant and non-dominant limbs, and to calculate the shoulder IR/ER ratio. Methods: Fifteen athletes participated in the study from age 20 ± 2 years, mass of 76 ± 4 kg, stature of 1.83 ± 4 cm, and BMI of 22 ± 1 kg/m2. Duration of practice of 10.74 ± 4.03 years; training frequency 5.95 ± 0.22 days/week, 2.07 ± 0.41 hours/day; and weekly number of meters swum 34.905. An isometric dynamometer (Globus Ergo System®, Codognè, Italy was used to assess ER and IR strength. Data were analyzed using descriptive statistics (mean and standard deviation, paired-sample t-test, Pearson’s correlation coefficient and the Statistical Package for Social Sciences software (SPSS, version 16.0. Results: IR and ER strength was lower in the left than in the right shoulder of the swimmers (p < 0.05. Additionally, ER strength ratio was higher than IR strength ratio (p < 0.05. Conclusion: The results showed that the swimmers had an alteration of the shoulder ER/IR ratio, especially in the dominant limb.

  13. Effects of 6-week sling-based training of the external-rotator muscles on the shoulder profile in elite female high school handball players.

    Science.gov (United States)

    Genevois, Cyril; Berthier, Philippe; Guidou, Vincent; Muller, Franck; Thiebault, Boris; Rogowski, Isabelle

    2014-11-01

    In women's handball, the large numbers of throws and passes make the shoulder region vulnerable to overuse injuries. Repetitive throwing motions generate imbalance between shoulder internal- and external-rotator muscles. It has not yet been established whether sling-based training can improve shoulder external-rotator muscle strength. This study investigated the effectiveness of a 6-wk strengthening program in improving shoulder functional profile in elite female high school handball players. Crossover study. National elite handball training center. 25 elite female high school handball players. The program, completed twice per week for 6 wk, included sling-based strengthening exercises using a suspension trainer for external rotation with scapular retraction and scapular retraction alone. Maximal shoulder external- and internal-rotation strength, shoulder external- and internal-rotation range of motion (ROM), and maximal throwing velocity were assessed preintervention and postintervention for dominant and nondominant sides. After sling training, external- and internal-rotation strength increased significantly for both sides (P ≤ .001, and P = .004, respectively), with the result that there was no significant change in external- and internal-rotation strength ratios for either the dominant or the nondominant shoulder. No significant differences were observed for external-rotation ROM, while internal-rotation ROM decreased moderately, in particular in the dominant shoulder (P = .005). Maximal throwing velocity remained constant for the dominant arm, whereas a significant increase was found for the nondominant arm (P = .017). This 6-wk strengthening program was effective in improving shoulder external-rotator muscle strength but resulted in a decrease in the ROM in shoulder internal rotation, while throwing velocity remained stable. Adding a stretching program to this type of sling-based training program might help avoid potential detrimental effects on shoulder ROM.

  14. Scapular Kinematics: A Comparison between Females with and Without General Hypermobility Syndrome in Arm Elevation

    Directory of Open Access Journals (Sweden)

    Salman Nazary-Moghadam

    2010-07-01

    Full Text Available Objective: Numerous studies showed increasing incidence of acute or recurrent dislocations of the shoulder joint in people with General Hypermobility Syndrome (GHS. Given the critical role of scapular orientation in function of shoulder, the aim of this study is to compare the parameters indicating position and orientation of scapula between females with and without General Hypermobility Syndrome in frontal and sagital plane in arm elevation. Materials & Methods: In this cross sectional and case-control study, 16 females with General Hypermobility Syndrome were selected simply and conveniently and 16 healthy females were selected and matched by age, body mass index and menstrual status. A three dimensional motion analysis system (vicon 460 was used to measure scapular position (upper-lower and medial-lateral translations and orientation (upward rotation, posterior tilt and internal rotation angle. Measurement were taken with the arm placed in different angles of arm elevation. Date analysis was performed with Independent T test. Results: Upward rotation angles in sagital plane in 90º (P=0.03, 120º (P=0.01 and full range of arm elevation (P=0.04 were lower in case group as compared to control group. Also patients with General Hypermobility Syndrome showed a lesser amount of lateral scapular translation in 90º (P=0.02 and full range of sagital plane arm elevation (P=0.02. In addition, lateral scapular translation in 120º (P=0.02 and full range of frontal plane arm elevation (P=0.01 was lower in case group compared with control group. Conclusion: Altered kinematics in General Hypermobility Syndrome has a greater role in shoulder injuries and neuromuscular defect  seems to be an underlying cause of scapular kinematics' changes in people with hypermobility syndrome.

  15. Work related complaints of neck, shoulder and arm among computer office workers: a cross-sectional evaluation of prevalence and risk factors in a developing country

    Directory of Open Access Journals (Sweden)

    Jayawardana Naveen

    2011-08-01

    Full Text Available Abstract Background Complaints of arms, neck and shoulders (CANS is common among computer office workers. We evaluated an aetiological model with physical/psychosocial risk-factors. Methods We invited 2,500 computer office workers for the study. Data on prevalence and risk-factors of CANS were collected by validated Maastricht-Upper-extremity-Questionnaire. Workstations were evaluated by Occupational Safety and Health Administration (OSHA Visual-Display-Terminal workstation-checklist. Participants' knowledge and awareness was evaluated by a set of expert-validated questions. A binary logistic regression analysis investigated relationships/correlations between risk-factors and symptoms. Results Sample size was 2,210. Mean age 30.8 ± 8.1 years, 50.8% were males. The 1-year prevalence of CANS was 56.9%, commonest region of complaint was forearm/hand (42.6%, followed by neck (36.7% and shoulder/arm (32.0%. In those with CANS, 22.7% had taken treatment from a health care professional, only in 1.1% seeking medical advice an occupation-related injury had been suspected/diagnosed. In addition 9.3% reported CANS-related absenteeism from work, while 15.4% reported CANS causing disruption of normal activities. A majority of evaluated workstations in all participants (88.4%, and in those with CANS (91.9% had OSHA non-compliant workstations. In the binary logistic regression analyses female gender, daily computer usage, incorrect body posture, bad work-habits, work overload, poor social support and poor ergonomic knowledge were associated with CANS and its' severity In a multiple logistic regression analysis controlling for age, gender and duration of occupation, incorrect body posture, bad work-habits and daily computer usage were significant independent predictors of CANS Conclusions The prevalence of work-related CANS among computer office workers in Sri Lanka, a developing, South Asian country is high and comparable to prevalence in developed countries

  16. Work related complaints of neck, shoulder and arm among computer office workers: a cross-sectional evaluation of prevalence and risk factors in a developing country.

    Science.gov (United States)

    Ranasinghe, Priyanga; Perera, Yashasvi S; Lamabadusuriya, Dilusha A; Kulatunga, Supun; Jayawardana, Naveen; Rajapakse, Senaka; Katulanda, Prasad

    2011-08-04

    Complaints of arms, neck and shoulders (CANS) is common among computer office workers. We evaluated an aetiological model with physical/psychosocial risk-factors. We invited 2,500 computer office workers for the study. Data on prevalence and risk-factors of CANS were collected by validated Maastricht-Upper-extremity-Questionnaire. Workstations were evaluated by Occupational Safety and Health Administration (OSHA) Visual-Display-Terminal workstation-checklist. Participants' knowledge and awareness was evaluated by a set of expert-validated questions. A binary logistic regression analysis investigated relationships/correlations between risk-factors and symptoms. Sample size was 2,210. Mean age 30.8 ± 8.1 years, 50.8% were males. The 1-year prevalence of CANS was 56.9%, commonest region of complaint was forearm/hand (42.6%), followed by neck (36.7%) and shoulder/arm (32.0%). In those with CANS, 22.7% had taken treatment from a health care professional, only in 1.1% seeking medical advice an occupation-related injury had been suspected/diagnosed. In addition 9.3% reported CANS-related absenteeism from work, while 15.4% reported CANS causing disruption of normal activities. A majority of evaluated workstations in all participants (88.4%,) and in those with CANS (91.9%) had OSHA non-compliant workstations. In the binary logistic regression analyses female gender, daily computer usage, incorrect body posture, bad work-habits, work overload, poor social support and poor ergonomic knowledge were associated with CANS and its' severity In a multiple logistic regression analysis controlling for age, gender and duration of occupation, incorrect body posture, bad work-habits and daily computer usage were significant independent predictors of CANS. The prevalence of work-related CANS among computer office workers in Sri Lanka, a developing, South Asian country is high and comparable to prevalence in developed countries. Work-related physical factors, psychosocial factors and

  17. Shoulder reflexes

    DEFF Research Database (Denmark)

    Diederichsen, L.; Krogsgaard, M.; Voigt, Michael

    2002-01-01

    long latency (300 ms) excitatory reflex has been found when nerves in the capsule were stimulated electrically during shoulder surgery. In addition, when the anterior-inferior capsule was excited in conscious humans with modest amplitude electrical stimuli during muscle activity, a strong inhibition...... activity around the shoulder. This has implications for rehabilitation and shoulder surgery.......Dynamic shoulder stability is dependent on muscular coordination and sensory inputs. In the shoulder, mechanoreceptors are found in the coracoacromial ligament, the rotator cuff tendons, the musculotendinous junctions of the rotator cuff and in the capsule. The number of receptors in the capsule...

  18. The reliability of three-dimensional scapular attitudes in healthy people and people with shoulder impingement syndrome

    Directory of Open Access Journals (Sweden)

    Hébert Luc J

    2007-06-01

    Full Text Available Abstract Background Abnormal scapular displacements during arm elevation have been observed in people with shoulder impingement syndrome. These abnormal scapular displacements were evaluated using different methods and instruments allowing a 3-dimensional representation of the scapular kinematics. The validity and the intrasession reliability have been shown for the majority of these methods for healthy people. However, the intersession reliability on healthy people and people with impaired shoulders is not well documented. This measurement property needs to be assessed before using such methods in longitudinal comparative studies. The objective of this study is to evaluate the intra and intersession reliability of 3-dimensional scapular attitudes measured at different arm positions in healthy people and to explore the same measurement properties in people with shoulder impingement syndrome using the Optotrak Probing System. Methods Three-dimensional scapular attitudes were measured twice (test and retest interspaced by one week on fifteen healthy subjects (mean age 37.3 years and eight subjects with subacromial shoulder impingement syndrome (mean age 46.1 years in three arm positions (arm at rest, 70° of humerothoracic flexion and 90° of humerothoracic abduction using the Optotrak Probing System. Two different methods of calculation of 3-dimensional scapular attitudes were used: relative to the position of the scapula at rest and relative to the trunk. Intraclass correlation coefficient (ICC and standard error of measure (SEM were used to estimate intra and intersession reliability. Results For both groups, the reliability of the three-dimensional scapular attitudes for elevation positions was very good during the same session (ICCs from 0.84 to 0.99; SEM from 0.6° to 1.9° and good to very good between sessions (ICCs from 0.62 to 0.97; SEM from 1.2° to 4.2° when using the method of calculation relative to the trunk. Higher levels of

  19. Usefulness of sono-guided needle puncture for MR arthrography of the shoulder

    International Nuclear Information System (INIS)

    Choi, Jae Woong; Hong, Suk Ju; Suh, San Il; Yong, Hwan Suk; Kim, Jung Hyuk; Park, Cheol Min; Suh, Won Hyuck; Kim, Myung Gyu

    2000-01-01

    To evaluate the usefulness of sono-guided needle puncture for MR arthrography of the shoulder to locate the path of access and to control the correct placement of the needle into the shoulder. Fifteen patients with suspicion of shoulder pathology were included in this study. Patients were laid in supine positions with the arm extended and slightly abducted, the palm of the hand facing upward. A sonographic unit with a high resolution transducer with 7.5 MHz linear array was used. Axial images in the anterior aspect of the shoulder were obtained to localize the coracoid process and the anteromedical portion of the humerus. Using an aseptic technique, a 21-guage needle was advanced into the shoulder joint under ultrasonographic guidance. When the needle made contract with the articular cartilage of the humeral head, the needle was tiled to position is point in the articular cavity. Solution of 0.1 ml gadopentetate dimeglumine in 25 ml of normal saline was prepared and 12-16 ml was injected into the joint cavity. The intra-articular position of the needle and the compete distension of the shoulder joint were again confirmed by sonography. The needle was accurately placed in 14 out of 15 patients without damage to neighboring structures. It took 10 to 15 minutes to complete the procedure in 14 patients. No side effects attributable to gadopentetate dimeglumine were found. Sono-guided needle puncture for the shoulder MR arthrography can be a substitutable method for fluoroscopic guidance, with easy access, advantages of lacking radiation hazard and eliminating the need for iodized contrast agents.

  20. The painful shoulder

    International Nuclear Information System (INIS)

    Hartl, P.W.

    1987-01-01

    The painful shoulder syndrome is very common. Diagnosis and differential diagnosis may be difficult. Shoulder pain may be caused by local processes or systemic diseases or can be referred. Periarthritis humeroscapularis (frozen shoulder) is the most common cause of painful shoulder syndrome. Biomechanical factors concerning the rotator cuff are involved in the etiopathogenesis of these pain syndromes. The therapy of frozen shoulder includes physical treatment, antirheumatic drugs, or X-ray treatment. Surgical measures may become necessary. In the course of rheumatoid arthritis the shoulder may be involved. Milwaukee-shoulder-syndrome has been described recently in crystal deposit diseases. Shoulder pain may be referred by mechanical irritations of nerve roots in the course of degenerative lesions of the cervical spine and also in the course of internal diseases of the heart, the lungs, or the gastrointestinal tract. In cases of shoulder pain without pathological data from arthrological, radiological or laboratory studies, one should always consider localized fibromyalgia in the shoulder-neck-region. The precise diagnosis of shoulder pain is an important prerequisite for treatment, the success of which should not be judged as pessimistic as it has been commonly done in the past. (orig.) [de

  1. How does scapula motion change after reverse total shoulder arthroplasty? - a preliminary report

    Directory of Open Access Journals (Sweden)

    Kim Myung-Sun

    2012-10-01

    Full Text Available Abstract Background Arm elevation is composed of glenohumeral and scapulothoracic motion. Many reports have addressed changes of scapular position across a spectrum of shoulder disease. However, no study has examined changes in scapular position after reverse total shoulder arthroplasty (RTSA. The purpose of this study was to evaluate the changes in scapular position after RTSA compared to patients’ contralateral, nonoperated shoulder. Methods Seven patients that underwent RTSA for cuff tear arthropathy from July 2007 to October 2008 were enrolled. The distance between the long axis of the thoracic spine and the inferior pole of the scapula (lateralization of the scapula was measured on shoulder A-P radiographs at 0 degrees (the neutral position and at 30, 60, 90, and 120 degrees of shoulder abduction. In addition, the angle between the long axis of the thoracic spine and medial border of the scapula was measured and compared with the patients’ contralateral shoulder. Results Scapulohumeral rhythm was 2.4:1 on the operated shoulder and 4.1:1 on the nonoperated, contralateral shoulder at 120 degrees of abduction. The distance between the line of the interspinous process of upper thoracic vertebra and the inferior pole of the scapula showed a negative slope at 0 to 30 degrees abduction on the operated side, but beyond 30 degrees of abduction, this distance showed a more sudden increase than in the contralateral shoulder. The angle between the vertical vertebral line and the scapular medial border also showed greater increase beyond 30 degrees abduction on the operated limb. Conclusions The pattern of scapular position after RTSA, was found to differ from that of the contralateral shoulder, and showed a more scapular upward rotation.

  2. A Scott bench with ergonomic thorax stabilisation pad improves body posture during preacher arm curl exercise.

    Science.gov (United States)

    Biscarini, Andrea; Benvenuti, Paolo; Busti, Daniele; Zanuso, Silvano

    2016-05-01

    We assessed whether the use of an ergonomic thorax stabilisation pad, during the preacher arm curl exercise, could significantly reduce the excessive shoulder protraction and thoracic kyphosis induced by the standard flat pad built into the existing preacher arm curl equipment. A 3D motion capture system and inclinometers were used to measure shoulder protraction and thoracic kyphosis in 15 subjects performing preacher arm curl with a plate-loaded machine provided with the standard flat pad. The same measures were repeated after replacing the flat pad with a new ergonomic pad, specifically designed to accommodate the thorax profile and improve body posture. Pad replacement significantly (p ergonomic pad may potentially allow a more effective training, prevent musculoskeletal discomfort and reduce the risk of injury. Practitioner summary: We have designed an ergonomic thorax stabilisation pad for the preacher arm curl exercise. The new ergonomic pad improves the poor posture conditions induced by the standard flat pad and may potentially allow a more effective training, prevent musculoskeletal discomfort, improve the breathing function and reduce the risk of injury.

  3. EMG-Based Continuous and Simultaneous Estimation of Arm Kinematics in Able-Bodied Individuals and Stroke Survivors

    Directory of Open Access Journals (Sweden)

    Jie Liu

    2017-08-01

    Full Text Available Among the potential biological signals for human-machine interactions (brain, nerve, and muscle signals, electromyography (EMG widely used in clinical setting can be obtained non-invasively as motor commands to control movements. The aim of this study was to develop a model for continuous and simultaneous decoding of multi-joint dynamic arm movements based on multi-channel surface EMG signals crossing the joints, leading to application of myoelectrically controlled exoskeleton robots for upper-limb rehabilitation. Twenty subjects were recruited for this study including 10 stroke subjects and 10 able-bodied subjects. The subjects performed free arm reaching movements in the horizontal plane with an exoskeleton robot. The shoulder, elbow and wrist movements and surface EMG signals from six muscles crossing the three joints were recorded. A non-linear autoregressive exogenous (NARX model was developed to continuously decode the shoulder, elbow and wrist movements based solely on the EMG signals. The shoulder, elbow and wrist movements were decoded accurately based only on the EMG inputs in all the subjects, with the variance accounted for (VAF > 98% for all three joints. The proposed approach is capable of simultaneously and continuously decoding multi-joint movements of the human arm by taking into account the non-linear mappings between the muscle EMGs and joint movements, which may provide less effortful control of robotic exoskeletons for rehabilitation training of individuals with neurological disorders and arm impairment.

  4. Treatment of myofascial trigger points in common shoulder disorders by physical therapy: a randomized controlled trial [ISRCTN75722066].

    Science.gov (United States)

    Bron, Carel; Wensing, Michel; Franssen, Jo Lm; Oostendorp, Rob Ab

    2007-11-05

    and are referred to a physical therapy practice specialized in musculoskeletal disorders of the neck-, shoulder-, and arm. After the initial assessment patients are randomly assigned to either an intervention group or a control-group (wait and see). The primary outcome measure is the overall score of the Dutch language version of the DASH (Disabilities of Arm, Shoulder and Hand) questionnaire. Since there is only little evidence for the efficacy of physical therapy interventions in certain shoulder disorders, there is a need for further research. We found only a few studies examining the efficacy of MTrP therapy for shoulder disorders. Therefore we will perform a randomised clinical trial of the effect of physical therapy interventions aimed to inactivate MTrPs, on pain and impairment in shoulder function in a population of chronic a-traumatic shoulder patients. We opted for an intervention strategy that best reflects daily practice. Manual high velocity thrust techniques and dry-needling are excluded. Because in most physical therapy interventions, blinding of the patient and the therapist is not possible, we will perform a randomised, controlled and observer-blinded study. This randomized clinical trial is registered at current controlled trials ISRCTN75722066.

  5. Shoulder muscle endurance: the development of a standardized and reliable protocol

    Directory of Open Access Journals (Sweden)

    Roy Jean-Sébastien

    2011-01-01

    Full Text Available Abstract Background Shoulder muscle fatigue has been proposed as a possible link to explain the association between repetitive arm use and the development of rotator cuff disorders. To our knowledge, no standardized clinical endurance protocol has been developed to evaluate the effects of muscle fatigue on shoulder function. Such a test could improve clinical examination of individuals with shoulder disorders. Therefore, the purpose of this study was to establish a reliable protocol for objective assessment of shoulder muscle endurance. Methods An endurance protocol was developed on a stationary dynamometer (Biodex System 3. The endurance protocol was performed in isotonic mode with the resistance set at 50% of each subject's peak torque as measured for shoulder external (ER and internal rotation (IR. Each subject performed 60 continuous repetitions of IR/ER rotation. The endurance protocol was performed by 36 healthy individuals on two separate occasions at least two days apart. Maximal isometric shoulder strength tests were performed before and after the fatigue protocol to evaluate the effects of the endurance protocol and its reliability. Paired t-tests were used to evaluate the reduction in shoulder strength due to the protocol, while intraclass correlation coefficients (ICC and minimal detectable change (MDC were used to evaluate its reliability. Results Maximal isometric strength was significantly decreased after the endurance protocol (P 0.84. Conclusions Changes in muscular performance observed during and after the muscular endurance protocol suggests that the protocol did result in muscular fatigue. Furthermore, this study established that the resultant effects of fatigue of the proposed isotonic protocol were reproducible over time. The protocol was performed without difficulty by all volunteers and took less than 10 minutes to perform, suggesting that it might be feasible for clinical practice. This protocol could be used to induce

  6. Kinematic evaluation of patients with total and reverse shoulder arthroplasty during rehabilitation exercises with different loads.

    Science.gov (United States)

    de Toledo, Joelly Mahnic; Loss, Jefferson Fagundes; Janssen, Thomas W; van der Scheer, Jan W; Alta, Tjarco D; Willems, W Jaap; Veeger, DirkJan H E J

    2012-10-01

    Following shoulder arthroplasty, any well-planned rehabilitation program should include muscle strengthening. However, it is not always clear how different external loads influence shoulder kinematics in patients with shoulder prostheses. The objective of this study was to describe shoulder kinematics and determine the contribution of the scapulothoracic joint to total shoulder motion of patients with total and reverse shoulder arthroplasties and of healthy individuals during rehabilitation exercises (anteflexion and elevation in the scapular plane) using different loading conditions (without external load, 1 kg and elastic resistance). Shoulder motions were measured using an electromagnetic tracking device. A force transducer was used to record force signals during loaded conditions using elastic resistance. Statistical comparisons were made using a three-way repeated-measures analysis of variance with a Bonferroni post hoc testing. The scapula contributed more to movement of the arm in subjects with prostheses compared to healthy subjects. The same applies for loaded conditions (1 kg and elastic resistance) relative to unloaded tasks. For scapular internal rotation, upward rotation and posterior tilt no significant differences among groups were found during both exercises. Glenohumeral elevation angles during anteflexion were significantly higher in the total shoulder arthroplasty group compared to the reverse shoulder arthroplasty group. Differences in contribution of the scapula to total shoulder motion between patients with different types of arthroplasties were not significant. However, compared to healthy subjects, they were. Furthermore, scapular kinematics of patients with shoulder arthroplasty was influenced by implementation of external loads, but not by the type of load. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Shoulder dystocia.

    Science.gov (United States)

    Grobman, William

    2013-03-01

    The frequency of shoulder dystocia in different reports has varied, ranging 0.2-3% of all vaginal deliveries. Once a shoulder dystocia occurs, even if all actions are appropriately taken, there is an increased frequency of complications, including third- or fourth-degree perineal lacerations, postpartum hemorrhage, and neonatal brachial plexus palsies. Health care providers have a poor ability to predict shoulder dystocia for most patients and there remains no commonly accepted model to accurately predict this obstetric emergency. Consequently, optimal management of shoulder dystocia requires appropriate management at the time it occurs. Multiple investigators have attempted to enhance care of shoulder dystocia by utilizing protocols and simulation training. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Regional anesthesia procedures for shoulder and upper arm surgery upper extremity update--2005 to present.

    Science.gov (United States)

    Sripada, Ramprasad; Bowens, Clifford

    2012-01-01

    This review of the literature since 2005 assesses developments of RA techniques commonly used for shoulder surgery, and their effectiveness for postoperative analgesia. Advantages of regional techniques include site-specific anesthesia and decreased postoperative opioid use. For shoulder surgeries, the ISB provides effective analgesia with minimal complications, whereas the impacts of IA single-injections remain unclear. When combined with GA, ISB can be used in lower volumes and reducing the complications for shoulder and proximal upper extremity. USG ISB and SCB are both effective and safe for shoulder surgery with a low incidence of complications, especially PONS.53 When compared with intravenous patient-controlled opioid analgesia, a perineural LA infusion using a disposable pump with patient-controlled LA bolus function has led to better pain relief and functional recovery while decreasing the need for rescue analgesics and the number of adverse events after ambulatory orthopedic surgery. The most remarkable advance in RA in the past 5 years is the increased usage of USG. Although there are no large-scale prospective studies to show the safety, efficacy, and success and complication rates for USG blocks, USG RA theoretically could have less risk for neurologic symptoms, except for those induced by LA (less likely perineurally, much more likely intraneurally). The next "quantum leap" lies in reducing LA concentrations and augmenting anesthetic-analgesic effects with perineural additives (including clonidine, buprenorphine, and likely low-dose dexamethasone). Since 2005, perineural catheters have been an analgesic option that offers improved pain relief among other benefits, and are now being used at home. It is clear that patients benefit greatly from a single injection and continuous nerve block for postoperative pain management,but the financial and logistical aspects need to be resolved, not to mention the phrenic hemiparesis coin toss. Whether combined

  9. [Shoulder dystocia: Guidelines for clinical practice--Short text].

    Science.gov (United States)

    Sentilhes, L; Sénat, M-V; Boulogne, A-I; Deneux-Tharaux, C; Fuchs, F; Legendre, G; Le Ray, C; Lopez, E; Schmitz, T; Lejeune-Saada, V

    2015-12-01

    diabetes (grade C), EFW greater than 5000g in the absence of maternal diabetes (grade C), history of shoulder dystocia associated with severe neonatal or maternal complications (Professional consensus), and finally during labor, in case of fetal macrosomia and failure to progress in the second stage, when the fetal head is above a +2 station (grade C). In case of shoulder dystocia, it is recommended not to pull excessively on the fetal head (grade C), do not perform uterine expression (grade C) and do not realize inverse rotation of the fetal head (professional consensus). McRoberts' maneuver, with or without a suprapubic pressure, is recommended in the first line (grade C). In case of failure, if the posterior shoulder is engaged, Wood's maneuver should be performed preferentially; if the posterior shoulder is not engaged, delivery of the posterior arm should be performed preferentially (professional consensus). It seems necessary to know at least two maneuvers to perform in case of shoulder dystocia unresolved by the maneuver of McRoberts (professional consensus). Pediatrician should be immediately informed in case of shoulder dystocia. The initial clinical examination should search complications such as brachial plexus birth injury or clavicle fracture (professional consensus). In absence of neonatal complication, monitoring of the neonate is not modified (professional consensus). The implementation of a practical training using simulation and concerning all caregivers of the delivery room is associated with a significant reduction in neonatal (LE3) but not maternal (LE3) injury. Shoulder dystocia remains a non-predictable obstetrics emergency. All physicians and midwives should know and perform obstetric maneuvers if needed quickly but without precipitation. A training program using simulation for the management of shoulder dystocia is encouraged for the initial and continuing formation of different actors in the delivery room (professional consensus). Copyright

  10. Impact of shoulder complaints after neck dissection on shoulder disability and quality of life

    NARCIS (Netherlands)

    Stuiver, Martijn M.; van Wilgen, Cornelis P.; de Boer, Erlijn M.; de Goede, Cees J. T.; Koolstra, Muriel; van Opzeeland, Anita; Venema, Piet; Sterken, Margriet W.; Vincent, Andrew; Dijkstra, Pieter U.

    2008-01-01

    To explore relationships between shoulder complaints after neck dissection, shoulder disability, and quality of life. To find clinical predictors for mid- to long-term shoulder disability. Prospective. Shoulder pain, shoulder mobility, and shoulder droop, as well as scores on shoulder disability

  11. The effect of arm sling on balance in patients with hemiplegia.

    Science.gov (United States)

    Acar, Merve; Karatas, Gulcin Kaymak

    2010-10-01

    The aim of this study was to investigate the effect of an arm sling on balance in patients with, hemiplegia following a stroke. Twenty-six patients with hemiplegia (11 men, 15 women) who had, shoulder subluxation were enrolled in the study. Balance was evaluated by the Berg Balance Scale, the, Functional Reach test, and a static balance index which was measured by the Kinesthetic Ability, Trainer 3000. Balance tests were performed twice, with arm sling and without arm sling use. Results of, this study show that the Berg Balance Scores and static balance index ameliorated with arm sling use (p=0.005 and p=0.004, respectively). Likewise, the Functional Reach test was better when performed with an arm sling (p=0.039). In conclusion, arm slings have a beneficial effect on balance in patients, with hemiplegia. An arm sling may be applied for its possible beneficial effect on balance especially in, the early phases of stroke rehabilitation while the upper extremity is still flaccid and arm swing is, reduced. Copyright © 2010 Elsevier B.V. All rights reserved.

  12. Compensating for intersegmental dynamics across the shoulder, elbow, and wrist joints during feedforward and feedback control.

    Science.gov (United States)

    Maeda, Rodrigo S; Cluff, Tyler; Gribble, Paul L; Pruszynski, J Andrew

    2017-10-01

    Moving the arm is complicated by mechanical interactions that arise between limb segments. Such intersegmental dynamics cause torques applied at one joint to produce movement at multiple joints, and in turn, the only way to create single joint movement is by applying torques at multiple joints. We investigated whether the nervous system accounts for intersegmental limb dynamics across the shoulder, elbow, and wrist joints during self-initiated planar reaching and when countering external mechanical perturbations. Our first experiment tested whether the timing and amplitude of shoulder muscle activity account for interaction torques produced during single-joint elbow movements from different elbow initial orientations and over a range of movement speeds. We found that shoulder muscle activity reliably preceded movement onset and elbow agonist activity, and was scaled to compensate for the magnitude of interaction torques arising because of forearm rotation. Our second experiment tested whether elbow muscles compensate for interaction torques introduced by single-joint wrist movements. We found that elbow muscle activity preceded movement onset and wrist agonist muscle activity, and thus the nervous system predicted interaction torques arising because of hand rotation. Our third and fourth experiments tested whether shoulder muscles compensate for interaction torques introduced by different hand orientations during self-initiated elbow movements and to counter mechanical perturbations that caused pure elbow motion. We found that the nervous system predicted the amplitude and direction of interaction torques, appropriately scaling the amplitude of shoulder muscle activity during self-initiated elbow movements and rapid feedback control. Taken together, our results demonstrate that the nervous system robustly accounts for intersegmental dynamics and that the process is similar across the proximal to distal musculature of the arm as well as between feedforward (i

  13. Shoulder MRI scan

    Science.gov (United States)

    ... exercises Rotator cuff - self-care Shoulder replacement - discharge Shoulder surgery - discharge Using your shoulder after replacement surgery References Hanypsiak B, DeLong JM, Lowe WR. Scapulothoracic ...

  14. An investigation of shoulder forces in active shoulder tackles in rugby union football.

    Science.gov (United States)

    Usman, Juliana; McIntosh, Andrew S; Fréchède, Bertrand

    2011-11-01

    In rugby union football the tackle is the most frequently executed skill and one most associated with injury, including shoulder injury to the tackler. Despite the importance of the tackle, little is known about the magnitude of shoulder forces in the tackle and influencing factors. The objectives of the study were to measure the shoulder force in the tackle, as well as the effects of shoulder padding, skill level, side of body, player size, and experimental setting on shoulder force. Experiments were conducted in laboratory and field settings using a repeated measures design. Thirty-five participants were recruited to the laboratory and 98 to the field setting. All were male aged over 18 years with rugby experience. The maximum force applied to the shoulder in an active shoulder tackle was measured with a custom built forceplate incorporated into a 45 kg tackle bag. The overall average maximum shoulder force was 1660 N in the laboratory and 1997 N in the field. This difference was significant. The shoulder force for tackling without shoulder pads was 1684 N compared to 1635 N with shoulder pads. There was no difference between the shoulder forces on the dominant and non-dominant sides. Shoulder force reduced with tackle repetition. No relationship was observed between player skill level and size. A substantial force can be applied to the shoulder and to an opponent in the tackle. This force is within the shoulder's injury tolerance range and is unaffected by shoulder pads. Copyright © 2011 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  15. Parsonage-Turner syndrome in a patient with bilateral shoulder pain: A case report.

    Science.gov (United States)

    Ohta, Ryuichi; Shimabukuro, Akira

    2017-11-01

    Objective: Parsonage-Turner syndrome is a peripheral neuropathy characterized by acute onset shoulder pain, myalgia, and sensory disturbances. The present report discusses a rare case of Parsonage-Turner syndrome and highlights the importance of accurate history recording and thorough physical examination for the diagnosis of the disease in rural areas. Patient: A 28-year-old woman presented to our clinic with acute bilateral shoulder pain and difficulty moving her right arm. A diagnosis of Parsonage-Turner syndrome was suspected based on the progression of symptoms, severity of pain, and lack of musculoskeletal inflammation. The diagnosis was confirmed by neurological specialists, and the patient was treated with methylprednisolone, after which her symptoms gradually improved. Discussion: The differential diagnosis of shoulder pain is complicated due to the wide variety of conditions sharing similar symptoms. Accurate history recording and thorough physical examination are required to differentiate among conditions involving the central nerves, peripheral nerves, and nerve plexuses. Conclusion: Although the symptoms of Parsonage-Turner syndrome vary based on disease progression and the location of impairment, proper diagnosis of acute shoulder pain without central neurological symptoms can be achieved in rural areas via thorough examination.

  16. Prevalence and Consequences of Arm, Neck, and/or Shoulder Complaints Among Music Academy Students: A Comparative Study.

    Science.gov (United States)

    Kok, Laura M; Nelissen, Rob G H H; Huisstede, Bionka M A

    2015-09-01

    CANS (complaints of arm, neck, and/or shoulder not caused by a systemic disease or acute trauma) are a recognized problem in specific occupational groups such as musicians. This study aimed to compare the prevalence, characteristics, and consequences of CANS between music academy students and a control group of peer-age medical students. A cross-sectional study among music academy students and medical students. Data were collected using a web-based questionnaire on musculoskeletal conditions of the upper extremity in the two cohorts. Students of three music academies (n=345) and one medical university (n=2,870) received the questionnaire, of which 25% (n=87) and 18% (n=503) responded, respectively. The 12-month prevalence of CANS was nearly twice as high among music academy students as the control group (80.7% vs 41.5%, pMusic academy students reported 2.6 times the point prevalence as medical students (47.0% vs 18.2%, pmusic students, compared to 10.3% of the medical students (pMusic academy students presented more complaints per anatomic localization and a higher number of involved anatomic localizations. Music students rated the influence of CANS on daily functioning as more severe (5.0 vs 3.1, pmusic academy students (46.3%) visited a healthcare professional compared to medical students (29.8%, p=0.013). The prevalence of CANS is high in music academy students compared to medical students. This emphasizes the necessity of effective (preventive) interventions in these high-demanding professionals.

  17. Impact of shoulder complaints after neck dissection on shoulder disability and quality of life

    NARCIS (Netherlands)

    Stuiver, Martijn M.; van Wilgen, Cornelis P.; de Boer, Erlijn M.; de Goede, Cees J. T.; Koolstra, Muriel; van Opzeeland, Anita; Venema, Piet; Sterken, Margriet W.; Vincent, Andrew; Dijkstra, Pieter U.

    OBJECTIVE: To explore relationships between shoulder complaints after neck dissection, shoulder disability, and quality of life. To find clinical predictors for mid- to long-term shoulder disability. STUDY DESIGN: Prospective. PATIENTS AND METHODS: Shoulder pain, shoulder mobility, and shoulder

  18. Impact of shoulder complaints after neck dissection on shoulder disability and quality of life

    NARCIS (Netherlands)

    Stuiver, M.M.; van Wilgen, C.P.; de Boer, E.M.J.; de Goede, C.J.T.; Koolstra, M.; van Opzeeland, A.; Venema, P.; Sterken, M.W.; Vincent, A.; Dijkstra, P.U.

    2008-01-01

    Objective: To explore relationships between shoulder complaints after neck dissection, shoulder disability, and quality of life. To find clinical predictors for mid- to long-term shoulder disability. Study Design: Prospective. Patients and Methods: Shoulder pain, shoulder mobility, and shoulder

  19. Positioning of the patient during shoulder surgery: an inexpensive, safe and easy technique.

    Science.gov (United States)

    Van Tongel, Alexander; Hardeman, François; Karelse, Anne; de Wilde, Lieven

    2013-01-01

    The knowledge of shoulder pathology has improved tremendously in the last decades, and shoulder surgery is increasingly performed because of new treatment options and better operative results. Nowadays most surgical shoulder procedures are performed in the sitting or semi-sitting (beach chair) position. Stability of the patient and the ability to flex, extend and rotate the shoulder during surgery are crucial to improve exposure of the surgical field and lower the risk of perioperative complications. We developed an easy, safe and inexpensive surgical set-up providing a very good posterior, superior and anterior access to the shoulder in the sitting or semi-sitting position. In this technique, the patient is placed supine with the head at the foot end of the table and the body positioned slightly eccentrically with the back being supported by the leg plate contralateral to the operative side, avoiding any contact with the scapula of the operative side. A neck support is attached on an extra bar at the contralateral side and accommodated to the patient's lordosis. Next, the leg plate on the operative side is removed, and the head and the body are secured to the table with adhesive dressing. This way a stable positioning of the patient is obtained during the whole procedure, and the shoulder girdle is completely free. The set-up can accommodate patients of different stature and weight without the need to adapt the technique. This position also gives the possibility to provide an excellent radiographic view of the shoulder during operative fracture treatment. Our technique further allows a significant reduction in costs. A surgical table, extra bar, additional arm support and neck support are usually available and can be used in different settings, without the need for a specific shoulder table.

  20. Shoulder pain and jerk during recovery phase of manual wheelchair propulsion.

    Science.gov (United States)

    Jayaraman, Chandrasekaran; Beck, Carolyn L; Sosnoff, Jacob J

    2015-11-05

    Repetitive loading of the upper limb due to wheelchair propulsion plays a leading role in the development of shoulder pain in manual wheelchair users (mWCUs). There has been minimal inquiry on understanding wheelchair propulsion kinematics from a human movement ergonomics perspective. This investigation employs an ergonomic metric, jerk, to characterize the recovery phase kinematics of two recommended manual wheelchair propulsion patterns: semi-circular and the double loop. Further it examines if jerk is related to shoulder pain in mWCUs. Data from 22 experienced adult mWCUs was analyzed for this study (semi-circular: n=12 (pain/without-pain:6/6); double-loop: n=10 (pain/without-pain:4/6)). Participants propelled their own wheelchair fitted with SMARTWheels on a roller dynamometer at 1.1 m/s for 3 min. Kinematic and kinetic data of the upper limbs were recorded. Three dimensional absolute jerk experienced at the shoulder, elbow and wrist joint during the recovery phase of wheelchair propulsion were computed. Two-way ANOVAs were conducted with the recovery pattern type and shoulder pain as between group factors. (1) Individuals using a semi-circular pattern experienced lower jerk at their arm joints than those using a double loop pattern (Ppropulsion was able to distinguish between pattern types (semi-circular and double loop) and the presence of shoulder pain. Jerk provides novel insights into wheelchair propulsion kinematics and in the future it may be beneficial to incorporate jerk based metric into rehabilitation practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. The biomechanical demands of manual scaling on the shoulders & neck of dental hygienists.

    Science.gov (United States)

    La Delfa, Nicholas J; Grondin, Diane E; Cox, Jocelyn; Potvin, Jim R; Howarth, Samuel J

    2017-01-01

    The purpose of this study was to evaluate the postural and muscular demands placed on the shoulders and neck of dental hygienists when performing a simulated manual scaling task. Nineteen healthy female dental hygienists performed 30-min of simulated manual scaling on a manikin head in a laboratory setting. Surface electromyography was used to monitor muscle activity from several neck and shoulder muscles, and neck and arm elevation kinematics were evaluated using motion capture. The simulated scaling task resulted in a large range of neck and arm elevation angles and excessive low-level muscular demands in the neck extensor and scapular stabilising muscles. The physical demands varied depending on the working position of the hygienists relative to the manikin head. These findings are valuable in guiding future ergonomics interventions aimed at reducing the physical exposures of dental hygiene work. Practitioner Summary: Given that this study evaluates the physical demands of manual scaling, a procedure that is fundamental to dental hygiene work, the findings are valuable to identify ergonomics interventions to reduce the prevalence of work-related injuries, disability and the potential for early retirement among this occupational group.

  2. Observational study on the pavement performance effects of shoulder rumble strip on shoulders

    Directory of Open Access Journals (Sweden)

    Sean Coffey

    2016-07-01

    Full Text Available Rumble strip implementation has shown a constant increase with its safety benefits. Rumble strips are milled into the roadway shoulder to produce noise and vibrations when driven on. With the milling process, the pavement performance is expected to be negatively impacted by the decreased depth, though not mathematically quantified. Using methods defined by the Long-Term Pavement Performance Program, the severity of the shoulder site’s distresses, with and without shoulder rumble strips, will be quantified. The quantification would permit the design to compensate for the impact. This design compensation allows the implementation of hard shoulder running, the use of shoulder as a travel lane during congestion, and retains the shoulder rumble strip safety instead of removing, as suggested by some proposed projects. While hard shoulder running would not impact specific time periods, the safety benefit of rumble strips could be needed at any time. This study aims to quantify the rumble strip impact to enable the full shoulder strength for hard shoulder running while retaining the safety benefits of rumble strips. Keywords: Rumble strips, Shoulder, Cracking, Pavement performance, Hard shoulder running

  3. Incidence and prognostic factors for postoperative frozen shoulder after shoulder surgery: a prospective cohort study.

    Science.gov (United States)

    Koorevaar, Rinco C T; Van't Riet, Esther; Ipskamp, Marcel; Bulstra, Sjoerd K

    2017-03-01

    Frozen shoulder is a potential complication after shoulder surgery. It is a clinical condition that is often associated with marked disability and can have a profound effect on the patient's quality of life. The incidence, etiology, pathology and prognostic factors of postoperative frozen shoulder after shoulder surgery are not known. The purpose of this explorative study was to determine the incidence of postoperative frozen shoulder after various operative shoulder procedures. A second aim was to identify prognostic factors for postoperative frozen shoulder after shoulder surgery. 505 consecutive patients undergoing elective shoulder surgery were included in this prospective cohort study. Follow-up was 6 months after surgery. A prediction model was developed to identify prognostic factors for postoperative frozen shoulder after shoulder surgery using the TRIPOD guidelines. We nominated five potential predictors: gender, diabetes mellitus, type of physiotherapy, arthroscopic surgery and DASH score. Frozen shoulder was identified in 11% of the patients after shoulder surgery and was more common in females (15%) than in males (8%). Frozen shoulder was encountered after all types of operative procedures. A prediction model based on four variables (diabetes mellitus, specialized shoulder physiotherapy, arthroscopic surgery and DASH score) discriminated reasonably well with an AUC of 0.712. Postoperative frozen shoulder is a serious complication after shoulder surgery, with an incidence of 11%. Four prognostic factors were identified for postoperative frozen shoulder: diabetes mellitus, arthroscopic surgery, specialized shoulder physiotherapy and DASH score. The combination of these four variables provided a prediction rule for postoperative frozen shoulder with reasonable fit. Level II, prospective cohort study.

  4. Model-based sensorimotor integration for multi-joint control: development of a virtual arm model.

    Science.gov (United States)

    Song, D; Lan, N; Loeb, G E; Gordon, J

    2008-06-01

    An integrated, sensorimotor virtual arm (VA) model has been developed and validated for simulation studies of control of human arm movements. Realistic anatomical features of shoulder, elbow and forearm joints were captured with a graphic modeling environment, SIMM. The model included 15 musculotendon elements acting at the shoulder, elbow and forearm. Muscle actions on joints were evaluated by SIMM generated moment arms that were matched to experimentally measured profiles. The Virtual Muscle (VM) model contained appropriate admixture of slow and fast twitch fibers with realistic physiological properties for force production. A realistic spindle model was embedded in each VM with inputs of fascicle length, gamma static (gamma(stat)) and dynamic (gamma(dyn)) controls and outputs of primary (I(a)) and secondary (II) afferents. A piecewise linear model of Golgi Tendon Organ (GTO) represented the ensemble sampling (I(b)) of the total muscle force at the tendon. All model components were integrated into a Simulink block using a special software tool. The complete VA model was validated with open-loop simulation at discrete hand positions within the full range of alpha and gamma drives to extrafusal and intrafusal muscle fibers. The model behaviors were consistent with a wide variety of physiological phenomena. Spindle afferents were effectively modulated by fusimotor drives and hand positions of the arm. These simulations validated the VA model as a computational tool for studying arm movement control. The VA model is available to researchers at website http://pt.usc.edu/cel .

  5. The impact of shoulder abduction loading on EMG-based intention detection of hand opening and closing after stroke.

    Science.gov (United States)

    Lan, Yiyun; Yao, Jun; Dewald, Julius P A

    2011-01-01

    Many stroke patients are subject to limited hand functions in the paretic arm due to a significant loss of Corticospinal Tract (CST) fibers. A possible solution for this problem is to classify surface Electromyography (EMG) signals generated by hand movements and uses that to implement Functional Electrical Stimulation (FES). However, EMG usually presents an abnormal muscle coactivation pattern shown as increased coupling between muscles within and/or across joints after stroke. The resulting Abnormal Muscle Synergies (AMS) could make the classification more difficult in individuals with stroke, especially when attempting to use the hand together with other joints in the paretic arm. Therefore, this study is aimed at identifying the impact of AMS following stroke on EMG pattern recognition between two hand movements. In an effort to achieve this goal, 7 chronic hemiparetic chronic stroke subjects were recruited and asked to perform hand opening and closing movements at their paretic arm while being either fully supported by a virtual table or loaded with 25% of subject's maximum shoulder abduction force. During the execution of motor tasks EMG signals from the wrist flexors and extensors were simultaneously acquired. Our results showed that increased synergy-induced activity at elbow flexors, induced by increasing shoulder abduction loading, deteriorated the performance of EMG pattern recognition for hand opening for those with a weak grasp strength and EMG activity. However, no such impact on hand closing has yet been observed possibly because finger/wrist flexion is facilitated by the shoulder abduction-induced flexion synergy.

  6. Shoulder Muscle Activation of Novice and Resistance Trained Women during Variations of Dumbbell Press Exercises

    Science.gov (United States)

    Luczak, Joshua; Bosak, Andy; Riemann, Bryan L.

    2013-01-01

    Previous research has compared the effects of trunk inclination angle on muscle activation using barbells and Smith machines in men. Whether similar effects occur with the use of dumbbells or in women remains unknown. The purpose was to compare upper extremity surface electromyographical (EMG) activity between dumbbell bench, incline, and shoulder presses. Dominate arm EMG data were recorded for collegiate-aged female resistance trained individuals (n = 12) and novice female resistance trained exercisers (n = 12) from which average EMG amplitude for each repetition phase (concentric, eccentric) was computed. No significant differences were found between experienced and novice resistance trained individuals. For the upper trapezius and anterior deltoid muscles, shoulder press activation was significantly greater than incline press which in turn was significantly greater than bench press across both phases. The bench and incline presses promoted significantly greater pectoralis major sternal activation compared to the shoulder press (both phases). While pectoralis major clavicular activation during the incline press eccentric phase was significantly greater than both the bench and shoulder presses, activation during the bench press concentric phase promoted significantly greater activation than the incline press which in turn was significantly greater than the shoulder press. These results provide evidence for selecting exercises in resistance and rehabilitation programs. PMID:26464884

  7. Shoulder Muscle Activation of Novice and Resistance Trained Women during Variations of Dumbbell Press Exercises

    Directory of Open Access Journals (Sweden)

    Joshua Luczak

    2013-01-01

    Full Text Available Previous research has compared the effects of trunk inclination angle on muscle activation using barbells and Smith machines in men. Whether similar effects occur with the use of dumbbells or in women remains unknown. The purpose was to compare upper extremity surface electromyographical (EMG activity between dumbbell bench, incline, and shoulder presses. Dominate arm EMG data were recorded for collegiate-aged female resistance trained individuals ( and novice female resistance trained exercisers ( from which average EMG amplitude for each repetition phase (concentric, eccentric was computed. No significant differences were found between experienced and novice resistance trained individuals. For the upper trapezius and anterior deltoid muscles, shoulder press activation was significantly greater than incline press which in turn was significantly greater than bench press across both phases. The bench and incline presses promoted significantly greater pectoralis major sternal activation compared to the shoulder press (both phases. While pectoralis major clavicular activation during the incline press eccentric phase was significantly greater than both the bench and shoulder presses, activation during the bench press concentric phase promoted significantly greater activation than the incline press which in turn was significantly greater than the shoulder press. These results provide evidence for selecting exercises in resistance and rehabilitation programs.

  8. Risk of shoulder tendinitis in relation to shoulder loads in monotonous repetitive work

    DEFF Research Database (Denmark)

    Frost, P.; Bonde, J. P.; Mikkelsen, S.

    2002-01-01

    BACKGROUND: Few studies relate the occurrence of shoulder disorders to quantified ergonomic exposures. This study evaluates the hypothesis that shoulder loads in repetitive work might contribute to the occurrence of shoulder tendinitis. METHODS: This is a cross-sectional study of 1961 workers...... in repetitive work and 782 referents. Shoulder loads were quantified at task level and measures of exposures were assigned based on task distribution. Symptoms in combination with clinical criteria defined shoulder tendinitis. RESULTS: The prevalence of shoulder tendinitis was higher among exposed workers...

  9. Influence of body mass index on the outcome of brachial plexus surgery: are there any differences between elbow and shoulder results?

    Science.gov (United States)

    Socolovsky, Mariano; Martins, Roberto S; Di Masi, Gilda; Bonilla, Gonzalo; Siqueira, Mario G

    2014-12-01

    Body mass index (BMI) has recently been identified as a predictor of outcomes following reconstructive surgery of shoulder palsies. In this study, we sought to determine if the same holds true for the reconstruction of elbow flexion. Forty patients who had undergone partial ulnar-to-biceps nerve transfer (Oberlin's procedure) for shoulder palsy were assessed and compared against 18 previously reported patients who had undergone reconstruction for elbow palsies. The British Medical Research Council (BMRC) scale and an index dividing shoulder abduction strength in the affected arm by healthy arm were recorded. All patients had undergone surgery within 12 months of injury and had ≥ 12 months of follow-up. M4 or M3 biceps strength was obtained in 90 % of patients. Final strength on the affected side averaged 5.8 kg, versus 20.2 kg on the normal side, for a mean recovery index score of 0.30. In this sample of 40 patients, BMI did not predict percentage strength or BMRC grade recovery. Neither did age, number of roots involved, the affected side, nor time to surgery. Comparing patients with elbow versus shoulder reconstruction, there were no differences, except that patients undergoing Oberlin's procedure had a statistically longer duration of time between injury and surgical repair (7.4 vs 5.1 months, p surgery.

  10. The effects of the court-type Thai traditional massage on anatomical relations, blood flow, and skin temperature of the neck, shoulder, and arm.

    Science.gov (United States)

    Plakornkul, Vasana; Vannabhum, Manmas; Viravud, Yadaridee; Roongruangchai, Jantima; Mutirangura, Pramook; Akarasereenont, Pravit; Laohapand, Tawee

    2016-09-15

    Court-type Thai traditional massage (CTTM) has specific major signal points (MaSP) for treating musculoskeletal conditions. The objectives of this study are to investigate the anatomical surfaces and structures of MaSPs, and to examine blood flow (BF) and skin temperature (ST) changes after applying pressure on the MaSPs on neck, shoulder, and arm areas. In the anatomical study, 83 cadavers were dissected and the anatomical surfaces and structures of the 15 MaSPs recorded. In human volunteers, BF, peak systolic velocity (PS), diameter of artery (DA), and ST changes were measured at baseline and after pressure application at 0, 30, 60, 180, and 300 s. There was no statistical difference in anatomical surfaces and structures of MaSP between the left and right side of the body. The 3 MaSPs on the neck were shown to be anatomically separated from the location of the common carotid arteries. The BF of MaSPs of the neck significantly and immediately increased after pressure application for 30 s and for 60 s in the arm (p pressure application for 300 s (p < 0.001). There was no significant correlation between BF and ST at any of the MaSPs. This study showed that MaSP massages were mainly directed towards muscles. MaSPs can cause significant, but brief, increases in BF and ST. Further studies are suggested to identify changes in BF and ST for all of the MaSPs after actual massage treatment sessions as well as other physiological effects of massage.

  11. MRI of symptomatic shoulders

    International Nuclear Information System (INIS)

    Kikukawa, Kenshi; Segata, Tateki; Kunitake, Katsuhiko; Morisawa, Keizo; Harada, Masataka; Hirano, Mako

    2004-01-01

    The purpose of this study was to determine the prevalence of cuff tear and acromioclavicular joint (ACJ) osteoarthrosis by magnetic resonance imaging (MRI) evaluation in symptomatic shoulders. MRI was performed on 124 shoulders in 115 patients whose age ranged from 16 to 83 years (average: 58.0 years). There were 74 men (79 shoulders) and 41 women (45 shoulders). The patients were divided into three groups according to age; A group (10 shoulders: 16-29 years), B group (43 shoulders: 30-59 years), and C group (71 shoulders: 60-83 years). Rotator cuff tears and ACJ osteoarthrosis were graded on scales 0 to 3 (normal, increased signal intensity, incomplete, complete), and 1 to 4 (none, mild, moderate, severe), respectively. There was a significant difference in the severity of the cuff tears and the ACJ osteoarthrosis with respect to age. Twenty percent of the shoulders were graded incomplete or complete cuff tears in group A, 88% in group B, and 93% in group C. No shoulders were graded moderate or severe ACJ changes in group A, 63% in group B, and 93% in group C. There was a definite correlation between the cuff tears and ACJ osteoarthrosis. MRI of the symptomatic shoulders indicated well correlation between the rotator cuff tears and ACJ osteoarthrosis. (author)

  12. Shoulder arthroscopy

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007206.htm Shoulder arthroscopy To use the sharing features on this page, please enable JavaScript. Shoulder arthroscopy is surgery that uses a tiny camera called ...

  13. JOINT KINETICS TO ASSESS THE INFLUENCE OF THE RACKET ON A TENNIS PLAYER'S SHOULDER

    Directory of Open Access Journals (Sweden)

    Thomas Creveaux

    2013-06-01

    Full Text Available This study aimed at investigating the influence of three rackets on shoulder net joint moments, power and muscle activity during the flat tennis serve under field- conditions. A 6-camera Eagle® motion analysis system, operating at 256 Hz, captured racket and dominant upper limb kinematics of the serve in five tennis players under three racket conditions (A: low mass, high balance and polar moment, B: low three moments of inertia, and C: high mass, swingweight and twistweight. The electromyographic activity of six trunk and arm muscles was simultaneously recorded. Shoulder net joint moments and power were computed by 3D inverse dynamics. The results showed that greater shoulder joint power and internal/external rotation peak moments were found to accelerate and decelerate racket A in comparison with the racket C. Moreover, serving with the racket A resulted in less activity in latissimus dorsi muscle during the acceleration phase, and biceps brachii muscle during the follow-through phase when compared with racket C. These initial findings encourage studying the biomechanical measurements to quantify the loads on the body during play in order to reduce them, and then prevent shoulder injuries. Racket specifications may be a critical point for coaches who train players suffering from shoulder pain and chronic upper limb injuries should be considered in relation to the racket specifications of the players

  14. Effect of arm cycling on gait of children with hemiplegic cerebral palsy

    African Journals Online (AJOL)

    The study group received arm cycling in addition to gait training exercise, while the control group received gait training exercises only. Three dimensional (3D) motion analysis was used before and after the training program to evaluate the angular displacements of shoulder, elbow, hip, knee, and ankle joints during gait sub ...

  15. Wearable Inertial Sensors Allow for Quantitative Assessment of Shoulder and Elbow Kinematics in a Cadaveric Knee Arthroscopy Model.

    Science.gov (United States)

    Rose, Michael; Curtze, Carolin; O'Sullivan, Joseph; El-Gohary, Mahmoud; Crawford, Dennis; Friess, Darin; Brady, Jacqueline M

    2017-12-01

    To develop a model using wearable inertial sensors to assess the performance of orthopaedic residents while performing a diagnostic knee arthroscopy. Fourteen subjects performed a diagnostic arthroscopy on a cadaveric right knee. Participants were divided into novices (5 postgraduate year 3 residents), intermediates (5 postgraduate year 4 residents), and experts (4 faculty) based on experience. Arm movement data were collected by inertial measurement units (Opal sensors) by securing 2 sensors to each upper extremity (dorsal forearm and lateral arm) and 2 sensors to the trunk (sternum and lumbar spine). Kinematics of the elbow and shoulder joints were calculated from the inertial data by biomechanical modeling based on a sequence of links connected by joints. Range of motion required to complete the procedure was calculated for each group. Histograms were used to compare the distribution of joint positions for an expert, intermediate, and novice. For both the right and left upper extremities, skill level corresponded well with shoulder abduction-adduction and elbow prono-supination. Novices required on average 17.2° more motion in the right shoulder abduction-adduction plane than experts to complete the diagnostic arthroscopy (P = .03). For right elbow prono-supination (probe hand), novices required on average 23.7° more motion than experts to complete the procedure (P = .03). Histogram data showed novices had markedly more variability in shoulder abduction-adduction and elbow prono-supination compared with the other groups. Our data show wearable inertial sensors can measure joint kinematics during diagnostic knee arthroscopy. Range-of-motion data in the shoulder and elbow correlated inversely with arthroscopic experience. Motion pattern-based analysis shows promise as a metric of resident skill acquisition and development in arthroscopy. Wearable inertial sensors show promise as metrics of arthroscopic skill acquisition among residents. Copyright © 2017

  16. Rib stress fracture in a male adaptive rower from the arms and shoulders sport class: case report.

    Science.gov (United States)

    Smoljanovic, Tomislav; Bojanic, Ivan; Pollock, Courtney L; Radonic, Radovan

    2011-10-15

    Adaptive rowing is rowing or sculling for rowers with a physical disability. It debuted at the Paralympic Games in 2008. In order to ensure an equitable playing field, rowers with similar levels of physical function and disability are classified into different sport classes for competition. Rowers with an inability to use a sliding seat and impaired trunk function resulting in an inability to perform trunk forward and backward lean via hip flexion/extension are assigned to the Arms and Shoulders (AS) class. AS rowers have to use a chest strap set immediately below the chest in order to localize any trunk movement in AS class. Conditions created by adaptations of rowing equipment and technique within the AS class create unique stresses on the upper thoracic region. The following case report demonstrates how etiology and management of a rib stress fracture in an AS rower differs in comparison to able-body rowers. Of significant importance were the limitations imposed on the rower's ability to maintain rowing-specific fitness, due to the nature of the rib stress fracture and requirement to decrease force transmission through the ribs for several weeks. The rower's gradual return to full training was further impacted by obligatory use of the chest strap, which directly applied pressure over the injured area. Protective orthosis for the chest was designed and applied in order to dissipate pressure of the chest strap over the thorax during rowing (most importantly at the catch position) both on the ergometer and in the boat.

  17. Risk of bursitis and other injuries and dysfunctions of the shoulder following vaccinations.

    Science.gov (United States)

    Martín Arias, L H; Sanz Fadrique, R; Sáinz Gil, M; Salgueiro-Vazquez, M E

    2017-09-05

    While vaccination injection site adverse reactions are usually mild and transient in nature, several cases of bursitis and other shoulder injuries have been reported in the medical literature. However, these lesions are not included in vaccine label inserts. To identify the characteristics of post-vaccination shoulder injuries and those of patients and involved vaccines, as well as their potential causes, a systematic review of the cases of vaccination-related bursitis and other shoulder injuries reported in the literature and notified to the Spanish Pharmacovigilance System database (FEDRA) have been conducted. We found 45 cases of bursitis and other shoulder injuries that appeared following the vaccine intramuscular injection given into the deltoid muscle (37 from the systematic review of the literature, and 8 from the scrutiny in the Spanish Pharmacovigilance System database, FEDRA). All the patients were adult, 71.1% females, with a mean and median age of 53.6years (range: 22-89). The most frequently involved vaccines were influenza and pneumococcal vaccines, respectively; followed by diphtheria-tetanus-pertussis, diphtheria-tetanus toxoid, human papillomavirus, and hepatitis A vaccines. The most frequent shoulder lesion was bursitis. Most of patients required medical care due to severe local pain and arm mobility restriction. In a majority of cases, symptoms started 48h post vaccination. Subdeltoid or subacromial bursitis and other shoulder lesions may be more common than suspected. Such lesions predominantly affect women. The cause may be related to antigens or adjuvants contained in the vaccines that would trigger an immune or inflammatory response. However, they are more likely to be the consequence of a poor injection technique (site, angle, needle size, and failure to take into account patient's characteristics, i. e., sex, body weight, and physical constitution). Therefore, vaccination-related shoulder injuries would be amenable to prevention. Copyright

  18. Shoulder Instability

    Science.gov (United States)

    ... hit hard with your shoulder in a football game or serve a volleyball really hard. Diagnosis How ... editorial staff Categories: Family Health, Kids and Teens, Men, WomenTags: laxity, out of place, shakiness, shoulder, subluxation ...

  19. SUSTAINED ISOMETRIC SHOULDER CONTRACTION ON MUSCULAR STRENGTH AND ENDURANCE: A RANDOMIZED CLINICAL TRIAL.

    Science.gov (United States)

    Myers, Natalie L; Toonstra, Jenny L; Smith, Jacob S; Padgett, Cooper A; Uhl, Tim L

    2015-12-01

    The Advanced Throwers Ten Exercise Program incorporates sustained isometric contractions in conjunction with dynamic shoulder movements. It has been suggested that incorporating isometric holds may facilitate greater increases in muscular strength and endurance. However, no objective evidence currently exists to support this claim. The purpose of this research was to compare the effects of a sustained muscle contraction resistive training program (Advanced Throwers Ten Program) to a more traditional exercise training protocol to determine if increases in shoulder muscular strength and endurance occur in an otherwise healthy population. It was hypothesized that utilizing a sustained isometric hold during a shoulder scaption exercise from the Advanced Throwers Ten would produce greater increases in shoulder strength and endurance as compared to a traditional training program incorporating a isotonic scapular plane abduction (scaption) exercise. Randomized Clinical Trial. Fifty healthy participants were enrolled in this study, of which 25 were randomized into the traditional training group (age: 26 ± 8, height:172 ± 10 cm, weight: 73 ± 13 kg, Marx Activity Scale: 11 ± 4) and 25 were randomized to the Advanced Throwers Ten group (age: 28 ± 9, height: 169 ± 23 cm, weight: 74 ± 16 kg, Marx Activity Scale: 11 ± 5). No pre-intervention differences existed between the groups (P>0.05). Arm endurance and strength data were collected pre and post intervention using a portable load cell (BTE Evaluator, Hanover, MD). Both within and between group analyses were done in order to investigate average torque (strength) and angular impulse (endurance) changes. The traditional and Advanced Throwers Ten groups both significantly improved torque and angular impulse on both the dominant and non-dominant arms by 10-14%. There were no differences in strength or endurance following the interventions between the two training groups (p>0

  20. [Imaging evaluation on adaptability of proximal humeral anatomy after shoulder replacement with individualized shoulder prosthesis].

    Science.gov (United States)

    Shi, Youxing; Tang, Kanglai; Yuan, Chengsong; Tao, Xu; Wang, Huaqing; Chen, Bo; Guo, Yupeng

    2015-03-24

    Modern shoulder prosthesis has evolved through four generations. And the fourth generation technology has a core three-dimensional design of restoring 3D reconstruction of proximal humeral anatomy. Thus a new shoulder prosthesis is developed on the basis of the technology of 3D prosthesis. Assessment of whether shoulder prosthesis can restore individualized reconstruction of proximal humeral anatomy is based on the adaptability of proximal humeral anatomy. To evaluate the adaptability of proximal humeral anatomy through measuring the parameters of proximal humeral anatomy after shoulder replacement with individualized shoulder prosthesis and compare with normal data. The parameters of proximal humeral anatomy were analyzed and evaluated for a total of 12 cases undergoing shoulder replacement with individualized shoulder prosthesis. The relevant anatomical parameters included neck-shaft angle (NSA), retroversion angle (RA), humeral head height (HH) and humeral head diameter (HD). And the anatomical parameters were compared with the data from normal side. All underwent shoulder replacement with individualized shoulder prosthesis. The postoperative parameters of proximal humeral anatomy were compared with those of normal side. And the difference of NSA was 0.05). Individualized shoulder prosthesis has excellent adaptability to shoulder. All core parameters are freely adjustable and specification models may be optimized. With matching tools, individualized shoulder prosthesis improves the accuracy and reliability in shoulder replacement.

  1. The Effect of Platelet-Rich Plasma (PRP on Improvement in Pain and Symptoms of Shoulder Subacromial Impingement Syndrome

    Directory of Open Access Journals (Sweden)

    Parisa Nejati

    2015-08-01

    Full Text Available Abstract Background: Subacromial impingement is one of the most common complaints of shoulder. Treatments include avoiding of painful activities, oral anti-pain drugs, physical therapy modalities, corticosteroid injection and exercise therapy. Some studies have shown that platelet- rich plasma(PRP is effective on tendinitis and tearing of tendons, ligaments and muscles, but evidence that has proved PRP as a conservative treatment in shoulder pathologies is very limited. This study aims to investigate the effect of PRP injection on relieving pain and improving daily function of patients with shoulder impingement syndrome. Materials and Methods: In this clinical trial study, patients older than 40 with pain more than three months were included. If they had three of four positive diagnostic clinical tests of shoulder impingement that were confirmed by shoulder MRI, could be injected PRP twice. The time between injections was 1 month. Pain was measured by visual analog scale (VAS and function was measured by two questionnaires named disabilities of the arm, shoulder and hand (DASH and western Ontario rotator cuff index (WORC. Range of motion (ROM of shoulder was measured in five directions by goniometry . All of these parameters were evaluated before intervention and in 1, 3, 6 months later. Results: with due attention to a six-month folloe-up, PRR injection was effective in pain reduction and improvement of patient's function (p<0.05. Shoulder Rom increased in all directions except external rotation and the power of shoulder muscles was evidently improved statistically in flexion, abduction and internal toration. Conclusion: PRP injection could effectively reduce pain and improve daily activities in patients with shoulder impingement syndrome.

  2. Intervention randomized controlled trials involving wrist and shoulder arthroscopy: a systematic review

    Science.gov (United States)

    2014-01-01

    Background Although arthroscopy of upper extremity joints was initially a diagnostic tool, it is increasingly used for therapeutic interventions. Randomized controlled trials (RCTs) are considered the gold standard for assessing treatment efficacy. We aimed to review the literature for intervention RCTs involving wrist and shoulder arthroscopy. Methods We performed a systematic review for RCTs in which at least one arm was an intervention performed through wrist arthroscopy or shoulder arthroscopy. PubMed and Cochrane Library databases were searched up to December 2012. Two researchers reviewed each article and recorded the condition treated, randomization method, number of randomized participants, time of randomization, outcomes measures, blinding, and description of dropouts and withdrawals. We used the modified Jadad scale that considers the randomization method, blinding, and dropouts/withdrawals; score 0 (lowest quality) to 5 (highest quality). The scores for the wrist and shoulder RCTs were compared with the Mann–Whitney test. Results The first references to both wrist and shoulder arthroscopy appeared in the late 1970s. The search found 4 wrist arthroscopy intervention RCTs (Kienböck’s disease, dorsal wrist ganglia, volar wrist ganglia, and distal radius fracture; first 3 compared arthroscopic with open surgery). The median number of participants was 45. The search found 50 shoulder arthroscopy intervention RCTs (rotator cuff tears 22, instability 14, impingement 9, and other conditions 5). Of these, 31 compared different arthroscopic treatments, 12 compared arthroscopic with open treatment, and 7 compared arthroscopic with nonoperative treatment. The median number of participants was 60. The median modified Jadad score for the wrist RCTs was 0.5 (range 0–1) and for the shoulder RCTs 3.0 (range 0–5) (p = 0.012). Conclusion Despite the increasing use of wrist arthroscopy in the treatment of various wrist disorders the efficacy of arthroscopically

  3. Reproducibility of a 3-dimensional gyroscope in measuring shoulder anteflexion and abduction

    Directory of Open Access Journals (Sweden)

    Penning Ludo I F

    2012-07-01

    Full Text Available Abstract Background Few studies have investigated the use of a 3-dimensional gyroscope for measuring the range of motion (ROM in the impaired shoulder. Reproducibility of digital inclinometer and visual estimation is poor. This study aims to investigate the reproducibility of a tri axial gyroscope in measurement of anteflexion, abduction and related rotations in the impaired shoulder. Methods Fifty-eight patients with either subacromial impingement (27 or osteoarthritis of the shoulder (31 participated. Active anteflexion, abduction and related rotations were measured with a tri axial gyroscope according to a test retest protocol. Severity of shoulder impairment and patient perceived pain were assessed by the Disability of Arm Shoulder and Hand score (DASH and the Visual Analogue Scale (VAS. VAS scores were recorded before and after testing. Results In two out of three hospitals patients with osteoarthritis (n = 31 were measured, in the third hospital patients with subacromial impingement (n = 27. There were significant differences among hospitals for the VAS and DASH scores measured before and after testing. The mean differences between the test and retest means for anteflexion were −6 degrees (affected side, 9 (contralateral side and for abduction 15 degrees (affected side and 10 degrees (contralateral side. Bland & Altman plots showed that the confidence intervals for the mean differences fall within −6 up to 15 degrees, individual test - retest differences could exceed these limits. A simulation according to ‘Generalizability Theory’ produces very good coefficients for anteflexion and related rotation as a comprehensive measure of reproducibility. Optimal reproducibility is achieved with 2 repetitions for anteflexion. Conclusions Measurements were influenced by patient perceived pain. Differences in VAS and DASH might be explained by different underlying pathology. These differences in shoulder pathology however did not alter

  4. A lightweight shoulder prosthesis with antagonistic impact-absorbing hybrid actuation for bimanual activities of daily living

    Directory of Open Access Journals (Sweden)

    Masashi Sekine

    2016-04-01

    Full Text Available In developing a shoulder prosthesis, in addition to appropriate payload and range of motion under the constraints of weight and shape, impact absorption is very important for safe use. Hybridization of two different actuators (pneumatic elastic actuators with the features of lightness and intrinsic visco-elasticity, and servo motors that have stable torque and a large range of motion in combination with an antagonistic mechanism was employed to achieve the development of the shoulder prosthesis. A two-link, two-degree-of-freedom arm was used to test the different hybridization configurations in order to investigate the impact absorption. A dynamic simulation platform based on four bimanual activities of daily living was established to obtain the required range of motion and torque for joints of a two-link, four-degree-of-freedom arm. The number of pneumatic elastic actuators required and the dimension of the antagonistic mechanism mechanical structures were optimized using the dynamic simulation platform. The best configuration of the two types of actuators was determined using the dynamic simulation based on the impact absorption results and other criteria. Moreover, a simplified prototype driven by hybrid actuation was made. It was shown that the pneumatic elastic actuator joint could improve impact absorption, and the actuator configuration of shoulder prostheses is activity of daily living dependent. The prototype could reproduce a certain activity of daily living motion, indicating its feasibility in daily living.

  5. Shoulder reflexes

    DEFF Research Database (Denmark)

    Diederichsen, Louise; Krogsgaard, Michael; Voigt, Michael

    2002-01-01

    Dynamic shoulder stability is dependent on muscular coordination and sensory inputs. In the shoulder, mechanoreceptors are found in the coracoacromial ligament, the rotator cuff tendons, the musculotendinous junctions of the rotator cuff and in the capsule. The number of receptors in the capsule...

  6. Analysis of reaching movements of upper arm in robot assisted exercises. Kinematic assessment of robot assisted upper arm reaching single-joint movements.

    Science.gov (United States)

    Iuppariello, Luigi; D'Addio, Giovanni; Romano, Maria; Bifulco, Paolo; Lanzillo, Bernardo; Pappone, Nicola; Cesarelli, Mario

    2016-01-01

    Robot-mediated therapy (RMT) has been a very dynamic area of research in recent years. Robotics devices are in fact capable to quantify the performances of a rehabilitation task in treatments of several disorders of the arm and the shoulder of various central and peripheral etiology. Different systems for robot-aided neuro-rehabilitation are available for upper limb rehabilitation but the biomechanical parameters proposed until today, to evaluate the quality of the movement, are related to the specific robot used and to the type of exercise performed. Besides, none study indicated a standardized quantitative evaluation of robot assisted upper arm reaching movements, so the RMT is still far to be considered a standardised tool. In this paper a quantitative kinematic assessment of robot assisted upper arm reaching movements, considering also the effect of gravity on the quality of the movements, is proposed. We studied a group of 10 healthy subjects and results indicate that our advised protocol can be useful for characterising normal pattern in reaching movements.

  7. Pregnancy Complications: Shoulder Dystocia

    Science.gov (United States)

    ... Home > Complications & Loss > Pregnancy complications > Shoulder dystocia Shoulder dystocia Now playing: E-mail to a friend Please ... women more likely than others to have shoulder dystocia? A pregnant woman may be at risk for ...

  8. Are the patient-rated wrist evaluation (PRWE) and the disabilities of the arm, shoulder and hand (DASH) questionnaire used in distal radial fractures truly valid and reliable?

    Science.gov (United States)

    Krol, R. G.; Bhandari, M.; Goslings, J. C.; Poolman, R. W.; Scholtes, V. A. B.

    2018-01-01

    Objectives The patient-rated wrist evaluation (PRWE) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire are patient-reported outcome measures (PROMs) used for clinical and research purposes. Methodological high-quality clinimetric studies that determine the measurement properties of these PROMs when used in patients with a distal radial fracture are lacking. This study aimed to validate the PRWE and DASH in Dutch patients with a displaced distal radial fracture (DRF). Methods The intraclass correlation coefficient (ICC) was used for test-retest reliability, between PROMs completed twice with a two-week interval at six to eight months after DRF. Internal consistency was determined using Cronbach’s α for the dimensions found in the factor analysis. The measurement error was expressed by the smallest detectable change (SDC). A semi-structured interview was conducted between eight and 12 weeks after DRF to assess the content validity. Results A total of 119 patients (mean age 58 years (sd 15)), 74% female, completed PROMs at a mean time of six months (sd 1) post-fracture. One overall meaningful dimension was found for the PRWE and the DASH. Internal consistency was excellent for both PROMs (Cronbach’s α 0.96 (PRWE) and 0.97 (DASH)). Test-retest reliability was good for the PRWE (ICC 0.87) and excellent for the DASH (ICC 0.91). The SDC was 20 for the PRWE and 14 for the DASH. No floor or ceiling effects were found. The content validity was good for both questionnaires. Conclusion The PRWE and DASH are valid and reliable PROMs in assessing function and disability in Dutch patients with a displaced DRF. However, due to the high SDC, the PRWE and DASH are less useful for individual patients with a distal radial fracture in clinical practice. Cite this article: Y. V. Kleinlugtenbelt, R. G. Krol, M. Bhandari, J. C. Goslings, R. W. Poolman, V. A. B. Scholtes. Are the patient-rated wrist evaluation (PRWE) and the disabilities of the arm, shoulder and

  9. The metabolic cost of human running: is swinging the arms worth it?

    Science.gov (United States)

    Arellano, Christopher J; Kram, Rodger

    2014-07-15

    Although the mechanical function is quite clear, there is no consensus regarding the metabolic benefit of arm swing during human running. We compared the metabolic cost of running using normal arm swing with the metabolic cost of running while restricting the arms in three different ways: (1) holding the hands with the arms behind the back in a relaxed position (BACK), (2) holding the arms across the chest (CHEST) and (3) holding the hands on top of the head (HEAD). We hypothesized that running without arm swing would demand a greater metabolic cost than running with arm swing. Indeed, when compared with running using normal arm swing, we found that net metabolic power demand was 3, 9 and 13% greater for the BACK, CHEST and HEAD conditions, respectively (all Prunning without arm swing, subjects significantly increased the peak-to-peak amplitudes of both shoulder and pelvis rotation about the vertical axis, most likely a compensatory strategy to counterbalance the rotational angular momentum of the swinging legs. In conclusion, our findings support our general hypothesis that swinging the arms reduces the metabolic cost of human running. Our findings also demonstrate that arm swing minimizes torso rotation. We infer that actively swinging the arms provides both metabolic and biomechanical benefits during human running. © 2014. Published by The Company of Biologists Ltd.

  10. Factors Associated with Pain, Disability and Quality of Life in Patients Suffering from Frozen Shoulder

    Directory of Open Access Journals (Sweden)

    Farshid Bagheri

    2016-07-01

    Full Text Available Background: Frozen shoulder is resulting in limb disability and reduction of quality of life but the factors associated with patients’ disability and quality of life is not clear. To assess pain, disability, the quality of life and factors associated with them in patients suffering from frozen shoulder.  Methods: We enrolled 120 patients (37 men and 83 women with phase-II idiopathic frozen shoulder in our cross-sectional study. Demographic data were collected and shoulder range of motion was measured in four different directions (elevation, abduction, external and internal rotation in both upper limbs. Patients were asked to fill out Visual Analog Scale for pain (VAS and, Short-Form Health Survey questionnaire (SF-36 as well as Disabilities of the Arm, Shoulder and Hand (DASH questionnaires. We asked the patients to fill out the Hamilton anxiety and depression questionnaires. Results: The mean of VAS pain, DASH, PCS, and MCS scores were 69(18, 53(17, 35(8.0, and 42(10 respectively. All the domains of SF36 questionnaires where below the normal population except physical function. VAS pain score was correlated to Hamilton depression scores in both bivariate and mulivarilable analysis. DASH score were correlated to sex, age, ROM, and both Hamilton anxiety and depression scores; However, DASH score only impact with Hamilton anxiety and ROM independently. PCS is correlated to age and MCS to Hamilton depression. Conclusion: Patient with frozen shoulder are more suffering from pain and disability secondary to psychiatric parameters such as depression and anxiety than demographic features or even restriction of range of motion.

  11. Feasibility of Using Low-Cost Motion Capture for Automated Screening of Shoulder Motion Limitation after Breast Cancer Surgery.

    Directory of Open Access Journals (Sweden)

    Valeriya Gritsenko

    Full Text Available To determine if a low-cost, automated motion analysis system using Microsoft Kinect could accurately measure shoulder motion and detect motion impairments in women following breast cancer surgery.Descriptive study of motion measured via 2 methods.Academic cancer center oncology clinic.20 women (mean age = 60 yrs were assessed for active and passive shoulder motions during a routine post-operative clinic visit (mean = 18 days after surgery following mastectomy (n = 4 or lumpectomy (n = 16 for breast cancer.Participants performed 3 repetitions of active and passive shoulder motions on the side of the breast surgery. Arm motion was recorded using motion capture by Kinect for Windows sensor and on video. Goniometric values were determined from video recordings, while motion capture data were transformed to joint angles using 2 methods (body angle and projection angle.Correlation of motion capture with goniometry and detection of motion limitation.Active shoulder motion measured with low-cost motion capture agreed well with goniometry (r = 0.70-0.80, while passive shoulder motion measurements did not correlate well. Using motion capture, it was possible to reliably identify participants whose range of shoulder motion was reduced by 40% or more.Low-cost, automated motion analysis may be acceptable to screen for moderate to severe motion impairments in active shoulder motion. Automatic detection of motion limitation may allow quick screening to be performed in an oncologist's office and trigger timely referrals for rehabilitation.

  12. Feasibility of Using Low-Cost Motion Capture for Automated Screening of Shoulder Motion Limitation after Breast Cancer Surgery.

    Science.gov (United States)

    Gritsenko, Valeriya; Dailey, Eric; Kyle, Nicholas; Taylor, Matt; Whittacre, Sean; Swisher, Anne K

    2015-01-01

    To determine if a low-cost, automated motion analysis system using Microsoft Kinect could accurately measure shoulder motion and detect motion impairments in women following breast cancer surgery. Descriptive study of motion measured via 2 methods. Academic cancer center oncology clinic. 20 women (mean age = 60 yrs) were assessed for active and passive shoulder motions during a routine post-operative clinic visit (mean = 18 days after surgery) following mastectomy (n = 4) or lumpectomy (n = 16) for breast cancer. Participants performed 3 repetitions of active and passive shoulder motions on the side of the breast surgery. Arm motion was recorded using motion capture by Kinect for Windows sensor and on video. Goniometric values were determined from video recordings, while motion capture data were transformed to joint angles using 2 methods (body angle and projection angle). Correlation of motion capture with goniometry and detection of motion limitation. Active shoulder motion measured with low-cost motion capture agreed well with goniometry (r = 0.70-0.80), while passive shoulder motion measurements did not correlate well. Using motion capture, it was possible to reliably identify participants whose range of shoulder motion was reduced by 40% or more. Low-cost, automated motion analysis may be acceptable to screen for moderate to severe motion impairments in active shoulder motion. Automatic detection of motion limitation may allow quick screening to be performed in an oncologist's office and trigger timely referrals for rehabilitation.

  13. Work-related complaints of arm, neck and shoulder among computer office workers in an Asian country: prevalence and validation of a risk-factor questionnaire

    Directory of Open Access Journals (Sweden)

    Jayawardana Naveen

    2011-04-01

    Full Text Available Abstract Background Complaints of arm, neck and/or shoulders (CANS affects millions of computer office workers. However its prevalence and associated risk factors in developing countries are yet to be investigated, due to non availability of validated assessment tools for these countries. We evaluated the 1-year prevalence of CANS among computer office workers in Sri Lanka and tested the psychometric properties of a translated risk factor questionnaire. Methods Computer office workers at a telecommunication company in Sri Lankan received the Sinhalese version of the validated Maastricht Upper Extremity Questionnaire (MUEQ. The 94 items in the questionnaire covers demographic characteristics, CANS and evaluates potential risk factors for CANS in six domains. Forward and backward translation of the MUEQ was done by two independent bi-lingual translators. One-year prevalence of CANS and psychometric properties of the Sinhalese questionnaire were investigated. Results Response rate was 97.7% (n = 440. Males were 42.7%. Mean age was 38.2 ± 9.5 years. One-year prevalence of CANS was 63.6% (mild-53.7% and severe-10%. The highest incidences were for neck (36.1% and shoulder (34.3% complaints. Two factors for each domain in the scale were identified by exploratory factor analysis (i.e. work-area, computer-position, incorrect body posture, bad-habits, skills and abilities, decision-making, time-management, work-overload, work-breaks, variation in work, work-environment and social-support. Calculation of internal consistency (Cronbach's alpha 0.43-0.82 and cross-validation provided evidence of reliability and lack of redundancy of items. Conclusion One year prevalence of CANS in the study population corresponds strongly with prevalence in developed countries. Translated version of the MUEQ has satisfactory psychometric properties for it to be used to assess work-related risk factors for development of CANS among Sri Lankan computer office workers.

  14. Functional connectivity between core and shoulder muscles increases during isometric endurance contractions in judo competitors

    DEFF Research Database (Denmark)

    Kawczyński, Adam; Samani, Afshin; Mroczek, Dariusz

    2015-01-01

    endurance contraction consisting of bilateral arm abduction at 90°. The normalized mutual information (NMI) was computed between muscle pairs as an index indicating functional connectivity. Results: The NMIs increased significantly during endurance test for 10 of the 15 muscle pairs (P ... : We concluded that the increases in NMIs highlighted functional changes in the interplay between core and shoulder muscles during an endurance contraction in elite judokas....

  15. Effect of lateralized design on muscle and joint reaction forces for reverse shoulder arthroplasty.

    Science.gov (United States)

    Liou, William; Yang, Yang; Petersen-Fitts, Graysen R; Lombardo, Daniel J; Stine, Sasha; Sabesan, Vani J

    2017-04-01

    Manufacturers of reverse shoulder arthroplasty (RSA) implants have recently designed innovative implants to optimize performance in rotator cuff-deficient shoulders. These advancements are not without tradeoffs and can have negative biomechanical effects. The objective of this study was to develop an integrated finite element analysis-kinematic model to compare the muscle forces and joint reaction forces (JRFs) of 3 different RSA designs. A kinematic model of a normal shoulder joint was adapted from the Delft model and integrated with the well-validated OpenSim shoulder model. Static optimizations then allowed for calculation of the individual muscle forces, moment arms, and JRFs relative to net joint moments. Three-dimensional computer models of 3 RSA designs-humeral lateralized design (HLD), glenoid lateralized design, and Grammont design-were integrated, and parametric studies were performed. Overall, there were decreases in deltoid and rotator cuff muscle forces for all 3 RSA designs. These decreases were greatest in the middle deltoid of the HLD model for abduction and flexion and in the rotator cuff muscles under both internal rotation and external rotation. The JRFs in abduction and flexion decreased similarly for all RSA designs compared with the normal shoulder model, with the greatest decrease seen in the HLD model. These findings demonstrate that the design characteristics implicit in these modified RSA prostheses result in mechanical differences most prominently seen in the deltoid muscle and overall JRFs. Further research using this novel integrated model can help guide continued optimization of RSA design and clinical outcomes. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  16. Painful shoulder

    Directory of Open Access Journals (Sweden)

    Benno Ejnismann

    2008-03-01

    Full Text Available Many factors can be involved in the painful shoulder. Beyond articularcauses other pathologies such as artrosis, periarticular diseases as rotadorcuff tears, long head of the biceps tendinitis, adhesive capsulitis, calcifyingtendinitis, degenerative arthritis of the acromioclavicular joint, cervicalradiculopathy and nervous injuries can cause pain in the shoulder.

  17. External rotation immobilization for primary shoulder dislocation: a randomized controlled trial.

    Science.gov (United States)

    Whelan, Daniel B; Litchfield, Robert; Wambolt, Elizabeth; Dainty, Katie N

    2014-08-01

    The traditional treatment for primary anterior shoulder dislocations has been immobilization in a sling with the arm in a position of adduction and internal rotation. However, recent basic science and clinical data have suggested recurrent instability may be reduced with immobilization in external rotation after primary shoulder dislocation. We performed a randomized controlled trial to compare the (1) frequency of recurrent instability and (2) disease-specific quality-of-life scores after treatment of first-time shoulder dislocation using either immobilization in external rotation or immobilization in internal rotation in a group of young patients. Sixty patients younger than 35 years of age with primary, traumatic, anterior shoulder dislocations were randomized (concealed, computer-generated) to immobilization with either an internal rotation sling (n = 29) or an external rotation brace (n = 31) at a mean of 4 days after closed reduction (range, 1-7 days). Patients with large bony lesions or polytrauma were excluded. The two groups were similar at baseline. Both groups were immobilized for 4 weeks with identical therapy protocols thereafter. Blinded assessments were completed by independent observers for a minimum of 12 months (mean, 25 months; range, 12-43 months). Recurrent instability was defined as a second documented anterior dislocation or multiple episodes of shoulder subluxation severe enough for the patient to request surgical stabilization. Validated disease-specific quality-of-life data (Western Ontario Shoulder Instability index [WOSI], American Shoulder and Elbow Surgeons evaluation [ASES]) were also collected. Ten patients (17%, five from each group) were lost to followup. Reported compliance with immobilization in both groups was excellent (80%). With the numbers available, there was no difference in the rate of recurrent instability between groups: 10 of 27 patients (37%) with the external rotation brace versus 10 of 25 patients (40%) with the

  18. Outcomes of an anatomic total shoulder arthroplasty with a contralateral reverse total shoulder arthroplasty.

    Science.gov (United States)

    Cox, Ryan M; Padegimas, Eric M; Abboud, Joseph A; Getz, Charles L; Lazarus, Mark D; Ramsey, Matthew L; Williams, Gerald R; Horneff, John G

    2018-06-01

    It is common for patients to require staged bilateral shoulder arthroplasties. There is a unique cohort of patients who require an anatomic total shoulder arthroplasty (TSA) and a contralateral reverse shoulder arthroplasty (RSA). This study compared the outcomes of patients with a TSA in 1 shoulder and an RSA in the contralateral shoulder. Our institutional database was queried to identify all patients with a TSA and a contralateral RSA. Data collection included patient demographics, preoperative and latest follow-up shoulder range of motion, radiographic analysis, and postoperative complications. Identified patients were assessed at follow-up visits or contacted by phone for functional outcome scores. Nineteen patients met our inclusion/exclusion criteria. There was statistically significant greater internal rotation in the TSA shoulder (P= .044) but no significant difference in forward elevation (P = .573) or external rotation (P= .368). There was no radiographic evidence of humeral or glenoid component loosening of any arthroplasty implants. There were no significant differences between TSA and RSA shoulders for the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment (P= .381), Simple Shoulder Test (P = .352), Single Assessment Numerical Evaluation (P = .709), and visual analog scale satisfaction (P= .448) or pain scores (P= .305). Thirteen patients (68.4%) preferred the RSA side, 1 patient (5.3%; z = 4.04, P < .001) patient preferred the TSA side, and 5 patients expressed no preference. Despite known limitations and differences between TSA and RSA designs, patients who have received both implants are highly satisfied with both. The only parameter in which the TSA had superior outcomes was internal rotation. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  19. Electromyographical Comparison of Four Common Shoulder Exercises in Unstable and Stable Shoulders

    Directory of Open Access Journals (Sweden)

    Aaron Sciascia

    2012-01-01

    Full Text Available This study examines if electromyographic (EMG amplitude differences exist between patients with shoulder instability and healthy controls performing scaption, prone horizontal abduction, prone external rotation, and push-up plus shoulder rehabilitation exercises. Thirty nine subjects were categorized by a single orthopedic surgeon as having multidirectional instability (n=10, anterior instability (n=9, generalized laxity (n=10, or a healthy shoulder (n=10. Indwelling and surface electrodes were utilized to measure EMG activity (reported as a % of maximum voluntary isometric contraction (MVIC in various shoulder muscles during 4 common shoulder exercises. The exercises studied effectively activated the primary musculature targeted in each exercise equally among all groups. The serratus anterior generated high activity (50–80% MVIC during a push-up plus, while the infraspinatus and teres major generated moderate-to-high activity (30–80% MVIC during both the prone horizontal and prone external rotation exercises. Scaption exercise generated moderate activity (20–50% MVIC in both rotator cuff and scapular musculature. Clinicians should feel confident in prescribing these shoulder-strengthening exercises in patients with shoulder instability as the activation levels are comparable to previous findings regarding EMG amplitudes and should improve the dynamic stabilization capability of both rotator cuff and scapular muscles using exercises designed to address glenohumeral joint instability.

  20. Kinematics of the contralateral and ipsilateral shoulder: A possible relationship with post-stroke shoulder pain

    NARCIS (Netherlands)

    Niessen, M.H.M.; Janssen, T.W.J.; Meskers, C.G.M.; Koppe, P.; Konijnenbelt, M.; Veeger, H.E.J.

    2008-01-01

    Objective: Post-stroke shoulder pain is a common phenomenon in hemiplegia and impedes rehabilitation. The aim of this study was to identify a possible relationship between post-stroke shoulder pain, scapula resting position and shoulder motion. Methods: Shoulder kinematics of 27 patients after

  1. Shoulder Problems in Athletes.

    Science.gov (United States)

    Clancy, William G., Jr.

    A description is given of typical sport-related injuries to the shoulder area. These include: (1) brachial plexus injuries; (2) peripheral nerve injuries about the shoulder; (3) acromioclavicular injuries; (4) sternoclavicular injuries; (5) shoulder dislocations; (6) recurrent traumatic subluxation/dislocations; and (7) overuse injuries.…

  2. Mid-term shoulder functional and quality of life outcomes after shoulder replacement in obese patients

    OpenAIRE

    Vincent, Heather K.; Struk, Aimee M.; Reed, Austin; Wright, Thomas W.

    2016-01-01

    Background Shoulder pain and loss of function are directly associated with obesity. Questions/purposes We hypothesized that significant interactions would exist between total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RSA) and obesity status on functional and quality of life (QOL) outcomes over the long term. Clinical and QOL outcomes (American Shoulder and Elbow Surgeons Evaluation form, Shoulder Pain and Disability Index, University of California at Los Angeles Sho...

  3. Testing the assumption in ergonomics software that overall shoulder strength can be accurately calculated by treating orthopedic axes as independent.

    Science.gov (United States)

    Hodder, Joanne N; La Delfa, Nicholas J; Potvin, Jim R

    2016-08-01

    To predict shoulder strength, most current ergonomics software assume independence of the strengths about each of the orthopedic axes. Using this independent axis approach (IAA), the shoulder can be predicted to have strengths as high as the resultant of the maximum moment about any two or three axes. We propose that shoulder strength is not independent between axes, and propose an approach that calculates the weighted average (WAA) between the strengths of the axes involved in the demand. Fifteen female participants performed maximum isometric shoulder exertions with their right arm placed in a rigid adjustable brace affixed to a tri-axial load cell. Maximum exertions were performed in 24 directions, including four primary directions, horizontal flexion-extension, abduction-adduction, and at 15° increments in between those axes. Moments were computed and comparisons made between the experimentally collected strengths and those predicted by the IAA and WAA methods. The IAA over-predicted strength in 14 of 20 non-primary exertions directions, while the WAA underpredicted strength in only 2 of these directions. Therefore, it is not valid to assume that shoulder axes are independent when predicting shoulder strengths between two orthopedic axes, and the WAA is an improvement over current methods for the posture tested. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Motor Ingredients Derived from a Wearable Sensor-Based Virtual Reality System for Frozen Shoulder Rehabilitation

    Directory of Open Access Journals (Sweden)

    Si-Huei Lee

    2016-01-01

    Full Text Available Objective. This study aims to extract motor ingredients through data mining from wearable sensors in a virtual reality goal-directed shoulder rehabilitation (GDSR system and to examine their effects toward clinical assessment. Design. A single-group before/after comparison. Setting. Outpatient research hospital. Subjects. 16 patients with frozen shoulder. Interventions. The rehabilitation treatment involved GDSR exercises, hot pack, and interferential therapy. All patients first received hot pack and interferential therapy on the shoulder joints before engaging in the exercises. The GDSR exercise sessions were 40 minutes twice a week for 4 weeks. Main Measures. Clinical assessments included Constant and Murley score, range of motion of the shoulder, and muscle strength of upper arm as main measures. Motor indices from sensor data and task performance were measured as secondary measures. Results. The pre- and posttest results for task performance, motor indices, and the clinical assessments indicated significant improvement for the majority of the assessed items. Correlation analysis between the task performance and clinical assessments revealed significant correlations among a number of items. Stepwise regression analysis showed that task performance effectively predicted the results of several clinical assessment items. Conclusions. The motor ingredients derived from the wearable sensor and task performance are applicable and adequate to examine and predict clinical improvement after GDSR training.

  5. The nature of arm movement in children with cerebral palsy when using computer-generated exercise games.

    Science.gov (United States)

    Weightman, Andrew; Preston, Nick; Levesley, Martin; Bhakta, Bipin; Holt, Raymond; Mon-Williams, Mark

    2014-05-01

    To compare upper limb kinematics of children with spastic cerebral palsy (CP) using a passive rehabilitation joystick with those of adults and able-bodied children, to better understand the design requirements of computer-based rehabilitation devices. A blocked comparative study involving seven children with spastic CP, nine able-bodied adults and nine able-bodied children, using a joystick system to play a computer game whilst the kinematics of their upper limb were recorded. The translational kinematics of the joystick's end point and the participant's shoulder movement (protraction/retraction) and elbow rotational kinematics (flexion/extension) were analysed for each group. Children with spastic CP matched their able-bodied peers in the time taken to complete the computer task, but this was due to a failure to adhere to the task instructions of travelling along a prescribed straight line when moving between targets. The spastic CP group took longer to initiate the first movement, which showed jerkier trajectories and demonstrated qualitatively different movement patterns when using the joystick, with shoulder movements that were significantly of greater magnitude than the able-bodied participants. Children with spastic CP generate large shoulder and hence trunk movements when using a joystick to undertake computer-generated arm exercises. This finding has implications for the development and use of assistive technologies to encourage exercise and the instructions given to users of such systems. A kinematic analysis of upper limb function of children with CP when using joystick devices is presented. Children with CP may use upper body movements to compensate for limitations in voluntary shoulder and elbow movements when undertaking computer games designed to encourage the practice of arm movement. The design of rehabilitative computer exercise systems should consider movement of the torso/shoulder as it may have implications for the quality of therapy in the

  6. Risk of shoulder tendinitis in relation to shoulder loads in monotonous repetitive work

    DEFF Research Database (Denmark)

    Frost, P.; Bonde, J. P.; Mikkelsen, S.

    2002-01-01

    BACKGROUND: Few studies relate the occurrence of shoulder disorders to quantified ergonomic exposures. This study evaluates the hypothesis that shoulder loads in repetitive work might contribute to the occurrence of shoulder tendinitis. METHODS: This is a cross-sectional study of 1961 workers...

  7. Joint Kinetics to Assess the Influence of the Racket on a Tennis Player’s Shoulder

    Science.gov (United States)

    Creveaux, Thomas; Dumas, Raphaël; Hautier, Christophe; Macé, Pierre; Chèze, Laurence; Rogowski, Isabelle

    2013-01-01

    This study aimed at investigating the influence of three rackets on shoulder net joint moments, power and muscle activity during the flat tennis serve under field- conditions. A 6-camera Eagle® motion analysis system, operating at 256 Hz, captured racket and dominant upper limb kinematics of the serve in five tennis players under three racket conditions (A: low mass, high balance and polar moment, B: low three moments of inertia, and C: high mass, swingweight and twistweight). The electromyographic activity of six trunk and arm muscles was simultaneously recorded. Shoulder net joint moments and power were computed by 3D inverse dynamics. The results showed that greater shoulder joint power and internal/external rotation peak moments were found to accelerate and decelerate racket A in comparison with the racket C. Moreover, serving with the racket A resulted in less activity in latissimus dorsi muscle during the acceleration phase, and biceps brachii muscle during the follow-through phase when compared with racket C. These initial findings encourage studying the biomechanical measurements to quantify the loads on the body during play in order to reduce them, and then prevent shoulder injuries. Racket specifications may be a critical point for coaches who train players suffering from shoulder pain and chronic upper limb injuries should be considered in relation to the racket specifications of the players. Key Points Light racket required more joint power than heavy one to achieve similar post impact ball velocity. Serving with a light racket resulted in higher shoulder internal and external rotation moments than using a heavy one for similar performance. Chronic shoulder pain should encourage coaches to check for potentially inappropriate racket specifications of their players. PMID:24149804

  8. Complications of shoulder dystocia.

    Science.gov (United States)

    Dajani, Nafisa K; Magann, Everett F

    2014-06-01

    Complications of shoulder dystocia are divided into fetal and maternal. Fetal brachial plexus injury (BPI) is the most common fetal complication occurring in 4-40% of cases. BPI has also been reported in abdominal deliveries and in deliveries not complicated by shoulder dystocia. Fractures of the fetal humerus and clavicle occur in about 10.6% of cases of shoulder dystocia and usually heal with no sequel. Hypoxic ischemic brain injury is reported in 0.5-23% of cases of shoulder dystocia. The risk correlates with the duration of head-to-body delivery and is especially increased when the duration is >5 min. Fetal death is rare and is reported in 0.4% of cases. Maternal complications of shoulder dystocia include post-partum hemorrhage, vaginal lacerations, anal tears, and uterine rupture. The psychological stress impact of shoulder dystocia is under-recognized and deserves counseling prior to home discharge. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Low-Cost Alternative External Rotation Shoulder Brace and Review of Treatment in Acute Shoulder Dislocations

    Directory of Open Access Journals (Sweden)

    Lacy, Kyle

    2015-01-01

    Full Text Available Traumatic dislocations of the shoulder commonly present to emergency departments (EDs. Immediate closed reduction of both anterior and posterior glenohumeral dislocations is recommended and is frequently performed in the ED. Recurrence of dislocation is common, as anteroinferior labral tears (Bankart lesions are present in many anterior shoulder dislocations.14,15,18,23 Immobilization of the shoulder following closed reduction is therefore recommended; previous studies support the use of immobilization with the shoulder in a position of external rotation, for both anterior and posterior shoulder dislocations.7-11,19 In this study, we present a technique for assembling a low-cost external rotation shoulder brace using materials found in most hospitals: cotton roll, stockinette, and shoulder immobilizers. This brace is particularly suited for the uninsured patient, who lacks the financial resources to pay for a pre-fabricated brace out of pocket. We also performed a cost analysis for our low-cost external rotation shoulder brace, and a cost comparison with pre-fabricated brand name braces. At our institution, the total materials cost for our brace was $19.15. The cost of a pre-fabricated shoulder brace at our institution is $150 with markup, which is reimbursed on average at $50.40 according to our hospital billing data. The low-cost external rotation shoulder brace is therefore a more affordable option for the uninsured patient presenting with acute shoulder dislocation. [West J Emerg Med. 2015;16(1:114–120.

  10. Shoulder Arthroscopy Simulator Training Improves Shoulder Arthroscopy Performance in a Cadaver Model

    Science.gov (United States)

    Henn, R. Frank; Shah, Neel; Warner, Jon J.P.; Gomoll, Andreas H.

    2013-01-01

    Purpose The purpose of this study was to quantify the benefits of shoulder arthroscopy simulator training with a cadaver model of shoulder arthroscopy. Methods Seventeen first year medical students with no prior experience in shoulder arthroscopy were enrolled and completed this study. Each subject completed a baseline proctored arthroscopy on a cadaveric shoulder, which included controlling the camera and completing a standard series of tasks using the probe. The subjects were randomized, and nine of the subjects received training on a virtual reality simulator for shoulder arthroscopy. All subjects then repeated the same cadaveric arthroscopy. The arthroscopic videos were analyzed in a blinded fashion for time to task completion and subjective assessment of technical performance. The two groups were compared with students t-tests, and change over time within groups was analyzed with paired t-tests. Results There were no observed differences between the two groups on the baseline evaluation. The simulator group improved significantly from baseline with respect to time to completion and subjective performance (parthroscopy simulator training resulted in significant benefits in clinical shoulder arthroscopy time to task completion in this cadaver model. This study provides important additional evidence of the benefit of simulators in orthopaedic surgical training. Clinical Relevance There may be a role for simulator training in shoulder arthroscopy education. PMID:23591380

  11. Shoulder arthroscopy simulator training improves shoulder arthroscopy performance in a cadaveric model.

    Science.gov (United States)

    Henn, R Frank; Shah, Neel; Warner, Jon J P; Gomoll, Andreas H

    2013-06-01

    The purpose of this study was to quantify the benefits of shoulder arthroscopy simulator training with a cadaveric model of shoulder arthroscopy. Seventeen first-year medical students with no prior experience in shoulder arthroscopy were enrolled and completed this study. Each subject completed a baseline proctored arthroscopy on a cadaveric shoulder, which included controlling the camera and completing a standard series of tasks using the probe. The subjects were randomized, and 9 of the subjects received training on a virtual reality simulator for shoulder arthroscopy. All subjects then repeated the same cadaveric arthroscopy. The arthroscopic videos were analyzed in a blinded fashion for time to task completion and subjective assessment of technical performance. The 2 groups were compared by use of Student t tests, and change over time within groups was analyzed with paired t tests. There were no observed differences between the 2 groups on the baseline evaluation. The simulator group improved significantly from baseline with respect to time to completion and subjective performance (P arthroscopy simulator training resulted in significant benefits in clinical shoulder arthroscopy time to task completion in this cadaveric model. This study provides important additional evidence of the benefit of simulators in orthopaedic surgical training. There may be a role for simulator training in shoulder arthroscopy education. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  12. Rapid resolution of chronic shoulder pain classified as derangement using the McKenzie method: a case series

    Science.gov (United States)

    Aytona, Maria Corazon; Dudley, Karlene

    2013-01-01

    The McKenzie method, also known as Mechanical Diagnosis and Therapy (MDT), is primarily recognized as an evaluation and treatment method for the spine. However, McKenzie suggested that this method could also be applied to the extremities. Derangement is an MDT classification defined as an anatomical disturbance in the normal resting position of the joint, and McKenzie proposed that repeated movements could be applied to reduce internal joint displacement and rapidly reduce derangement symptoms. However, the current literature on MDT application to shoulder disorders is limited. Here, we present a case series involving four patients with chronic shoulder pain from a duration of 2–18 months classified as derangement and treated using MDT principles. Each patient underwent mechanical assessment and was treated with repeated movements based on their directional preference. All patients demonstrated rapid and clinically significant improvement in baseline measures and the disabilities of the arm, shoulder, and hand (QuickDASH) scores from an average of 38% at initial evaluation to 5% at discharge within 3–5 visits. Our findings suggest that MDT may be an effective treatment approach for shoulder pain. PMID:24421633

  13. Can we predict shoulder dystocia?

    Science.gov (United States)

    Revicky, Vladimir; Mukhopadhyay, Sambit; Morris, Edward P; Nieto, Jose J

    2012-02-01

    To analyse the significance of risk factors and the possibility of prediction of shoulder dystocia. This was a retrospective cohort study. There were 9,767 vaginal deliveries at 37 and more weeks of gestation analysed during 2005-2007. Studied population included 234 deliveries complicated by shoulder dystocia. Shoulder dystocia was defined as a delivery that required additional obstetric manoeuvres to release the shoulders after gentle downward traction has failed. First, a univariate analysis was done to identify the factors that had a significant association with shoulder dystocia. Parity, age, gestation, induction of labour, epidural analgesia, birth weight, duration of second stage of labour and mode of delivery were studied factors. All factors were then combined in a multivariate logistic regression analysis. Adjusted odds ratios (Adj. OR) with 95% confidence intervals (CI) were calculated. The incidence of shoulder dystocia was 2.4% (234/9,767). Only mode of delivery and birth weight were independent risk factors for shoulder dystocia. Parity, age, gestation, induction of labour, epidural analgesia and duration of second stage of labour were not independent risk factors. Ventouse delivery increases the risk of shoulder dystocia almost 3 times, forceps delivery comparing to the ventouse delivery increases risk almost 3.4 times. Risk of shoulder dystocia is minimal with the birth weight of 3,000 g or less. It is difficult to foretell the exact birth weight and the mode of delivery, therefore occurrence of shoulder dystocia is highly unpredictable. Regular drills for shoulder dystocia and awareness of increased incidence with instrumental deliveries are important to reduce fetal and maternal morbidity and mortality.

  14. Localization Performance of Multiple Vibrotactile Cues on Both Arms.

    Science.gov (United States)

    Wang, Dangxiao; Peng, Cong; Afzal, Naqash; Li, Weiang; Wu, Dong; Zhang, Yuru

    2018-01-01

    To present information using vibrotactile stimuli in wearable devices, it is fundamental to understand human performance of localizing vibrotactile cues across the skin surface. In this paper, we studied human ability to identify locations of multiple vibrotactile cues activated simultaneously on both arms. Two haptic bands were mounted in proximity to the elbow and shoulder joints on each arm, and two vibrotactile motors were mounted on each band to provide vibration cues to the dorsal and palmar side of the arm. The localization performance under four conditions were compared, with the number of the simultaneously activated cues varying from one to four in each condition. Experimental results illustrate that the rate of correct localization decreases linearly with the increase in the number of activated cues. It was 27.8 percent for three activated cues, and became even lower for four activated cues. An analysis of the correct rate and error patterns show that the layout of vibrotactile cues can have significant effects on the localization performance of multiple vibrotactile cues. These findings might provide guidelines for using vibrotactile cues to guide the simultaneous motion of multiple joints on both arms.

  15. Periarthritis of the shoulder-MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Hirano, Mako; Nomura, Kazutoshi; Hashimoto, Noburo; Fukumoto, Tetsuya; Oshima, Suguru; Katahira, Kazuhiro [Kumamoto National Hospital (Japan)

    1997-09-01

    We examined MRI findings in patients with periarthritis of the shoulder. We excluded cuff tears, calcified tendinitis, instability of the shoulder, fracture and impingement syndrome of young patients. Subjects comprised 36 cases, 38 shoulders (25 men and 11 women), with an average age of 59.1 years (42-75). Scanning was performed on a Gyroscan T5-II 0.5-T (Philips). T1-weighted and T2-weighted sequences in the coronal oblique plane, T2-weighted sequences in the coronal sagittal plane and horizontal plane were taken. Twelve shoulders showed some change in the humeral heads. Degeneration of the rotator cuff was observed in 15 shoulders. Joint fluid collection was observed in the gleno-humeral joints of 15 shoulders, in the subacromial bursa of 11 shoulders and in the acromio-clavicular joints of 7 shoulders. Twenty four shoulders had fluid collection in the sheath of the long head of the biceps long tendon. Localized high signal area was observed around the inferior pouch in 11 shoulders. We studied the relationship between MRI findings and clinical symptoms. There was no significant relationship but the shoulders with night pain and severe contractures had a higher positive rate of joint fluid collection on MRI than the shoulders without night pain and with less contractures. (author)

  16. Periarthritis of the shoulder-MRI findings

    International Nuclear Information System (INIS)

    Hirano, Mako; Nomura, Kazutoshi; Hashimoto, Noburo; Fukumoto, Tetsuya; Oshima, Suguru; Katahira, Kazuhiro

    1997-01-01

    We examined MRI findings in patients with periarthritis of the shoulder. We excluded cuff tears, calcified tendinitis, instability of the shoulder, fracture and impingement syndrome of young patients. Subjects comprised 36 cases, 38 shoulders (25 men and 11 women), with an average age of 59.1 years (42-75). Scanning was performed on a Gyroscan T5-II 0.5-T (Philips). T1-weighted and T2-weighted sequences in the coronal oblique plane, T2-weighted sequences in the coronal sagittal plane and horizontal plane were taken. Twelve shoulders showed some change in the humeral heads. Degeneration of the rotator cuff was observed in 15 shoulders. Joint fluid collection was observed in the gleno-humeral joints of 15 shoulders, in the subacromial bursa of 11 shoulders and in the acromio-clavicular joints of 7 shoulders. Twenty four shoulders had fluid collection in the sheath of the long head of the biceps long tendon. Localized high signal area was observed around the inferior pouch in 11 shoulders. We studied the relationship between MRI findings and clinical symptoms. There was no significant relationship but the shoulders with night pain and severe contractures had a higher positive rate of joint fluid collection on MRI than the shoulders without night pain and with less contractures. (author)

  17. Multimodal assessment of sensorimotor shoulder function in patients with untreated anterior shoulder instability and asymptomatic handball players.

    Science.gov (United States)

    Mornieux, Guillaume; Hirschmüller, Anja; Gollhofer, Albert; Südkamp, Norbert P; Maier, Dirk

    2018-04-01

    Functional evaluation of sensorimotor function of the shoulder joint is important for guidance of sports-specific training, prevention and rehabilitation of shoulder instability. Such assessment should be multimodal and comprise all qualities of sensorimotor shoulder function. This study evaluates feasibility of such multimodal assessment of glenohumeral sensorimotor function in patients with shoulder instability and handball players. Nine patients with untreated anterior instability of their dominant shoulder and 15 asymptomatic recreational handball players performed proprioceptive joint position sense and dynamic stabilization evaluations on an isokinetic device, as well as a functional throwing performance task. Outcome measures were analysed individually and equally weighted in a Shoulder-Specific Sensorimotor Index (S-SMI). Finally, isokinetic strength evaluations were conducted. We observed comparable sensorimotor functions of unstable dominant shoulders compared to healthy, contralateral shoulders (e.g. P=0.59 for S-SMI). Handball players demonstrated superior sensorimotor function of their dominant shoulders exhibiting a significantly higher throwing performance and S-SMI (P0.22). The present study proves feasibility of multimodal assessment of shoulder sensorimotor function in overhead athletes and patients with symptomatic anterior shoulder instability. Untreated shoulder instability led to a loss of dominance-related sensorimotor superiority indicating functional internal rotation deficiency. Dominant shoulders of handball players showed a superior overall sensorimotor function but weakness of dominant internal rotation constituting a risk factor for occurrence of posterior superior impingement syndrome. The S-SMI could serve as a diagnostic tool for guidance of sports-specific training, prevention and rehabilitation of shoulder instability.

  18. Exercise therapy for treatment of supraspinatus tears does not alter glenohumeral kinematics during internal/external rotation with the arm at the side.

    Science.gov (United States)

    Ferrer, Gerald A; Miller, R Matthew; Zlotnicki, Jason P; Tashman, Scott; Irrgang, James J; Musahl, Volker; Debski, Richard E

    2018-01-01

    Rotator cuff tears are a significant clinical problem, with exercise therapy being a common treatment option for patients. Failure rates of exercise therapy may be due to the failure to improve glenohumeral kinematics. Tears involving the supraspinatus may result in altered glenohumeral kinematics and joint instability for internal/external rotation with the arm at the side because not all muscles used to stabilize the glenohumeral joint are functioning normally. The objective of the study is to assess in vivo glenohumeral kinematic changes for internal/external rotation motions with the arm at the side of patients with a symptomatic full-thickness supraspinatus tear before and after a 12-week exercise therapy programme. Five patients underwent dynamic stereoradiography analysis before and after a 12-week exercise therapy protocol to measure changes in glenohumeral kinematics during transverse plane internal/external rotation with the arm at the side. Patient-reported outcomes and shoulder strength were also evaluated. No patient sought surgery immediately following exercise therapy. Significant improvements in isometric shoulder strength and patient-reported outcomes were observed (p internal/external rotation with the arm at the side. Despite satisfactory clinical outcomes following exercise therapy, glenohumeral kinematics did not change. The lack of changes may be due to the motion studied or the focus of current exercise therapy protocols being increasing shoulder strength and restoring range of motion. Current exercise therapy protocols should be adapted to also focus on restoring glenohumeral kinematics to improve joint stability since exercise therapy may have different effects depending on the motions of daily living. Prognostic study, Level II.

  19. Shoulder surgery - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000179.htm Shoulder surgery - discharge To use the sharing features on this page, please enable JavaScript. You had shoulder surgery to repair the tissues inside or around your ...

  20. Shoulder pain in hemiplegia.

    Science.gov (United States)

    Andersen, L T

    1985-01-01

    Development of a painful shoulder in the hemiplegic patient is a significant and serious problem, because it can limit the patient's ability to reach his or her maximum functional potential. Several etiologies of shoulder pain have been identified, such as immobilization of the upper extremity, trauma to the joint structures, including brachial plexus injuries, and subluxation of the gleno-humeral joint. A review of the literature explains the basic anatomy and kinesiology of the shoulder complex, the various etiologies of hemiplegic shoulder pain, and the pros and cons of specific treatment techniques. This knowledge is essential for the occupational therapist to evaluate effectively techniques used to treat the patient with hemiplegic shoulder pain. More effective management of this problem will facilitate the patient's ability to reach his or her maximum functional potential.

  1. The Influence of Preoperative and Postoperative Psychological Symptoms on Clinical Outcome after Shoulder Surgery: A Prospective Longitudinal Cohort Study.

    Science.gov (United States)

    Koorevaar, Rinco C T; van 't Riet, Esther; Gerritsen, Marleen J J; Madden, Kim; Bulstra, Sjoerd K

    2016-01-01

    Psychological symptoms are highly prevalent in patients with shoulder complaints. Psychological symptoms in patients with shoulder complaints might play a role in the aetiology, perceived disability and pain and clinical outcome of treatment. The aim of this study was to assess whether preoperative symptoms of distress, depression, anxiety and somatisation were associated with a change in function after shoulder surgery and postoperative patient perceived improvement of pain and function. In addition, the change of psychological symptoms after shoulder surgery was analyzed and the influence of postoperative symptoms of psychological disorders after surgery on the change in function after shoulder surgery and perceived postoperative improvement of pain and function. A prospective longitudinal cohort study was performed in a general teaching hospital. 315 consecutive patients planned for elective shoulder surgery were included. Outcome measures included change of Disabilities of the Arm, Shoulder and Hand (DASH) score and anchor questions about improvement in pain and function after surgery. Psychological symptoms were identified before and 12 months after surgery with the validated Four-Dimensional Symptom Questionnaire (4DSQ). Psychological symptoms were encountered in all the various shoulder diagnoses. Preoperative symptoms of psychological disorders persisted after surgery in 56% of patients, 10% of patients with no symptoms of psychological disorders before surgery developed new psychological symptoms. Preoperative symptoms of psychological disorders were not associated with the change of DASH score and perceived improvement of pain and function after shoulder surgery. Patients with symptoms of psychological disorders after surgery were less likely to improve on the DASH score. Postoperative symptoms of distress and depression were associated with worse perceived improvement of pain. Postoperative symptoms of distress, depression and somatisation were

  2. Influence of Gravity Compensation on Muscle Activation Patterns During Different Temporal Phases of Arm Movements of Stroke Patients

    NARCIS (Netherlands)

    Prange, Grada Berendina; Jannink, M.J.A.; Stienen, Arno; van der Kooij, Herman; IJzerman, Maarten Joost; Hermens, Hermanus J.

    2009-01-01

    Background. Arm support to help compensate for the effects of gravity may improve functional use of the shoulder and elbow during therapy after stroke, but gravity compensation may alter motor control. Objective. To obtain quantitative information on how gravity compensation influences muscle

  3. Complications of shoulder arthroscopy.

    Science.gov (United States)

    Moen, Todd C; Rudolph, Glen H; Caswell, Kyle; Espinoza, Christopher; Burkhead, Wayne Z; Krishnan, Sumant G

    2014-07-01

    Over the past 20 to 30 years, arthroscopic shoulder techniques have become increasingly popular. Although these techniques have several advantages over open surgery, surgical complications are no less prevalent or devastating than those associated with open techniques. Some of the complications associated with arthroscopic shoulder surgery include recurrent instability, soft-tissue injury, and neurapraxia. These complications can be minimized with thoughtful consideration of the surgical indications, careful patient selection and positioning, and a thorough knowledge of the shoulder anatomy. Deep infection following arthroscopic shoulder surgery is rare; however, the shoulder is particularly susceptible to Propionibacterium acnes infection, which is mildly virulent and has a benign presentation. The surgeon must maintain a high index of suspicion for this infection. Thromboemoblic complications associated with arthroscopic shoulder techniques are also rare, and studies have shown that pharmacologic prophylaxis has minimal efficacy in preventing these complications. Because high-quality studies on the subject are lacking, minimal evidence is available to suggest strategies for prevention. Copyright 2014 by the American Academy of Orthopaedic Surgeons.

  4. Arm morbidity following sentinel lymph node biopsy or axillary lymph node dissection: a study from the Danish Breast Cancer Cooperative Group

    DEFF Research Database (Denmark)

    Husted, Madsen A.; Haugaard, K.; Soerensen, J.

    2008-01-01

    BACKGROUND: Sentinel lymph node biopsy was implemented in the treatment of early breast cancer with the aim of reducing shoulder and arm morbidity. Relatively few prospective studies have been published where the morbidity was assessed by clinical examination. Very few studies have examined...... lymph node biopsy with node negative patients having a lymph node dissection of levels I and II of the axilla, we found significant increase in arm volume among the patients who had an axillary dissection. Only minor, but significant, differences in shoulder mobility were observed comparing the two...... groups of node negative patients. Highly significant difference was found comparing sensibility. Comparing the morbidity in node positive patients who had a one-step axillary dissection with patients having a two-step procedure (sentinel lymph node biopsy followed by delayed axillary dissection) revealed...

  5. Recurrent shoulder dystocia: is it predictable?

    Science.gov (United States)

    Kleitman, Vered; Feldman, Roi; Walfisch, Asnat; Toledano, Ronen; Sheiner, Eyal

    2016-11-01

    To examine the course and outcome of deliveries occurring in women who previously experienced shoulder dystocia. In addition, recurrent shoulder dystocia risk factors were assessed. A retrospective cohort analysis comparing all singleton deliveries with and without shoulder dystocia in their preceding delivery was conducted. Independent predictors of recurrent shoulder dystocia were investigated using a multiple logistic regression model. Of the 201,422 deliveries included in the analysis, 307 occurred in women with a previous shoulder dystocia (0.015 %). Women with a history of shoulder dystocia were more likely to be older, experienced higher rates of gestational diabetes mellitus, polyhydramnios, prolonged second stage, operative delivery and macrosomia (>4000 g) in the following delivery. Previous shoulder dystocia was found to be an independent risk factor for recurrent shoulder dystocia (OR = 6.1, 95 % CI 3.2-11.8, p value dystocia is an independent risk factor for recurrent shoulder dystocia. Deliveries in women with a history of shoulder dystocia are characterized by higher rates of operative delivery, prolonged second stage of labor and macrosomia.

  6. Shoulder dystocia: definitions and incidence.

    Science.gov (United States)

    Hansen, Alexandra; Chauhan, Suneet P

    2014-06-01

    Though subjective in nature, both the American College of Obstetricians and Gynecologists practice bulletin and the Royal College of Obstetricians and Gynaecologists green guideline are in agreement on the descriptor of shoulder dystocia: requirement of additional obstetric maneuvers when gentle downward traction has failed to affect the delivery of the shoulders. The rate of shoulder dystocia is about 1.4% of all deliveries and 0.7% for vaginal births. Compared to non-diabetics (0.6%), among diabetics, the rate of impacted shoulders is 201% higher (1.9%); newborns delivered by vacuum or forceps have 254% higher likelihood of shoulder dystocia than those born spontaneously (2.0% vs. 0.6%, respectively). When the birthweight is categorized as 4500 g, the likelihood of shoulder dystocia in the US vs. other countries varies significantly. Future studies should focus on lowering the rate of shoulder dystocia and its associated morbidities, without concomitantly increasing the rate of cesarean delivery. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Results of the Total Evolutive Shoulder System (TESS): a single-centre study of 56 consecutive patients.

    Science.gov (United States)

    Kadum, Bakir; Mafi, Nader; Norberg, Sigge; Sayed-Noor, Arkan S

    2011-12-01

    Shoulder arthroplasty surgery has undergone remarkable progress. New concepts like reverse and stemless shoulder prostheses have been widely used. The Total Evolutive Shoulder System (TESS) is a new innovative system that provides the surgeon with different prosthetic versions. The purpose of the present study was to evaluate our short-term results and complications of the TESS. 56 consecutive patients were operated with one of the two versions of TESS (anatomical or reverse) between October 2007 and December 2009. Preoperative and postoperative evaluation of the function and life quality was achieved by the Quick Disability of the Arm, Shoulder and Hand (DASH) index and EQ-5D self-report questionnaire, respectively. Radiographic follow-up by anteroposterior, axillary and lateral views was done. The anterosuperior approach was used in all cases. We compared the outcome in fracture patients with other categories. 49 patients were available for 9-24 months (mean 14) clinical and radiographic postoperative follow-up. The mean of quick DASH improved from 56 preoperatively to 34 postoperatively (p TESS prosthesis showed promising short-term results with few complications. The reverse version could be implanted without stem if initial stability was adequate. Long-term follow-up is required to confirm the results of this innovative system in the long run.

  8. Human arm stiffness and equilibrium-point trajectory during multi-joint movement.

    Science.gov (United States)

    Gomi, H; Kawato, M

    1997-03-01

    By using a newly designed high-performance manipulandum and a new estimation algorithm, we measured human multi-joint arm stiffness parameters during multi-joint point-to-point movements on a horizontal plane. This manipulandum allows us to apply a sufficient perturbation to subject's arm within a brief period during movement. Arm stiffness parameters were reliably estimated using a new algorithm, in which all unknown structural parameters could be estimated independent of arm posture (i.e., constant values under any arm posture). Arm stiffness during transverse movement was considerably greater than that during corresponding posture, but not during a longitudinal movement. Although the ratios of elbow, shoulder, and double-joint stiffness were varied in time, the orientation of stiffness ellipses during the movement did not change much. Equilibrium-point trajectories that were predicted from measured stiffness parameters and actual trajectories were slightly sinusoidally curved in Cartesian space and their velocity profiles were quite different from the velocity profiles of actual hand trajectories. This result contradicts the hypothesis that the brain does not take the dynamics into account in movement control depending on the neuromuscular servo mechanism; rather, it implies that the brain needs to acquire some internal models of controlled objects.

  9. Relation between the Disability of the Arm, Shoulder and Hand Score and Muscle Strength in Post-Cardiac Surgery Patients.

    Science.gov (United States)

    Izawa, Kazuhiro P; Kasahara, Yusuke; Hiraki, Koji; Hirano, Yasuyuki; Watanabe, Satoshi

    2017-11-27

    Background: The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire is a valid and reliable patient-reported outcome measure. DASH can be assessed by self-reported upper extremity disability and symptoms. We aimed to examine the relationship between the physiological outcome of muscle strength and the DASH score after cardiac surgery. Methods: This cross-sectional study assessed 50 consecutive cardiac patients that were undergoing cardiac surgery. Physiological outcomes of handgrip strength and knee extensor muscle strength and the DASH score were measured at one month after cardiac surgery and were assessed. Results were analyzed using Spearman correlation coefficients. Results: The final analysis comprised 43 patients (men: 32, women: 11; age: 62.1 ± 9.1 years; body mass index: 22.1 ± 4.7 kg/m²; left ventricular ejection fraction: 53.5 ± 13.7%). Respective handgrip strength, knee extensor muscle strength, and DASH score were 27.4 ± 8.3 kgf, 1.6 ± 0.4 Nm/kg, and 13.3 ± 12.3, respectively. The DASH score correlated negatively with handgrip strength ( r = -0.38, p = 0.01) and with knee extensor muscle strength ( r = -0.32, p = 0.04). Conclusion: Physiological outcomes of both handgrip strength and knee extensor muscle strength correlated negatively with the DASH score. The DASH score appears to be a valuable tool with which to assess cardiac patients with poor physiological outcomes, particularly handgrip strength as a measure of upper extremity function, which is probably easier to follow over time than lower extremity function after patients complete cardiac rehabilitation.

  10. Relation between the Disability of the Arm, Shoulder and Hand Score and Muscle Strength in Post-Cardiac Surgery Patients

    Directory of Open Access Journals (Sweden)

    Kazuhiro P. Izawa

    2017-11-01

    Full Text Available Background: The Disabilities of the Arm, Shoulder, and Hand (DASH questionnaire is a valid and reliable patient-reported outcome measure. DASH can be assessed by self-reported upper extremity disability and symptoms. We aimed to examine the relationship between the physiological outcome of muscle strength and the DASH score after cardiac surgery. Methods: This cross-sectional study assessed 50 consecutive cardiac patients that were undergoing cardiac surgery. Physiological outcomes of handgrip strength and knee extensor muscle strength and the DASH score were measured at one month after cardiac surgery and were assessed. Results were analyzed using Spearman correlation coefficients. Results: The final analysis comprised 43 patients (men: 32, women: 11; age: 62.1 ± 9.1 years; body mass index: 22.1 ± 4.7 kg/m2; left ventricular ejection fraction: 53.5 ± 13.7%. Respective handgrip strength, knee extensor muscle strength, and DASH score were 27.4 ± 8.3 kgf, 1.6 ± 0.4 Nm/kg, and 13.3 ± 12.3, respectively. The DASH score correlated negatively with handgrip strength (r = −0.38, p = 0.01 and with knee extensor muscle strength (r = −0.32, p = 0.04. Conclusion: Physiological outcomes of both handgrip strength and knee extensor muscle strength correlated negatively with the DASH score. The DASH score appears to be a valuable tool with which to assess cardiac patients with poor physiological outcomes, particularly handgrip strength as a measure of upper extremity function, which is probably easier to follow over time than lower extremity function after patients complete cardiac rehabilitation.

  11. Shoulder Pain After Thoracic Surgery

    DEFF Research Database (Denmark)

    Blichfeldt-Eckhardt, Morten R; Andersen, Claus; Ørding, Helle

    2017-01-01

    OBJECTIVES: To study the time course of ipsilateral shoulder pain after thoracic surgery with respect to incidence, pain intensity, type of pain (referred versus musculoskeletal), and surgical approach. DESIGN: Prospective, observational cohort study. SETTING: Odense University Hospital, Denmark...... for musculoskeletal involvement (muscle tenderness on palpation and movement) with follow-up 12 months after surgery. Clinically relevant pain was defined as a numeric rating scale score>3. Of the 60 patients included, 47 (78%) experienced ipsilateral shoulder pain, but only 25 (42%) reported clinically relevant...... shoulder pain. On postoperative day 4, 19 patients (32%) still suffered shoulder pain, but only 4 patients (7%) had clinically relevant pain. Four patients (8%) still suffered shoulder pain 12 months after surgery. In 26 patients (55%), the shoulder pain was classified as referred versus 21 patients (45...

  12. Arm to leg coordination in elite butterfly swimmers.

    Science.gov (United States)

    Chollet, D; Seifert, L; Boulesteix, L; Carter, M

    2006-04-01

    This study proposed the use of four time gaps to assess arm-to-leg coordination in the butterfly stroke at increasing race paces. Fourteen elite male swimmers swam at four velocities corresponding to the appropriate paces for, respectively, the 400-m, 200-m, 100-m, and 50-m events. The different stroke phases of the arm and leg were identified by video analysis and then used to calculate four time gaps (T1: time gap between entry of the hands in the water and the high break-even point of the first undulation; T2: time gap between the beginning of the hands' backward movement and the low break-even point of the first undulation; T3: time gap between the hands' arrival in a vertical plane to the shoulders and the high break-even point of the second undulation; T4: time gap between the hands' release from the water and the low break-even point of the second undulation), the values of which described the changing relationship of arm to leg movements over an entire stroke cycle. With increases in pace, elite swimmers increased the stroke rate, the relative duration of the arm pull, the recovery and the first downward movement of the legs, and decreased the stroke length, the relative duration of the arm catch phase and the body glide with arms forward (measured by T2), until continuity in the propulsive actions was achieved. Whatever the paces, the T1, T3, and T4 values were close to zero and revealed a high degree of synchronisation at key motor points of the arm and leg actions. This new method to assess butterfly coordination could facilitate learning and coaching by situating the place of the leg undulation in relation with the arm stroke.

  13. Arthroscopic Shoulder Surgery in Female Professional Tennis Players: Ability and Timing to Return to Play.

    Science.gov (United States)

    Young, Simon W; Dakic, Jodie; Stroia, Kathleen; Nguyen, Michael L; Safran, Marc R

    2017-07-01

    To assess the outcome and time to return to previous level of competitive play after shoulder surgery in professional tennis players. Retrospective case series. Tertiary academic centre. The records of all female tennis players on the Women's Tennis Association (WTA) professional circuit between January 2008 and June 2010 were reviewed to identify players who underwent shoulder surgery on their dominant (serving) shoulder. Primary outcomes were the ability and time to return to professional play and if they were able to return to their previous level of function as determined by singles ranking. Preoperative and postoperative singles rankings were used to determine rate and completeness of return to preoperative function. During the study period, 8 professional women tennis players from the WTA tour underwent shoulder surgery on their dominant arm. Indications included rotator cuff debridement or repair, labral reconstruction for instability or superior labral anterior posterior lesion, and neurolysis of the suprascapular nerve. Seven players (88%) returned to professional play. The mean time to return to play was 7 months after surgery. However, only 25% (2 of 8) players achieved their preinjury singles rank or better by 18 months postoperatively. In total, 4 players returned to their preinjury singles ranking, with their peak singles ranking being attained at a mean of 2.4 years postoperatively. In professional female tennis players, a high return to play rate after arthroscopic shoulder surgery is associated with a prolonged and often incomplete return to previous level of performance. Thus, counseling the patient to this fact is important to manage expectations. Level IV-Case Series.

  14. Shoulder Stiffness : Current Concepts and Concerns

    NARCIS (Netherlands)

    Itoi, Eiji; Arce, Guillermo; Bain, Gregory I.; Diercks, Ronald L.; Guttmann, Dan; Imhoff, Andreas B.; Mazzocca, Augustus D.; Sugaya, Hiroyuki; Yoo, Yon-Sik

    Shoulder stiffness can be caused by various etiologies such as immobilization, trauma, or surgical interventions. The Upper Extremity Committee of ISAKOS defined the term "frozen shoulder" as idiopathic stiff shoulder, that is, without a known cause. Secondary stiff shoulder is a term that should be

  15. [Shoulder injuries in golf].

    Science.gov (United States)

    Liem, D; Gosheger, G; Schmidt, C

    2014-03-01

    Due to its growing popularity golf has now come into the focus of orthopedic sports medicine. With a wide range of age groups and playing levels, orthopedic surgeons will encounter a wide range of musculoskeletal problems which are usually the result of overuse rather than trauma. The shoulder joint plays an important role in the golf swing whereby not only the muscles around the glenohumeral joint but also the scapula stabilizing muscles are extremely important for an effective golf swing. Golf is strictly not considered to be an overhead sport; however, the extreme peak positions of the golf swing involve placing the shoulder joint in maximum abduction and adduction positions which can provoke impingement, lesions of the pulley system or even a special form of posterior shoulder instability. Even after complex shoulder operations, such as rotator cuff repair or shoulder arthroplasty, a return to the golf course at nearly the same level of play can be expected.

  16. Inter-rater and intra-rater reliability of a movement control test in shoulder.

    Science.gov (United States)

    Rajasekar, S; Bangera, Rakshith K; Sekaran, Padmanaban

    2017-07-01

    Movement faults are commonly observed in patients with musculoskeletal pain. The Kinetic Medial Rotation Test (KMRT) is a movement control test used to identify movement faults of the scapula and gleno-humeral joints during arm movement. Objective tests such as the KMRT need to be reliable and valid for the results to be applied across different clinical settings and patient populations. The primary objective of the present study was to determine the intra-rater and inter-rater reliability of KMRT in subjects with and without shoulder pain. Sixty subjects were included in this study based on specific inclusion and exclusion criteria. Two musculoskeletal physiotherapists with different levels of clinical experience performed the tests. The intra-rater reliability was tested in twenty asymptomatic subjects by a single assessor at two week intervals. An equal number of subjects with and without shoulder pain were tested by both the assessors to determine the inter-rater reliability. Both components of the KMRT, the Gleno- Humeral Anterior Translation (GHAT) and the Scapular Forward Tilt (SCFT) were tested. The Kappa values for inter-rater reliability of the GHAT and SCFT were K = 0.68 & K = 0.65 respectively in subjects with shoulder pain. In asymptomatic subjects, the inter-rater reliability of GHAT was K = 0.61 and SCFT was K = 0.85. Intra-rater reliability ranged from K = 0.66 for GHAT to K = 0.87 for SCFT. Our study found substantial agreement in inter-rater reliability of KMRT in subjects with shoulder pain, whereas substantial to near perfect agreement was found in intra-rater and inter-rater reliability of KMRT in subjects without shoulder pain. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. HIGH-RESOLUTION ULTRASONOGRAPHY OF SHOULDER FOR ROTATOR CUFF TEAR: CORRELATION WITH ARTHROSCOPIC FINDINGS

    Directory of Open Access Journals (Sweden)

    Vishnumurthy H. Y

    2016-09-01

    Full Text Available INTRODUCTION Rotator cuff disease is the most common cause of shoulder pain. Ultrasonography being non-invasive, widely available, more cost-effective method and is the first choice in imaging of rotator cuff tears. Arthroscopy of shoulder is considered as the gold standard for diagnosis of rotator cuff tears. Objective of this study was to compare the diagnostic accuracy of high-resolution ultrasonography of shoulder for rotator cuff tears with arthroscopy of shoulder. METHODS Thirty patients clinically suspected to have rotator cuff tear who underwent ultrasonography and arthroscopy of shoulder were included in the study. Duration of study was for two years. All ultrasonography examinations were conducted in ultrasound machine using GE Voluson 730 PRO high frequency (10-12 MHz linear array transducer done by two experienced radiologists. Arthroscopies were done by two experienced shoulder arthroscopic surgeons. RESULTS Age of the patients with rotator cuff tears ranged from 40 to 80 years. 57% were females and 43% were males among the patients who had rotator cuff tears. 71.43% of the rotator cuff tears were found in the dominant arm. 64.28% of patients with rotator cuff tear had given history of fall or trauma to the corresponding shoulder within 6 months prior to presentation. 39.28% of patients who had rotator cuff tears were known diabetics. Supraspinatus tendon was the most commonly affected tendon, followed by infraspinatus and subscapularis tendons. For overall detection of rotator cuff tears, ultrasonography in comparison with the arthroscopy has sensitivity and specificity of 92.85% and 100%. For detection of full thickness rotator cuff tear, its sensitivity and specificity was 94.73% and 100% and for partial thickness rotator cuff tears 76.92% and 100%. Ultrasonography has 100% sensitivity and specificity for detection of supraspinatus full thickness tear. For supraspinatus partial thickness tear, sensitivity and specificity was 88

  18. Arthroscopic Bankart repair and subscapularis augmentation: an alternative technique treating anterior shoulder instability with bone loss.

    Science.gov (United States)

    Maiotti, Marco; Russo, Raffaele; Zanini, Antonio; Schröter, Steffen; Massoni, Carlo; Bianchedi, Diana

    2016-06-01

    This study presents the preliminary results of a new arthroscopic technique consisting of the association of 2 procedures, capsulolabral repair and subscapularis augmentation tenodesis, in the treatment of traumatic anterior shoulder instability with both glenoid bone loss and a Hill-Sachs lesion. Eighty-nine patients engaged in sports were enrolled in this retrospective case-series study with 2 to 5 years' follow-up. All patients underwent a computed tomography scan to assess the percentage of glenoid bone loss by the Pico method. A prior stabilization procedure had failed in 20 patients, who were then segregated into a different group. Visual analog scale (VAS), Rowe, and American Shoulder and Elbow Surgeons (ASES) scores were used to assess the results. Only 3 of 89 patients had a post-traumatic redislocation. The mean length of follow-up was 31.5 months (range, 25-60 months). The VAS, Rowe, and ASES scores showed significant improvements: The VAS score decreased from a mean of 3.1 to 0.5 (P = .0157), the Rowe score increased from 58.9 to 94.1 (P = .0215), and the ASES score increased from 68.5 to 95.5 (P = .0197). The mean deficit of external rotation was 6° with the arm at the side of the trunk, and the mean deficit was 3° with the arm in 90° of abduction. The described procedure is a reproducible and effective technique used to restore joint stability in patients engaged in sports who have incurred anterior recurrent shoulder dislocation associated with glenoid bone loss (Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  19. Shoulder arthroplasty for sequelae of poliomyelitis.

    Science.gov (United States)

    Werthel, Jean-David; Schoch, Bradley; Sperling, John W; Cofield, Robert; Elhassan, Bassem T

    2016-05-01

    Polio infection can often lead to orthopedic complications such as arthritis, osteoporosis, muscle weakness, skeletal deformation, and chronic instability of the joints. The purpose of this study was to assess the outcomes and associated complications of arthroplasty in shoulders with sequelae of poliomyelitis. Seven patients (average age, 70 years) were treated between 1976 and 2013 with shoulder arthroplasty for the sequelae of polio. One patient underwent reverse shoulder arthroplasty, 2 had a hemiarthroplasty, and 4 had total shoulder arthroplasty. Average follow-up was 87 months. Outcome measures included pain, range of motion, and postoperative modified Neer ratings. Overall pain scores improved from 5 to 1.6 points (on a 5-point scale) after shoulder arthroplasty. Six shoulders had no or mild pain at latest follow-up, and 6 shoulders rated the result as much better or better. Mean shoulder elevation improved from 72° to 129°, and external rotation improved from 11° to 56°. Average strength in elevation decreased from 3.9 to 3.4 postoperatively, and external rotation strength decreased from 3.9 to 3.3. This, however, did not reach significance. Evidence of muscle imbalance with radiographic instability was found in 4 shoulders that demonstrated superior subluxation, anterior subluxation, or both. This remained asymptomatic. No shoulder required revision or reoperation. Shoulder arthroplasty provides significant pain relief and improved motion in patients with sequelae of poliomyelitis. Muscle weakness may be responsible for postoperative instability, and careful selection of the patient with good upper extremity muscles must be made. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  20. Comparative Study Between the Effect of Myofascial Release Using M2T Blade and Kinesiotape on Recreational Badminton Shoulder Pain Subjects: A Randomised Clinical Trial

    Directory of Open Access Journals (Sweden)

    Varun Naik

    2017-05-01

    Full Text Available Background: Shoulder pain is one of the most common conditions seen in recreational badminton players. It is caused due to repeated movements at the shoulder joint which further limits the range of motion and hence hampers the activities of daily living. M2T helps to release the myofascial tightness which causes the pain. Kinesiotape also helps in increasing the range of motion. Patients and Methods: Thirty recreational shoulder pain subjects were assessed and treated between the age group of 18-30 years at the KLE University’s Indoor Stadium, Jawaharlal Nehru Medical College, Belagavi, Karnataka, India. Methods: The recreational shoulder pain subjects were divided into Group “A” and Group “B” by Randomized clinical trial. Outcome measures used were the visual analogue scale (VAS for pain and the Disability of Arm, Hand, and Shoulder (DASH. VAS and DASH were assessed pre-treatment and post-treatment. Results: Inter-group comparison for both the groups had differences but showed no statistical significance. Hence based on results it can be concluded that both the treatment techniques are effective in reducing pain and increasing ability at the shoulder joint.

  1. Arm rotated medially with supination – the ARMS variant: description of its surgical correction

    Directory of Open Access Journals (Sweden)

    Melcher Sonya E

    2009-03-01

    Full Text Available Abstract Background Patients who have suffered obstetric brachial plexus injury (OBPI have a high incidence of musculoskeletal complications stemming from the initial nerve injury. The presence of muscle imbalances and contractures leads to typical bony changes affecting the shoulder, including the SHEAR (Scapular Hypoplasia, Elevation and Rotation deformity. The SHEAR deformity commonly occurs in conjunction with Medial Rotation Contracture (MRC of the arm. OBPI also causes muscle imbalances at the level of the forearm, that lead to a fixed supination deformity (SD in a small number of patients. Both MRC and SD will cause severe functional limitations without surgical intervention. Methods Fourteen OBPI patients were diagnosed with MRC of the shoulder and SD of the forearm along with SHEAR deformity during a 16 month study period, with eight patients available to long-term follow-up (age range 2.2 – 18 years. Surgical correction of the MRC was performed as a triangle tilt or humeral osteotomy depending on the age of the child, after which, the patients were treated with a radial osteotomy to correct the fixed supination deformity. Function was assessed using the modified Mallet scale, examination of apparent supination and appearance of the extremity at rest. Results Significant functional improvements were observed in patients with surgical reconstruction. Mallet score increased by an average of 5.2 (p Conclusion The simultaneous presence of two opposing deformities in the same limb will visually offset each other at the level of the wrist and hand, giving the false impression of neutral positioning of the limb. In reality, the neutral-appearing position of the hand indicates a fixed supination posture of the forearm in the face of a medial rotation contracture of the shoulder. Both of these deformities require surgical attention, and the presence of concurrent MRC and SD should be monitored for in OBPI patients.

  2. Dominant vs. non-dominant shoulder morphology in volleyball players and associations with shoulder pain and spike speed.

    Science.gov (United States)

    Challoumas, Dimitrios; Artemiou, Andreas; Dimitrakakis, Georgios

    2017-01-01

    The aims of our study were to compare the dominant (DOM) and non-dominant (NDOM) shoulders of high-level volleyball athletes and identify possible associations of shoulder adaptations with spike speed (SS) and shoulder pathology. A total of 22 male volleyball players from two teams participating in the first division of the Cypriot championship underwent clinical shoulder tests and simple measurements around their shoulder girdle joints bilaterally. SS was measured with the use of a sports speed radar. Compared with the NDOM side, the DOM scapula was more lateralised, the DOM dorsal capsule demonstrated greater laxity, the DOM dorsal muscles stretching ability was compromised, and the DOM pectoralis muscle was more lengthened. Players with present or past DOM shoulder pain demonstrated greater laxity in their DOM dorsal capsule, tightening of their DOM inferior capsule, and lower SS compared with those without shoulder pain. Dorsal capsule measurements bilaterally were significant predictors of SS. None of the shoulder measurements was associated with team roles or infraspinatus atrophy, while scapular lateralisation was more pronounced with increasing years of experience, and scapular antetilting was greater with increasing age. Adaptations of the DOM shoulder may be linked to pathology and performance. We describe simple shoulder measurements that may have the potential to predict chronic shoulder injury and become part of injury prevention programmes. Detailed biomechanical and large prospective studies are warranted to assess the validity of our findings and reach more definitive conclusions.

  3. Cross-cultural adaptation and validation of the Portuguese version of the Oxford Shoulder Score (OSS).

    Science.gov (United States)

    Gonçalves, Rui Soles; Caldeira, Carolina Quintal; Rodrigues, Mónica Vieira; Felícia, Sabine Cardoso; Cavalheiro, Luís Manuel; Ferreira, Pedro Lopes

    2018-03-08

    To translate and culturally adapt the Oxford Shoulder Score (OSS) to the European Portuguese language, and to test its reliability (internal consistency, reproducibility and measurement error) and validity (construct validity). The OSS Portuguese version was obtained through translations, back-translations, consensus panels, clinical review and cognitive pre-test. Portuguese OSS, Disabilities of the Arm, Shoulder and Hand (DASH) questionnaires, and the visual analogue scales of pain at rest [VAS rest] and during movement [VAS movement] were applied to 111 subjects with shoulder pain (degenerative or inflammatory disorders) and recommended for physical therapy. A clinical and sociodemographic questionnaire was also applied. The reliability was good, with a Cronbach's alpha coefficient of 0.90, an intraclass correlation coefficient (ICC) of 0.92, a standard error of measurement (SEM) of 2.59 points and a smallest detectable change (SDC) of 7.18 points. Construct validity was supported by the confirmation of three initial hypotheses involving expected significant correlation between OSS and other measures (DASH, VAS rest and VAS movement) and between OSS and the number of days of work absenteeism. The Portuguese OSS version presented suitable psychometric properties, in terms of reliability (internal consistency, reproducibility and measurement error) and validity (construct validity).

  4. Neurovascular complications due to the Hippocrates method for reducing anterior shoulder dislocations.

    Science.gov (United States)

    Regauer, Markus; Polzer, Hans; Mutschler, Wolf

    2014-01-18

    In spite of the fact that the Hippocrates method hardly has been evaluated in a scientific manner and numerous associated iatrogenic complications have been reported, this method remains to be one of the most common techniques for reducing anterior shoulder dislocations. We report the case of a 69-year-old farmer under coumarin anticoagulant therapy who sustained acute first time anterior dislocation of his dominant right shoulder. By using the Hippocrates method with the patient under general anaesthesia, the brachial vein was injured and an increasing hematoma subsequently caused brachial plexus paresis by pressure. After surgery for decompression and vascular suturing, symptoms declined rapidly, but brachial plexus paresis still was not fully reversible after 3 mo of follow-up. The hazardousness of using the Hippocrates method can be explained by traction on the outstretched arm with force of the operator's body weight, direct trauma to the axillary region by the physician's heel, and the topographic relations of neurovascular structures and the dislocated humeral head. As there is a variety of alternative reduction techniques which have been evaluated scientifically and proofed to be safe, we strongly caution against the use of the Hippocrates method as a first line technique for reducing anterior shoulder dislocations, especially in elder patients with fragile vessels or under anticoagulant therapy, and recommend the scapular manipulation technique or the Milch technique, for example, as a first choice.

  5. Incidence and prognostic factors for postoperative frozen shoulder after shoulder surgery : a prospective cohort study

    NARCIS (Netherlands)

    Koorevaar, Rinco C. T.; van't Riet, Esther; Ipskamp, Marcel; Bulstra, Sjoerd K.

    Frozen shoulder is a potential complication after shoulder surgery. It is a clinical condition that is often associated with marked disability and can have a profound effect on the patient's quality of life. The incidence, etiology, pathology and prognostic factors of postoperative frozen shoulder

  6. Heterotopic bone formation following total shoulder arthroplasty

    DEFF Research Database (Denmark)

    Kjaersgaard-Andersen, P.; Frich, Lars Henrik; Sjøbjerg, J.O.

    1989-01-01

    The incidence and location of heterotopic bone formation following total shoulder arthroplasty were evaluated in 58 Neer Mark-II total shoulder replacements. One year after surgery, 45% had developed some ectopic ossification. In six shoulders (10%) the ossifications roentgenographically bridged...... the glenohumeral and/or the glenoacromial space. There was no correlation between shoulder pain and the development of ossification. Shoulders with grade III heterotopic bone formation had a limited range of active elevation compared with shoulders without or with only a milder lesion. Men and patients...... with osteoarthritis of the shoulder joint were significantly disposed to the development of heterotopic bone. Heterotopic bone formation following total shoulder arthroplasty is frequent, but disabling heterotopic ossifications seem to be rare....

  7. The Effect of Fatigued External Rotator Muscles of the Shoulder on the Shoulder Position Sense

    Directory of Open Access Journals (Sweden)

    Naoya Iida

    2011-10-01

    Full Text Available This study aimed to investigate the effect of fatigue in shoulder external rotator muscles on position sense of shoulder abduction, internal rotation, and external rotation. The study included 10 healthy subjects. Shoulder position sense was measured before and after a fatigue task involving shoulder external rotator muscles. The fatigue task was performed using an isokinetic machine. To confirm the muscle fatigue, electromyography (EMG was recorded, and an integrated EMG and median power frequency (MDF during 3 sec performed target torque were calculated. After the fatigue task, the MDF of the infraspinatus muscle significantly decreased. This indicates that the infraspinatus muscle was involved in the fatigue task. In addition, the shoulder position sense of internal and external rotation significantly decreased after the fatigue task. These results suggest that the fatigue reduced the accuracy of sensory input from muscle spindles. However, no significant difference was observed in shoulder position sense of abduction before and after the fatigue task. This may be due to the fact that infraspinatus muscle did not act as prime movers in shoulder abduction. These results suggest that muscle fatigue decreased position sense during movements in which the affected muscles acted as prime movers.

  8. Ultrasonographic evaluation of the canine shoulder.

    Science.gov (United States)

    Long, C D; Nyland, T G

    1999-01-01

    The aim of this study was to determine the normal ultrasonographic anatomy of the canine shoulder. Fourteen shoulders from 7 clinically normal mid-sized dogs were radiographed and imaged using high frequency ultrasound. Each shoulder was isolated postmortem, and the ultrasonographic and gross anatomy was studied during dissection. The ultrasonographic appearance of the shoulder specimens was similar to that found in the live dogs. Twenty-four shoulders isolated postmortem from 12 variably sized dogs were also used to characterize the normal ultrasound anatomy over a range of sizes. Important anatomic structures that could be consistently evaluated were the biceps tendon and bursa, the bicipital groove surface, the supraspinatous tendon, the infraspinatous tendon, the teres minor tendon, and the caudal aspect of the humeral head. Results of ultrasonographic examination of 4 dogs with shoulder lameness are described to illustrate some applications of canine shoulder ultrasonography in the evaluation of the canine shoulder. In these dogs, ultrasound was a valuable tool to evaluate effusion and synovial proliferation within the bicipital bursa, supraspinatous and biceps tendinitis, biceps tendon strain, and dystrophic calcification.

  9. US of the shoulder

    International Nuclear Information System (INIS)

    Gardellin, G.; Perin, B.

    1987-01-01

    Twenty five healty people and 25 patients with shoulder pain underwent US control over a 12-month period: 24 patients with shoulder pain had rotator cuff and/or biceps tendon lesions. The US findings on rotator cuff and biceps tendon lesions are compared with those of arthrography and/or surgery (96% sensitivity). US is rapid, safe, non invasive, inexpensive and often more accurate, and its use is recommended for the routine examination of the shoulder joint insteat of arthrography

  10. Shoulder dystocia: management and documentation.

    Science.gov (United States)

    Stitely, Michael L; Gherman, Robert B

    2014-06-01

    Shoulder dystocia is an obstetric emergency that occurs when the fetal shoulders become impacted at the pelvic inlet. Management is based on performing maneuvers to alleviate this impaction. A number of protocols and training mnemonics have been developed to assist in managing shoulder dystocia when it occurs. This article reviews the evidence regarding the performance, timing, and sequence of these maneuvers; reviews the mechanism of fetal injury in relation to shoulder dystocia; and discusses issues concerning documentation of the care provided during this obstetric emergency. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Pneumatic tool torque reaction: reaction forces, displacement, muscle activity and discomfort in the hand-arm system.

    Science.gov (United States)

    Kihlberg, S; Kjellberg, A; Lindbeck, L

    1993-06-01

    Reaction forces, hand-arm displacement, muscle activity and discomfort ratings were studied during the securing of threaded fasteners with three angle nutrunners with different shut-off mechanisms, but with the same spindle torque (72-74 Nm). The three tools were tested according to the method specified in ISO 6544. One of the tools had an almost instantaneous shut-off. Another had a more slowly declining torque curve. For the third tool the maximum torque was maintained for a while before shut-off. Twelve male subjects participated in the study. A force platform measured the reaction force between the subject and the floor. The option of the hand-arm system and the shoulder was measured with an optoelectronic measuring system. The muscle activity (EMG) in six muscles in the arm and shoulder was measured with surface electrodes. Significant differences in the arm movements and ground reaction forces were found between the three tools. The smallest values were found with the fast shut-off tool while the delayed shut-off tool caused the largest values. The EMG measures gave inconsistent response patterns. Discomfort ratings were highly correlated with the time for which the tool torque exceeded 90% of peak preset torque, but the time for which the tool torque exceeded 90% of peak calculated by the method specified in ISO 6544. Nutrunners with a shut-off mechanism that causes a slowly decreasing torque or a torque that is maintained for a while before shut-off should be avoided. If no substitutes are available, then a torque reaction bar should be mounted on the tool.

  12. [Anterior shoulder instabilities: about 73 cases].

    Science.gov (United States)

    Jamal, Louaste; Bousbaa, Hicham; Cherrad, Taoufik; Wahidi, Mohammed; Amhajji, Larbi; Rachid, Khalid

    2016-01-01

    Between 2005 and 2014, 73 patients (77 shoulders) underwent Latarjet procedure for anterior shoulder instability. This retrospective study aims to evaluate the clinical and radiographic results of this surgical technique. Surgical intervention was performed to treat 69 cases with recurrent dislocation, 5 cases with recurrent painful subluxation and 3 cases with painful shoulder. All patients underwent radiographic evaluation before surgery and during the most recent medical control. According to Rowe score, 73 (94.8%) of 77 shoulders got a good or excellent result. In the longest follow-up, 74 shoulders were free from glenohumeral arthrosis.

  13. Proposal for SICSeG guidelines for rehabilitation after anatomical shoulder prosthesis in concentric shoulder osteoarthritis.

    Science.gov (United States)

    Fusaro, I; Orsini, S; Stignani, S; Creta, D; Cava, F C; Benedetti, M G

    2013-06-01

    The purpose of this paper is to provide up-to-date guidelines on rehabilitation after anatomical shoulder prosthesis for concentric shoulder osteoarthritis, as previous guidelines date back to late 1970s and are no longer adequate due to the evolution of prosthesis models and surgical techniques. The physiatric committee of the Italian Society of Shoulder and Elbow Surgery (SICSeG-Società Italiana di Chirurgia della Spalla e del Gomito) performed a search for all the existing literature related to rehabilitation after shoulder replacement. A total of 29 papers concerning shoulder rehabilitation were reviewed. In addition, the main Italian orthopedic surgeons and physiatrists dealing with shoulder surgery and rehabilitation were interviewed to obtain indications when literature was not conclusive. From literature evaluation and expert consultation, we produced guidelines concerning: patient evaluation by means of adequate rating scales, preoperative treatment, early intermediate and advanced postoperative phases, rehabilitation of scapulo-thoracic joint, return to work and sports, length of rehabilitation and follow-up. This proposal for guidelines was presented during the 11th SICSeG Congress on May 2012 and to the main scientific societies concerned in shoulder surgery and rehabilitation. A consensus conference is needed in order to formalize and make them usable from all the professional figures involved in this field.

  14. Gimballed Shoulders for Friction Stir Welding

    Science.gov (United States)

    Carter, Robert; Lawless, Kirby

    2008-01-01

    In a proposed improvement of tooling for friction stir welding, gimballed shoulders would supplant shoulders that, heretofore, have been fixedly aligned with pins. The proposal is especially relevant to self-reacting friction stir welding. Some definitions of terms, recapitulated from related prior NASA Tech Briefs articles, are prerequisite to a meaningful description of the proposed improvement. In friction stir welding, one uses a tool that includes (1) a rotating shoulder on top (or front) of the workpiece and (2) a pin that rotates with the shoulder and protrudes from the shoulder into the depth of the workpiece. In conventional friction stir welding, the main axial force exerted by the tool on the workpiece is reacted through a ridged backing anvil under (behind) the workpiece. When conventional friction stir welding is augmented with an auto-adjustable pin-tool (APT) capability, the depth of penetration of the pin into the workpiece is varied in real time by a position- or forcecontrol system that extends or retracts the pin as needed to obtain the desired effect. In self-reacting (also known as self-reacted) friction stir welding as practiced heretofore, there are two shoulders: one on top (or front) and one on the bottom (or back) of the workpiece. In this case, a threaded shaft protrudes from the tip of the pin to beyond the back surface of the workpiece. The back shoulder is held axially in place against tension by a nut on the threaded shaft. Both shoulders rotate with the pin and remain aligned coaxially with the pin. The main axial force exerted on the workpiece by the tool and front shoulder is reacted through the back shoulder and the threaded shaft into the friction-stir-welding machine head, so that a backing anvil is no longer needed. A key transmits torque between the bottom shoulder and the threaded shaft, so that the bottom shoulder rotates with the shaft. This concludes the prerequisite definitions of terms.

  15. Effects of Messages Delivered by Mobile Phone on Increasing Compliance With Shoulder Exercises Among Patients With a Frozen Shoulder.

    Science.gov (United States)

    Chen, Hui-Chun; Chuang, Tai-Yuan; Lin, Pi-Chu; Lin, Yen-Kuang; Chuang, Yeu-Hui

    2017-07-01

    The aim of this study was to examine the effects of reminders, encouragement, and educational messages delivered by mobile phone on shoulder exercise compliance and improvements in shoulder function among patients with a frozen shoulder. A randomized controlled trial design was used. A convenience sample of patients with a frozen shoulder in an orthopedic outpatient clinic was recruited. All participants were instructed on how to do shoulder exercises and were provided with a printed pamphlet about shoulder exercises. Then, the intervention group received reminders, encouragement, and educational messages by mobile phone daily for the next 2 weeks, while the comparison group did not. The intervention group had higher compliance with shoulder exercises than did the comparison group (t = 2.263, p = .03) and had significant improvements in shoulder forward flexion (F = 12.067, p = .001), external rotation (F = 13.61, p = .001), and internal rotation (F = 5.903, p = .018) compared to those in the comparison group after the 2-week intervention. The text messages significantly increased patient compliance with shoulder exercises and thus improved patients' shoulder range of motion. Hospital or clinics can send appropriate messages to patients via text message platforms in order to remind and encourage them to do shoulder exercises. © 2017 Sigma Theta Tau International.

  16. Effect of Kinesiotaping and Stretching Exercise on Forward Shoulder Angle in Females with Rounded Shoulder Posture

    Directory of Open Access Journals (Sweden)

    Arghavan Hajibashi

    2014-12-01

    Full Text Available Background: Rounded shoulder posture is a common abnormal posture in upper quarter. Kinesiotape is a new intervention that recently used in rehabilitation. There are no studies have examined the effect of kinesiotape on rounded shoulder posture. Therefore the purpose of this study was to determine the effect of scapular kinesiotaping and pectoralis minor stretching exercise on forward shoulder angle in female subjects with rounded shoulder posture. Methods: Twenty female students aged between 18 to 25 years old with rounded shoulder posture participated in this study. Then, the subjects were randomly and equally assigned to two groups: the stretch group and the stretch plus kinesiotape group. Both groups were trained for doing home exercise to stretch Pectoralis minor bilaterally for two weeks. Kinesiotape group received kinesiotape on scapular area additionally. Forward shoulder angle was measured in four sessions including pre-intervention (first session, immediately after the first intervention (second session, fourth day (third session and at the end of two weeks (fourth session. Two-way repeated measures ANOVA (4×2 was used for data analysis. Results: kinesiotape group showed significant within-group decrease in forward shoulder angle between first session with three other sessions (P≤0.05.There was no significant within-group difference in stretch group and between groups (P=0.20 forward shoulder angle-by-group interaction in measurement sessions was significantly different (P=0.02 Conclusion: scapular kinesiotaping along with pectoralis minor stretching exercise improved rounded shoulder posture in subjects of the present study. kinesiotape is suggested as a complem

  17. Optimal design of an alignment-free two-DOF rehabilitation robot for the shoulder complex.

    Science.gov (United States)

    Galinski, Daniel; Sapin, Julien; Dehez, Bruno

    2013-06-01

    This paper presents the optimal design of an alignment-free exoskeleton for the rehabilitation of the shoulder complex. This robot structure is constituted of two actuated joints and is linked to the arm through passive degrees of freedom (DOFs) to drive the flexion-extension and abduction-adduction movements of the upper arm. The optimal design of this structure is performed through two steps. The first step is a multi-objective optimization process aiming to find the best parameters characterizing the robot and its position relative to the patient. The second step is a comparison process aiming to select the best solution from the optimization results on the basis of several criteria related to practical considerations. The optimal design process leads to a solution outperforming an existing solution on aspects as kinematics or ergonomics while being more simple.

  18. Holmes’ Tremor with Shoulder Pain Treated by Deep Brain Stimulation of Unilateral Ventral Intermediate Thalamic Nucleus and Globus Pallidus Internus

    Directory of Open Access Journals (Sweden)

    Sabri Aydın

    2017-05-01

    Full Text Available A 21-year-old male was admitted with severe right arm and hand tremors after a thalamic hemorrhage caused by a traffic accident. He was also suffering from agonizing pain in his right shoulder that manifested after the tremor. Neurologic examination revealed a disabling, severe, and irregular kinetic and postural tremor in the right arm during target-directed movements. There was also an irregular ipsilateral rest tremor and dystonic movements in the distal part of the right arm. The amplitude was moderate at rest and extremely high during kinetic and intentional movements. The patient underwent left globus pallidum internus and ventral intermediate thalamic nucleus deep brain stimulation. The patient improved by more than 80% as rated by the Fahn-Tolosa-Marin Tremor Rating Scale and Visual Analog Scale six months after surgery.

  19. Predictive factors for the success of McRoberts' manoeuvre and suprapubic pressure in relieving shoulder dystocia: a cross-sectional study.

    Science.gov (United States)

    Lok, Zara Lin Zau; Cheng, Yvonne Kwun Yue; Leung, Tak Yeung

    2016-10-29

    McRoberts' and suprapubic pressure are often recommended as the initial choices of manoeuvres to manage shoulder dystocia, as they are believed to be less invasive compared to other manoeuvres. However, their success rates range from 23 to 40 %. This study aims to investigate the predictive factors for the success of McRoberts' manoeuvre with or without suprapubic pressure (M+/-S). All cases of shoulder dystocia in a tertiary hospital in South East Asia were recruited from 1995 to 2009. Subjects were analysed according to either 'success' or 'failure' of M+/-S. Maternal and fetal antenatal and intrapartum factors were compared by univariate and multivariate analysis. Among 198 cases of shoulder dystocia, M+/-S as the primary manoeuvre was successful in 25.8 %. The other 74.2 % needed either rotational or posterior arm manoeuvres or combination of manoeuvres. Instrumental delivery was the single most significant factor associated with an increased risk of failed M+/-S on logistic regression (p dystocia occurred after instrumental delivery but was 47.7 % after spontaneous vaginal delivery. When shoulder dystocia occurs after instrumental vaginal delivery, the chance of failure of M+/-S is 85 %, which is 4.7 times higher than that after spontaneous vaginal delivery. Hence all operators performing instrumental delivery should be proficient in performing all manoeuvres to relieve shoulder dystocia when M+/-S cannot do so.

  20. Shoulder strengthening exercises adapted to specific shoulder pathologies can be selected using new simulation techniques: a pilot study.

    Science.gov (United States)

    Charbonnier, Caecilia; Lädermann, Alexandre; Kevelham, Bart; Chagué, Sylvain; Hoffmeyer, Pierre; Holzer, Nicolas

    2018-02-01

    Shoulder strength training exercises represent a major component of rehabilitation protocols designed for conservative or postsurgical management of shoulder pathologies. Numerous methods are described for exercising each shoulder muscle or muscle group. Limited information is available to assess potential deleterious effects of individual methods with respect to specific shoulder pathologies. Thus, the goal of this pilot study was to use a patient-specific 3D measurement technique coupling medical imaging and optical motion capture for evaluation of a set of shoulder strength training exercises regarding glenohumeral, labral and subacromial compression, as well as elongation of the rotator cuff muscles. One volunteer underwent magnetic resonance imaging (MRI) and motion capture of the shoulder. Motion data from the volunteer were recorded during three passive rehabilitation exercises and twenty-nine strengthening exercises targeting eleven of the most frequently trained shoulder muscles or muscle groups and using four different techniques when available. For each exercise, glenohumeral and labral compression, subacromial space height and rotator cuff muscles elongation were measured on the entire range of motion. Significant differences in glenohumeral, subacromial and labral compressions were observed between sets of exercises targeting individual shoulder muscles. Muscle lengths computed by simulation compared to MRI measurements showed differences of 0-5%. This study represents the first screening of shoulder strengthening exercises to identify potential deleterious effects on the shoulder joint. Motion capture combined with medical imaging allows for reliable assessment of glenohumeral, labral and subacromial compression, as well as muscle-tendon elongation during shoulder strength training exercises.

  1. Can shoulder dystocia be reliably predicted?

    Science.gov (United States)

    Dodd, Jodie M; Catcheside, Britt; Scheil, Wendy

    2012-06-01

    To evaluate factors reported to increase the risk of shoulder dystocia, and to evaluate their predictive value at a population level. The South Australian Pregnancy Outcome Unit's population database from 2005 to 2010 was accessed to determine the occurrence of shoulder dystocia in addition to reported risk factors, including age, parity, self-reported ethnicity, presence of diabetes and infant birth weight. Odds ratios (and 95% confidence interval) of shoulder dystocia was calculated for each risk factor, which were then incorporated into a logistic regression model. Test characteristics for each variable in predicting shoulder dystocia were calculated. As a proportion of all births, the reported rate of shoulder dystocia increased significantly from 0.95% in 2005 to 1.38% in 2010 (P = 0.0002). Using a logistic regression model, induction of labour and infant birth weight greater than both 4000 and 4500 g were identified as significant independent predictors of shoulder dystocia. The value of risk factors alone and when incorporated into the logistic regression model was poorly predictive of the occurrence of shoulder dystocia. While there are a number of factors associated with an increased risk of shoulder dystocia, none are of sufficient sensitivity or positive predictive value to allow their use clinically to reliably and accurately identify the occurrence of shoulder dystocia. © 2012 The Authors ANZJOG © 2012 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  2. Magnetic resonance imaging of the shoulder

    International Nuclear Information System (INIS)

    Ilieva, E.

    2015-01-01

    Full text: Magnetic resonance imaging (MRI) is an excellent non-invasive imaging tool that can complement the physical examination in the evaluation of traumatic and non-traumatic injuries of the shoulder. The superb soft tissue contrast and multiplanar capabilities of MRI make it a preferred modality to provide a global assessment of the soft tissue and osseous structures of the shoulder. Learning objectives: to review briefly the anatomy of the shoulder and the specificity of sequences and planes for MRI; to demonstrate the characteristic MR findings of some of the most common shoulder disorders; to indicate how MR arthrography (MRA) of the shoulder can add extra value to the diagnostic process; to outline a systematic approach to the interpretation of the shoulder MR examination. Choosing the most suitable sequences and planes as well as the thorough knowledge of the anatomic structures assist the correct diagnosis of the pathologic disorders of the shoulder which is of great importance for the precise treatment management, surgical versus conservative, as well as for the appropriate surgical approach, open versus arthroscopic

  3. Shoulder pain and disability index: cross cultural validation and evaluation of psychometric properties of the Spanish version.

    Science.gov (United States)

    Membrilla-Mesa, Miguel David; Cuesta-Vargas, Antonio Ignacio; Pozuelo-Calvo, Rocio; Tejero-Fernández, Victor; Martín-Martín, Lydia; Arroyo-Morales, Manuel

    2015-12-21

    The Shoulder Pain Disability Index (SPADI) is a recently published but widely used outcome measure. This study included 136 patients with shoulder disorders. SPADI was first translated and back-translated and then subjected to psychometric validation. Participants completed the Spanish versions of the SPADI, general health (SF-12), the Simple Shoulder Test (SST), Disability of Arm, Shoulder, and Hand (DASH) questionnaires and a pain intensity visual analog scale (VAS). The factors explained 62.8 % of the variance, with an internal consistency of α = 0.916 and 0.860, respectively. The confirmatory factor analysis showed a Comparative Fit Index of 0.82 and a Normed Fit Index of 0.80. The Root Mean Square Error of Aproximation was 0.12. The x (2) test for the 2-factor model was significant (x (2) = 185.41, df = 62, p validity analysis, strong positive correlations were observed between Spanish Version of the SPADI and DASH (pain: r = 0.80; p Spanish Version of the SPADI and VAS (pain: r = 0.67; p Spanish Version of the SPADI and SST-Sp (pain: r = -0.71; p Spanish Version of the SPADI was only weakly correlated with physical and mental components of SF-12 (both r = 0.40; p Spanish version of SPADI demonstrated satisfactory psychometric properties in a patient sample in the hospital setting.

  4. Arthroscopic Findings in Anterior Shoulder Instability

    OpenAIRE

    Hantes, Michael; Raoulis, Vasilios

    2017-01-01

    Background: In the last years, basic research and arthroscopic surgery, have improved our understanding of shoulder anatomy and pathology. It is a fact that arthroscopic treatment of shoulder instability has evolved considerably over the past decades. The aim of this paper is to present the variety of pathologies that should be identified and treated during shoulder arthroscopy when dealing with anterior shoulder instability cases. Methods: A review of the current literature regarding arthros...

  5. The Shoulder Objective Practical Assessment Tool: Evaluation of a New Tool Assessing Residents Learning in Diagnostic Shoulder Arthroscopy.

    Science.gov (United States)

    Talbot, Christopher L; Holt, Edward M; Gooding, Benjamin W T; Tennent, Thomas D; Foden, Philip

    2015-08-01

    To design and validate an objective practical assessment tool for diagnostic shoulder arthroscopy that would provide residents with a method to evaluate their progression in this field of surgery and to identify specific learning needs. We designed and evaluated the shoulder Objective Practical Assessment Tool (OPAT). The shoulder OPAT was designed by us, and scoring domains were created using a Delphi process. The shoulder OPAT was trialed by members of the British Elbow & Shoulder Society Education Committee for internal consistency and ease of use before being offered to other trainers and residents. Inter-rater reliability and intrarater reliability were calculated. One hundred forty orthopaedic residents, of varying seniority, within 5 training regions in the United Kingdom, were questioned regarding the tool. A pilot study of 6 residents was undertaken. Internal consistency was 0.77 (standardized Cronbach α). Inter-rater reliability was 0.60, and intrarater reliability was 0.82. The Spearman correlation coefficient (r) between the global summary score for the shoulder OPAT and the current assessment tool used in postgraduate training for orthopaedic residents undertaking diagnostic shoulder arthroscopy equaled 0.74. Of the residents, 82% agreed or strongly agreed when asked if the shoulder OPAT would be a useful tool in monitoring progression and 72% agreed or strongly agreed with the introduction of the shoulder OPAT within the orthopaedic domain. This study shows that the shoulder OPAT fulfills several aspects of reliability and validity when tested. Despite the inter-rater reliability being 0.60, we believe that the shoulder OPAT has the potential to play a role alongside the current assessment tool in the training of orthopaedic residents. The shoulder OPAT can be used to assess residents during shoulder arthroscopy and has the potential for use in medical education, as well as arthroscopic skills training in the operating theater. Copyright © 2015

  6. Questions and Answers About Shoulder Problems

    Science.gov (United States)

    ... injury. Injection of a cortisone medicine into your shoulder joint. Surgery to repair the tear if you don’t ... TENS). Injection of a corticosteroid drug if your shoulder is not better. Surgery if the shoulder does not improve with other ...

  7. New approach to evaluate late arm impairment and effects of dragon boat activity in breast cancer survivors.

    Science.gov (United States)

    Melchiorri, Giovanni; Viero, Valerio; Triossi, Tamara; Sorge, Roberto; Tancredi, Virginia; Cafaro, Domenico; Andreis, Caterina; Vulpiani, Maria Chiara; Saraceni, Vincenzo Maria

    2017-11-01

    To verify the applicability of a new approach based on the strength curves (SCs) methodology in late arm impairment in breast cancer (BC) survivors and to evaluate the effects of dragon boat (DB) activity on the late regaining of the muscle strength, upper limb impairment, and quality of life in patients undergoing surgery for BC.Retrospective observational study on 64 subjects (54.5 ± 9.7 years), 47 of them had undergone unilateral mastectomy surgery and were evaluated for late arm impairment. A clinical evaluation of the shoulder and compilation of functional assessment (DASH, Rowe, Constant-Murley) and quality of life (SF-36) scales were carried out. Assessment of muscle strength with SC obtained with isometric assessments and serratus anterior muscle test were performed.Differences between the SC are evident between healthy and operated subjects. Among the 3 groups of operated subjects the difference in strength is maximum at 0°. Statistically significant difference was found between operated and nonoperated only in SF-36 scale. No significant difference was found between groups for shoulder instability and winged scapula.The SC can be used in the study of upper limb impairment after surgery for BC: measurements carried out at 1st degrees of the range of motion are more useful for clinicians. DB activity is useful to reduce the late arm impairment.

  8. Soft tissue disorders of the shoulder. Frozen shoulder, calcific tendintis, and bicipital tendinitis.

    Science.gov (United States)

    Simon, W H

    1975-04-01

    The painful periarticular conditions about the shoulder joint-calcific tendinitis, bicipital tendinitis, and frozen shoulder syndrome-are seen commonly in the general practice of medicine or in the practice of orthopedic surgery. Their etiologies are unknown. Their treatment is relatively simple and depends upon a knowledge of the anatomic structures involved and the proper use of rest and exercise. Operative intervention is rarely necessary in any of these conditions. The frozen shoulder syndrome, however, in our experience is best treated in the subacute or chronic stages by infiltration brisement under general anesthesia.

  9. Cumulative occupational shoulder exposures and surgery for subacromial impingement syndrome: a nationwide Danish cohort study.

    Science.gov (United States)

    Dalbøge, Annett; Frost, Poul; Andersen, Johan Hviid; Svendsen, Susanne Wulff

    2014-11-01

    The primary aim was to examine exposure-response relationships between cumulative occupational shoulder exposures and surgery for subacromial impingement syndrome (SIS), and to compare sex-specific exposure-response relationships. The secondary aim was to examine the time window of relevant exposures. We conducted a nationwide register study of all persons born in Denmark (1933-1977), who had at least 5 years of full-time employment. In the follow-up period (2003-2008), we identified first-time events of surgery for SIS. Cumulative exposure estimates for a 10-year exposure time window with a 1-year lag time were obtained by linking occupational codes with a job exposure matrix. The exposure estimates were expressed as, for example, arm-elevation-years in accordance with the pack-year concept of tobacco consumption. We used a multivariable logistic regression technique equivalent to discrete survival analysis. The adjusted OR (ORadj) increased to a maximum of 2.1 for arm-elevation-years, repetition-years and force-years, and to 1.5 for hand-arm-vibration-years. Sex-specific exposure-response relationships were similar for men and women, when assessed using a relative risk scale. The ORadj increased gradually with the number of years contributing to the cumulative exposure estimates. The excess fraction was 24%. Cumulative occupational shoulder exposures carried an increase in risk of surgery for SIS with similar exposure-response curves for men and women. The risk of surgery for SIS increased gradually, when the period of exposure assessment was extended. In the general working population, a substantial fraction of all first-time operations for SIS could be related to occupational exposures. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Decreased Shoulder External Rotation and Flexion Are Greater Predictors of Injury Than Internal Rotation Deficits: Analysis of 132 Pitcher-Seasons in Professional Baseball.

    Science.gov (United States)

    Camp, Christopher L; Zajac, John M; Pearson, David B; Sinatro, Alec M; Spiker, Andrea M; Werner, Brian C; Altchek, David W; Coleman, Struan H; Dines, Joshua S

    2017-09-01

    The primary aims of this work were to (1) describe normal range of motion (ROM) profiles for elite pitchers, (2) describe the characteristics of shoulder and elbow injuries in professional pitchers over a 6-year period in one Major League Baseball organization, and (3) identify ROM measures that were independently associated with a future shoulder or elbow injury. Over 6 seasons (2010-2015), a preseason assessment was performed on all pitchers invited to Major League Baseball Spring Training for a single organization. ROM measures included shoulder flexion, horizontal adduction, external rotation (ER), internal rotation, as well as elbow flexion and extension, were measured for both the dominant and nondominant arm, and total range of motion and deficits were calculated. All noncontact shoulder and elbow injuries were identified. Using multivariate binomial logistic regression analysis to control for age, height, weight, and all other ROM measures, the factors associated with an increased risk of subsequent shoulder or elbow injury were identified. A total of 53 shoulder (n = 25) and elbow (n = 28) injuries occurred during 132 pitcher seasons (n = 81 pitchers). The most significant categorical risk factor associated with increased elbow injury rates was the presence of a shoulder flexion deficit >5° (odds ratio [OR] 2.83; P = .042). For continuous variables, the risk of elbow injury increased by 7% for each degree of increased shoulder ER deficit (OR 1.07; P = .030) and 9% for each degree of decreased shoulder flexion (OR 1.09; P = .017). None of the measures significantly correlated with shoulder injuries. Preseason shoulder ER and flexion deficits are independent risk factors for the development of elbow injuries during the upcoming season. Although prior work has supported the importance of reducing glenohumeral internal rotation deficits in pitchers, this study demonstrates that deficits in shoulder ER and flexion are more significant predictors of

  11. Correlation of glenohumeral internal rotation deficit and total rotational motion to shoulder injuries in professional baseball pitchers.

    Science.gov (United States)

    Wilk, Kevin E; Macrina, Leonard C; Fleisig, Glenn S; Porterfield, Ronald; Simpson, Charles D; Harker, Paul; Paparesta, Nick; Andrews, James R

    2011-02-01

    Glenohumeral internal rotation deficit (GIRD) indicates a 20° or greater loss of internal rotation of the throwing shoulder compared with the nondominant shoulder. To determine whether GIRD and a deficit in total rotational motion (external rotation + internal rotation) compared with the nonthrowing shoulder correlate with shoulder injuries in professional baseball pitchers. Case series; Level of evidence, 4. Over 3 competitive seasons (2005 to 2007), passive range of motion measurements were evaluated on the dominant and nondominant shoulders for 170 pitcher-seasons. This included 122 professional pitchers during the 3 seasons of data collection, in which some pitchers were measured during multiple seasons. Ranges of motion were measured with a bubble goniometer during the preseason, by the same examiner each year. External and internal rotation of the glenohumeral joint was assessed with the participant supine and the arm abducted 90° in the plane of the scapula, with the scapula stabilized anteriorly at the coracoid process. The reproducibility of the test methods had an intraclass correlation coefficient of .81. Days in which the player was unable to participate because of injury or surgery were recorded during the season by the medical staff of the team and defined as an injury. Pitchers with GIRD (n = 40) were nearly twice as likely to be injured as those without but without statistical significance (P = .17). Pitchers with total rotational motion deficit greater than 5° had a higher rate of injury. Minor league pitchers were more likely than major league pitchers to be injured. However, when players were injured, major league pitchers missed a significantly greater number of games than minor league pitchers. Compared with pitchers without GIRD, pitchers with GIRD appear to be at a higher risk for injury and shoulder surgery.

  12. Arm trajectories and writing strategy in healthy children

    Directory of Open Access Journals (Sweden)

    Chiappedi Matteo

    2012-11-01

    Full Text Available Abstract Background Evaluation of elementary writing skills in children is usually obtained with high resolution (and high cost techniques or with low resolution pen-and-paper tests. In this observational study we tested a quantitative method to obtain normative data to describe arm movement during a writing precursor gesture. Methods We recruited 226 healthy children (mean age 9,1 years [range: 6.3 – 11.4 years], attending primary schools belonging to the “Istituto Comprensivo” of Rivanazzano Terme (Pavia. We asked to drive a cursor through a polygonal path (labyrinth projected in front of them using a wireless mouse. Dartfish™ video analysis software was used to elaborate images and Excel™, MedCalc™ and Statistica 7™ to analyze values of shoulder, elbow and wrist ranges of motion, arm trajectories, execution times and gesture accuracy. Results Differences seen in motor strategies, when divided according to attended class, suggest a proximal-distal maturation of motor control. Obtained values were not significantly correlated with variables such as gender, ethnicity or cognitive functioning. Conclusions This type of approach to a study of arm movement during childhood represents a valid alternative to other tests, considering that it can differentiate children who perform similarly in the VMI test and is non-invasive, low-cost and easily reproducible.

  13. Shoulder injuries in soccer goalkeepers: review and development of a FIFA 11+ shoulder injury prevention program

    Directory of Open Access Journals (Sweden)

    Ejnisman B

    2016-08-01

    Full Text Available Benno Ejnisman,1 Gisele Barbosa,1 Carlos V Andreoli,1 A de Castro Pochini,1 Thiago Lobo,2 Rodrigo Zogaib,2 Moises Cohen,1 Mario Bizzini,3 Jiri Dvorak3 1Department of Orthopaedics, Federal University of São Paulo, 2Sports Medicine Department, Santos FC, São Paulo, Brazil; 3FIFA-Medical Assessment and Research Centre, Schulthess Clinic, Zurich, Switzerland Abstract: In the last years, shoulder injuries have represented an increasing health problem in soccer players. The goalkeepers are more exposed to shoulder disorders than other field players. Injury prevention exercises for upper limbs were cited in few studies involving throwing athletes, but we know that goalkeepers need a specific program. The purpose of this study is to describe the development of an adapted Fédération Internationale de Football Association (FIFA 11+ program, namely the FIFA 11+ shoulder, which targets the prevention of shoulder injuries in soccer goalkeepers. The FIFA 11+ shoulder program is structured into three parts: general warming-up exercises, exercises to improve strength and balance of the shoulder, elbow, wrist, and finger muscles, and advanced exercises for core stability and muscle control. The exercises were selected based on recommendations from studies demonstrating high electromyographic activity. Keywords: goalkeeper, shoulder, injury prevention, prevention program

  14. Towards a digital body: the virtual arm illusion

    Directory of Open Access Journals (Sweden)

    2008-08-01

    Full Text Available The integration of the human brain with computers is an interesting new area of applied neuroscience, where one application is replacement of a person’s real body by a virtual representation. Here we demonstrate that a virtual limb can be made to feel part of your body if appropriate multisensory correlations are provided. We report an illusion that is invoked through tactile stimulation on a person’s hidden real right hand with synchronous virtual visual stimulation on an aligned 3D stereo virtual arm projecting horizontally out of their shoulder. An experiment with 21 male participants showed displacement of ownership towards the virtual hand, as illustrated by questionnaire responses and proprioceptive drift. A control experiment with asynchronous tapping was carried out with a different set of 20 male participants who did not experience the illusion. After 5 minutes of stimulation the virtual arm rotated. Evidence suggests that the extent of the illusion was also correlated with the degree of muscle activity onset in the right arm as measured by EMG during this period that the arm was rotating, for the synchronous but not the asynchronous condition. A completely virtual object can therefore be experienced as part of one’s self, which opens up the possibility that an entire virtual body could be felt as one’s own in future virtual reality applications or online games, and be an invaluable tool for the understanding of the brain mechanisms underlying body ownership.

  15. Frozen shoulder and the Big Five personality traits.

    Science.gov (United States)

    Debeer, Philippe; Franssens, Fien; Roosen, Isabelle; Dankaerts, Wim; Claes, Laurence

    2014-02-01

    In the past, several studies have suggested the existence of a "periarthritic personality" in patients with frozen shoulder. We conducted a study to determine differences in personality traits in patients with primary and secondary frozen shoulders. We prospectively evaluated 118 patients (84 women and 34 men; mean age, 53.8 years; SD 7.56) with a frozen shoulder. Of these patients, 48 had an idiopathic frozen shoulder and 70 had a secondary frozen shoulder. Personality traits were determined by the NEO Five-Factor Inventory (NEO-FFI) scale. This questionnaire measures the 5 major personality traits and is based on the norms determined in a neutral test situation for 2415 controls. Compared with healthy controls, no differences in personality traits were found in patients with primary and secondary frozen shoulder, except for Conscientiousness and Extraversion, for which patients with secondary frozen shoulder scored significantly higher than healthy controls. Patients with primary frozen shoulder scored significantly higher on Openness to Experience than did patients with secondary frozen shoulder; on the other 4 Big Five personality traits, no significant differences were found between patients with primary and secondary frozen shoulder. More specifically, patients with idiopathic frozen shoulder did not score higher on the trait Neuroticism as would be expected from previous publications. Our study results do not indicate that patients with an idiopathic frozen shoulder have a specific personality compared with healthy controls. Only a few differences were found in personality traits when the entire frozen shoulder group was compared with healthy controls and between patients with primary and secondary frozen shoulders. The results of this study suggest that these differences are not sufficient to speak about a specific "frozen shoulder personality." Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights

  16. Shoulder Dystocia: Prediction and Management

    OpenAIRE

    Hill, Meghan G; Cohen, Wayne R

    2016-01-01

    Shoulder dystocia is a complication of vaginal delivery and the primary factor associated with brachial plexus injury. In this review, we discuss the risk factors for shoulder dystocia and propose a framework for the prediction and prevention of the complication. A recommended approach to management when shoulder dystocia occurs is outlined, with review of the maneuvers used to relieve the obstruction with minimal risk of fetal and maternal injury.

  17. Shoulder dystocia: prediction and management.

    Science.gov (United States)

    Hill, Meghan G; Cohen, Wayne R

    2016-01-01

    Shoulder dystocia is a complication of vaginal delivery and the primary factor associated with brachial plexus injury. In this review, we discuss the risk factors for shoulder dystocia and propose a framework for the prediction and prevention of the complication. A recommended approach to management when shoulder dystocia occurs is outlined, with review of the maneuvers used to relieve the obstruction with minimal risk of fetal and maternal injury.

  18. Stemless shoulder arthroplasty: current status.

    Science.gov (United States)

    Churchill, R Sean

    2014-09-01

    Since the original Neer humeral replacement in the 1950s, the standard primary anatomic total shoulder arthroplasty design has slowly evolved. Most recently, the humeral stem has become progressively shorter to help combat stem-related complications. Currently, there are several companies who have developed and marketed a stemless humeral arthroplasty component. Manufacturers' data for 5 stemless shoulder arthroplasty components currently on the market were analyzed and reviewed. A literature review of short-term results for stemless shoulder arthroplasty was completed. Of the stemless shoulder arthroplasty systems available on the market, 3 are currently undergoing clinical trials in the United States. The Tornier Simpliciti (Tornier, Edina, MN, USA) clinical trial began in 2011. The study with 2-year minimum follow-up results is scheduled for completion in November 2014. The Arthrex Eclipse (Arthrex, Naples, FL, USA) clinical trial was started in January 2013. The tentative study completion date is 2017. The Biomet Nano (Biomet, Warsaw, IN, USA) clinical trial began in October 2013 and also has a tentative completion date of 2017. No other clinical trial is currently under way in the United States. Early results for stemless shoulder arthroplasty indicate clinical results similar to standard stemmed shoulder arthroplasty. Radiographic analysis indicates implant stability without migration or subsidence at 2- to 3-year minimum follow-up.. Several stemless shoulder arthroplasty implants are available outside the United States. Early clinical and radiographic results are promising, but well-designed clinical studies and midterm results are lacking. Three clinical trials are currently under way in the United States with initial availability for use anticipated in 2015. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  19. Frozen shoulder and risk of cancer

    DEFF Research Database (Denmark)

    Pedersen, Alma B; Horváth-Puhó, Erzsébet; Ehrenstein, Vera

    2017-01-01

    BACKGROUND: Frozen shoulder might be a complication or a presenting symptom of cancer. We examined the risk of a cancer diagnosis after an incident diagnosis of frozen shoulder. METHODS: We used prospectively collected data from Danish registries to identify patients with frozen shoulder during 1...

  20. Return to sports after shoulder arthroplasty

    Science.gov (United States)

    Johnson, Christine C; Johnson, Daniel J; Liu, Joseph N; Dines, Joshua S; Dines, David M; Gulotta, Lawrence V; Garcia, Grant H

    2016-01-01

    Many patients prioritize the ability to return to sports following shoulder replacement surgeries, including total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (RTSA), and hemiarthroplasty (HA). While activity levels after hip and knee replacements have been well-established in the literature, studies on this topic in the field of shoulder arthroplasty are relatively limited. A review of the literature regarding athletic activity after shoulder arthroplasty was performed using the PubMed database. All studies relevant to shoulder arthroplasty and return to sport were included. The majority of patients returned to their prior level of activity within six months following TSA, RTSA, and shoulder HA. Noncontact, low demand activities are permitted by most surgeons postoperatively and generally have higher return rates than contact sports or high-demand activities. In some series, patients reported an improvement in their ability to participate in sports following the arthroplasty procedure. The rates of return to sports following TSA (75%-100%) are slightly higher than those reported for HA (67%-76%) and RTSA (75%-85%). Patients undergoing TSA, RTSA, and shoulder HA should be counseled that there is a high probability that they will be able to return to their preoperative activity level within six months postoperatively. TSA has been associated with higher rates of return to sports than RTSA and HA, although this may reflect differences in patient population or surgical indication. PMID:27672564

  1. Simulation and Shoulder Dystocia.

    Science.gov (United States)

    Shaddeau, Angela K; Deering, Shad

    2016-12-01

    Shoulder dystocia is an unpredictable obstetric emergency that requires prompt interventions to ensure optimal outcomes. Proper technique is important but difficult to train given the urgent and critical clinical situation. Simulation training for shoulder dystocia allows providers at all levels to practice technical and teamwork skills in a no-risk environment. Programs utilizing simulation training for this emergency have consistently demonstrated improved performance both during practice drills and in actual patients with significantly decreased risks of fetal injury. Given the evidence, simulation training for shoulder dystocia should be conducted at all institutions that provide delivery services.

  2. [Shoulder disability questionnaires: a systematic review].

    Science.gov (United States)

    Fayad, F; Mace, Y; Lefevre-Colau, M M

    2005-07-01

    To identify all available shoulder disability questionnaires designed to measure physical functioning and to examine those with satisfactory clinimetric quality. We used the Medline database and the "Guide des outils de mesure de l'évaluation en médecine physique et de réadaptation" textbook to search for questionnaires. Analysis took into account the development methodology, clinimetric quality of the instruments and frequency of their utilization. We classified the instruments according to the International Classification of Functioning, Disability and Health. Thirty-eight instruments have been developed to measure disease-, shoulder- or upper extremity-specific outcome. Four scales assess upper-extremity disability and 3 others shoulder disability. We found 6 scales evaluating disability and shoulder pain, 7 scales measuring the quality of life in patients with various conditions of the shoulder, 14 scales combining objective and subjective measures, 2 pain scales and 2 unclassified scales. Older instruments developed before the advent of modern measurement development methodology usually combine objective and subjective measures. Recent instruments were designed with appropriate methodology. Most are self-administered questionnaires. Numerous shoulder outcome measure instruments are available. There is no "gold standard" for assessing shoulder function outcome in the general population.

  3. Stretching positions for the coracohumeral ligament: Strain measurement during passive motion using fresh/frozen cadaver shoulders

    Directory of Open Access Journals (Sweden)

    Izumi Tomoki

    2011-01-01

    Full Text Available Abstract Background Contracture of the coracohumeral ligament is reported to restrict external rotation of the shoulder with arm at the side and restrict posterior-inferior shift of the humeral head. The contracture is supposed to restrict range of motion of the glenohumeral joint. Methods To obtain stretching position of the coracohumeral ligament, strain on the ligament was measured at the superficial fibers of the ligament using 9 fresh/frozen cadaver shoulders. By sequential measurement using a strain gauge, the ligament strain was measured from reference length (L0. Shoulder positions were determined using a 3 Space Tracker System. Through a combination of previously reported coracohumeral stretching positions and those observed in preliminary measurement, ligament strain were measured by passive external rotation from 10° internal rotation, by adding each 10° external rotation, to maximal external rotation. Results Stretching positions in which significantly larger strain were obtained compared to the L0 values were 0° elevation in scapula plane with 40°, 50° and maximum external rotation (5.68%, 7.2%, 7.87%, 30° extension with 50°, maximum external rotation (4.20%, 4.79%, and 30° extension + adduction with 30°, 40°, 50° and maximum external rotation (4.09%, 4.67%, 4.78%, 5.05%(P Conclusions Significant strain of the coracohumeral ligament will be achieved by passive external rotation at lower shoulder elevations, extension, and extension with adduction.

  4. Predicting response to physiotherapy treatment for musculoskeletal shoulder pain: protocol for a longitudinal cohort study

    Science.gov (United States)

    2013-01-01

    Background Shoulder pain affects all ages, with a lifetime prevalence of one in three. The most effective treatment is not known. Physiotherapy is often recommended as the first choice of treatment. At present, it is not possible to identify, from the initial physiotherapy assessment, which factors predict the outcome of physiotherapy for patients with shoulder pain. The primary objective of this study is to identify which patient characteristics and baseline measures, typically assessed at the first physiotherapy appointment, are related to the functional outcome of shoulder pain 6 weeks and 6 months after starting physiotherapy treatment. Methods/Design Participants with musculoskeletal shoulder pain of any duration will be recruited from participating physiotherapy departments. For this longitudinal cohort study, the participants care pathway, including physiotherapy treatment will be therapist determined. Potential prognostic variables will be collected from participants during their first physiotherapy appointment and will include demographic details, lifestyle, psychosocial factors, shoulder symptoms, general health, clinical examination, activity limitations and participation restrictions. Outcome measures (Shoulder Pain and Disability Index, Quick Disability of the Arm, Shoulder and Hand, and Global Impression of Change) will be collected by postal self-report questionnaires 6 weeks and 6 months after commencing physiotherapy. Details of attendance and treatment will be collected by the treating physiotherapist. Participants will be asked to complete an exercise dairy. An initial exploratory analysis will assess the relationship between potential prognostic factors at baseline and outcome using univariate statistical tests. Those factors significant at the 5% level will be further considered as prognostic factors using a general linear model. It is estimated that 780 subjects will provide more than 90% power to detect an effect size of less than 0

  5. Morphology of large rotator cuff tears and of the rotator cable and long-term shoulder disability in conservatively treated elderly patients.

    Science.gov (United States)

    Morag, Yoav; Jamadar, David A; Miller, Bruce; Brandon, Catherine; Gandikota, Girish; Jacobson, Jon A

    2013-01-01

    The objective of this study was to describe the morphology of the rotator cuff tendon tears and long-term shoulder disability in conservatively treated elderly patients and determine if an association exists between these factors. Assessment of the rotator cuff tendon tear dimensions and depth, rotator interval involvement, rotator cable morphology and location, and rotator cuff muscle status was carried out on magnetic resonance studies of 24 elderly patients treated nonoperatively for rotator cuff tendon tears. Long-term shoulder function was measured using the Western Ontario Rotator Cuff (WORC) index; Disabilities of the Shoulder, Arm, and Hand questionnaire; and the American Shoulder Elbow Self-assessment form, and a correlation between the outcome scores and morphologic magnetic resonance findings was carried out. The majority of large rotator cuff tendon tears are limited to the rotator cuff crescent. Medial rotator interval involvement (isolated or in association with lateral rotator interval involvement) was significantly associated with WORC physical symptoms total (P = 0.01), WORC lifestyle total (P = 0.04), percentage of all WORC domains (P = 0.03), and American Shoulder Elbow Self-assessment total (P = 0.01), with medial rotator interval involvement associated with an inferior outcome. Medial rotator interval tears are associated with long-term inferior outcome scores in conservatively treated elderly patients with large rotator cuff tendon tears.

  6. Painful shoulder. Introduction into fundamental facts and problems

    Energy Technology Data Exchange (ETDEWEB)

    Hartl, P W

    1987-10-19

    The painful shoulder syndrome is very common. Diagnosis and differential diagnosis may be difficult. Shoulder pain may be caused by local processes or systemic diseases or can be referred. Periarthritis humeroscapularis (frozen shoulder) is the most common cause of painful shoulder syndrome. Biomechanical factors concerning the rotator cuff are involved in the etiopathogenesis of these pain syndromes. The therapy of frozen shoulder includes physical treatment, antirheumatic drugs, or X-ray treatment. Surgical measures may become necessary. In the course of rheumatoid arthritis the shoulder may be involved. Milwaukee-shoulder-syndrome has been described recently in crystal deposit diseases. Shoulder pain may be referred by mechanical irritations of nerve roots in the course of degenerative lesions of the cervical spine and also in the course of internal diseases of the heart, the lungs, or the gastrointestinal tract. In cases of shoulder pain without pathological data from arthrological, radiological or laboratory studies, one should always consider localized fibromyalgia in the shoulder-neck-region. The precise diagnosis of shoulder pain is an important prerequisite for treatment, the success of which should not be judged as pessimistic as it has been commonly done in the past.

  7. Thermal Shrinkage for Shoulder Instability

    OpenAIRE

    Toth, Alison P.; Warren, Russell F.; Petrigliano, Frank A.; Doward, David A.; Cordasco, Frank A.; Altchek, David W.; O’Brien, Stephen J.

    2010-01-01

    Thermal capsular shrinkage was popular for the treatment of shoulder instability, despite a paucity of outcomes data in the literature defining the indications for this procedure or supporting its long-term efficacy. The purpose of this study was to perform a clinical evaluation of radiofrequency thermal capsular shrinkage for the treatment of shoulder instability, with a minimum 2-year follow-up. From 1999 to 2001, 101 consecutive patients with mild to moderate shoulder instability underwent...

  8. Gimbaled-shoulder friction stir welding tool

    Science.gov (United States)

    Carter, Robert W. (Inventor); Lawless, Kirby G. (Inventor)

    2010-01-01

    A gimbaled-shoulder friction stir welding tool includes a pin and first and second annular shoulders coupled to the pin. At least one of the annular shoulders is coupled to the pin for gimbaled motion with respect thereto as the tool is rotated by a friction stir welding apparatus.

  9. Viewing medium affects arm motor performance in 3D virtual environments.

    Science.gov (United States)

    Subramanian, Sandeep K; Levin, Mindy F

    2011-06-30

    2D and 3D virtual reality platforms are used for designing individualized training environments for post-stroke rehabilitation. Virtual environments (VEs) are viewed using media like head mounted displays (HMDs) and large screen projection systems (SPS) which can influence the quality of perception of the environment. We estimated if there were differences in arm pointing kinematics when subjects with and without stroke viewed a 3D VE through two different media: HMD and SPS. Two groups of subjects participated (healthy control, n=10, aged 53.6 ± 17.2 yrs; stroke, n=20, 66.2 ± 11.3 yrs). Arm motor impairment and spasticity were assessed in the stroke group which was divided into mild (n=10) and moderate-to-severe (n=10) sub-groups based on Fugl-Meyer Scores. Subjects pointed (8 times each) to 6 randomly presented targets located at two heights in the ipsilateral, middle and contralateral arm workspaces. Movements were repeated in the same VE viewed using HMD (Kaiser XL50) and SPS. Movement kinematics were recorded using an Optotrak system (Certus, 6 markers, 100 Hz). Upper limb motor performance (precision, velocity, trajectory straightness) and movement pattern (elbow, shoulder ranges and trunk displacement) outcomes were analyzed using repeated measures ANOVAs. For all groups, there were no differences in endpoint trajectory straightness, shoulder flexion and shoulder horizontal adduction ranges and sagittal trunk displacement between the two media. All subjects, however, made larger errors in the vertical direction using HMD compared to SPS. Healthy subjects also made larger errors in the sagittal direction, slower movements overall and used less range of elbow extension for the lower central target using HMD compared to SPS. The mild and moderate-to-severe sub-groups made larger RMS errors with HMD. The only advantage of using the HMD was that movements were 22% faster in the moderate-to-severe stroke sub-group compared to the SPS. Despite the similarity in

  10. Viewing medium affects arm motor performance in 3D virtual environments

    Directory of Open Access Journals (Sweden)

    Subramanian Sandeep K

    2011-06-01

    Full Text Available Abstract Background 2D and 3D virtual reality platforms are used for designing individualized training environments for post-stroke rehabilitation. Virtual environments (VEs are viewed using media like head mounted displays (HMDs and large screen projection systems (SPS which can influence the quality of perception of the environment. We estimated if there were differences in arm pointing kinematics when subjects with and without stroke viewed a 3D VE through two different media: HMD and SPS. Methods Two groups of subjects participated (healthy control, n = 10, aged 53.6 ± 17.2 yrs; stroke, n = 20, 66.2 ± 11.3 yrs. Arm motor impairment and spasticity were assessed in the stroke group which was divided into mild (n = 10 and moderate-to-severe (n = 10 sub-groups based on Fugl-Meyer Scores. Subjects pointed (8 times each to 6 randomly presented targets located at two heights in the ipsilateral, middle and contralateral arm workspaces. Movements were repeated in the same VE viewed using HMD (Kaiser XL50 and SPS. Movement kinematics were recorded using an Optotrak system (Certus, 6 markers, 100 Hz. Upper limb motor performance (precision, velocity, trajectory straightness and movement pattern (elbow, shoulder ranges and trunk displacement outcomes were analyzed using repeated measures ANOVAs. Results For all groups, there were no differences in endpoint trajectory straightness, shoulder flexion and shoulder horizontal adduction ranges and sagittal trunk displacement between the two media. All subjects, however, made larger errors in the vertical direction using HMD compared to SPS. Healthy subjects also made larger errors in the sagittal direction, slower movements overall and used less range of elbow extension for the lower central target using HMD compared to SPS. The mild and moderate-to-severe sub-groups made larger RMS errors with HMD. The only advantage of using the HMD was that movements were 22% faster in the moderate-to-severe stroke sub

  11. One-stage surgical treatment for concomitant rotator cuff tears with shoulder stiffness has comparable results with isolated rotator cuff tears: a systematic review.

    Science.gov (United States)

    Sabzevari, Soheil; Kachooei, Amir Reza; Giugale, Juan; Lin, Albert

    2017-08-01

    Addressing preoperative shoulder stiffness before rotator cuff repair (RCR) is advocated, but the effectiveness of this approach is debatable. We hypothesized that 1-stage treatment of concomitant rotator cuff tear (RCT) with shoulder stiffness has comparable results with isolated RCT. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the databases including MEDLINE, Embase, Cochrane Library, and Scopus were searched using the keywords of "shoulder stiffness" OR "adhesive capsulitis" OR "frozen shoulder" AND "rotator cuff." Studies that met all the criteria compared the 2 arms of isolated RCT vs. RCT with concomitant shoulder stiffness, received no physical therapy before surgery, and reported data of preoperative and postoperative range of motion (ROM) and functional outcomes after surgery. Four level III studies met the inclusion criteria. The non-stiff group (isolated RCT) included 460 patients who underwent RCR; the stiff group (RCT with concomitant shoulder stiffness) included 111 patients who underwent RCR and manipulation under anesthesia with or without capsular release. There were significant differences in preoperative ROM between stiff and non-stiff groups. At final follow-up, there were no statistical differences in all ROM between the 2 groups. There was no significant difference in comparing preoperative and postoperative outcome scores including visual analog scale for pain, Constant, modified American Shoulder and Elbow Surgeons, and University of California-Los Angeles scores. Concomitant surgical treatment of nonmassive RCT and moderate shoulder stiffness in 1 stage may have comparable results to the surgical treatment of RCT in patients without preoperative stiffness. Therefore, a physical therapy regimen before surgical intervention may not be necessary. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  12. Complaints of the arm, neck and shoulder among computer office workers in Sudan: a prevalence study with validation of an Arabic risk factors questionnaire

    Directory of Open Access Journals (Sweden)

    Hassan Amar A

    2008-06-01

    Full Text Available Abstract Background Complaints of the arm, neck and/or shoulders (CANS in general and computer-related disorders in particular affect millions of computer office workers in Western developed countries. However, with the widespread use of computer systems in developing countries, the associated musculoskeletal complaints are yet to be investigated. Aim To study the prevalence of work-related CANS, among computer office workers in Sudan, and to test the psychometric properties of a translated Dutch questionnaire in Arabic language. Methods In 2005 282 computer office workers at a mobile telecommunication company and three banks in Khartoum, Sudan, received an Arabic language version of the validated Maastricht upper extremity questionnaire (MUEQ. The questionnaire holds 109 items covering demographic characteristics, in addition to six main domains (i.e. work station, body posture, break time, job control, job demands and social support assessing potential physical and psychosocial risk factors. Forward/backward translation of the MUQE was done independently by two different translators. Prevalence over the past year were computed for CANS. Further, the psychometric properties of the Arabic questionnaire were investigated (i.e. factor structure and reliability and cross-validation was carried out. Results The response rate of the questionnaire was 88% (n = 250. The one-year prevalence of CANS showed that 53% of the respondents could be classified as mild cases. The highest incidences were found for neck and shoulder symptoms (64% and 41% respectively. The analysis of the psychometric properties of the scale resulted in the identification of 2 factors for each of the 6 domains (i.e. office equipment, computer position, head and body posture, awkward body posture, autonomy, quality of break time, skill discretion, decision authority, time pressure, task complexity, social support, and work flow. The calculation of internal consistency and cross

  13. Recurrent Shoulder Dystocia: Risk Factors and Counseling.

    Science.gov (United States)

    Gurewitsch Allen, Edith D

    2016-12-01

    A prior history of delivery complicated by shoulder dystocia confers a 6-fold to nearly 30-fold increased risk of shoulder dystocia recurrence in a subsequent vaginal delivery, with most reported rates between 12% and 17%. Whereas prevention of shoulder dystocia in the general population is neither feasible nor cost-effective, directing intervention efforts at the particular subgroup of women with a prior history of shoulder dystocia has merit. Potentially modifiable risk factors and individualized management strategies that may reduce shoulder dystocia recurrence and its associated significant morbidities are reviewed.

  14. Magnetic resonance imaging of the shoulder

    International Nuclear Information System (INIS)

    Ziemianski, A.; Romanowski, L.

    1994-01-01

    The technique of the own method of shoulder examination was presented. Anatomy and the most common diseases of the shoulder are discussed. The diseases of the shoulder diagnosed on the basis of the MR are: rotator cuff disease, impingement syndrome and instability. MR findings occurred in these entities were demonstrated. The most common MR finding of the rotator cuff disease was higher signal intensity within the supraspinatus tendon, while in shoulder instability was labral abnormality. Impingement syndrome is the previous syndrome of the full MR imaging of the rotator cuff disease. (author)

  15. An entropy-assisted musculoskeletal shoulder model.

    Science.gov (United States)

    Xu, Xu; Lin, Jia-Hua; McGorry, Raymond W

    2017-04-01

    Optimization combined with a musculoskeletal shoulder model has been used to estimate mechanical loading of musculoskeletal elements around the shoulder. Traditionally, the objective function is to minimize the summation of the total activities of the muscles with forces, moments, and stability constraints. Such an objective function, however, tends to neglect the antagonist muscle co-contraction. In this study, an objective function including an entropy term is proposed to address muscle co-contractions. A musculoskeletal shoulder model is developed to apply the proposed objective function. To find the optimal weight for the entropy term, an experiment was conducted. In the experiment, participants generated various 3-D shoulder moments in six shoulder postures. The surface EMG of 8 shoulder muscles was measured and compared with the predicted muscle activities based on the proposed objective function using Bhattacharyya distance and concordance ratio under different weight of the entropy term. The results show that a small weight of the entropy term can improve the predictability of the model in terms of muscle activities. Such a result suggests that the concept of entropy could be helpful for further understanding the mechanism of muscle co-contractions as well as developing a shoulder biomechanical model with greater validity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. The association of foot arch posture and prior history of shoulder or elbow surgery in elite-level baseball pitchers.

    Science.gov (United States)

    Feigenbaum, Luis A; Roach, Kathryn E; Kaplan, Lee D; Lesniak, Bryson; Cunningham, Sean

    2013-11-01

    Case-control. The specific aim of this study was to examine the association between abnormal foot arch postures and a history of shoulder or elbow surgery in baseball pitchers. Pitching a baseball generates forces throughout the musculoskeletal structures of the upper and lower limbs. Structures such as the longitudinal arch of the foot are adaptable to stresses over time. Repeated pitching-related stresses may contribute to acquiring abnormal foot arch postures. Inversely, congenitally abnormal foot arch posture may lead to altered stresses of the upper limb during pitching. A convenience sample of 77 pitchers was recruited from a Division I university team and a professional baseball franchise. Subjects who had a history of shoulder or elbow surgery to the pitching arm were classified as cases. Subjects who met the criteria for classification of pes planus or pes cavus based on longitudinal arch angle were classified as having abnormal foot arch posture. Odds ratios were calculated to examine the association between abnormal foot arch posture and pitching-arm injury requiring surgery. Twenty-three subjects were classified as cases. The odds of being a case were 3.4 (95% confidence interval: 1.2, 9.6; P = .02) times greater for subjects with abnormal foot arch posture and 2.9 (95% confidence interval: 1.0, 8.1; P = .04) times greater for subjects with abnormal foot posture on the lunge leg. Abnormal foot arch posture and a surgical history in the pitching shoulder or elbow may be associated. Because the foot and its arches are adaptable and change over time, the pathomechanics of this association should be further explored.

  17. [Prediction, prevention and management of shoulder dystocia].

    Science.gov (United States)

    Csorba, Roland

    2012-05-20

    Shoulder dystocia is one of the most tragic, fatal and unexpected obstetrical events, which is mostly unpredictable and unpreventable. This clinical picture is defined as a delivery that requires additional obstetric maneuvers to release the shoulders after gentle downward traction has failed. Shoulder dystocia occurs when the fetal shoulder impacts on the maternal symphysis or sacral promontory. The incidence of shoulder dystocia is 0.2-0.6%. High perinatal mortality and morbidity is associated with the condition, even when it is managed appropriately. Obstetricians should be aware of the existing risk factors, but should always be alert to the possibility of shoulder dystocia in all labors. Maternal morbidity is also increased, particularly postpartum hemorrhage, rupture of the uterus, injury of the bladder, urethra and the bowels and fourth-degree perineal tears. Complications of the newborn include asphyxia, perinatal mortality, fracture of the clavicula and the humerus. Brachial plexus injuries are one of the most important fetal complications of shoulder dystocia, complicating 4-16% of such deliveries. The purpose of this article is to review the current evidence regarding the possible prediction, prevention and management of shoulder dystocia.

  18. Validation of single-plane fluoroscopy and 2D/3D shape-matching for quantifying shoulder complex kinematics.

    Science.gov (United States)

    Lawrence, Rebekah L; Ellingson, Arin M; Ludewig, Paula M

    2018-02-01

    Fluoroscopy and 2D/3D shape-matching has emerged as the standard for non-invasively quantifying kinematics. However, its accuracy has not been well established for the shoulder complex when using single-plane fluoroscopy. The purpose of this study was to determine the accuracy of single-plane fluoroscopy and 2D/3D shape-matching for quantifying full shoulder complex kinematics. Tantalum markers were implanted into the clavicle, humerus, and scapula of four cadaveric shoulders. Biplane radiographs were obtained with the shoulder in five humerothoracic elevation positions (arm at the side, 30°, 60°, 90°, maximum). Images from both systems were used to perform marker tracking, while only those images acquired with the primary fluoroscopy system were used to perform 2D/3D shape-matching. Kinematics errors due to shape-matching were calculated as the difference between marker tracking and 2D/3D shape-matching and expressed as root mean square (RMS) error, bias, and precision. Overall RMS errors for the glenohumeral joint ranged from 0.7 to 3.3° and 1.2 to 4.2 mm, while errors for the acromioclavicular joint ranged from 1.7 to 3.4°. Errors associated with shape-matching individual bones ranged from 1.2 to 3.2° for the humerus, 0.5 to 1.6° for the scapula, and 0.4 to 3.7° for the clavicle. The results of the study demonstrate that single-plane fluoroscopy and 2D/3D shape-matching can accurately quantify full shoulder complex kinematics in static positions. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

  19. Functional shoulder ratios with high velocities of shoulder internal rotation are most sensitive to determine shoulder rotation torque imbalance: a cross-sectional study with elite handball players and controls.

    Science.gov (United States)

    Castro, Marcelo Peduzzi de; Fonseca, Pedro; Morais, Sara Tribuzi; Borgonovo-Santos, Márcio; Coelho, Eduardo Filipe Cruz; Ribeiro, Daniel Cury; Vilas-Boas, João Paulo

    2017-12-04

    The aim of the present study was to determine which approach to calculating shoulder ratios is the most sensitive for determining shoulder torque imbalance in handball players. Twenty-six participants (handball athletes, n = 13; healthy controls, n = 13) performed isokinetic concentric and eccentric shoulder internal rotation (IR) and external rotation (ER) assessment at 60, 180 and 300°/s. We used eight approaches to calculating shoulder ratios: four concentric (i.e. concentric ER torque divided by concentric IR torque), and four functional (i.e. eccentric ER torque divided by concentric IR torque) at the velocities of 60, 180 and 300°/s for both IR and ER, and combining 60°/s of ER and 300°/s of IR. A three factorial ANOVA (factors: shoulder ratios, upper limb sides, and groups) along with Tukey's post-hoc analysis, and effect sizes were calculated. The findings suggested the functional shoulder ratio combining 60°/s of ER and 300°/s of IR is the most sensitive to detect differences between upper limbs for handball players, and between players and controls for the dominant side. The functional shoulder ratio combining 60°/s of ER with 300°/s of IR seems to present advantages over the other approaches for identifying upper limb asymmetries and differences in shoulder torque balance related to throwing.

  20. Reflex muscle contraction in anterior shoulder instability.

    Science.gov (United States)

    Wallace, D A; Beard, D J; Gill, R H; Eng, B; Carr, A J

    1997-01-01

    Reduced proprioception may contribute to recurrent anterior shoulder instability. Twelve patients with unilateral shoulder instability were investigated for evidence of deficient proprioception with an activated pneumatic cylinder and surface electromyography electrodes; the contralateral normal shoulder was used as a control. The latency between onset of movement and the detection of muscle contraction was used as an index of proprioception. No significant difference in muscle contraction latency was detected between the stable and unstable shoulders, suggesting that there was no significant defect in muscular reflex activity. This study does not support the use proprioception-enhancing physiotherapy in the treatment of posttraumatic anterior shoulder instability.

  1. [Shoulder injuries in overhead sports].

    Science.gov (United States)

    Wörtler, K

    2010-05-01

    Overhead sport places great demands on the shoulder joint. Shoulder pain in overhead athletes and throwers can in the majority of cases be attributed to lesions resulting from chronic overuse of tendons and capsuloligamentous structures or to sequels of microinstability and secondary impingement. Due to its great impact on therapeutic decisions, imaging in athletes with unclear shoulder pain is a challenge. In this connection, magnetic resonance (MR) arthrography represents the cross-sectional imaging modality of first choice, as it allows depiction and exclusion of pathologic alterations of all relevant joint structures with sufficient confidence.This article reviews the biomechanical and clinical aspects and MR arthrographic features of the most common shoulder pathologies in overhead athletes, including biceps tendinopathy, superior labral anterior-posterior (SLAP) lesions, rotator cuff lesions, as well as extrinsic and intrinsic impingement syndromes.

  2. Shoulder biomechanics

    Energy Technology Data Exchange (ETDEWEB)

    Lugo, Roberto; Kung, Peter; Ma, C. Benjamin [Sports Medicine and Shoulder Service, University of California, San Francisco, 500 Parnassus Avenue, MU 320W-0728 San Francisco, CA 914143 (United States)], E-mail: maben@orthosurg.ucsf.edu

    2008-10-15

    The biomechanics of the glenohumeral joint depend on the interaction of both static and dynamic-stabilizing structures. Static stabilizers include the bony anatomy, negative intra-articular pressure, the glenoid labrum, and the glenohumeral ligaments along with the joint capsule. The dynamic-stabilizing structures include the rotator cuff muscles and the other muscular structures surrounding the shoulder joint. The combined effect of these stabilizers is to support the multiple degrees of motion within the glenohumeral joint. The goal of this article is to review how these structures interact to provide optimal stability and how failure of some of these mechanisms can lead to shoulder joint pathology.

  3. Emergency department management of shoulder dystocia.

    Science.gov (United States)

    Del Portal, Daniel A; Horn, Amanda E; Vilke, Gary M; Chan, Theodore C; Ufberg, Jacob W

    2014-03-01

    Precipitous obstetric deliveries can occur outside of the labor and delivery suite, often in the emergency department (ED). Shoulder dystocia is an obstetric emergency with significant risk of adverse outcome. To review multiple techniques for managing a shoulder dystocia in the ED. We review various techniques and approaches for achieving delivery in the setting of shoulder dystocia. These include common maneuvers, controversial interventions, and interventions of last resort. Emergency physicians should be familiar with multiple techniques for managing a shoulder dystocia to reduce the chances of fetal and maternal morbidity and mortality. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Isotropy of an Upper Limb Exoskeleton and the Kinematics and Dynamics of the Human Arm

    Directory of Open Access Journals (Sweden)

    Joel C. Perry

    2009-01-01

    shoulder and elbow, and nearly half of the total torque at the wrist. These results suggest that the majority of human arm joint torques are devoted to supporting the human arm position in space while compensating gravitational loads whereas a minor portion of the joint torques is dedicated to arm motion itself. A unique axial orientation at the base of the exoskeleton allowed the singular configuration of the shoulder joint to be moved towards the boundary of the human arm workspace while supporting 95% of the arm's workspace. At the same time, this orientation allowed the best exoskeleton manipulability at the most commonly used human arm configuration during ADLs. One of the potential implications of these results might be the need to compensate gravitational load during robotic-assistive rehabilitation treatment. Moreover, results of a manipulability analysis of the exoskeleton system indicate that the singular configuration of the exoskeleton system may be moved out of the human arm physiological workspace while maximising the overlap between the human arm and the exoskeleton workspaces. The collected database along with kinematic and dynamic analyses may provide a fundamental basis towards the development of assistive technologies for the human arm.

  5. Shoulder Ultrasonography: Performance and Common Findings

    Directory of Open Access Journals (Sweden)

    Diana Gaitini

    2012-01-01

    Full Text Available Ultrasound (US of the shoulder is the most commonly requested examination in musculoskeletal US diagnosis. Sports injuries and degenerative and inflammatory processes are the main sources of shoulder pain and functional limitations. Because of its availability, low cost, dynamic examination process, absence of radiation exposure, and ease of patient compliance, US is the preferred mode for shoulder imaging over other, more sophisticated, and expensive methods. Operator dependence is the main disadvantage of US examinations. Use of high range equipment with high resolution transducers, adhering to a strict examination protocol, good knowledge of normal anatomy and pathological processes and an awareness of common pitfalls are essential for the optimal performance and interpretation of shoulder US. This article addresses examination techniques, the normal sonographic appearance of tendons, bursae and joints, and the main pathological conditions found in shoulder ultrasonography.

  6. Shoulder dystocia: risk factors, predictability, and preventability.

    Science.gov (United States)

    Mehta, Shobha H; Sokol, Robert J

    2014-06-01

    Shoulder dystocia remains an unpredictable obstetric emergency, striking fear in the hearts of obstetricians both novice and experienced. While outcomes that lead to permanent injury are rare, almost all obstetricians with enough years of practice have participated in a birth with a severe shoulder dystocia and are at least aware of cases that have resulted in significant neurologic injury or even neonatal death. This is despite many years of research trying to understand the risk factors associated with it, all in an attempt primarily to characterize when the risk is high enough to avoid vaginal delivery altogether and prevent a shoulder dystocia, whose attendant morbidities are estimated to be at a rate as high as 16-48%. The study of shoulder dystocia remains challenging due to its generally retrospective nature, as well as dependence on proper identification and documentation. As a result, the prediction of shoulder dystocia remains elusive, and the cost of trying to prevent one by performing a cesarean delivery remains high. While ultimately it is the injury that is the key concern, rather than the shoulder dystocia itself, it is in the presence of an identified shoulder dystocia that occurrence of injury is most common. The majority of shoulder dystocia cases occur without major risk factors. Moreover, even the best antenatal predictors have a low positive predictive value. Shoulder dystocia therefore cannot be reliably predicted, and the only preventative measure is cesarean delivery. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Cross-cultural adaptation and validation of the Italian version of the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow score.

    Science.gov (United States)

    Merolla, Giovanni; Corona, Katia; Zanoli, Gustavo; Cerciello, Simone; Giannotti, Stefano; Porcellini, Giuseppe

    2017-12-01

    The Kerlan-Jobe Orthopaedic Clinic (KJOC) Shoulder and Elbow score is a reliable and sensitive tool to measure the performance of overhead athletes. The purpose of this study was to carry out a cross-cultural adaptation and validation of the KJOC questionnaire in Italian and to assess its reliability, validity, and responsiveness. Ninety professional athletes with a painful shoulder were included in this study and were assigned to the "injury group" (n = 32) or the "overuse group" (n = 58); 65 were managed conservatively and 25 were treated by arthroscopic surgery. To assess the reliability of the KJOC score, patients were asked to fill in the questionnaire at baseline and after 2 weeks. To test the construct validity, KJOC scores were compared to those obtained with the Italian version of the Disabilities of the Arm, Shoulder, and Hand (DASH) scale, and with the DASH sports/performing arts module. To test KJOC score responsiveness, the follow-up KJOC scores of the participants treated conservatively were compared to those of the patients treated by arthroscopic surgery. Statistical analysis demonstrated that the KJOC questionnaire is reliable in terms of the single items and the overall score (ICC 0.95-0.99); that it has high construct validity (r s  = -0.697; p differences in shoulder function (p < 0.0001). The Italian version of the KJOC Shoulder and Elbow score performed in a similar way to the English version and demonstrated good validity, reliability, and responsiveness after conservative and surgical treatment. II.

  8. Agreement between patient self-assessment and physician assessment of shoulder range of motion.

    Science.gov (United States)

    Uribe, Bastian; El Bitar, Youssef; Wolf, Brian R; Bollier, Matthew; Kuhn, John E; Hettrich, Carolyn M

    2016-10-01

    Shoulder outcome scores that include range of motion (ROM) and apprehension signs are limited by the need for direct involvement of the physician. Patient-reported outcome measures are patient centered and self-administered, and they can help physicians track the patient's progress between office visits and for long-term follow-up once the patient has been discharged. Thirty consecutive patients completed a form before their 6-month follow-up after surgery on the labrum or capsule as a result of instability or pain related to instability. The form included bilateral ROM, apprehension, and instability episodes. The same parameters were measured by the physician during the visit. The patient's and physician's responses were compared. The primary outcome was the percentage agreement with exact and approximate agreement. Exact agreement was moderate for forward elevation at 56.6%; fair for abduction and external rotation at 90° at 24.5% and 34%, respectively; and poor for internal rotation at 90° and external rotation with the arm at the side at 2.6% and 12%, respectively. Approximate agreement within a range of positive or negative 20° range was very good for forward elevation (94%), abduction (92%), and external rotation at 90° (87%); moderate for external rotation with the arm at the side; and fair for internal rotation at 90°. There was 70% agreement regarding apprehension, 93% regarding subluxation events, and 100% regarding redislocation events. Some measures of shoulder ROM showed a moderate to high level of agreement between patient-reported measurements and the physician's measurements. This method for short- and long-term follow-up could potentially replace routine clinic visits. Copyright © 2016. Published by Elsevier Inc.

  9. Shoulder dystocia and associated manoeuvres as risk factors for perineal trauma.

    Science.gov (United States)

    Gauthaman, Nivedita; Walters, Samuel; Tribe, In-Ae; Goldsmith, Louise; Doumouchtsis, Stergios K

    2016-04-01

    Shoulder dystocia (SD) is an obstetric emergency that can be associated with serious neonatal morbidity and mortality. The aim of this study was to identify the incidence and risk factors for obstetric anal sphincter injuries (OASIS) in women who sustained SD at birth. This was a retrospective observational study over a 5-year period whereby 403 cases of SD were identified. The primary outcome measure was to identify the incidence of OASIS in women with SD. We also evaluated the role of the manoeuvres used for the management of SD and aimed to identify possible correlations between specific manoeuvres and OASIS by univariate and multivariate regression analysis. Shoulder dystocia was associated with a three-fold increase in the risk of OASIS in our population. The use of internal manoeuvres (OR 2.182: 95 % CI 1.173-4.059), an increased number of manoeuvres ≥ 4 (OR 4.667: 95 % CI 1.846-11.795), Woods' screw manoeuvre (OR 3.096: 95 % CI 1.554-6.169), reverse Woods' screw manoeuvre (OR 4.848: 95 % CI 1.647-14.277) and removal of the posterior arm (OR 2.222: 95 % CI 1.117-4.421) were all associated with a significant increase in the likelihood of OASIS. In our study, instrumental deliveries, the use of internal manoeuvres (Woods' screw and reverse Woods' screw) and four or more manoeuvres for the management of SD were independently associated with a higher incidence of OASIS. To effectively manage shoulder dystocia with lower risks of perineal trauma, these factors could be considered when designing further prospective studies and developing management protocols.

  10. Shoulder injuries in overhead sports

    International Nuclear Information System (INIS)

    Woertler, K.

    2010-01-01

    Overhead sport places great demands on the shoulder joint. Shoulder pain in overhead athletes and throwers can in the majority of cases be attributed to lesions resulting from chronic overuse of tendons and capsuloligamentous structures or to sequels of microinstability and secondary impingement. Due to its great impact on therapeutic decisions, imaging in athletes with unclear shoulder pain is a challenge. In this connection, magnetic resonance (MR) arthrography represents the cross-sectional imaging modality of first choice, as it allows depiction and exclusion of pathologic alterations of all relevant joint structures with sufficient confidence. This article reviews the biomechanical and clinical aspects and MR arthrographic features of the most common shoulder pathologies in overhead athletes, including biceps tendinopathy, superior labral anterior-posterior (SLAP) lesions, rotator cuff lesions, as well as extrinsic and intrinsic impingement syndromes. (orig.) [de

  11. Bone mineral density measurement over the shoulder region

    DEFF Research Database (Denmark)

    Doetsch, A M; Faber, J; Lynnerup, N

    2002-01-01

    values decreased with age (P shoulder BMD levels increased significantly with increased body mass index (BMI) (P positive relationship between the increased hip/shoulder BMD differential with BMI supports the conclusion that the shoulder is subject......The purpose of this study was to (1). establish a method for measuring bone mineral density (BMD) over the shoulder region; (2). compare the relationship between shoulder BMD levels with hip BMD and body mass index (BMI); and (3). discuss the relevance of the shoulder scan as an early indicator...... of osteoporosis compared with hip scans, the latter representing a weight-bearing part of the skeleton. We developed a scanning procedure, including a shoulder fixation device, and determined the most appropriate software in order to establish a reference material with the highest possible precision. Duplicate...

  12. Torso and Bowing Arm Three-Dimensional Joint Kinematics of Elite Cellists: Clinical and Pedagogical Implications for Practice.

    Science.gov (United States)

    Hopper, Luke; Chan, Cliffton; Wijsman, Suzanne; Ackland, Timothy; Visentin, Peter; Alderson, Jacqueline

    2017-06-01

    Elite cello playing requires complex and refined motor control. Cellists are prone to right shoulder and thoracolumbar injuries. Research informing injury management of cellists and cello pedagogy is limited. The aims of this study were to quantify the torso, right shoulder, and elbow joint movement used by elite cellists while performing a fundamental playing task, a C major scale, under two volume conditions. An eight degrees of freedom upper limb biomechanical model was applied to 3D motion capture data of the torso, upper arm, and forearm for 31 cellists with a mean experience of 19.4 yrs (SD 9.1). Two-factor ANOVA compared the joint positions between the four cello strings and two volume conditions. Significant (ppedagogical practices.

  13. Ultrasonography of the painful shoulder

    International Nuclear Information System (INIS)

    Terriza, M.D.; Manzanares, R.

    1995-01-01

    A thorough knowledge of the normal anatomy was applied in the study of 132 patients with painful shoulder to establish the ultrasonographic findings that indicate the diagnosis of lesions of the rotator cuff of the shoulder (tendentious, tendons degeneration and the different types of fracture) as well as bursitis, lesions of the tendon of the long head of the biceps, joint effusions, lesions of the humeral head, etc. As an initial method of studying painful shoulder using standard plain radiography, this techniques is considered a reliable diagnostic procedure. (Author)

  14. Clinical forms of shoulder instability in pediatric patients

    Directory of Open Access Journals (Sweden)

    Yaroslav N. Proshchenko

    2016-12-01

    Full Text Available Background. The recurrence rate of adolescent chronic shoulder instability is approximately 56%–68%. However, this pathology is often missed in childhood and adolescence. Aim. To identify the clinical forms of shoulder joint instability in pediatric patients. Materials and methods. The authors present the data from 57 pediatric patients aged 3−17 years with a total of 61 unstable shoulder joints. All patients were divided into groups according to the form of instability. Traumatic chronic shoulder instability was identified in 40 patients (Bankart and Hill–Sachs injuries. Of these, non-traumatic shoulder instability was diagnose in 17, including five with recurrent dislocation, and spontaneous shoulder dislocation due to dysplasia of glenoid and labrum was diagnosed in 12. Of the 57 patients in the study cohort, 53 underwent surgery. Postoperatively, two patients developed recurrent shoulder dislocation (Andreev–Boichev technique due type III shoulder dysplasia in the first patient and multidirectional injury in the second. Conclusions. Shoulder joint instability should be considered as the traumatic or non-traumatic form. Treatment decisions should be based on anatomical characteristics that predispose to recurrent dislocation.

  15. Measurement properties of the QuickDASH (disabilities of the arm, shoulder and hand) outcome measure and cross-cultural adaptations of the QuickDASH: a systematic review.

    Science.gov (United States)

    Kennedy, Carol A; Beaton, Dorcas E; Smith, Peter; Van Eerd, Dwayne; Tang, Kenneth; Inrig, Taucha; Hogg-Johnson, Sheilah; Linton, Denise; Couban, Rachel

    2013-11-01

    To identify and synthesize evidence for the measurement properties of the QuickDASH, a shortened version of the 30-item DASH (Disabilities of the Arm, Shoulder and Hand) instrument. This systematic review used a best evidence synthesis approach to critically appraise the measurement properties [using COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN)] of the QuickDASH and cross-cultural adaptations. A standard search strategy was conducted between 2005 (year of first publication of QuickDASH) and March 2011 in MEDLINE, EMBASE and CINAHL. The search identified 14 studies to include in the best evidence synthesis of the QuickDASH. A further 11 studies were identified on eight cross-cultural adaptation versions. Many measurement properties of the QuickDASH have been evaluated in multiple studies and across most of the measurement properties. The best evidence synthesis of the QuickDASH English version suggests that this tool is performing well with strong positive evidence for reliability and validity (hypothesis testing), and moderate positive evidence for structural validity testing. Strong negative evidence was found for responsiveness due to lower correlations with global estimates of change. Information about the measurement properties of the cross-cultural adaptation versions is still lacking, or the available information is of poor overall methodological quality.

  16. [Case of acute pain of herpes zoster with preceding immobility of the shoulder].

    Science.gov (United States)

    Takekawa, Kimiko

    2012-07-01

    A 62-year-old-man treated for nephrotic syndrome with steroid developed acute pain of herpes zoster after immobility of the shoulder. Steroids might have suppressed the first symptoms of pain. But immobility probably appeared as VZV infection developing to spinal ventral root. Suprascapular nerve block was effective for severe pain of the right arm. Sympathetic nerve contained in suprascapular nerve might have been blocked. Sympathetically maintained pain may occur when primary afferent neurons are excited by inflammation due to VZV infection. Pain was abolished 17 weeks after the onset of rash using blocks three times and amitriptyrin and valproic acid. Immobility was resolved seven months after the onset of rash.

  17. Analysis of factors related to arm weakness in patients with breast cancer-related lymphedema.

    Science.gov (United States)

    Lee, Daegu; Hwang, Ji Hye; Chu, Inho; Chang, Hyun Ju; Shim, Young Hun; Kim, Jung Hyun

    2015-08-01

    The aim of this study was to evaluate the ratio of significant weakness in the affected arm of breast cancer-related lymphedema patients to their unaffected side. Another purpose was to identify factors related to arm weakness and physical function in patients with breast cancer-related lymphedema. Consecutive patients (n = 80) attended a single evaluation session following their outpatient lymphedema clinic visit. Possible independent factors (i.e., lymphedema, pain, psychological, educational, and behavioral) were evaluated. Handgrip strength was used to assess upper extremity muscle strength and the disabilities of arm, shoulder, and hand (DASH) questionnaire was used to assess upper extremity physical function. Multivariate logistic regression was performed using factors that had significant differences between the handgrip weakness and non-weakness groups. Out of the 80 patients with breast cancer-related lymphedema, 29 patients (36.3 %) had significant weakness in the affected arm. Weakness of the arm with lymphedema was not related to lymphedema itself, but was related to the fear of using the affected limb (odds ratio = 1.76, 95 % confidence interval = 1.30-2.37). Fears of using the affected limb and depression significantly contributed to the variance in DASH scores. Appropriate physical and psychological interventions, including providing accurate information and reassurance of physical activity safety, are necessary to prevent arm weakness and physical dysfunction in patients with breast cancer-related lymphedema.

  18. Construct validity, test-retest reliability and internal consistency of the Thai version of the disabilities of the arm, shoulder and hand questionnaire (DASH-TH) in patients with carpal tunnel syndrome.

    Science.gov (United States)

    Buntragulpoontawee, Montana; Phutrit, Suphatha; Tongprasert, Siam; Wongpakaran, Tinakon; Khunachiva, Jeeranan

    2018-03-27

    This study evaluated additional psychometric properties of the Thai version of the disabilities of the arm, shoulder and hand questionnaire (DASH-TH) which included, test-retest reliability, construct validity, internal consistency of in patients with carpal tunnel syndrome. As for determining construct validity, the Thai EuroQOL questionnaire (EQ-5D-5L) was also administered in order to examine convergent and divergent validity. Fifty patients completed both questionnaires. The DASH-TH showed excellent test-retest reliability (intraclass correlation coefficient = 0.811) and internal consistency (Cronbach's alpha = 0.911). The exploratory factor analysis yielded a six-factor solution while the confirmatory factor analysis denoted that the hypothesized model adequately fit the data with a comparative fit index of 0.967 and a Tucker-Lewis index of 0.964. The related subscales between the DASH-TH and the Thai EQ-5D-5L were significantly correlated, indicating the DASH-TH's convergent and discriminant validity. The DASH-TH demonstrated good reliability, internal consistency construct validity, and multidimensionality, in assessing the upper extremity function in carpal tunnel syndrome patients.

  19. Clinical comparison of automatic, noninvasive measurements of blood pressure in the forearm and upper arm.

    Science.gov (United States)

    Schell, Kathleen; Bradley, Elisabeth; Bucher, Linda; Seckel, Maureen; Lyons, Denise; Wakai, Sandra; Bartell, Deborah; Carson, Elizabeth; Chichester, Melanie; Foraker, Teresa; Simpson, Kathleen

    2005-05-01

    When the upper arm (area from shoulder to elbow) is inaccessible and/or a standard-sized blood pressure cuff does not fit, some healthcare workers use the forearm to measure blood pressure. To compare automatic noninvasive measurements of blood pressure in the upper arm and forearm. A descriptive, correlational comparison study was conducted in the emergency department of a 1071-bed teaching hospital. Subjects were 204 English-speaking patients 6 to 91 years old in medically stable condition who had entered the department on foot or by wheelchair and who had no exclusions to using their left upper extremity. A Welch Allyn Vital Signs 420 series monitor was used to measure blood pressure in the left upper arm and forearm with the subject seated and the upper arm or forearm at heart level. Pearson r correlation coefficients between measurements in the upper arm and forearm were 0.88 for systolic blood pressure and 0.76 for diastolic blood pressure (P upper arm and forearm differed significantly (t = 2.07, P = .04). A Bland-Altman analysis indicated that the distances between the mean values and the limits of agreement for the 2 sites ranged from 15 mm Hg (mean arterial pressure) to 18.4 mm Hg (systolic pressure). Despite strict attention to correct cuff size and placement of the upper arm or forearm at heart level, measurements of blood pressure obtained noninvasively in the arm and forearm of seated patients in stable condition are not interchangeable.

  20. Measurement of muscle thickness of the serratus anterior and lower trapezius using ultrasound imaging in competitive recreational adult swimmers, with and without current shoulder pain.

    Science.gov (United States)

    McKenna, Leanda J; de Ronde, Mandy; Le, Minyang; Burke, William; Graves, Anna; Williams, Sian A

    2018-02-01

    To compare serratus anterior and lower trapezius muscle thickness between swimmers with and without current shoulder pain, and between sides when measured by real-time ultrasound imaging. A single blinded age and gender-matched case-control study with 26 symptomatic and 26 asymptomatic recreational swimmers. Muscle thickness of serratus anterior and lower trapezius were measured using previously validated real-time ultrasound imaging protocols. Serratus anterior thickness was measured in side lying with 90° of glenohumeral flexion at rest and during a scapular protraction contraction. Lower trapezius thickness was measured in prone with 145° of glenohumeral abduction whilst at rest and when holding the weight of the arm. There was no statistically significant difference between the muscle thickness of serratus anterior and lower trapezius between the symptomatic shoulder and the dominance-matched shoulder in the asymptomatic group of swimmers. There was also no significant difference in muscle thickness between the symptomatic side and asymptomatic side within the symptomatic group. There appears to be no difference in serratus anterior and lower trapezius thickness between swimmers who have mild to moderate shoulder pain, who continue to swim and those who do not have shoulder pain. When imaging the serratus anterior and lower trapezius in swimmers with mild shoulder pain, clinicians should expect no differences between sides. If muscle thickness differences between sides are detected in recreational swimmers, this may indicate that the swimmer is participating in other asymmetrical activities or has a higher level of shoulder pain. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  1. Objective Assessment of Joint Stiffness: A Clinically Oriented Hardware and Software Device with an Application to the Shoulder Joint.

    Science.gov (United States)

    McQuade, Kevin; Price, Robert; Liu, Nelson; Ciol, Marcia A

    2012-08-30

    Examination of articular joints is largely based on subjective assessment of the "end-feel" of the joint in response to manually applied forces at different joint orientations. This technical report aims to describe the development of an objective method to examine joints in general, with specific application to the shoulder, and suitable for clinical use. We adapted existing hardware and developed laptop-based software to objectively record the force/displacement behavior of the glenohumeral joint during three common manual joint examination tests with the arm in six positions. An electromagnetic tracking system recorded three-dimensional positions of sensors attached to a clinician examiner and a patient. A hand-held force transducer recorded manually applied translational forces. The force and joint displacement were time-synchronized and the joint stiffness was calculated as a quantitative representation of the joint "end-feel." A methodology and specific system checks were developed to enhance clinical testing reproducibility and precision. The device and testing protocol were tested on 31 subjects (15 with healthy shoulders, and 16 with a variety of shoulder impairments). Results describe the stiffness responses, and demonstrate the feasibility of using the device and methods in clinical settings.

  2. Intertester reliability of clinical shoulder instability and laxity tests in subjects with and without self-reported shoulder problems.

    Science.gov (United States)

    Eshoj, Henrik; Ingwersen, Kim Gordon; Larsen, Camilla Marie; Kjaer, Birgitte Hougs; Juul-Kristensen, Birgit

    2018-03-03

    First, to investigate the intertester reliability of clinical shoulder instability and laxity tests, and second, to describe the mutual dependency of each test evaluated by each tester for identifying self-reported shoulder instability and laxity. A standardised protocol for conducting reliability studies was used to test the intertester reliability of the six clinical shoulder instability and laxity tests: apprehension, relocation, surprise, load-and-shift, sulcus sign and Gagey. Cohen's kappa (κ) with 95% CIs besides prevalence-adjusted and bias-adjusted kappa (PABAK), accounting for insufficient prevalence and bias, were computed to establish the intertester reliability and mutual dependency. Forty individuals (13 with self-reported shoulder instability and laxity-related shoulder problems and 27 normal shoulder individuals) aged 18-60 were included. Fair (relocation), moderate (load-and-shift, sulcus sign) and substantial (apprehension, surprise, Gagey) intertester reliability were observed across tests (κ 0.39-0.73; 95% CI 0.00 to 1.00). PABAK improved reliability across tests, resulting in substantial to almost perfect intertester reliability for the apprehension, surprise, load-and-shift and Gagey tests (κ 0.65-0.90). Mutual dependencies between each test and self-reported shoulder problem showed apprehension, relocation and surprise to be the most often used tests to characterise self-reported shoulder instability and laxity conditions. Four tests (apprehension, surprise, load-and-shift and Gagey) out of six were considered intertester reliable for clinical use, while relocation and sulcus sign tests need further standardisation before acceptable evidence. Furthermore, the validity of the tests for shoulder instability and laxity needs to be studied. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. Shoulder complaints after nerve sparing neck dissections

    NARCIS (Netherlands)

    van Wilgen, CP; Dijkstra, PU; van der Laan, BFAM; Plukker, JTM; Roodenburg, JLN

    The purpose of the study was to analyse the prevalence of shoulder complaints after nerve sparing neck dissection at least I year after surgery, and to analyse the influence of radiation therapy on shoulder complaints. Patients were interviewed for shoulder complaints, and patients filled out the

  4. Rare Inferior Shoulder Dislocation (Luxatio Erecta

    Directory of Open Access Journals (Sweden)

    Hakan Cift

    2015-01-01

    Full Text Available Although shoulder dislocations have been seen very frequently, inferior dislocation of shoulder constitutes only 0.5% of all shoulder dislocations. We share our 4 patients with luxatio erecta and present their last clinical control. 2 male and 2 female Caucasian patients were diagnosed as luxatio erecta. Patients’ ages were 78, 62, 65, and 76. All patients’ reduction was done by traction-abduction and contour traction maneuver in the operating room. The patients had no symptoms and no limitation of range of motion of their shoulder at their last control. Luxatio erecta is seen rarely, and these patients may have neurovascular injury. These patients should be carefully examined and treated by the orthopaedic and traumatology surgeons.

  5. Rare Inferior Shoulder Dislocation (Luxatio Erecta)

    Science.gov (United States)

    Cift, Hakan; Soylemez, Salih; Demiroglu, Murat; Ozkan, Korhan; Ozden, Vahit Emre; Ozkut, Afsar T.

    2015-01-01

    Although shoulder dislocations have been seen very frequently, inferior dislocation of shoulder constitutes only 0.5% of all shoulder dislocations. We share our 4 patients with luxatio erecta and present their last clinical control. 2 male and 2 female Caucasian patients were diagnosed as luxatio erecta. Patients' ages were 78, 62, 65, and 76. All patients' reduction was done by traction-abduction and contour traction maneuver in the operating room. The patients had no symptoms and no limitation of range of motion of their shoulder at their last control. Luxatio erecta is seen rarely, and these patients may have neurovascular injury. These patients should be carefully examined and treated by the orthopaedic and traumatology surgeons. PMID:25883820

  6. Neck and Upper Limb Dysfunction in Patients following Neck Dissection: Looking beyond the Shoulder.

    Science.gov (United States)

    Gane, Elise M; O'Leary, Shaun P; Hatton, Anna L; Panizza, Benedict J; McPhail, Steven M

    2017-10-01

    Objective To measure patient-perceived upper limb and neck function following neck dissection and to investigate potential associations between clinical factors, symptoms, and function. Study Design Cross-sectional. Setting Two tertiary hospitals in Brisbane, Australia. Subjects and Methods Inclusion criteria: patients treated with neck dissection (2009-2014). aged <18 years, accessory nerve or sternocleidomastoid sacrifice, previous neck dissection, preexisting shoulder/neck injury, and inability to provide informed consent (cognition, insufficient English). Primary outcomes were self-reported function of the upper limb (Quick Disabilities of the Arm, Shoulder, and Hand) and neck (Neck Disability Index). Secondary outcomes included demographics, oncological management, self-efficacy, and pain. Generalized linear models were prepared to examine relationships between explanatory variables and self-reported function. Results Eighty-nine participants (male n = 63, 71%; median age, 62 years; median 3 years since surgery) reported mild upper limb and neck dysfunction (median [quartile 1, quartile 3] scores of 11 [3, 32] and 12 [4, 28], respectively). Significant associations were found between worse upper limb function and longer time since surgery (coefficient, 1.76; 95% confidence interval [CI], 0.01-3.51), having disease within the thyroid (17.40; 2.37-32.44), postoperative radiation therapy (vs surgery only) (13.90; 6.67-21.14), and shoulder pain (0.65; 0.44-0.85). Worse neck function was associated with metastatic cervical lymph nodes (coefficient, 6.61; 95% CI, 1.14-12.08), shoulder pain (0.19; 0.04-0.34), neck pain (0.34; 0.21-0.47), and symptoms of neuropathic pain (0.61; 0.25-0.98). Conclusion Patients can experience upper limb and neck dysfunction following nerve-preserving neck dissection. The upper quadrant as a whole should be considered when assessing rehabilitation priorities after neck dissection.

  7. MR imaging of the shoulder

    International Nuclear Information System (INIS)

    Heuck, A.; Appel, M.; Kaiser, E.; Luttke, G.; Lukas, P.

    1990-01-01

    This paper evaluates the occurrence, frequency, and significance of increased signal intensity (SI) in the rotator cuff (RC) of normal volunteers suggestive of pathologic findings such as partial tears and tendinitis. Shoulders of 30 volunteers without evidence of prior shoulder disease or trauma were studied. MR imaging at 1.5 T included T1-weighted, proton-density, and T2-weighted spin-echo (SE) and T2*-weighted gradient-echo sequences in axial, oblique coronal, and sagittal planes. Shoulders of 30 cadavers were dissected and studied for correlation with MR findings, five of them after MR examination

  8. Rheumatoid arthritis of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Dijkstra, J.; Dijkstra, P.F.; Klundert, W. v. d.

    1985-02-01

    The course of rheumatoid arthritis in the shoulder is evaluated in 143 patients. In a period of 29 years, 630 X-rays were taken of 286 shoulders. In this series 2 or more X-rays per shoulder were taken of 89 patients (29 male, 60 female). The various changes in the glenohumeral and acromioclavicular joints were described. Gross destruction appears to be rare, compared to the more frequently seen minor cystic changes. The progress of the disease is often slow or halting. One or both of the shoulders in some of the patients (15 male and 29 female) did not have any detectable X-rays changes, although some of them were followed up for more than 20 years. During our follow-up it became apparent that the acromioclavicular and glenohumeral joints do not follow the same course neither in time nor in severity of joint destruction. Therefore, we divided the shoulder joint into the acromioclavicular and glenohumeral joint. One normal stage and 5 stages of pathology are recognised to fit into previously published schemes of the other joints. Stage 5 appears to be a new phenomenon of neojoint formation, under the previous humeral head with the inferior glenoid rim. Joint disease in the acromioclavicular joint could be divided only into 3 stages.

  9. Rheumatoid arthritis of the shoulder

    International Nuclear Information System (INIS)

    Dijkstra, J.; Dijkstra, P.F.; Jan van Breemen Inst., Amsterdam; Klundert, W. v. d.

    1985-01-01

    The course of rheumatoid arthritis in the shoulder is evaluated in 143 patients. In a period of 29 years, 630 X-rays were taken of 286 shoulders. In this series 2 or more X-rays per shoulder were taken of 89 patients (29 male, 60 female). The various changes in the glenohumeral and acromioclavicular joints were described. Gross destruction appears to be rare, compared to the more frequently seen minor cystic changes. The progress of the disease is often slow or halting. One or both of the shoulders in some of the patients (15 male and 29 female) did not have any detectable X-rays changes, although some of them were followed up for more than 20 years. During our follow-up it became apparent that the acromioclavicular and glenohumeral joints do not follow the same course neither in time nor in severity of joint destruction. Therefore, we divided the shoulder joint into the acromioclavicular and glenohumeral joint. One normal stage and 5 stages of pathology are recognised to fit into previously published schemes of the other joints. Stage 5 appears to be a new phenomenon of neojoint formation, under the previous humeral head with the inferior glenoid rim. Joint disease in the acromioclavicular joint could be divided only into 3 stages. (orig.) [de

  10. The effect of electrical stimulation in combination with Bobath techniques in the prevention of shoulder subluxation in acute stroke patients.

    Science.gov (United States)

    Fil, Ayla; Armutlu, Kadriye; Atay, Ahmet Ozgur; Kerimoglu, Ulku; Elibol, Bulent

    2011-01-01

    To examine the efficiency of electrical stimulation in combination with Bobath techniques in the prevention of inferior and anterior shoulder subluxation in acute stroke patients. A prospective randomized controlled trial. Intensive care unit and inpatient clinics of neurology in a university hospital. Forty-eight patients with acute stroke, divided equally into control and study groups. Subjects in both groups were treated in accordance with the Bobath concept during the early hospitalization period. In addition to Bobath techniques, electrical stimulation was also applied to the supraspinatus muscle, mid and posterior portions of the deltoid muscle of patients in the study group. Two radiological methods were used to measure the horizontal, vertical and total asymmetry and vertical distance values of the shoulder joint. Motor functions of the arm were evaluated with the Motor Assessment Scale. The hospitalization period was 12.62 ± 2.24 days for the control group and 11.66 ± 1.88 days for the study group. Shoulder subluxation occurred in 9 (37.5%) subjects in the control group, whereas it was not observed in the study group. All shoulder joint displacement values were higher in the control group than in the study group (horizontal asymmetry P = 0.0001, vertical asymmetry P = 0.0001, total asymmetry P = 0.0001, vertical range P = 0.002). Application of electrical stimulation combined with the Bobath approach proved to be efficient in preventing inferior and anterior shoulder subluxation in the acute stages of stroke.

  11. Computational reverse shoulder prosthesis model: Experimental data and verification.

    Science.gov (United States)

    Martins, A; Quental, C; Folgado, J; Ambrósio, J; Monteiro, J; Sarmento, M

    2015-09-18

    The reverse shoulder prosthesis aims to restore the stability and function of pathological shoulders, but the biomechanical aspects of the geometrical changes induced by the implant are yet to be fully understood. Considering a large-scale musculoskeletal model of the upper limb, the aim of this study is to evaluate how the Delta reverse shoulder prosthesis influences the biomechanical behavior of the shoulder joint. In this study, the kinematic data of an unloaded abduction in the frontal plane and an unloaded forward flexion in the sagittal plane were experimentally acquired through video-imaging for a control group, composed of 10 healthy shoulders, and a reverse shoulder group, composed of 3 reverse shoulders. Synchronously, the EMG data of 7 superficial muscles were also collected. The muscle force sharing problem was solved through the minimization of the metabolic energy consumption. The evaluation of the shoulder kinematics shows an increase in the lateral rotation of the scapula in the reverse shoulder group, and an increase in the contribution of the scapulothoracic joint to the shoulder joint. Regarding the muscle force sharing problem, the musculoskeletal model estimates an increased activity of the deltoid, teres minor, clavicular fibers of the pectoralis major, and coracobrachialis muscles in the reverse shoulder group. The comparison between the muscle forces predicted and the EMG data acquired revealed a good correlation, which provides further confidence in the model. Overall, the shoulder joint reaction force was lower in the reverse shoulder group than in the control group. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Persistent Neck and Shoulder Pains among Computer Office Workers: A Longitudinal Study

    Directory of Open Access Journals (Sweden)

    Farideh Sadeghian

    2012-11-01

    Nurses in Ibadan, South-west Nigeria: a cross-sectional survey. BMC Musculoskelet Disord 2010;11:12-9. 3. Spielholz P, Silverstein B, Morgan M, Checkoway H, Kaufman J. Comparison of self-report, video observation and direct measurement methods for upper extremity musculoskeletal disorder physical risk factors. Ergonomics 2001;44(6:588-613. 4. Hush JM, Maher CG, Refshauge KM. Risk factors for neck pain in office workers: a prospective study. BMC Musculoskelet Disord 2006;7(1:81-5. 5. Meislin RJ, Sperling JW, Stitik TP. Persistent shoulder pain: epidemiology, patho physiology, and diagnosis. Am J Orthop 2005;34(12 Suppl:5-9. 6. Ranasinghe P, Perera YS, Lamabadusuriya DA, Kulatunga S, Jayawardana N, Rajapakse S, et al. Work-related complaints of arm, neck and shoulder among computer office workers in an Asian country: prevalence and validation of a risk-factor questionnaire. BMC Musculoskelet Disord 2011;12:68-78. 7. Wærsted M, Hanvold T N, Veiersted KB. Computer work and musculoskeletal disorders of the neck and upper extremity: A systematic review. BMC Musculoskelet Disord 2010;11:79-93. 8. Gerr F, Marcus M, Ensor C, Kleinbaum D, Cohen S, Edwards A, et al. A prospective study of computer users, I: study design and incidence of musculoskeletal symptoms and disorders. Am J Ind Med 2002;41(4:221-35. 9. Nakazawa T, Okubo Y, Suwazono Y, Kobayashi E, Komine S, Kato N, et al. Association between duration of daily VDT use and subjective symptoms. Am J Ind Med 2002;42(5:421-6. 10. Brandt LP, Andersen JH, Lassen CF, Kryger A, Overgaard E, Vilstrup I. Neck and shoulder symptoms and disorders among Danish computer workers. Scand J Work Environ Health 2004;30(5:399-409. 11. Wahlström J. Ergonomics musculoskeletal disorders and computer work. Occup Med 2005;55(3:168-76. 12. Eltayeb SM, Staal JB, Khamis AH, de Bie RA. Symptoms of neck, shoulder, forearms, and hands: a cohort study among computer office workers in Sudan. Clin J Pain 2011;27(3:275-81. 13. Harcombe H, McBride D, Derrett

  13. [Symphysiotomy to relieve shoulder dystocia

    NARCIS (Netherlands)

    Mourad, S.M.; Nieuwenhof, H.P. van de; Biert, J.; Heidema, W.M.; Bekker, M.N.

    2014-01-01

    Symphysiotomy to manage shoulder dystocia is seldom used in the western world. For this reason, in well-resourced countries knowledge of its recuperation rate and the management of physical discomfort in the post-partum period is scarce. We describe two cases of symphysiotomy for shoulder dystocia.

  14. Differences in muscle activities during shoulder elevation in patients with symptomatic and asymptomatic rotator cuff tears: analysis by positron emission tomography.

    Science.gov (United States)

    Shinozaki, Nobuhisa; Sano, Hirotaka; Omi, Rei; Kishimoto, Koshi N; Yamamoto, Nobuyuki; Tashiro, Manabu; Itoi, Eiji

    2014-03-01

    Differences in muscle activity patterns between patients with symptomatic and asymptomatic full-thickness rotator cuff tears have not yet been fully clarified. The purpose of this study was to investigate the muscle activity pattern by use of positron emission tomography (PET) in patients with symptomatic and asymptomatic rotator cuff tears. Ten shoulders of 9 patients with full-thickness rotator cuff tears were divided into 2 groups by a numerical pain rating scale (0-10), symptomatic (≥2) and asymptomatic (0 or 1), with 5 shoulders each. Scaption exercise of bilateral arms (200 repetitions in 10 minutes) with a weight of 0.25 kg each was performed before and after injection of fluorodeoxyglucose. After PET examination, the standardized uptake value of each muscle was calculated to quantify its activity and compared between the two groups. The activity of the anterior and middle deltoid was significantly decreased in the symptomatic group compared with the asymptomatic group (anterior deltoid, P = .02; middle deltoid, P = .03). In contrast, the activity of the superior trapezius was significantly increased in the symptomatic group compared with the asymptomatic group (P = .02). In patients with a symptomatic tear, the deltoid activity was decreased and the trapezius activity was increased. It is likely that they might have moved the painful glenohumeral joint less and instead moved the painless scapulothoracic joint more during the prescribed exercise. We conclude that patients with painful rotator cuff tears use the parascapular muscles more than those without pain do during arm elevation. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  15. Strength asymmetry of the shoulders in elite volleyball players.

    Science.gov (United States)

    Hadzic, Vedran; Sattler, Tine; Veselko, Matjaž; Markovic, Goran; Dervisevic, Edvin

    2014-01-01

    Volleyball players are reported to have shoulder strength imbalances. Previous authors have primarily investigated small samples of male players at a single skill level, without considering playing position, and with inconsistent findings. To evaluate shoulder strength asymmetry and a history of shoulder injury in a large sample of professional volleyball players of both sexes across different playing positions and skill levels. Descriptive laboratory study. A sample of 183 volleyball players (99 men, 84 women). We assessed shoulder internal-rotator and external-rotator concentric strength at 60°/s using an isokinetic dynamometer and dominant-nondominant differences in shoulder strength and strength ratios using repeated-measures analyses of variance. Peak torque was normalized for body mass and external-rotation/internal-rotation concentric strength. Internal-rotation strength was asymmetric in favor of the dominant side in both sexes, regardless of previous shoulder injury status. Male volleyball players had a lower shoulder strength ratio on the dominant side, regardless of previous shoulder injury status. However, this finding was valid only when hand dominance was taken into account. Female volleyball players playing at a higher level (ie, first versus second division) were 3.43 times more likely to have an abnormal strength ratio. Playing position was not associated with an abnormal shoulder strength ratio or strength asymmetry. In male volleyball players, the external-rotation/internal-rotation strength ratio of the dominant shoulder was lower, regardless of playing position, skill level, or a previous shoulder injury. In female players, the ratio was less only in those at a higher skill level. Although speculative, these findings generally suggest that female volleyball players could have a lower risk of developing shoulder-related problems than male volleyball players. Isokinetic shoulder testing may reveal important information about the possible risk

  16. Geometrical analysis of stemless shoulder arthroplasty: a radiological study of seventy TESS total shoulder prostheses.

    Science.gov (United States)

    Kadum, Bakir; Hassany, Hamid; Wadsten, Mats; Sayed-Noor, Arkan; Sjödén, Göran

    2016-04-01

    The aim of this study was to investigate the ability of a stemless shoulder prosthesis to restore shoulder anatomy in relation to premorbid anatomy. This prospective study was performed between May 2007 and December 2013. The inclusion criteria were patients with primary osteoarthritis (OA) who had undergone stemless total anatomic shoulder arthroplasty. Radiographic measurements were done on anteroposterior X-ray views of the glenohumeral joint. Sixty-nine patients (70 shoulders) were included in the study. The mean difference between premorbid centre of rotation (COR) and post-operative COR was 1 ± 2 mm (range -3 to 5.8 mm). The mean difference between premorbid humeral head height (HH) and post-operative HH was -1 ± 3 mm (range -9.7 to 8.5 mm). The mean difference between premorbid neck-shaft angle (NSA) and post-operative NSA was -3 ± 12° (range -26 to 20°). Stemless implants could be of help to reconstruct the shoulder anatomy. This study shows that there are some challenges to be addressed when attempting to ensure optimal implant positioning. The critical step is to determine the correct level of bone cut to avoid varus or valgus humeral head inclination and ensure correct head size.

  17. Long-term outcome of segmental reconstruction of the humeral head for the treatment of locked posterior dislocation of the shoulder.

    Science.gov (United States)

    Gerber, Christian; Catanzaro, Sabrina; Jundt-Ecker, Michele; Farshad, Mazda

    2014-11-01

    Locked posterior glenohumeral dislocations with impaction fractures involving less than 30% to 35% of the humeral head are most frequently treated with lesser tuberosity transfer into the defect, whereas those involving more than 35% to 40% are treated with humeral head arthroplasty. As an alternative, reconstruction of the defect with segmental femoral or humeral head allograft has been proposed, but the long-term outcome of this joint-preserving procedure is unknown. Twenty-two shoulders in 21 patients with a locked posterior shoulder dislocation and an impaction of at least 30% (mean, 43%) of the humeral head were treated with segmental reconstruction of the humeral head defect. They were reviewed clinically and radiographically at a minimum follow-up of 5 years. Of the 22 shoulders, 19 could be followed up at 128 months (range, 60-294 months) postoperatively. Only 2 of the 19 patients needed a prosthesis more than 180 months after the index operation. Of the other 17, 4 had radiographically advanced osteoarthritis (OA), 4 had mild OA, and 9 had no or minimal OA. Eighteen shoulders were rated as subjectively excellent, none were rated as good, and one was rated as fair. The final Constant-Murley score averaged 77 points (range, 52-98 points), the Subjective Shoulder Value averaged 88% (range, 75%-100%), and only 2 patients had mild to moderate pain. Mean active anterior elevation was 145°, and mean external rotation with the arm at the side was 42°. Segmental reconstruction of humeral head defects for large anteromedial impaction fractures caused by locked posterior dislocations durably restores stability and freedom from pain with an excellent subjective long-term outcome. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  18. Handball load and shoulder injury rate

    DEFF Research Database (Denmark)

    Møller, M.; Nielsen, R.O.; Attermann, J.

    2017-01-01

    Background Knowledge of injury patterns, an essential step towards injury prevention, is lacking in youth handball. Aim To investigate if an increase in handball load is associated with increased shoulder injury rates compared with a minor increase or decrease, and if an association is influenced...... by scapular control, isometric shoulder strength or glenohumeral range of motion (ROM). Methods 679 players (14-18 years) provided weekly reports on shoulder injury and handball load (training and competition hours) over 31 weeks using the SMS, phone and medical examination system. Handball load in a given...... week was categorised into (1) 60% relative to the weekly average amount of handball load the preceding 4 weeks. Assessment of shoulder isometric rotational and abduction strength, ROM and scapular control...

  19. [Neonatal complications related to shoulder dystocia].

    Science.gov (United States)

    Lopez, E; de Courtivron, B; Saliba, E

    2015-12-01

    To describe neonatal complications related to shoulder dystocia. This systematic evidence review is based on PubMed search, Cochrane library and experts' recommendations. The risks of brachial plexus birth injury, clavicle and humeral fracture, perinatal asphyxia, hypoxic-ischemic encephalopathy and perinatal mortality are increased after shoulder dystocia. The medical team should be able to provide neonatal resuscitation in the delivery room in case of perinatal asphyxia following shoulder dystocia, according to national and international guidelines. The initial clinical examination should search for complications such as brachial plexus birth injury or clavicle fracture. The risk of perinatal complications is increased in newborn after shoulder dystocia. The medical team should be able to manage these complications. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  20. Subacromial shoulder disorders among baggage handlers

    DEFF Research Database (Denmark)

    Thygesen, Lau Caspar; Mikkelsen, Sigurd; Pedersen, Ellen Bøtker

    2016-01-01

    PURPOSE: To assess the influence of cumulative employment as baggage handler on the risk of incident subacromial shoulder disorders. Baggage handling is characterized by repetitive work primarily consisting of heavy lifting in awkward positions and time pressure. METHODS: This cohort study is based...... increased incidence of subacromial shoulder disorders for workers with longer cumulative years of employment. These results support that long-term lifting in awkward positions and time pressure influences the risk of subacromial shoulder disorders....... System. The primary exposure was cumulative years of employment as a baggage handler, and the primary outcome was diagnoses and surgical treatment of subacromial shoulder disorders. RESULTS: The cohort contained 3396 baggage handlers and 63,909 workers in the reference group. Baggage handlers with longer...

  1. Rare Inferior Shoulder Dislocation (Luxatio Erecta)

    OpenAIRE

    Cift, Hakan; Soylemez, Salih; Demiroglu, Murat; Ozkan, Korhan; Ozden, Vahit Emre; Ozkut, Afsar T.

    2015-01-01

    Although shoulder dislocations have been seen very frequently, inferior dislocation of shoulder constitutes only 0.5% of all shoulder dislocations. We share our 4 patients with luxatio erecta and present their last clinical control. 2 male and 2 female Caucasian patients were diagnosed as luxatio erecta. Patients’ ages were 78, 62, 65, and 76. All patients’ reduction was done by traction-abduction and contour traction maneuver in the operating room. The patients had no symptoms and no limitat...

  2. Thermal shrinkage for shoulder instability.

    Science.gov (United States)

    Toth, Alison P; Warren, Russell F; Petrigliano, Frank A; Doward, David A; Cordasco, Frank A; Altchek, David W; O'Brien, Stephen J

    2011-07-01

    Thermal capsular shrinkage was popular for the treatment of shoulder instability, despite a paucity of outcomes data in the literature defining the indications for this procedure or supporting its long-term efficacy. The purpose of this study was to perform a clinical evaluation of radiofrequency thermal capsular shrinkage for the treatment of shoulder instability, with a minimum 2-year follow-up. From 1999 to 2001, 101 consecutive patients with mild to moderate shoulder instability underwent shoulder stabilization surgery with thermal capsular shrinkage using a monopolar radiofrequency device. Follow-up included a subjective outcome questionnaire, discussion of pain, instability, and activity level. Mean follow-up was 3.3 years (range 2.0-4.7 years). The thermal capsular shrinkage procedure failed due to instability and/or pain in 31% of shoulders at a mean time of 39 months. In patients with unidirectional anterior instability and those with concomitant labral repair, the procedure proved effective. Patients with multidirectional instability had moderate success. In contrast, four of five patients with isolated posterior instability failed. Thermal capsular shrinkage has been advocated for the treatment of shoulder instability, particularly mild to moderate capsular laxity. The ease of the procedure makes it attractive. However, our retrospective review revealed an overall failure rate of 31% in 80 patients with 2-year minimum follow-up. This mid- to long-term cohort study adds to the literature lacking support for thermal capsulorrhaphy in general, particularly posterior instability. The online version of this article (doi:10.1007/s11420-010-9187-7) contains supplementary material, which is available to authorized users.

  3. Shoulder Dystocia: Incidence and Risk Factors.

    Science.gov (United States)

    Ouzounian, Joseph G

    2016-12-01

    Shoulder dystocia complicates ∼1% of vaginal births. Although fetal macrosomia and maternal diabetes are risk factors for shoulder dystocia, for the most part its occurrence remains largely unpredictable and unpreventable.

  4. Timing and Activation Intensity of Shoulder Muscles during Handball Penalty Throwing in Subjects with and without Shoulder Impingement

    Directory of Open Access Journals (Sweden)

    Zahra Zonnor

    2017-08-01

    Full Text Available Introduction: Shoulder injuries are common among athletes in sports that involve overhead throwing of the ball such as handball. The objectives of this study were to evaluate the timing and activation intensity of shoulder muscles during handball penalty throwing in individuals with shoulder pain and in control subjects. Materials and Methods: Using BTS FREE EMG 300 system with bipolar surface electrodes, the timing (onset and intensity of the activation of the shoulder muscles were measured including upper trapezius, anterior, middle and posterior deltoid, latissimus dorsi, pectoralis major, supraspinatus and triceps during penalty throwing. Multivariate analysis of variance (ANOVA was used for between group comparisons with the significance level P< 0.05. Results: The activation intensity of upper trapezius and latissimus dorsi muscles in the healthy individuals were about 50.74% and 43.42% higher than in patients. Middle deltoid in healthy individuals was about 38.05% smaller than that in patients. In control group, supraspinatus muscle started earlier (23.5 ms than the shoulder motion initiation. Triceps muscle was activated about 18.5 ms later than shoulder motion initiation. In patients, supraspinatus muscle started sooner (11 ms and triceps brachialis muscle started later than the other muscles (22.16 ms. Conclusion: The coordination of shoulder muscles i.e. the onset and intensity of muscle activity is disturbed in the patient group during throwing. Hence, strength and stretching programs are recommended for athletes to reduce the risk of shoulder pain syndrome. The rehabilitation program can be focused on modifying the pattern of activity in upper trapezius, supraspinatus, latissimus dorsi and deltoid muscles in addition to pain control in the rehabilitation centers.

  5. Postoperative imaging of the shoulder

    International Nuclear Information System (INIS)

    Woertler, K.; Rummeny, E.J.

    2004-01-01

    Correct interpretation of imaging findings in the postoperative shoulder is impaired by surgical distortion of normal anatomy and possible artifacts. Advanced postoperative imaging of the shoulder in addition to the selection of the best suited modality necessitates familiarity with the surgical procedure that has been performed and its consecutive morphological changes. This article reviews the most common arthroscopic and open techniques used for treatment of shoulder instability, lesions of the superior labral-bicipital complex, primery impingement, and rotator cuff tears, their typical postoperative imaging findings, as well as the diagnostic performance of cross sectional imaging techniques in the detection of recurrent lesions and complications. (orig.) [de

  6. Physiotherapy treatment of the diabetic shoulder: a longitudinal study following patients with diabetes and shoulder pain using a pre-post treatment design.

    Science.gov (United States)

    Kyhlbäck, Maria; Schröder Winter, Helena; Thierfelder, Tomas; Söderlund, Anne

    2014-01-01

    The aim of this study was to describe and evaluate a physiotherapy program targeted to reduce pain intensity and improve the daily functioning of diabetics with shoulder problems. It was hypothesized that patients receiving specific physiotherapy treatment improved more frequently and rapidly than diabetic patients followed up without specific physiotherapeutic intervention. A pre-post treatment design was completed for a group of 10 subjects. The treatment protocol, also applied during the daily activities of the subjects, was aiming at reducing pain intensity and shoulder stiffness and improving impaired functioning in daily activities by muscle relaxation, light-load exercise and enhancing proper shoulder co-ordination. The group analysis showed significant decrease of pain intensity level as well as improved shoulder functioning and sustained level of subject self-efficacy beliefs throughout the study period. The results suggest that it is possible to relieve shoulder pain intensity and improve daily activities of patients with diabetes-related shoulder problems by employing a physiotherapy program focusing on muscle relaxation, light-load exercise and on the enhancement of proper shoulder co-ordination in daily activities. A physiotherapy program can be effective in reducing pain and improving shoulder function in diabetics with shoulder problems. The treatment should focus on muscle relaxation, light-load exercise and on the enhancement of proper shoulder co-ordination in daily activities.

  7. Eccentric training for shoulder abductors improves pain, function and isokinetic performance in subjects with shoulder impingement syndrome: a case series Treino excêntrico para abdutores do ombro melhora dor, função e desempenho isocinético em sujeitos com síndrome do impacto: série de casos

    Directory of Open Access Journals (Sweden)

    Paula R. Camargo

    2012-02-01

    Full Text Available BACKGROUND: Conservative treatments have been proposed for people with shoulder impingement syndrome (SIS, such as strengthening of the rotator cuff and scapular muscles and stretching of the soft tissues of the shoulder. However, there is a lack of studies analyzing the effectiveness of eccentric training in the treatment of SIS. OBJECTIVES: To evaluate the effects of eccentric training for shoulder abductors on pain, function, and isokinetic performance during concentric and eccentric abduction of the shoulder in subjects with SIS. METHODS: Twenty subjects (7 females, 34.2 SD 10.2 years, 1.7 SD 0.1 m, 78.0 SD 16.3 kg with unilateral SIS completed the study protocol. Bilateral isokinetic eccentric training at 60º/s for shoulder abductors was performed for six consecutive weeks, twice a week, on alternate days. For each training day, three sets of 10 repetitions were performed with a 3-minute rest period between the sets for each side. The range of motion trained was 60° (ranging from 80° to 20°. The Disabilities of the Arm, Shoulder and Hand (DASH questionnaire was used to evaluate functional status and symptoms of the upper limbs. Peak torque, total work and acceleration time were measured during concentric and eccentric abduction of the arm at 60º/s and 180º/s using an isokinetic dynamometer. RESULTS: DASH scores, peak torque, total work and acceleration time improved (pCONTEXTUALIZAÇÃO: Tratamentos conservadores têm sido propostos para pessoas com síndrome do impacto (SI do ombro, como fortalecimento do manguito rotador e dos músculos escapulares e alongamento dos tecidos moles do ombro. No entanto, são escassos os estudos que analisaram a eficácia do treinamento excêntrico no tratamento da SI. OBJETIVOS: Avaliar os efeitos do treinamento excêntrico para abdutores do ombro na dor, função e desempenho isocinético durante a abdução concêntrica e excêntrica do ombro em indivíduos com SI. MÉTODOS: Vinte indivíduos (sete

  8. Shoulder Activity Level is Associated With Type of Employment and Income in the Normative Population Without Shoulder Disorders.

    Science.gov (United States)

    Brophy, Robert H; Lin, Kenneth M; Skillington, S Andrew; Hepper, C Tate; Smith, Matthew V

    2016-10-01

    Socioeconomic variables influence various healthcare issues in different ways. The effect of socioeconomic variables on the shoulder has not been well studied. Because activity level, defined by how much a patient actually does, is an important patient outcome measure and prognostic factor for the shoulder, studying its association with occupation and income will advance our understanding of how these variables relate to shoulder disorders, treatments, and outcomes. We asked: (1) Does shoulder activity score correlate with income level, stratified by gender? (2) Do different employment groups-heavy, moderate, light, student, retired-have different shoulder activity scores, as stratified by gender? (3) Is type of sports participation (contact or overhead) associated with income level, employment type, race, or household size? A survey collected the Brophy and Marx shoulder activity score and demographic information, such as age, gender, race, income, type of employment, and household size from 1625 individuals 18 years and older with no current or previous shoulder pain or injury who are members of a research panel matched to the United States population by age, gender, household income and size, race/ethnicity, and geography. Men and women were analyzed separately. Activity level was controlled for age. Shoulder activity correlated with income level among men (R = 0.03; p employment had the highest Shoulder Activity Scale (SAS) level (12.1 ± 4.9), which was more than SAS levels in sedentary (9.1 ± 4.5; mean difference, 3.0; 95% CI, 2.5-3.6; p = 0.001), student (8.8 ± 5.1; mean difference, 3.3; 95% CI, 3.0-3.7; p = 0.007), retired (8.0 ± 4.6; mean difference, 4.1; 95% CI, 3.6-4.7; p = 0.0001), and not working (7.5 ± 5.3; mean difference, 4.6; 95% CI, 4.6-4.6; p employment had the highest SAS level (12.0 ± 5.8). However, as there were few women working in heavy labor, the only significant difference in women was between moderate employment (8.8 ± 4.2) and

  9. The Danish Shoulder Arthroplasty Registry: clinical outcome and short-term survival of 2,137 primary shoulder replacements

    DEFF Research Database (Denmark)

    Rasmussen, Jeppe; Jakobsen, John; Brorson, Stig

    2012-01-01

    The Danish Shoulder Arthroplasty Registry (DSR) was established in 2004. Data are reported electronically by the surgeons. Patient-reported outcome is collected 10-14 months postoperatively using the Western Ontario osteoarthritis of the shoulder index (WOOS). 2,137 primary shoulder arthroplasties...... (70% women) were reported to the registry between January 2006 and December 2008. Mean age at surgery was 69 years (SD 12). The most common indications were a displaced proximal humeral fracture (54%) or osteoarthritis (30%). 61% were stemmed hemiarthroplasties, 28% resurfacing hemiarthroplasties, 8......% reverse shoulder arthroplasties, and 3% total arthroplasties. Median WOOS was 59% (IQR: 37-82). 5% had been revised by the end of June 2010. The most frequent indications for revision were dislocation or glenoid attrition....

  10. Risk of subacromial shoulder disorder in airport baggage handlers

    DEFF Research Database (Denmark)

    Møller, Sanne Pagh; Brauer, Charlotte; Mikkelsen, Sigurd

    2018-01-01

    age,exposure variables showed close to significant associations with subacromial shoulder disorder.Results could not confirm our hypothesis that combined information on work task duration and shoulder load intensity was stronger associated with subacromial shoulder disorder than seniority.......Musculoskeletal shoulder-load among baggage handlers measured by combining duration and intensity based on biomechanical and epidemiological information may be a stronger predictor of subacromial shoulder disordersthanbaggage handler seniority.In 2012, a cohort of baggage handlers employed...... at Copenhagen Airport in 1990-2012, and a cohort of unskilledotherwise employed men answered a survey.Self-reported information on work tasks during employment in the airport in combination with work task specific biomechanically modelled forces in the shoulder joint was used to estimate shoulder-load. Exposure...

  11. Mid-term shoulder functional and quality of life outcomes after shoulder replacement in obese patients.

    Science.gov (United States)

    Vincent, Heather K; Struk, Aimee M; Reed, Austin; Wright, Thomas W

    2016-01-01

    Shoulder pain and loss of function are directly associated with obesity. We hypothesized that significant interactions would exist between total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RSA) and obesity status on functional and quality of life (QOL) outcomes over the long term. Clinical and QOL outcomes (American Shoulder and Elbow Surgeons Evaluation form, Shoulder Pain and Disability Index, University of California at Los Angeles Shoulder Rating scale, Medical Outcomes Short Form 12 (SF-12), range of motion (ROM), and strength) were longitudinally compared in patients with low and high body mass index (BMI) after a TSA or a RSA. Prospectively collected data of patients with a TSA or RSA were reviewed (N = 310). Preoperative, 2-year, and final follow-up visits were included (range 3-17 years; mean 5.0 ± 2.5 years). Patient data were stratified for analysis using BMI. Morbidly obese patients had worse preoperative functional scores and QOL compared to the other groups. There were no significant interactions of BMI group by surgery type for any of the outcome variables except for active external rotation ROM. Morbidly obese patients attained lower SF-12 scores compared to the remaining groups at each time point. Both TSA and RSA can be expected to impart positive functional outcomes in patients irrespective of BMI. Morbidly obese patients do not attain the same gains in Medical Outcomes SF-12 scores as the non-morbidly obese patients. The lower improvements in active external ROM may be due to morphological limitations of excessive adiposity. This is a level II study.

  12. Shoulder arthroscopy: the basics.

    Science.gov (United States)

    Farmer, Kevin W; Wright, Thomas W

    2015-04-01

    Shoulder arthroscopy is a commonly performed and accepted procedure for a wide variety of pathologies. Surgeon experience, patient positioning, knowledge of surgical anatomy, proper portal placement, and proper use of instrumentation can improve technical success and minimize complication risks. This article details the surgical anatomy, indications, patient positioning, portal placement, instrumentation, and complications for basic shoulder arthroscopy. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  13. Shoulder distention arthrography as a treatment modality

    International Nuclear Information System (INIS)

    Kang, Heung Sik; Park, Chan Sup; Kim, Jin Ho; Kim, Sang Bum

    1987-01-01

    18 patients with painful stiff shoulder joint were underwent shoulder distension arthrography as a treatment modality, followed by physical therapy. Range of motion of shoulder joint was evaluated at 1 week and 4 weeks after arthrography. The results were as follows; 1. Arthrographic findings were decreased volume of joint cavity, obliteration of axillary recess, small subscapularis bursa, serrated capsular margin and non-filling of biceps tendon sheath. In 3 cases, rotator cuff tear was found. 2. Range of motion of shoulder joint was improved after distension arthrography. 3. In 3 patients have rotator cuff tear, range of motion was not improved

  14. Variability of peak shoulder force during wheelchair propulsion in manual wheelchair users with and without shoulder pain.

    Science.gov (United States)

    Moon, Y; Jayaraman, C; Hsu, I M K; Rice, I M; Hsiao-Wecksler, E T; Sosnoff, J J

    2013-01-01

    Manual wheelchair users report a high prevalence of shoulder pain. Growing evidence shows that variability in forces applied to biological tissue is related to musculoskeletal pain. The purpose of this study was to examine the variability of forces acting on the shoulder during wheelchair propulsion as a function of shoulder pain. Twenty-four manual wheelchair users (13 with pain, 11 without pain) participated in the investigation. Kinetic and kinematic data of wheelchair propulsion were recorded for 3 min maintaining a constant speed at three distinct propulsion speeds (fast speed of 1.1 m/s, a self-selected speed, and a slow speed of 0.7 m/s). Peak resultant shoulder forces in the push phase were calculated using inverse dynamics. Within individual variability was quantified as the coefficient of variation of cycle to cycle peak resultant forces. There was no difference in mean peak shoulder resultant force between groups. The pain group had significantly smaller variability of peak resultant force than the no pain group (Ppropulsion variability could be a novel marker of upper limb pain in manual wheelchair users. © 2013.

  15. Targeting study of gelatin adsorbed clodronate in reticuloendothelial system and its potential application in immune thrombocytopenic purpura of rat model

    International Nuclear Information System (INIS)

    Li, P.; Tan, Z.; Zhu, Y.

    2007-01-01

    Full text: Depletion of splenic and hepatic macrophages has potentials to alleviate hemorrhage in patients who suffered from immune thrombocytopenic purpura (ITP). This investigation was aimed to assess whether nanotechnology can play a role in this clinical setting by absorbing bisphosphonate clodronate (CLOD) to type A gelatin nanospheres (GNS) to form CLOD-GNS. First, the stability of CLOD-GNS was assessed in- vitro and up to 6 mg CLOD can be adsorbed in 1 mg GNS. The ability of CLOD-GNS to target the spleen and the liver was then evaluated by biodistribution assay and 99mTc-CLOD-GNS scintigraphy in rats. It showed that up to 70.6% of CLOD-GNS could be accumulated in the liver and spleen. The survival of the macrophages in vitro and the phagocytic ability of hepatic and splenic macrophage in vivo were reduced and later demonstrated by99mTc-phytic colloid scintigraphy. In rats with induced ITP, administration of CLOD-GNS successfully prevented peripheral platelet levels from decreasing. Our preliminary data demonstrate that CLOD-GNS can effectively target the reticuloendothelial system and has potentials in the treatment of ITP warrants further study. (author)

  16. Physiotherapy in frozen shoulder syndrome - literature review

    Directory of Open Access Journals (Sweden)

    Katarzyna Korabiusz

    2017-08-01

    Full Text Available Introduction: The frozen shoulder syndrome is seen as civilization illness. A significant amount of people suffer from it. The frozen shoulder syndrome is one of the most frequent dysfunctions of pectoral girdle. It is seen as a second frequent reason for visits at General Practicioner. There are three stages of this illness, there are a lot of symptoms, but one that occurs most commonly is pain. This illness can be completely curable. Research goal: Goal of this dissertation is a review of literature about available physiotherapy methods used in frozen shoulder syndrome. Conclusion: Kinesiotherapy, kinesiotaping, criotherapy, LASER, Traebert’s currents, iontophoresis, magnetic fields, ultrasounds, massage, manual therapy and combined therapy   are effective physiotherapy methods used in treating frozen shoulder syndrome. Those methods reduce pain indispositions and increase range of movement in shoulder joint.

  17. Magnetic resonance imaging of traumatic anterior instability of the shoulder

    International Nuclear Information System (INIS)

    Horii, Motoyuki

    1994-01-01

    The diagnostic capability of MRI in depicting abnormalities in traumatic anterior instability of the shoulder (TAI) was evaluated with special attention to MR arthrogram enhanced by joint effusion or saline solution. Sixty five shoulders with TAI and 19 control shoulders were scanned using the field gradient echo method (STAGE technique) on axial plane with a 1.0 or 1.5 Tesla system. MR arthrogram was obtained in 36 shoulders with TAI (Group A) and 11 control shoulders (Group C). Conventional MRI was obtained in 29 shoulders with TAI (Group B) and 8 control shoulders (Group D). Abnormalities in Bankart lesion were assessed according to signal intensity and labral shape. Abnormal signal was obtained in 8 shoulders (27.6%) in group B. Changes in shape were seen in 35 shoulders (97.2%) in group A and 18 (62.1%) in group B. Interruption of the anterior capsule was suspected in 3 (8.3%) in group A. Hill-Sachs lesion was suspected in 60 shoulders. Shoulders in the control group showed no abnormal change. Details of Bankart lesion confirmed by subsequent arthroscopy were diagnosed correctly in all of 14 shoulders on MR arthrogram and 8 of 16 shoulders on conventional MRI. These results show that MRI, MR arthrogram in particular, is useful for depicting abnormalities in TAI. (author)

  18. Short-term Clinical Results of Manipulation Under Ultrasound-Guided Brachial Plexus Block in Patients with Idiopathic Frozen Shoulder and Diabetic Secondary Frozen Shoulder.

    Science.gov (United States)

    Ando, Akira; Hamada, Junichiro; Hagiwara, Yoshihiro; Sekiguchi, Takuya; Koide, Masashi; Itoi, Eiji

    2018-01-01

    This study examined the effectiveness of manipulation under ultrasound-guided brachial plexus block in patients with recalcitrant idiopathic frozen shoulder and diabetic secondary frozen shoulder (diabetic frozen shoulder). Forty-four idiopathic frozen shoulders and 10 diabetic frozen shoulders with failed conservative treatment for at least 3 months were included in this study. The manipulation was performed under ultrasound-guided brachial plexus block and visual analogue scale, range of motion, and Constant scores were measured before manipulation and at the last follow-up examination. No major complications were observed during the procedure. Sufficient improvement was not obtained in two patients during the procedure and to avoid complications, the procedure was discontinued and subsequently arthroscopic capsular release was performed. Visual analogue scale, range of motion towards all directions, and Constant scores were significantly improved after the manipulation in both the idiopathic frozen shoulder and diabetic frozen shoulder groups, however the diabetic group showed inferior results compared with those of the idiopathic group. This manipulation was effective and shortened the duration of symptoms in most of the idiopathic and diabetic frozen shoulders without major complications during the procedure. Diabetic frozen shoulder showed inferior clinical results and difficulty in recovery in range of motion, which indicated that diabetic frozen shoulder should be discussed as a different entity.

  19. Shoulder Dystocia: Quality, Safety, and Risk Management Considerations.

    Science.gov (United States)

    Moni, Saila; Lee, Colleen; Goffman, Dena

    2016-12-01

    Shoulder dystocia is a term that evokes terror and fear among many physicians, midwives, and health care providers as they recollect at least 1 episode of shoulder dystocia in their careers. Shoulder dystocia can result in significant maternal and neonatal complications. Because shoulder dystocia is an urgent, unanticipated, and uncommon event with potentially catastrophic consequences, all practitioners and health care teams must be well-trained to manage this obstetric emergency. Preparation for shoulder dystocia in a systematic way, through standardization of process, practicing team-training and communication, along with technical skills, through simulation education and ongoing quality improvement initiatives will result in improved outcomes.

  20. Shoulder replacement

    Science.gov (United States)

    ... problem. Many people are able to return to sports such as golf, swimming, gardening, bowling, and others. Your new shoulder joint will last longer if less stress is placed on it. With normal use, a ...

  1. Anomalous Innervation of the Median Nerve in the Arm in the Absence of the Musculocutaneous Nerve

    Directory of Open Access Journals (Sweden)

    Khursheed Raza

    2017-03-01

    Full Text Available The brachial plexus innervates the upper extremities. While variations in the formation of the brachial plexus and its terminal branches are quite common, it is uncommon for the median nerve to innervate the muscles of the arm. During the dissection of an elderly male cadaver at the Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India, in 2016, the coracobrachialis muscle was found to be supplied by a direct branch from the lateral root of the median nerve and the musculocutaneous nerve was absent. The branches of the median nerve supplied the biceps brachii and brachialis muscles and the last branch continued as the lateral cutaneous nerve of the forearm. These variations may present atypically in cases of arm flexor paralysis or sensory loss on the lateral forearm. Knowledge of these variations is important in surgeries and during the administration of regional anaesthesia near the shoulder joint and upper arm.

  2. MR imaging of the shoulder

    International Nuclear Information System (INIS)

    Fritts, H.M.; Craig, E.; Kyle, R.; Strefling, M.; Miller, D.; Heithoff, K.; Schellhas, K.

    1988-01-01

    Magnetic resonance (MR) imaging (1.5-T unit) was performed in over 600 shoulders to evaluate shoulder pain. Ultrasound (US) and arthrography were performed in over 100 patients. Surgery was performed in over 75 patients. MR imaging offers information not well evaluated with other modalities, including bony impingement, tendinitis, bursitis, and osseous abnormalities, such as primary arthritis, avascular necrosis, occult fractures, and tumors. US and MR findings correlate well with surgical findings for medium to large rotator cuff tears. MR imaging with T2 weighting is superior for differentiating small tears from associated tendinitis. An algorithm for cost-effective shoulder imaging integrating US, MR imaging, arthrography, and computed tomographic arthrography are presented

  3. Rugby and Shoulder Trauma: A Systematic Review.

    Science.gov (United States)

    Papalia, R; Tecame, A; Torre, G; Narbona, P; Maffulli, N; Denaro, V

    2015-01-01

    Rugby is a popular contact sport worldwide. Collisions and tackles during matches and practices often lead to traumatic injuries of the shoulder. This review reports on the epidemiology of injuries, type of lesions and treatment of shoulder injuries, risk factors, such as player position, and return to sport activities. Electronic searches through PubMed (Medline), EMBASE, and Cochrane Library retrieved studies concerning shoulder injuries in rugby players. Data regarding incidence, type and mechanisms of lesion, risk factors and return to sport were extracted and analyzed. The main reported data were incidence, mechanism of injury and type of lesion. Most of the studies report tackle as the main event responsible for shoulder trauma (between 50% and 85%), while the main lesions reported were Bankart lesions, Superior Labral tear from Anterior to Posterior (SLAP tears), anterior dislocation and rotator cuff tears. Open or arthroscopic repair improve clinical outcomes. Shoulder lesions are common injuries in rugby players. Surgical treatment seems to be effective in for rotator cuff tears and shoulder instability. More and better designed studies are needed for a higher Level of Evidence analysis of this topic.

  4. Interobserver reliability of physical examination of shoulder girdle

    NARCIS (Netherlands)

    Nomden, Jettie G.; Slagers, Anton J.; Bergman, Geert; Winters, Jan C.; Kropmans, Thomas J. B.; Dijkstra, Pieter U.

    The object of this study was to assess interobserver reliability in 23 tests concerning physical examination of the shoulder girdle. A physical therapist and a physical therapist/manual therapist independently performed a physical examination of the shoulder girdle in 91 patients with shoulder

  5. Obstetric Emergencies: Shoulder Dystocia and Postpartum Hemorrhage.

    Science.gov (United States)

    Dahlke, Joshua D; Bhalwal, Asha; Chauhan, Suneet P

    2017-06-01

    Shoulder dystocia and postpartum hemorrhage represent two of the most common emergencies faced in obstetric clinical practice, both requiring prompt recognition and management to avoid significant morbidity or mortality. Shoulder dystocia is an uncommon, unpredictable, and unpreventable obstetric emergency and can be managed with appropriate intervention. Postpartum hemorrhage occurs more commonly and carries significant risk of maternal morbidity. Institutional protocols and algorithms for the prevention and management of shoulder dystocia and postpartum hemorrhage have become mainstays for clinicians. The goal of this review is to summarize the diagnosis, incidence, risk factors, and management of shoulder dystocia and postpartum hemorrhage. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. MRI findings in the painful hemiplegic shoulder

    International Nuclear Information System (INIS)

    Tavora, D.G.F.; Gama, R.L.; Bomfim, R.C.; Nakayama, M.; Silva, C.E.P.

    2010-01-01

    Aim: To evaluate the magnetic resonance imaging (MRI) findings in painful hemiplegic shoulder (PHS) in hemiplegic post-stroke patients. Materials and methods: Patients with hemiplegia following their first cerebrovascular accident who were admitted to the Sarah Network of Hospitals for Rehabilitation were studied. Forty-five patients with pain in the hemiplegic shoulder and 23 post-stroke patients without shoulder pain were investigated. MRI and radiographic findings of the hemiplegic and contralateral asymptomatic shoulders were evaluated. Results: Some MRI findings were more frequent in PHS group, including synovial capsule thickening, synovial capsule enhancement, and enhancement in the rotator cuff interval. Conclusions: Adhesive capsulitis was found to be a possible cause of PHS.

  7. MRI findings in the painful hemiplegic shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Tavora, D.G.F., E-mail: danielgurgel@sarah.b [Department of Radiology, Sarah Network of Hospitals for Rehabilitation, Fortaleza (Brazil); Gama, R.L.; Bomfim, R.C. [Department of Radiology, Sarah Network of Hospitals for Rehabilitation, Fortaleza (Brazil); Nakayama, M. [Department of Radiology, Federal University of Grande Dourados, Dourados (Brazil); Silva, C.E.P. [Department of Statistics, Sarah Network of Hospitals for Rehabilitation, Fortaleza (Brazil)

    2010-10-15

    Aim: To evaluate the magnetic resonance imaging (MRI) findings in painful hemiplegic shoulder (PHS) in hemiplegic post-stroke patients. Materials and methods: Patients with hemiplegia following their first cerebrovascular accident who were admitted to the Sarah Network of Hospitals for Rehabilitation were studied. Forty-five patients with pain in the hemiplegic shoulder and 23 post-stroke patients without shoulder pain were investigated. MRI and radiographic findings of the hemiplegic and contralateral asymptomatic shoulders were evaluated. Results: Some MRI findings were more frequent in PHS group, including synovial capsule thickening, synovial capsule enhancement, and enhancement in the rotator cuff interval. Conclusions: Adhesive capsulitis was found to be a possible cause of PHS.

  8. Athletes’ Shoulder Joints Traumas Manual Therapy Rehabilitation

    OpenAIRE

    A.N. Sykhorychko; Т.G. Kovalenko; М.А. Sykhorychko

    2012-01-01

    The examination of 60 athletes, aged 18-30, suffering from chronic pains in shoulder joints was conducted. So, 20 women and 20 men were engaged in track and field and team sports, 15 in weightlifting and strength sports, 5 women in strength sports. Shoulder Joints Traumas Manual Therapy enables to reduce pain syndrome, restore shoulder joint flexibility, normalize trophism after trauma and normalize cervicothoracic transition biomechanics.

  9. The volleyball athlete's shoulder: biomechanical adaptations and injury associations.

    Science.gov (United States)

    Challoumas, Dimitrios; Stavrou, Antonio; Dimitrakakis, Georgios

    2017-06-01

    In volleyball, the dominant shoulder of the athlete undergoes biomechanical and morphological adaptations; however, definitive conclusions about their exact nature, aetiology, purpose and associations with shoulder injury have not been reached. We present a systematic review of the existing literature describing biomechanical adaptations in the dominant shoulders of volleyball players and factors that may predispose to shoulder pain/injury. A thorough literature search via Medline, EMBASE and SCOPUS was conducted for original studies of volleyball players and 15 eligible articles were identified. Assessment of study quality was performed using the STROBE statement. The reviewed literature supports the existence of a glenohumeral internal rotation deficit (GIRD) and a possible (and less pronounced) external rotation gain in the dominant vs. the non-dominant shoulder of volleyball athletes. Unlike other overhead sports, the GIRD in volleyball athletes appears to be anatomical as a response to the repetitive overhead movements and not to be associated with shoulder pain/injury. Additionally, the dominant shoulder exhibits muscular imbalance, which appears to be a significant risk factor for shoulder pain. Strengthening of the external rotators should be used alongside shoulder stretching and joint mobilisations, core strengthening and optimisation of spike technique as part of injury management and prevention programmes.

  10. Suprascapular block in the therapy of chronic pain in the shoulder and the shoulder joint: Suprascapular block

    Directory of Open Access Journals (Sweden)

    Palibrk Ivan

    2016-01-01

    Full Text Available Introduction: Chronic pain in the shoulder and the shoulder joint is a very common pathology in modern human population. The etiology of chronic pain is often unknown, although the trauma, degenerative diseases, inflammation, tumors and neurological disease appear as common etiologic factors. Patients with this pain had a significantly reduced quality of life.1,2 Method: During the two years, twelve patients diagnosed painful shoulder syndrome. Eleven of the twelve patients involved in the study had started physical therapy. Under the physical treatment pain intensity decreased, but not completely. Hand had reduced mobility. We applied a suprascapular block. We used 1 ml (7 mg betamethasone. Results: Suprascapular block was applied to the eleven patients in physical therapy. After three days of application, the pain was significantly reduced, by 50% in seven patients. Mobility of the hand was greatly improved. In three of the remaining four patients the block was repeated after one month. The pain was significantly smaller after that. Physical therapy is done all the time. Conclusion: The treatment of chronic pain in the shoulder and the shoulder joint is multidisciplinary. In some cases, the use of corticosteroids suprascapular block is very useful.

  11. Magnetic Resonance Imaging of the Rotator Cuff in Destroyed Rheumatoid Shoulder: Comparison with Findings during Shoulder Replacement

    International Nuclear Information System (INIS)

    Soini, I.; Belt, E.A.; Niemitukia, L.; Maeenpaeae, H.M.; Kautiainen, H.J.

    2004-01-01

    Purpose: To evaluate the predictive value of preoperative magnetic resonance imaging (MRI) with respect to rotator cuff ruptures. Material and Methods: Thirty-one patients with rheumatic disease underwent preoperative MRI before shoulder arthroplasty. The scans were reviewed independently by two experienced radiologists. Three surgeons performed all the replacements (hemiarthroplasties), and the condition of the rotator cuff was assessed. Complete and massive tears of the rotator cuff were recorded and compared at surgery and on MRI. Results: With MRI, 21 shoulders (68%) were classified as having complete or massive tears of the rotator cuff and at surgery 14 shoulders (45%). Cohen's kappa coefficient was 0.44 (95% CI: 0.16 to 0.72) and accuracy 0.71 (95% CI: 0.52 to 0.86). Conclusion: In severely destroyed rheumatoid shoulder, the findings of soft tissues were incoherent both with MRI and at surgery. The integrity of tendons could not readily be elucidated with MRI because of an inflammatory process and scarred tissues; in surgery, too, changes were frequently difficult to categorize. Preoperative MRI of severely destroyed rheumatoid shoulder before arthroplasty turned out to be of only minor importance

  12. Designing and testing lightweight shoulder prostheses with hybrid actuators for movements involved in typical activities of daily living and impact absorption

    Directory of Open Access Journals (Sweden)

    Sekine M

    2015-07-01

    Full Text Available Masashi Sekine,1,2 Kahori Kita,1 Wenwei Yu1 1Center for Frontier Medical Engineering, 2Graduate School of Engineering, Chiba University, Chiba, Japan Abstract: Unlike forearm amputees, transhumeral amputees have residual stumps that are too small to provide a sufficient range of operation for their prosthetic parts to perform usual activities of daily living. Furthermore, it is difficult for small residual stumps to provide sufficient impact absorption for safe manipulation in daily living, as intact arms do. Therefore, substitution of upper limb function in transhumeral amputees requires a sufficient range of motion and sufficient viscoelasticity for shoulder prostheses under critical weight and dimension constraints. We propose the use of two different types of actuators, ie, pneumatic elastic actuators (PEAs and servo motors. PEAs offer high power-to-weight performance and have intrinsic viscoelasticity in comparison with motors or standard industrial pneumatic cylinder actuators. However, the usefulness of PEAs in large working spaces is limited because of their short strokes. Servo motors, in contrast, can be used to achieve large ranges of motion. In this study, the relationship between the force and stroke of PEAs was investigated. The impact absorption of both types of actuators was measured using a single degree-of-freedom prototype to evaluate actuator compliance for safety purposes. Based on the fundamental properties of the actuators identified, a four degree-of-freedom robotic arm is proposed for prosthetic use. The configuration of the actuators and functional parts was designed to achieve a specified range of motion and torque calculated from the results of a simulation of typical movements performed in usual activities of daily living. Our experimental results showed that the requirements for the shoulder prostheses could be satisfied. Keywords: shoulder prosthesis, hybrid actuation, pneumatic elastic actuator, antagonistic

  13. Athletes’ Shoulder Joints Traumas Manual Therapy Rehabilitation

    Directory of Open Access Journals (Sweden)

    A.N. Sykhorychko

    2012-06-01

    Full Text Available The examination of 60 athletes, aged 18-30, suffering from chronic pains in shoulder joints was conducted. So, 20 women and 20 men were engaged in track and field and team sports, 15 in weightlifting and strength sports, 5 women in strength sports. Shoulder Joints Traumas Manual Therapy enables to reduce pain syndrome, restore shoulder joint flexibility, normalize trophism after trauma and normalize cervicothoracic transition biomechanics.

  14. Shoulder Injury Incidence Rates in NASA Astronauts

    Science.gov (United States)

    Laughlin, Mitzi S.; Murray, Jocelyn D.; Foy, Millennia; Wear, Mary L.; Van Baalen, Mary

    2014-01-01

    Evaluation of the astronaut shoulder injury rates began with an operational concern at the Neutral Buoyancy Laboratory (NBL) during Extravehicular Activity (EVA) training. An astronaut suffered a shoulder injury during an NBL training run and commented that it was possibly due to a hardware issue. During the subsequent investigation, questions arose regarding the rate of shoulder injuries in recent years and over the entire history of the astronaut corps.

  15. High Fidelity In Situ Shoulder Dystocia Simulation

    Directory of Open Access Journals (Sweden)

    Andrew Pelikan, MD

    2018-04-01

    Full Text Available Audience: Resident physicians, emergency department (ED staff Introduction: Precipitous deliveries are high acuity, low occurrence in most emergency departments. Shoulder dystocia is a rare but potentially fatal complication of labor that can be relieved by specific maneuvers that must be implemented in a timely manner. This simulation is designed to educate resident learners on the critical management steps in a shoulder dystocia presenting to the emergency department. A special aspect of this simulation is the unique utilization of the “Noelle” model with an instructing physician at bedside maneuvering the fetus through the stations of labor and providing subtle adjustments to fetal positioning not possible though a mechanized model. A literature search of “shoulder dystocia simulation” consists primarily of obstetrics and mid-wife journals, many of which utilize various mannequin models. None of the reviewed articles utilized a bedside provider maneuvering the fetus with the Noelle model, making this method unique. While the Noelle model is equipped with a remote-controlled motor that automatically rotates and delivers the baby either to the head or to the shoulders and can produce a turtle sign and which will prevent delivery of the baby until signaled to do so by the instructor, using the bedside instructor method allows this simulation to be reproduced with less mechanistically advanced and lower cost models.1-5 Objectives: At the end of this simulation, learners will: 1 Recognize impending delivery and mobilize appropriate resources (ie, both obstetrics [OB] and NICU/pediatrics; 2 Identify risk factors for shoulder dystocia based on history and physical; 3 Recognize shoulder dystocia during delivery; 4 Demonstrate maneuvers to relieve shoulder dystocia; 5 Communicate with team members and nursing staff during resuscitation of a critically ill patient. Method: High-fidelity simulation. Topics: High fidelity, in situ, Noelle model

  16. Shoulder pain -- a common problem in world-class badminton players.

    Science.gov (United States)

    Fahlström, Martin; Yeap, Joo Seng; Alfredson, Håkan; Söderman, Kerstin

    2006-06-01

    Badminton is a sport that requires a lot of over-shoulder motion, with the shoulder in abduction/external rotation. This questionnaire study on 188 international top-level badminton players during the World Mixed Team Championships showed that previous or present shoulder pain on the dominant side was reported by 52% of the players. Previous shoulder pain was reported by 37% of the players and on-going shoulder pain by 20% of the players. There were no significant differences in the prevalence of shoulder pain between men and women. The majority of the shoulder pain had started gradually. The pain was usually associated with shoulder activity, and stiffness was a common, associated symptom. Furthermore, the shoulder pain was associated with consequences such as sleeping disturbances, changes in training and competition habits, and it also affected activities of daily living. The majority of the players had sought medical advice and had been given different kinds of treatment. The study showed that shoulder pain is a common and significant problem in world-class badminton players, and the consequences are most likely of importance for their training and playing capacity.

  17. Clinically relevant magnetic resonance imaging (MRI findings in elite swimmers’ shoulders

    Directory of Open Access Journals (Sweden)

    Arno Celliers

    2017-01-01

    Objective: To assess clinically relevant MRI findings in the shoulders of symptomatic and asymptomatic elite swimmers. Method: Twenty (aged 16–23 years elite swimmers completed questionnaires on their swimming training, pain and shoulder function. MRI of both shoulders (n = 40 were performed and all swimmers were given a standardised clinical shoulder examination. Results: Both shoulders of 11 male and 9 female elite swimmers (n = 40 were examined. Eleven of the 40 shoulders were clinically symptomatic and 29 were asymptomatic. The most common clinical finding in both the symptomatic and asymptomatic shoulders was impingement during internal rotation, with impingement in 54.5% of the symptomatic shoulders and in 31.0% of the asymptomatic shoulders. The most common MRI findings in the symptomatic and asymptomatic shoulders were supraspinatus tendinosis (45.5% vs. 20.7%, subacromial subdeltoid fluid (45.5% vs. 34.5%, increased signal in the AC Joint (45.5% vs. 37.9% and AC joint arthrosis (36.4% vs. 34.5%. Thirty-nine (97.5% of the shoulders showed abnormal MRI features. Conclusion: MRI findings in the symptomatic and asymptomatic shoulders of young elite swimmers are similar and care should be taken when reporting shoulder MRIs in these athletes. Asymptomatic shoulders demonstrate manifold MRI abnormalities that may be radiologically significant but appear not to be clinically significant.

  18. An MRI study on the relations between muscle atrophy, shoulder function and glenohumeral deformity in shoulders of children with obstetric brachial plexus injury

    Directory of Open Access Journals (Sweden)

    van Doorn-Loogman Mirjam H

    2009-05-01

    Full Text Available Abstract Background A substantial number of children with an obstetric brachial plexus lesion (OBPL will develop internal rotation adduction contractures of the shoulder, posterior humeral head subluxations and glenohumeral deformities. Their active shoulder function is generally limited and a recent study showed that their shoulder muscles were atrophic. This study focuses on the role of shoulder muscles in glenohumeral deformation and function. Methods This is a prospective study on 24 children with unilateral OBPL, who had internal rotation contractures of the shoulder (mean age 3.3 years, range 14.7 months to 7.3 years. Using MR imaging from both shoulders the following parameters were assessed: glenoid form, glenoscapular angle, subluxation of the humeral head, thickness and segmental volume of the subscapularis, infraspinatus and deltoid muscles. Shoulder function was assessed measuring passive external rotation of the shoulder and using the Mallet score for active function. Statistical tests used are t-tests, Spearman's rho, Pearsons r and logistic regression. Results The affected shoulders showed significantly reduced muscle sizes, increased glenoid retroversion and posterior subluxation. Mean muscle size compared to the normal side was: subscapularis 51%, infraspinatus 61% and deltoid 76%. Glenoid form was related to infraspinatus muscle atrophy. Subluxation was related to both infraspinatus and subscapularis atrophy. There was no relation between atrophy of muscles and passive external rotation. Muscle atrophy was not related to the Mallet score or its dimensions. Conclusion Muscle atrophy was more severe in the subscapularis muscle than in infraspinatus and deltoid. As the muscle ratios are not related to passive external rotation nor to active function of the shoulder, there must be other muscle properties influencing shoulder function.

  19. The critical shoulder angle is associated with osteoarthritis in the shoulder but not rotator cuff tears

    DEFF Research Database (Denmark)

    Bjarnison, Arnar O; Sørensen, Thomas J; Kallemose, Thomas

    2017-01-01

    BACKGROUND: In 2013 Moor et al introduced the concept of the critical shoulder angle (CSA) and suggested that an abnormal CSA was a leading factor in development of rotator cuff tear (RCT) and osteoarthritis (OA) of the shoulder. This study assessed whether the CSA was associated with RCT and OA...

  20. History of shoulder instability surgery.

    Science.gov (United States)

    Randelli, Pietro; Cucchi, Davide; Butt, Usman

    2016-02-01

    The surgical management of shoulder instability is an expanding and increasingly complex area of study within orthopaedics. This article describes the history and evolution of shoulder instability surgery, examining the development of its key principles, the currently accepted concepts and available surgical interventions. A comprehensive review of the available literature was performed using PubMed. The reference lists of reviewed articles were also scrutinised to ensure relevant information was included. The various types of shoulder instability including anterior, posterior and multidirectional instability are discussed, focussing on the history of surgical management of these topics, the current concepts and the results of available surgical interventions. The last century has seen important advancements in the understanding and treatment of shoulder instability. The transition from open to arthroscopic surgery has allowed the discovery of previously unrecognised pathologic entities and facilitated techniques to treat these. Nevertheless, open surgery still produces comparable results in the treatment of many instability-related conditions and is often required in complex or revision cases, particularly in the presence of bone loss. More high-quality research is required to better understand and characterise this spectrum of conditions so that successful evidence-based management algorithms can be developed. IV.

  1. Do axes of rotation change during fast and slow motions of the dominant and non-dominate arms?

    Directory of Open Access Journals (Sweden)

    Pagano Christopher

    2011-12-01

    Full Text Available The velocity-dependent change in rotational axes observed in the control of unconstrained 3D arm rotations for the dominant limb seems to conform to a minimum inertia resistance (MIR principle [4]. This is an efficient biomechanical solution that allows for the reduction of torques. We tested whether the MIR principle governs rotating movement when subjects were instructed to maintain the shoulder-elbow joint axis close to horizontal for both dominant and non dominant limbs. Subjects (n=12 performed externalinternal rotations of their arms in two angular positions (90° versus 150°, two angular velocities (slow (S versus fast (F, and in two sensory conditions (kinaesthetic (K versus visuo- kinaesthetic (VK. We expected more scattered displacements of the rotation axis employed for rotating the non dominant limb compared to the dominant limb. The results showed that the rotational axis of a multiarticulated limb coincided with SH-EL at S & F velocity for both arms.

  2. Avoiding Shoulder Injury from Resistance Training.

    Science.gov (United States)

    Durall, Chris J.; Manske, Robert C.; Davies, George J.

    2001-01-01

    Identifies shoulder exercises commonly performed in fitness centers that may contribute to or exacerbate glenohumeral joint (shoulder) injury, describing alternative exercises that may be substituted and a offering rationale for the variations. The article focuses on anterior and posterior glenohumeral instability, subacromial impingement (primary…

  3. Difference in clinical outcome between total shoulder arthroplasty and reverse shoulder arthroplasty used in hemiarthroplasty revision surgery

    NARCIS (Netherlands)

    Hartel, B.P.; Alta, T.D.; Sewnath, M.E.; Willems, W.J.H.

    2015-01-01

    INTRODUCTION: The increase of shoulder replacements will lead to a higher revision rate of shoulder arthroplasties. The aim of this study is to evaluate the clinical results of revision surgery performed in our hospital, distinguish the differences in clinical outcome according to revision

  4. Comparative characteristics of shoulder blade (Scapula) and shoulder bone (Humerus) of roe deer (Capreolus capreolus) and sheep (Ovis aries) in order to determine the animal species

    OpenAIRE

    Blagojević Miloš; Nikolić Zora; Prokić Bogomir Bolka; Ćupić-Miladinović Dejana

    2016-01-01

    In illegal hunting it is often possible only on the basis of morphological characteristics to determine the animal species. By the method of comparison there was performed the forensic analysis of roe deer and sheep osteological features. For the purpose of investigating the shoulder blade (Scapula) and shoulder bone (Humerus) comparative characteristics, there were used 6 shoulder blades and 6 shoulder bones of roe deer and 8 shoulder blades and 8 shoulder...

  5. CT diagnosis with shoulder joint injuries

    International Nuclear Information System (INIS)

    Gay, B.; Hoerl, M.; Schindler, G.

    1986-01-01

    With recidivistic shoulder luxation the CT examination makes possible the objective comprehension of predisposable anatomical evidence as well as the proof of posttraumatic changes. Changes in the acetabular margin (Bankart lesion) as well as in the humerus head (Hills-Sachs lesion) are depicted with recidivistic shoulder luxation as the morphological substrate of the posttraumatic damage. Individual examinations of 83 patients with recidivistic shoulder luxations showed that the mentioned changes often appear in combinations. With the CT examination the Hills-Sachs lesion can be comprehended and its location, extension and depth can be judged as well. (orig./MG) [de

  6. Rugby and Shoulder Trauma: A Systematic Review

    OpenAIRE

    Papalia, R.; Tecame, A.; Torre, G.; Narbona, P.; Maffulli, N.; Denaro, V.

    2014-01-01

    Rugby is a popular contact sport worldwide. Collisions and tackles during matches and practices often lead to traumatic injuries of the shoulder. This review reports on the epidemiology of injuries, type of lesions and treatment of shoulder injuries, risk factors, such as player position, and return to sport activities. Electronic searches through PubMed (Medline), EMBASE, and Cochrane Library retrieved studies concerning shoulder injuries in rugby players. Data regarding incidence, type and ...

  7. Diaphragm-Sparing Nerve Blocks for Shoulder Surgery.

    Science.gov (United States)

    Tran, De Q H; Elgueta, Maria Francisca; Aliste, Julian; Finlayson, Roderick J

    Shoulder surgery can result in significant postoperative pain. Interscalene brachial plexus blocks (ISBs) constitute the current criterion standard for analgesia but may be contraindicated in patients with pulmonary pathology due to the inherent risk of phrenic nerve block and symptomatic hemidiaphragmatic paralysis. Although ultrasound-guided ISB with small volumes (5 mL), dilute local anesthetic (LA) concentrations, and LA injection 4 mm lateral to the brachial plexus have been shown to reduce the risk of phrenic nerve block, no single intervention can decrease its incidence below 20%. Ultrasound-guided supraclavicular blocks with LA injection posterolateral to the brachial plexus may anesthetize the shoulder without incidental diaphragmatic dysfunction, but further confirmatory trials are required. Ultrasound-guided C7 root blocks also seem to offer an attractive, diaphragm-sparing alternative to ISB. However, additional large-scale studies are needed to confirm their efficacy and to quantify the risk of periforaminal vascular breach. Combined axillary-suprascapular nerve blocks may provide adequate postoperative analgesia for minor shoulder surgery but do not compare favorably to ISB for major surgical procedures. One intriguing solution lies in the combined use of infraclavicular brachial plexus blocks and suprascapular nerve blocks. Theoretically, the infraclavicular approach targets the posterior and lateral cords, thus anesthetizing the axillary nerve (which supplies the anterior and posterior shoulder joint), as well as the subscapular and lateral pectoral nerves (both of which supply the anterior shoulder joint), whereas the suprascapular nerve block anesthetizes the posterior shoulder. Future randomized trials are required to validate the efficacy of combined infraclavicular-suprascapular blocks for shoulder surgery.

  8. Little Leaguer's shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Fleming, J.L.; Hollingsworth, C.L.; Bisset, G.S. [Department of Radiology, Duke University Medical Center, Durham, NC (United States); Squire, D.L. [Department of Pediatrics, Duke University Medical Center, Durham, NC (United States)

    2004-06-01

    A case of Little Leaguer's shoulder in a skeletally immature patient is described with a review of the English literature. This entity manifests as widening of the proximal humeral physis and is well known to our orthopedic colleagues. To our knowledge, however, there is little in the current radiologic literature describing Little Leaguer's shoulder. We describe such a case. (orig.)

  9. Shoulder Fractures

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Shoulder Fractures Email to a friend * required fields ...

  10. All-in-One Magnetic Resonance Arthrography of the Shoulder in a Vertically Open Magnetic Resonance Unit

    Energy Technology Data Exchange (ETDEWEB)

    Vandevenne, J.E.; Vanhoenacker, F.; Beaulieu, C.F.; Bergman, A.; Butts Pauly, K.; Dillingham, M.F.; Lang, P.K. (Dept. of Radiology, Univ. Hospital Antwerp, Edegem-Antwerp (Belgium))

    2008-10-15

    Background: Magnetic resonance (MR) arthrography frequently involves joint injection under imaging guidance followed by MR imaging in static positions. Purpose: To evaluate if MR arthrography of the shoulder joint can be performed in a comprehensive fashion combining the MR-guided injection procedure, static MR imaging, and dynamic motion MR imaging in a single test. Material and Methods: Twenty-three shoulder joints were injected with Gd-DTPA2- under MR guidance. Static MR imaging was performed and included a three-point Dixon method to achieve water-selective images. Dynamic motion MR imaging with and without applying pressure to the upper arm was used to evaluate glenohumeral joint instability. In 10 cases, surgical correlation was available. Results: The all-in-one MR arthrography technique was successful in all patients, and took an average time of 65 min. All but one glenohumeral injection procedure were performed with a single needle pass, and no complications were observed. Out of eight labrum tears seen with static MR imaging, seven were confirmed at surgery. In 10 cases, dynamic motion MR imaging correlated well with the surgeon's intraoperative evaluation for presence and direction of instability. Conclusion: MR arthrography of the shoulder joint using a vertically open magnet can be performed as a single comprehensive test, including the injection and the static and dynamic motion MR imaging. Good diagnostic accuracy for intraarticular lesions and glenohumeral instability was found in a small sample.

  11. Proprioception of the shoulder after stroke

    NARCIS (Netherlands)

    Niessen, M.H.M.; Veeger, H.E.J.; Koppe, P.A.; Konijnenbelt, M.; van Dieen, J.H.

    2008-01-01

    Niessen MH, Veeger DH, Koppe PA, Konijnenbelt MH, van Dieën J, Janssen TW. Proprioception of the shoulder after stroke. Objective: To investigate position sense and kinesthesia of the shoulders of stroke patients. Design: Case-control study. Setting: A rehabilitation center. Participants: A total of

  12. Shoulder joint loading and posture during medicine cart pushing task.

    Science.gov (United States)

    Xu, Xu; Lin, Jia-Hua; Boyer, Jon

    2013-01-01

    Excessive physical loads and awkward shoulder postures during pushing and pulling are risk factors for shoulder pain. Pushing a medicine cart is a major component of a work shift for nurses and medical assistants in hospitals and other health care facilities. A laboratory experiment was conducted to examine the effects of common factors (e.g., lane congestion, cart load stability, floor surface friction) on shoulder joint moment and shoulder elevation angle of participants during cart pushing. Participants pushed a medicine cart on straight tracks and turning around right-angle corners. Peak shoulder joint moments reached 25.1 Nm, 20.3 Nm, and 26.8 Nm for initial, transition, and turning phases of the pushing tasks, indicating that shoulder joint loading while pushing a medical cart is comparable to levels previously reported from heavy manual activities encountered in industry (e.g., garbage collection). Also, except for user experience, all other main study factors, including congestion level, cart load stability, location of transition strip, shoulder tendency, surface friction, and handedness, significantly influenced shoulder joint moment and shoulder elevation angle. The findings provide a better understanding of shoulder exposures associated with medicine cart operations and may be helpful in designing and optimizing the physical environment where medicine carts are used.

  13. Sex differences in the shoulder joint position sense acuity: a cross-sectional study.

    Science.gov (United States)

    Vafadar, Amir K; Côté, Julie N; Archambault, Philippe S

    2015-09-30

    Work-related musculoskeletal disorders (WMSD) is the most expensive form of work disability. Female sex has been considered as an individual risk factor for the development of WMSD, specifically in the neck and shoulder region. One of the factors that might contribute to the higher injury rate in women is possible differences in neuromuscular control. Accordingly the purpose of this study was to estimate the effect of sex on shoulder joint position sense acuity (as a part of shoulder neuromuscular control) in healthy individuals. Twenty-eight healthy participants, 14 females and 14 males were recruited for this study. To test position sense acuity, subjects were asked to flex their dominant shoulder to one of the three pre-defined angle ranges (low, mid and high-ranges) with eyes closed, hold their arm in that position for three seconds, go back to the starting position and then immediately replicate the same joint flexion angle, while the difference between the reproduced and original angle was taken as the measure of position sense error. The errors were measured using Vicon motion capture system. Subjects reproduced nine positions in total (3 ranges × 3 trials each). Calculation of absolute repositioning error (magnitude of error) showed no significant difference between men and women (p-value ≥ 0.05). However, the analysis of the direction of error (constant error) showed a significant difference between the sexes, as women tended to mostly overestimate the target, whereas men tended to both overestimate and underestimate the target (p-value ≤ 0.01, observed power = 0.79). The results also showed that men had a significantly more variable error, indicating more variability in their position sense, compared to women (p-value ≤ 0.05, observed power = 0.78). Differences observed in the constant JPS error suggest that men and women might use different neuromuscular control strategies in the upper limb. In addition, higher JPS

  14. Cryotherapy does not impair shoulder joint position sense.

    Science.gov (United States)

    Dover, Geoffrey; Powers, Michael E

    2004-08-01

    To determine the effects of a cryotherapy treatment on shoulder proprioception. Crossover design with repeated measures. University athletic training and sports medicine research laboratory. Thirty healthy subjects (15 women, 15 men). A 30-minute cryotherapy treatment. Joint position sense was measured in the dominant shoulder by using an inclinometer before and after receiving 30 minutes of either no ice or a 1-kg ice bag application. Skin temperature was measured below the tip of the acromion process and recorded every 5 minutes for the entire 30 minutes and immediately after testing. Three different types of error scores were calculated for data analyses and used to determine proprioception. Separate analyses of absolute, constant, and variable error failed to identify changes in shoulder joint proprioception as a function of the cryotherapy application. Application of an ice bag to the shoulder does not impair joint position sense. The control of proprioception at the shoulder may be more complex than at other joints in the body. Clinical implications may involve modifying rehabilitation considerations when managing shoulder injuries.

  15. Psychosocial factors and shoulder symptom development among workers.

    Science.gov (United States)

    Smith, Caroline K; Silverstein, Barbara A; Fan, Z Joyce; Bao, Stephen; Johnson, Peter W

    2009-01-01

    Shoulder injuries are a common cause of pain and discomfort. Many work-related factors have been associated with the onset of shoulder symptoms. The psychosocial concepts in the demand-control model have been studied in association with musculoskeletal symptoms but with heterogeneous findings. The purpose of this study was to assess the relationship between the psychosocial concepts of the demand-control model and the incidence of shoulder symptoms in a working population. After following 424 subjects for approximately 1 year, 85 incident cases were identified from self-reported data. Cox proportional hazards modeling was used to assess the associations between shoulder symptoms and demand-control model quadrants. Cases were more likely to be female and report other upper extremity symptoms at baseline (P determine demand-control quadrants was successful in identifying subjects at risk of developing work-related shoulder symptoms. Research is needed to determine if this relationship holds with clinically diagnosed shoulder and other upper extremity musculoskeletal disorders. This may be part of a simple tool for assessing risk of developing these UEMSDs. (c) 2008 Wiley-Liss, Inc.

  16. Paraplegia and the shoulder.

    Science.gov (United States)

    Hastings, Jennifer; Goldstein, Barry

    2004-08-01

    Among consumers, families, therapists, physicians, and other rehabilitation professionals, there has been an increasing interest in shoulder pain associated with spinal cord injury. These disorders primarily affect the soft tissues, including the tendons (eg, rotator cuff tendonitis and bicipital tendinitis), muscles (eg, myalgias and myofascial pain syndromes), and bursae. Disorders of bone and joints also have been of interest (eg, osteoporosis and osteoarthritis of the acromioclavicular and glenohumeral joints). This article addresses the historical context, epidemiology, pathophysiology,diagnosis, prevention, and treatment of shoulder pain as it relates to patients with spinal cord injury.

  17. Mortality after shoulder arthroplasty

    DEFF Research Database (Denmark)

    Amundsen, Alexander; Rasmussen, Jeppe Vejlgaard; Olsen, Bo Sanderhoff

    2016-01-01

    BACKGROUND: The primary aim was to quantify the 30-day, 90-day, and 1-year mortality rates after primary shoulder replacement. The secondary aims were to assess the association between mortality and diagnoses and to compare the mortality rate with that of the general population. METHODS: The study...... included 5853 primary operations reported to the Danish Shoulder Arthroplasty Registry between 2006 and 2012. Information about deaths was obtained from the Danish Cause of Death Register and the Danish Civil Registration System. Age- and sex-adjusted control groups were retrieved from Statistics Denmark...

  18. Shoulder impairment before breast cancer surgery.

    Science.gov (United States)

    Flores, Ann Marie; Dwyer, Kathleen

    2014-09-01

    To compare pre- and post-operative shoulder active range of motion (AROM) values from female breast cancer survivors to population norm values for shoulder AROM; and to compare shoulder AROM differences pre- and post-surgery between female African American and White breast cancer survivors (BCA). This pilot study used a convenience sample and longitudinal design measuring participants 2 times (T0 = baseline, after biopsy but within 2 weeks before BCA surgery; T1 = 2 nd postoperative week). The U.S. has the largest BCA survivor population in history and yet the mortality burden remains highest among AA BCA survivors. AAs may also have greater burden of physical and functional side effects compared to whites and the general population. The data were collected from a convenience sample (n = 33; n AA = 9, n W = 24) and included data on shoulder AROM, medical chart review for pre- and co-morbid conditions, and self-reported demographics and medical history. We used t-tests to compare sample AROM means to population norms. We then compared our sample across 2 timepoints (T0 = pre-surgery; T1 = 2 weeks post-surgery) using independent samples t-tests and repeated measures analysis of variance (p shoulder abduction (at T0) and flexion (at T1) than whites. However, 100% had significantly reduced AROM for all movements at T0 (prior to surgery but after biopsy) when compared to population norms. The significant reduction in shoulder AROM after biopsy but before surgery points to a possible unmet need for early physical therapy intervention. Further research using randomized controlled trial design is recommended.

  19. Simple shoulder test and Oxford Shoulder Score: Persian translation and cross-cultural validation.

    Science.gov (United States)

    Naghdi, Soofia; Nakhostin Ansari, Noureddin; Rustaie, Nilufar; Akbari, Mohammad; Ebadi, Safoora; Senobari, Maryam; Hasson, Scott

    2015-12-01

    To translate, culturally adapt, and validate the simple shoulder test (SST) and Oxford Shoulder Score (OSS) into Persian language using a cross-sectional and prospective cohort design. A standard forward and backward translation was followed to culturally adapt the SST and the OSS into Persian language. Psychometric properties of floor and ceiling effects, construct convergent validity, discriminant validity, internal consistency reliability, test-retest reliability, standard error of the measurement (SEM), smallest detectable change (SDC), and factor structure were determined. One hundred patients with shoulder disorders and 50 healthy subjects participated in the study. The PSST and the POSS showed no missing responses. No floor or ceiling effects were observed. Both the PSST and POSS detected differences between patients and healthy subjects supporting their discriminant validity. Construct convergent validity was confirmed by a very good correlation between the PSST and POSS (r = 0.68). There was high internal consistency for both the PSST (α = 0.73) and the POSS (α = 0.91 and 0.92). Test-retest reliability with 1-week interval was excellent (ICCagreement = 0.94 for PSST and 0.90 for POSS). Factor analyses demonstrated a three-factor solution for the PSST (49.7 % of variance) and a two-factor solution for the POSS (61.6 % of variance). The SEM/SDC was satisfactory for PSST (5.5/15.3) and POSS (6.8/18.8). The PSST and POSS are valid and reliable outcome measures for assessing functional limitations in Persian-speaking patients with shoulder disorders.

  20. Online resources for shoulder instability: what are patients reading?

    Science.gov (United States)

    Garcia, Grant H; Taylor, Samuel A; Dy, Christopher J; Christ, Alexander; Patel, Ronak M; Dines, Joshua S

    2014-10-15

    Evaluations of the medical literature suggest that many online sites provide poor-quality information. The purpose of our study was to investigate the value of online resources for patient education about shoulder instability. Three search terms ("shoulder instability," "loose shoulder," and "shoulder dislocation") were entered into three Internet search engines. Three orthopaedic residents independently gauged the quality and accuracy of the information with use of a set of predetermined scoring criteria, in addition to noting whether or not four potential surgery options were mentioned. The readability of the web sites was evaluated with use of the Flesch-Kincaid score. Eighty-two unique web sites were evaluated. Quality and accuracy were significantly higher with use of the term "shoulder instability" compared with the term "loose shoulder" (quality, p reading level was significantly more advanced for the "shoulder instability" web sites (p reading levels above the eighth grade level (p = 0.001) (88% of web sites). Only twenty-three sites (28%) mentioned surgical options for shoulder instability, and of these, only eight mentioned thermal capsulorrhaphy as a primary treatment. Online information regarding shoulder instability is often inaccurate and/or at an inappropriately high reading level. The quality of information is highly dependent on the specific search term used. Clinicians need to be aware of the information that is available online and should help direct patients to proper sites and guide Internet search terms. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

  1. Training of goal directed arm movements with motion interactive video games in children with cerebral palsy - a kinematic evaluation.

    Science.gov (United States)

    Sandlund, Marlene; Domellöf, Erik; Grip, Helena; Rönnqvist, Louise; Häger, Charlotte K

    2014-10-01

    The main aim of this study was to evaluate the quality of goal-directed arm movements in 15 children with cerebral palsy (CP) following four weeks of home-based training with motion interactive video games. A further aim was to investigate the applicability and characteristics of kinematic parameters in a virtual context in comparison to a physical context. Kinematics and kinetics were captured while the children performed arm movements directed towards both virtual and physical targets. The children's movement precision improved, their centre of pressure paths decreased, as did the variability in maximal shoulder angles when reaching for virtual objects. Transfer to a situation with physical targets was mainly indicated by increased movement smoothness. Training with motion interactive games seems to improve arm motor control in children with CP. The results highlight the importance of considering both the context and the task itself when investigating kinematic parameters.

  2. Investigation of CT picture in so-called loose shoulder

    International Nuclear Information System (INIS)

    Kuroda, Shigehito; Sakamaki, Hiroshi; Matsuoka, Akira; Moriishi, Takeji; Takada, Keiichi.

    1985-01-01

    CT picture of the shoulder joint was analyzed in 124 shoulders (114 patients). A line perpendicular to a given line between the precornu of acetabular tegmen (A) and the postcornu of acetabular tegmen (B) was drawn and the intersection where the line and the caput humeri meet (C) was obtained. The angle of CAB was defined as the backward angular aperture of the acetabular tegmen. The angular aperture was 26.2 0 +-1.9 in 16 so-called loose shoulders, 17.3 0 +-1.0 in 28 loose shoulders restricted to the inward rotation, and 12.2 0 +-0.4 in 80 normal shoulders, showing a distinct correlation between the angular aperture and the degree of loose shoulder. An increased backward angular aperture of the acetabular tegmen was considered greatly attributable to the forward glenohumeral movement resulting from malformation of the acetabular tegmen and flaccidity of the joint. Glenoid osteotomy was thus performed in 9 patients, 6 of whom underwent CT scanning before and after osteotomy. Coronal and transverse CT images of the shoulder joint disclosed a noticeable improvement of the glenohumeral alignment. The angular aperture shown on CT seems to be of major importance not only in the diagnosis of so-called loose shoulder but also in surgical choice. (Namekawa, K.)

  3. ANALYSIS OF LEVEL OF BOTH SHOULDERS IN PHYSICAL THERAPY STUDENTS

    Directory of Open Access Journals (Sweden)

    Ghazala Noor Nizami

    2017-09-01

    Full Text Available Background: During lectures, usually students sit in an awkward position, for prolonged period of time and that may cause postural instability. For a good posture, bilateral landmarks should be on same level, when viewed from front or behind. Therefore, both shoulders should also be on same level as well. Any alteration in level of shoulders in healthy individual may lead to deformity in spine or extremity. The objective of this study was to analyze the level of both shoulders in the physical therapy students and to find its correlation with the perception of students about their shoulder balance. Methods: An observational (cross – sectional study was conducted on students of Doctor in Physical Therapy (DPT from colleges of Physical Therapy, Karachi. 100 Students were selected by Simple Random Sampling technique. Data from students was collected by administering a questionnaire. It includes close-ended questions. Afterwards, the level of both shoulders of the students, were assessed by using Scoliosis Meter. Results: Response from students showed that 79% of them assumed that both shoulders are in same level. When level of shoulder of students was assessed by scoliosis meter, it showed that 37% students have absolute level shoulder. Spearman’s Correlation coefficient (r = 0.046, p= 0.65 showed a weak, positive correlation between perception of the students about shoulder level and assessment of shoulder tilt. Conclusion: This showed that the perception of students about level of both shoulders was not correlated to the actual levels of the shoulders. Hence, as they were not assuming it uneven, so they may not pay any attention to keep themselves straight.

  4. Relationship among shoulder proprioception, kinematics, and pain after stroke

    NARCIS (Netherlands)

    Niessen, M.H.M.; Veeger, H.E.J.; Meskers, C.G.M.; Koppe, P.A.; Konijnenbelt, M.H.; Janssen, T.W.J.

    2009-01-01

    Niessen MH, Veeger DH, Meskers CG, Koppe PA, Konijnenbelt MH, Janssen TW. Relationship among shoulder proprioception, kinematics, and pain after stroke. Objective: To identify a possible relationship among chronic poststroke shoulder pain (PSSP), scapular resting pose, and shoulder proprioception.

  5. Total shoulder replacement in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Sneppen, O; Fruensgaard, S; Johannsen, Hans Viggo

    1996-01-01

    A prospective study of 62 Neer mark II total shoulder arthroplasties performed during the period from 1981 to 1990 on 51 patients with rheumatoid arthritis was undertaken to evaluate factors associated with component loosening and proximal humeral migration. Thirty-two (51%) showed proximal......, range of movement, abduction force, or function. The risk of clinical asymptomatic loosening is a relatively late complication that is eventually followed by pronounced bone destruction related to the loose component. Long-term radiographic control of total shoulders with rheumatoid arthritis...... is recommended. Hemiarthroplasty with a cemented humeral prosthesis may be a better treatment in the end stage of rheumatoid arthritis of the shoulder....

  6. Very High Prevalence of Frozen Shoulder in Patients With Type 1 Diabetes of ≥45 Years' Duration: The Dialong Shoulder Study.

    Science.gov (United States)

    Juel, Niels Gunnar; Brox, Jens Ivar; Brunborg, Cathrine; Holte, Kristine Bech; Berg, Tore Julsrud

    2017-08-01

    To compare the prevalence of shoulder disorders and self-reported shoulder disability in patients with long-term type 1 diabetes mellitus and diabetes-free subjects; and to explore the association between the long-term glycemic burden and shoulder disability in the diabetes group. Cross-sectional study of shoulder diagnoses with 30 years' historical data on glycemic burden in patients with diabetes. Diabetics center and a university hospital. Subjects attending the Norwegian Diabetics Center in 2015 with type 1 diabetes since 1970 or earlier were eligible (N=136). One hundred and five patients were included, and 102 (50% women; mean age, 61.9y) completed the study together with 73 diabetes-free subjects (55% women; mean age, 62.5y). Not applicable. Shoulder diagnoses decided through clinical examination according to scientific diagnostic criteria. Frozen shoulder was diagnosed in 60 (59%) patients with diabetes and 0 diabetes-free subjects, with a lifetime prevalence of 76% in the diabetes group versus 14% in the diabetes-free subjects. Patients with diabetes had higher disability and higher mean QuickDASH scores (23.0±19.9) than diabetes-free subjects (8.9±12.0), with a mean difference of -14.2 (95% confidence interval, -19.3 to -9.0) points (Pshoulder in patients with long-lasting type 1 diabetes was 59%, and the lifetime prevalence was 76%. The diabetes group had more shoulder disability than diabetes-free subjects. The historical HbA 1c level was associated with increased shoulder disability. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  7. Effects of augmented trunk stabilization with external compression support on shoulder and scapular muscle activity and maximum strength during isometric shoulder abduction.

    Science.gov (United States)

    Jang, Hyun-jeong; Kim, Suhn-yeop; Oh, Duck-won

    2015-04-01

    The aim of the present study was to investigate the effects of augmented trunk stabilization with external compression support (ECS) on the electromyography (EMG) activity of shoulder and scapular muscles and shoulder abductor strength during isometric shoulder abduction. Twenty-six women volunteered for the study. Surface EMG was used to monitor the activity of the upper trapezius (UT), lower trapezius (LT), serratus anterior (SA), and middle deltoid (MD), and shoulder abductor strength was measured using a dynamometer during three experimental conditions: (1) no external support (condition-1), (2) pelvic support (condition-2), and (3) pelvic and thoracic supports (condition-3) in an active therapeutic movement device. EMG activities were significantly lower for UT and higher for MD during condition 3 than during condition 1 (p strength was significantly higher during condition 3 than during condition 1 (p isometric shoulder abduction and increasing shoulder abductor strength. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Posterior glenoid rim deficiency in recurrent (atraumatic) posterior shoulder instability

    International Nuclear Information System (INIS)

    Weishaupt, D.; Zanetti, M.; Hodler, J.; Nyffeler, R.W.; Gerber, C.

    2000-01-01

    Objective. To assess the shape of the posterior glenoid rim in patients with recurrent (atraumatic) posterior instability.Design and patients. CT examinations of 15 shoulders with recurrent (atraumatic) posterior instability were reviewed in masked fashion with regard to abnormalities of the glenoid shape, specifically of its posterior rim. The glenoid version was also assessed. The findings were compared with the findings in 15 shoulders with recurrent anterior shoulder instability and 15 shoulders without instability. For all patients, surgical correlation was available.Results. Fourteen of the 15 (93%) shoulders with recurrent (atraumatic) posterior shoulder instability had a deficiency of the posteroinferior glenoid rim. In patients with recurrent anterior instability or stable shoulders such deficiencies were less common (60% and 73%, respectively). The craniocaudal length of the deficiencies was largest in patients with posterior instability. When a posteroinferior deficiency with a craniocaudal length of 12 mm or more was defined as abnormal, sensitivity and specificity for diagnosing recurrent (atraumatic) posterior instability were 86.7% and 83.3%, respectively. There was a statistically significant difference in glenoid version between shoulders with posterior instability and stable shoulders (P=0.01).Conclusion. Recurrent (atraumatic) posterior shoulder instability should be considered in patients with a bony deficiency of the posteroinferior glenoid rim with a craniocaudal length of more than 12 mm. (orig.)

  9. Velocity-dependent changes of rotational axes in the non-visual control of unconstrained 3D arm motions.

    Science.gov (United States)

    Isableu, B; Rezzoug, N; Mallet, G; Bernardin, D; Gorce, P; Pagano, C C

    2009-12-29

    We examined the roles of inertial (e(3)), shoulder-centre of mass (SH-CM) and shoulder-elbow articular (SH-EL) rotation axes in the non-visual control of unconstrained 3D arm rotations. Subjects rotated the arm in elbow configurations that yielded either a constant or variable separation between these axes. We hypothesized that increasing the motion frequency and the task complexity would result in the limbs' rotational axis to correspond to e(3) in order to minimize rotational resistances. Results showed two velocity-dependent profiles wherein the rotation axis coincided with the SH-EL axis for S and I velocities and then in the F velocity shifted to either a SH-CM/e(3) trade-off axis for one profile, or to no preferential axis for the other. A third profile was velocity-independent, with the SH-CM/e(3) trade-off axis being adopted. Our results are the first to provide evidence that the rotational axis of a multi-articulated limb may change from a geometrical axis of rotation to a mass or inertia based axis as motion frequency increases. These findings are discussed within the framework of the minimum inertia tensor model (MIT), which shows that rotations about e(3) reduce the amount of joint muscle torque that must be produced by employing the interaction torque to assist movement.

  10. The influence of experimentally induced pain on shoulder muscle activity

    DEFF Research Database (Denmark)

    Diederichsen, L.P.; Winther, A.; Dyhre-Poulsen, P.

    2009-01-01

    healthy men (range 22-27 years), with no history of shoulder or cervical problems, were included in the study. Pain was induced by 5% hypertonic saline injections into the supraspinatus muscle or subacromially. Seated in a shoulder machine, subjects performed standardized concentric abduction (0A degrees......Muscle function is altered in painful shoulder conditions. However, the influence of shoulder pain on muscle coordination of the shoulder has not been fully clarified. The aim of the present study was to examine the effect of experimentally induced shoulder pain on shoulder muscle function. Eleven...... muscles. EMG was recorded before pain, during pain and after pain had subsided and pain intensity was continuously scored on a visual analog scale (VAS). During abduction, experimentally induced pain in the supraspinatus muscle caused a significant decrease in activity of the anterior deltoid, upper...

  11. Cadaveric Study of the Articular Branches of the Shoulder Joint.

    Science.gov (United States)

    Eckmann, Maxim S; Bickelhaupt, Brittany; Fehl, Jacob; Benfield, Jonathan A; Curley, Jonathan; Rahimi, Ohmid; Nagpal, Ameet S

    This cadaveric study investigated the anatomic relationships of the articular branches of the suprascapular (SN), axillary (AN), and lateral pectoral nerves (LPN), which are potential targets for shoulder analgesia. Sixteen embalmed cadavers and 1 unembalmed cadaver, including 33 shoulders total, were dissected. Following dissections, fluoroscopic images were taken to propose an anatomical landmark to be used in shoulder articular branch blockade. Thirty-three shoulders from 17 total cadavers were studied. In a series of 16 shoulders, 16 (100%) of 16 had an intact SN branch innervating the posterior head of the humerus and shoulder capsule. Suprascapular sensory branches coursed laterally from the spinoglenoid notch then toward the glenohumeral joint capsule posteriorly. Axillary nerve articular branches innervated the posterolateral head of the humerus and shoulder capsule in the same 16 (100%) of 16 shoulders. The AN gave branches ascending circumferentially from the quadrangular space to the posterolateral humerus, deep to the deltoid, and inserting at the inferior portion of the posterior joint capsule. In 4 previously dissected and 17 distinct shoulders, intact LPNs could be identified in 14 (67%) of 21 specimens. Of these, 12 (86%) of 14 had articular branches innervating the anterior shoulder joint, and 14 (100%) of 14 LPN articular branches were adjacent to acromial branches of the thoracoacromial blood vessels over the superior aspect of the coracoid process. Articular branches from the SN, AN, and LPN were identified. Articular branches of the SN and AN insert into the capsule overlying the glenohumeral joint posteriorly. Articular branches of the LPN exist and innervate a portion of the anterior shoulder joint.

  12. Daily exposure to hand arm vibration by different electric olive beaters

    Directory of Open Access Journals (Sweden)

    Angela Calvo

    2014-11-01

    Full Text Available The electric hand held olive harvesters have a low weight (about 2 kg and cause the fruit pick up by means of impacts produced by their vibrational tools: for this reason they transmit elevated vibration doses to the operator’s hand arm system during the work. In this paper electric beaters of different manufacturers and different models were considered, to analyse their vibrational behaviour in field, during the olive harvesting campaign in a site located in Northern Italy. One operator did the tests, to avoid the operator’s uncertainty on the obtained results. All the five examined beaters gave high acceleration values (in a range from 10 to 26 ms–2, but the most restricting data were the daily vibration exposures, calculated considering the real working duration time acquired in field, almost ranged between 10 and 18 ms–2. Also the operator posture during the work (with the arms over the shoulders may set health problems, related to upper limb disorders, other than the already known musculoskeletal, nervous and vascular pathologies.

  13. Shoulder disorders in general practice : Prognostic indicators of outcome

    NARCIS (Netherlands)

    Van Der Windt, Daniëlle A W M; Koes, Bart W.; Boeke, A. Joan P; Devillé, Walter; De Jong, Bareld A.; Bouter, Lex M.

    Background. Shoulder pain is common in primary health care. Nevertheless, information on the outcome of shoulder disorders is scarce, especially for patients encountered in general practice. Aim. To study the course of shoulder disorders in general practice and to determine prognostic indicators of

  14. AN ELECTROMYOGRAPHIC ANALYSIS OF THE SHOULDER COMPLEX MUSCULATURE WHILE PERFORMING EXERCISES USING THE BODYBLADE® CLASSIC AND BODYBLADE® PRO.

    Science.gov (United States)

    Escamilla, Rafael F; Yamashiro, Kyle; Dunning, Russell; Mikla, Tony; Grover, Matthew; Kenniston, Mike; Loera, Jesse; Tanasse, Travis; Andrews, James R

    2016-04-01

    In spite of the bodyblade (BB®) being used in clinical settings during shoulder and trunk rehabilitation and training for 24 years, there are only five known scientific papers that have described muscle recruitment patterns using the BB®. Moreover, there are no known studies that have examined muscle activity differences between males and females (who both use the bodyblade in the clinic) or between different BB® devices. The primary purposes of this investigation were to compare glenohumeral and scapular muscle activity between the Bodyblade® Pro (BB®P) and Bodyblade® Classic (BB®C) devices while performing a variety of exercises, as well as to compare muscle activity between males and females. It was hypothesized that glenohumeral and scapular muscle activity would be significantly greater in females compared to males, significantly greater while performing exercises with the BB®P compared to the BB®C, significantly different among various BB® exercises, and greater with two hand use compared to one hand use for the same exercise. Controlled laboratory study using a repeated-measures, counterbalanced design. Twenty young adults, 10 males and 10 females, performed seven BB® exercises using the BB®C and BB®P, which are: 1) BB®1 - one hand, up and down motion, arm at side; 2) BB®2 - one hand, front to back motion, shoulder flexed 90 °; 3) BB®3 - one hand, up and down motion, shoulder abducted 90 °; 4) BB®4 - one hand, side to side motion, shoulder and elbow flexed 45 °; 5) BB®5 - two hands, side to side motion, shoulders and elbows flexed 45 °; 6) BB®6 - two hands, up and down motion, shoulders flexed 90 °; and 7) BB®7 - two hands, front to back motion, shoulders flexed 90 °. EMG data were collected from anterior and posterior deltoids, sternal pectoralis major, latissimus dorsi, infraspinatus, upper and lower trapezius, and serratus anterior during 10 sec of continuous motion for each exercise, and then normalized using maximum

  15. Clinical outcome of shoulder muscle transfer for shoulder deformities in obstetric brachial plexus palsy: A study of 150 cases

    Directory of Open Access Journals (Sweden)

    Mukund R Thatte

    2011-01-01

    Full Text Available Background: Residual muscle weakness, cross-innervation (caused by misdirected regenerating axons, and muscular imbalance are the main causes of internal rotation contractures leading to limitation of shoulder joint movement, glenoid dysplasia, and deformity in obstetric brachial plexus palsy. Muscle transfers and release of antagonistic muscles improve range of motion as well as halt or reverse the deterioration in the bony architecture of the shoulder joint. The aim of our study was to evaluate the clinical outcome of shoulder muscle transfer for shoulder abnormalities in obstetric brachial plexus palsy. Materials and Methods: One hundred and fifty patients of obstetric brachial plexus palsy with shoulder deformity underwent shoulder muscle transfer along with anterior shoulder release at our institutions from 1999 to 2007. Shoulder function was assessed both preoperatively and postoperatively using aggregate modified Mallet score and active and passive range of motion. The mean duration of follow-up was 4 years (2.5-8 years. Results: The mean preoperative abduction was 45° ± 7.12, mean passive external rotation was 10° ± 6.79, the mean active external rotation was 0°, and the mean aggregate modified Mallet score was 11.2 ± 1.41. At a mean follow-up of 4 years (2.5-8 years, the mean active abduction was 120° ± 18.01, the mean passive external rotation was 80° ± 10.26, while the mean active external rotation was 45° ± 3.84. The mean aggregate modified Mallet score was 19.2 ± 1.66. Conclusions: This procedure can thus be seen as a very effective tool to treat internal rotation and adduction contractures, achieve functional active abduction and external rotation, as well as possibly prevent glenohumeral dysplasia, though the long-term effects of this procedure may still have to be studied in detail clinico-radiologically to confirm this hypothesis. Level of evidence: Therapeutic level IV

  16. Myositis ossificans around shoulder following military training programme

    Directory of Open Access Journals (Sweden)

    Mustafa C Kir

    2011-01-01

    Full Text Available The myositis ossificans around shoulder in military recruits are not reported yet. Three young male soldiers presented with complaints of palpable mass at the anterior aspect of shoulder; tenderness around the superior part of deltopectoral groove close to acromioclavicular joint; and restriction of shoulder motion. They also noticed ecchymosis and pain around the coracoid process and anterior shoulder region during regular firing exercises. Plain X-rays and computerized tomography showed extra-capsular, dense, irregular structure in the space between pectoralis and deltoid muscles which correlated with heterotopic bone. One patient refused surgical intervention because of the completion of his military serving period. Surgical excision was performed for the other two patients. During surgical exploration, both ossified masses were found in deltopectoral region and mostly in fibers of clavicular and acromial parts of deltoid muscle. Pathological reports confirmed the structure of masses as mature trabecular bone. Postoperatively indomethacin treatment and active shoulder exercises were started until the full range of motion was regained. Mini soft bag was used on the rifle contact area of the shoulder. No complications or recurrences were observed during the 24 months of followup period.

  17. Shoulder pain after caesarean section: comparison between general and spinal anaesthesia.

    Science.gov (United States)

    Zirak, N; Soltani, G; Hafizi, L; Mashayekhi, Z; Kashani, I

    2012-05-01

    This study investigated shoulder pain as a maternal complication after caesarean section (CS), evaluation of its prevalence and comparison between spinal anaesthesia (SA) and general anaesthesia (GA) groups. A total of 200 women as CS candidates were allocated into two equal groups; SA and GA. The total prevalence of shoulder pain was 39.45%. The two groups were matched according to demographic data. However, the incidence of shoulder pain in the GA group was more than that in the SA group (p =0.004). Shoulder pain in the right shoulder in the GA group was more prevalent than the left shoulder (p <0.001). Moderate severity of shoulder pain was significantly more in the GA group (p =0.000), while in the SA group, the mild severity was significant (p <0.001). Our study revealed that the incidence of shoulder pain after CS is significant. Moreover, shoulder pain was significantly more common in the GA group than the SA group.

  18. Iatrogenic nerve injuries during shoulder surgery.

    Science.gov (United States)

    Carofino, Bradley C; Brogan, David M; Kircher, Michelle F; Elhassan, Bassem T; Spinner, Robert J; Bishop, Allen T; Shin, Alexander Y

    2013-09-18

    The current literature indicates that neurologic injuries during shoulder surgery occur infrequently and result in little if any morbidity. The purpose of this study was to review one institution's experience treating patients with iatrogenic nerve injuries after shoulder surgery. A retrospective review of the records of patients evaluated in a brachial plexus specialty clinic from 2000 to 2010 identified twenty-six patients with iatrogenic nerve injury secondary to shoulder surgery. The records were reviewed to determine the operative procedure, time to presentation, findings on physical examination, treatment, and outcome. The average age was forty-three years (range, seventeen to seventy-two years), and the average delay prior to referral was 5.4 months (range, one to fifteen months). Seven nerve injuries resulted from open procedures done to treat instability; nine, from arthroscopic surgery; four, from total shoulder arthroplasty; and six, from a combined open and arthroscopic operation. The injury occurred at the level of the brachial plexus in thirteen patients and at a terminal nerve branch in thirteen. Fifteen patients (58%) did not recover nerve function after observation and required surgical management. A structural nerve injury (laceration or suture entrapment) occurred in nine patients (35%), including eight of the thirteen who presented with a terminal nerve branch injury and one of the thirteen who presented with an injury at the level of the brachial plexus. Nerve injuries occurring during shoulder surgery can produce severe morbidity and may require surgical management. Injuries at the level of a peripheral nerve are more likely to be surgically treatable than injuries of the brachial plexus. A high index of suspicion and early referral and evaluation should be considered when evaluating patients with iatrogenic neurologic deficits after shoulder surgery.

  19. Decreased shoulder function and pain common in recreational badminton players.

    Science.gov (United States)

    Fahlström, M; Söderman, K

    2007-06-01

    The aim of this study was to describe the prevalence and consequences of painful conditions in the shoulder region in recreational badminton players. A questionnaire study was performed on 99 players, of whom 57 were also assessed with Constant score. Previous or present pain in the dominant shoulder was reported by 52% of the players. Sixteen percent of the players had on-going shoulder pain associated with badminton play. A majority of these players reported that their training habits were affected by the pain. Total Constant score was lower in the painful shoulders. Furthermore, range of active pain-free shoulder abduction was decreased. However, isometric shoulder strength test showed no differences when compared with pain-free shoulders. Even though the pain caused functional problems, the players were still playing with on-going symptoms. The diagnoses were mostly unknown, although history and clinical tests indicate problems resembling subacromial impingement.

  20. Reverse Total Shoulder Arthroplasty as Treatment for Rotator Cuff-Tear Arthropathy and Shoulder Dislocations in an Elderly Male with Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    John G. Skedros

    2017-01-01

    Full Text Available We report the case of a 70-year-old male with Parkinson’s disease (PD and recurrent traumatic left shoulder dislocations. This case is rare because (1 he had a massive irreparable rotator cuff tear and end-stage arthritis (i.e., rotator cuff-tear arthropathy of the same shoulder and (2 his shoulder was ultimately reconstructed with a reverse total shoulder arthroplasty (RTSA. His first dislocation occurred after a fall. Recurrent shoulder dislocations occurred despite successful closed reduction and physical therapy. Initial surgical treatment included an open capsular-labral reconstruction; RTSA was not an ideal option because of the presumed risk of failure from PD-related dyskinesias. However, the capsular-labral reconstruction failed after he lost balance and stumbled but did not fall. A RTSA was then done which restored the patient’s shoulder stability and greatly improved his pain. At final follow-up two years later, he reported pain relief and improved function. This was partially attributed to the fact that he had moved to an assisted living center. He also began using an electric wheelchair one year after the RTSA. We report this case because of the unusual set of conditions and circumstances, namely, the implantation of a RTSA in a patient with PD and shoulder instability.

  1. Shoulder pain among high-level volleyball players and preseason features.

    Science.gov (United States)

    Forthomme, Benedicte; Wieczorek, Valerie; Frisch, Anne; Crielaard, Jean-Michel; Croisier, Jean-Louis

    2013-10-01

    The main goal of this prospective study was to identify the most significant intrinsic risk factors for shoulder pain by measuring strength developed by shoulder rotators and by carrying out various morphostatic assessments. Sixty-six players (mean ± SD age = 24 ± 5 yr) were recruited from nine volleyball teams from the first and second divisions (34 men and 32 women) to participate in the study. Before the start of the volleyball season, all the participants completed a preseason questionnaire and underwent both a bilateral isokinetic evaluation of the shoulders and morphostatic measurements. During the subsequent 6 months of the competition period, the players reported through a weekly questionnaire any shoulder pain experienced. During the ongoing season, 23% (15 of 66 players) of the volleyball players experienced dominant shoulder pain. Interestingly, participants who reported a history of dominant shoulder pain were found to have nine times higher risk of suffering further pain in their dominant shoulder. The eccentric maximal strength developed by the internal and external rotators was found to represent a protective factor in the volleyball players (respective odds ratios = 0.946, P = 0.01 and 0.94, P = 0.05). No risk factors were found among the shoulder morphostatic measurements. In our study, the evaluation of shoulder rotator muscle strength through isokinetic assessment, especially eccentric mode, appeared to be the most contributing parameter to identify risk factors for shoulder pain. This evaluation should allow to better identify players at risk.

  2. Painful Shoulder in Swimmers: A Diagnostic Challenge.

    Science.gov (United States)

    McMaster, William C.

    1986-01-01

    This article discusses the incidence, diagnosis, and treatment of painful shoulder in swimmers, including: regional problems that can cause shoulder pain; physical, clinical, and laboratory tests for diagnostic use; and approaches to management of the problem. (Author/CB)

  3. Risk factors for blood transfusion after shoulder arthroplasty.

    Science.gov (United States)

    Padegimas, E M; Clyde, C T; Zmistowski, B M; Restrepo, C; Williams, G R; Namdari, S

    2016-02-01

    Currently, there is little information about the need for peri-operative blood transfusion in patients undergoing shoulder arthroplasty. The purpose of this study was to identify the rate of transfusion and its predisposing factors, and to establish a blood conservation strategy. We identified all patients who had undergone shoulder arthroplasty at our hospital between 1 January 2011 and 31 December 2013. The rate of transfusion was determined from the patient's records. While there were exceptions, patients typically underwent transfusion if they had a level of haemoglobin of transfusion. High- and low-risk cohorts for transfusion were identified from a receiver operating characteristic (ROC) curve. Of 1174 shoulder arthroplasties performed on 1081 patients, 53 cases (4.5%) required transfusion post-operatively. Predictors of blood transfusion were a lower pre-operative haematocrit (p transfusion. In total 48 of the 436 (11%) shoulder arthroplasties with a pre-operative haematocrit transfusion compared with five of the 738 (0.70%) shoulder arthroplasties with a haematocrit above this level. We found that transfusion was needed less frequently than previously described for shoulder arthroplasty. Patients with a pre-operative haematocrit blood transfusion, while those with a haematocrit above this level are unlikely to require transfusion. The rate of transfusion after shoulder arthroplasty is under 5%, and those with a pre-operative haematocrit greater than or equal to 39.6% have a very low likelihood (transfusion. ©2016 The British Editorial Society of Bone & Joint Surgery.

  4. Navigating the Alphabet Soup of Labroligamentous Pathology of the Shoulder.

    Science.gov (United States)

    Fitzpatrick, Darren; Grubin, Jeremy

    2016-02-01

    Because of the widespread use of eponyms and acronyms to describe labroligamentous findings in the shoulder, interpreting shoulder magnetic resonance imaging reports can be challenging. A summary of the appearance of these lesions on shoulder magnetic resonance images can help the orthopedic surgeon to understand these entities as imaging findings and to determine the appropriate treatment for patients with shoulder injuries.

  5. Reliability, validity, and responsiveness of the Persian version of Shoulder Activity Scale in a group of patients with shoulder disorders.

    Science.gov (United States)

    Negahban, Hossein; Mohtasebi, Elham; Goharpey, Shahin

    2015-01-01

    The aim of this methodological study was to cross-culturally translate the Shoulder Activity Scale (SAS) into the Persian and determine its clinimetric properties including reliability, validity, and responsiveness in patients with shoulder disorders. Persian version of the SAS was obtained after standard forward-backward translation. Three questionnaires were completed by the respondents: SAS, shoulder pain and disability index (SPADI), and Short-Form 36 Health Survey (SF-36). The patients completed the SAS, 1 week after the first visit to evaluate the test-retest reliability. Construct validity was evaluated by examining the associations between the scores on the SAS and the scores obtained from the SPADI, SF-36, and age of the patients. To assess responsiveness, data were collected in the first visit and then again after 4 weeks physiotherapy intervention. Test-retest reliability and internal consistency were assessed using Intra-class Correlation Coefficient (ICC) and Cronbach's alpha, respectively. To evaluate construct validity, Spearman's rank correlation was used. The ability of the SAS to detect changes was evaluated by the receiver-operating characteristics method. No problem or language difficulties were reported during translation process. Test-retest reliability of the SAS was excellent with an ICC of 0.98. Also, the marginal Cronbach's alpha level of 0.64 was obtained. The correlation between the SAS and the SPADI was low, proving divergent validity, whereas the correlations between the SAS and the SF-36/age were moderate proving convergent validity. A marginally acceptable responsiveness was achieved for the Persian SAS. The study provides some evidences to support the test-retest reliability, internal consistency, construct validity, and responsiveness of the Persian version of the SAS in patients with shoulder disorders. Therefore, it seems that this instrument is a useful measure of shoulder activity level in research setting and clinical practice

  6. Posterior axilla sling traction for shoulder dystocia: case review and a new method of shoulder rotation with the sling.

    Science.gov (United States)

    Cluver, Catherine Anne; Hofmeyr, G Justus

    2015-06-01

    The purpose of this study was to report on all cases in which posterior axilla sling traction (PAST) has been used to deliver cases of intractable shoulder dystocia and to describe a new method of shoulder rotation with the sling. A record of all published and known cases was collected that included information on preliminary obstetric techniques that were used and how the PAST technique was performed. Maternal outcomes that included maternal injury and length of hospital stay and fetal outcomes, which included birthweight, Apgar scores, nerve injuries, fractures, hospital stay, and outcome, were documented. We have recorded 19 cases where PAST has been used. In 5 cases, the babies had died in utero. Ten were assisted deliveries. PAST was successful in 18 cases. In one case, it was partially successful because it enabled delivery of the posterior shoulder with digital axillary traction. The most commonly used material was suction tubing. Once the posterior shoulder was delivered, the shoulder dystocia was resolved in all cases. Time from insertion to delivery was dystocia fail. Advantages are that it is easy to use (even by someone who has not seen it used previously), that the sling material is readily available, and that it is inserted quickly with 2 fingers. This is the first report of its use to rotate the posterior shoulder to the anterior position for delivery. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. An Evaluation of the Responsiveness and Discriminant Validity of Shoulder Questionnaires among Patients Receiving Surgical Correction of Shoulder Instability

    Directory of Open Access Journals (Sweden)

    Kyle A. R. Kemp

    2012-01-01

    Full Text Available Health-related quality-of-life (HRQL measures must detect clinically important changes over time and between different patient subgroups. Forty-three patients (32 M, 13 F; mean age  =  26.00  ±  8.19 years undergoing arthroscopic Bankart repair completed three validated shoulder questionnaires (Western Ontario Shoulder Instability index (WOSI, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment form (ASES, Constant score preoperatively, and at 6, 12, and 24 months postoperatively. Responsiveness and discriminant validity was assessed between those with a satisfactory outcome and those with (1 a major recurrence of instability, (2 a single episode of subluxation, (3 any postoperative episode of instability. Eight (20% patients reported recurrent instability. Compared to baseline, the WOSI detected improvement at the 6- (P<0.001 and 12-month (P=0.011 evaluations. The ASES showed improvement at 6 months (P=0.003, while the Constant score did not report significant improvement until 12 months postoperatively (P=0.001. Only the WOSI detected differential shoulder function related to shoulder instability. Those experiencing even a single episode of subluxation reported a 10% drop in their WOSI score, attaining the previously established minimal clinically important difference (MCID. Those experiencing a frank dislocation or multiple episodes of subluxation reported a 20% decline. The WOSI allows better discrimination of the severity of postoperative instability symptoms following arthroscopic Bankart repair.

  8. Grading of shoulder ulcerations in sows by biopsies

    DEFF Research Database (Denmark)

    Jensen, Henrik Elvang; Dahl-Pedersen, Kirstin; Barington, Krisitane

    2014-01-01

    legislation, stating that sows with shoulder ulcers grade 3 or 4 must be kept loose and have access to soft bedding. Thus, the aim of the present study was to evaluate if biopsies from the center of a shoulder ulcer can be used to point out animals for which an intervention must be initiated. Postmortem......, a punch biopsy was sampled from the center of the ulceration or from the tissue overlaying the tuber spina scapula. Afterward, the shoulders were cross-sectioned and evaluated grossly and histologically (“gold standard”). In total, 121 shoulders were included in the study, and the diagnostic value...... of a punch biopsy in grading shoulder ulcerations was evaluated. The results showed a sensitivity of 0.78, a specificity of 0.98, a positive likelihood ratio of 38.36, and a negative likelihood ratio of 0.22. The agreement between the cross-section evaluation and the punch biopsy was found to be 0...

  9. Eponymous terms in anterior shoulder stabilization surgery

    NARCIS (Netherlands)

    Somford, M. P.; van der Linde, J. A.; Wiegerinck, J. I.; Hoornenborg, D.; van den Bekerom, M. P. J.; van Deurzen, D. F. P.

    2017-01-01

    Shoulder dislocation and its treatment are probably as old as time. Surgical treatment has gained acceptance recently, especially in recurrent cases. Within roughly the last 100 years, numerous treatment strategies have been developed and questions elucidated regarding the entity of shoulder

  10. Diagnosing patients with longstanding shoulder joint pain

    DEFF Research Database (Denmark)

    Nørregaard, J; Krogsgaard, M R; Lorenzen, T

    2002-01-01

    OBJECTIVE: To examine the interobserver agreement of commonly used clinical tests and diagnoses in patients with shoulder pain, and the accuracy of these tests and ultrasonographic findings in comparison with arthroscopic findings. METHODS: Eighty six patients with longstanding shoulder joint pain...

  11. Use of soil stabilizers on highway shoulders.

    Science.gov (United States)

    2005-01-01

    This study evaluated soil additives as stabilizers for aggregate and topsoil shoulders. Its purpose was to determine (1) the effect soil stabilizers have on the strength and stability of soil shoulders, and (2) the costs and benefits of using stabili...

  12. Validation of the Danish version of Oxford Shoulder Score

    DEFF Research Database (Denmark)

    Frich, Lars Henrik; Noergaard, Peter Moensted; Brorson, Stig

    2011-01-01

    The Oxford Shoulder Score (OSS) is a patient-administered condition-specific questionnaire for patients with degenerative or inflammatory shoulder disease. The purpose of this study was to validate a Danish translation of the OSS and to compare it with the Constant Score (CS).......The Oxford Shoulder Score (OSS) is a patient-administered condition-specific questionnaire for patients with degenerative or inflammatory shoulder disease. The purpose of this study was to validate a Danish translation of the OSS and to compare it with the Constant Score (CS)....

  13. Humeral retroversion and shoulder rotational mobility in young handball practitioners.

    Science.gov (United States)

    Quadros, Gustavo Aguiar; Döhnert, Marcelo Baptista

    2015-01-01

    : To evaluate the prevalence of humeral retroversion and rotational mobility (RHH) in young handball practitioners and non-practitioners. : This is a cross-sectional study performed with two groups: the handball group, with 14 female students practicing handball and the control group, with 13 young participants non-practicing pitch sports. : The handball group presented full rotational movement (FRM) hi-gher than the control group in both the dominant shoulder (p=0.001) and the non-dominant shoulder (p=0.0001). The mobility of active and passive internal rotation was significantly higher in handball players in both shoulders. The handball group presented lower internal rotation range of motion for the dominant shoulder as compared to the non-dominant shoul-der (p=0.001). : Young handball practitioners, des-pite skeletally immature, showed a higher MRT than the control group. The handball group showed loss of internal rotation (medial) on the dominant shoulder as compared to the non--dominant shoulder. Level of Evidence II, Prospective Study.

  14. Flail arm-like syndrome associated with HIV-1 infection

    Directory of Open Access Journals (Sweden)

    Nalini A

    2009-01-01

    Full Text Available During the last 20 years at least 23 cases of motor neuron disease have been reported in HIV-1 seropositive patients. In this report we describe the clinical picture of a young man with HIV-1 clade C infection and flail arm-like syndrome, who we were able to follow-up for a long period. We investigated and prospectively monitored a 34-year-old man with features of flail arm syndrome, who developed the weakness and wasting 1 year after being diagnosed with HIV-1 infection after a routine blood test. He presented in 2003 with progressive, symmetrical wasting and weakness of the proximal muscles of the upper limb of 2 years′ duration. He had severe wasting and weakness of the shoulder and arm muscles. There were no pyramidal signs. He has been on HAART for the last 4 years and the weakness or wasting has not worsened. At the last follow-up in July 2007, the patient had the same neurological deficit and no other symptoms or signs of HIV-1 infection. MRI of the spinal cord in 2007 showed characteristic T2 hyperintense signals in the central part of the spinal cord, corresponding to the central gray matter. Thus, our patient had HIV-1 clade C infection associated with a ′flail arm-like syndrome.′ The causal relationship between HIV-1 infection and amyotrophic lateral sclerosis (ALS-like syndrome is still uncertain. The syndrome usually manifests as a lower motor neuron syndrome, as was seen in our young patient. It is known that treatment with antiretroviral therapy (ART stabilizes/improves the condition. In our patient the weakness and atrophy remained stable over a period of 3.5 years after commencing HAART regimen.

  15. Presentation of frozen shoulder among diabetic and non-diabetic patients☆

    Science.gov (United States)

    Uddin, Mohammad Moin; Khan, Aminuddin A.; Haig, Andrew J.; Uddin, Mohammad Kafil

    2014-01-01

    Objective The literature is inconsistent regarding the level of pain and disability in frozen shoulder patients with or without diabetes mellitus. The aim of this study is to evaluate some demographic features of frozen shoulder patients and to look into the disparity of information by comparing the level of pain and disability due to frozen shoulder between diabetic and non-diabetic people. Design This is a prospective comparative study. People with frozen shoulder attending an outpatient department were selected by consecutive sampling. Disability levels were assessed by the Shoulder Pain & Disability Index (SPADI). Means of pain and disability scores were compared using unpaired t-test. Results Among 140 persons with shoulder pain 99 (71.4%) had frozen shoulder. From the participating 40 frozen shoulder patients, 26 (65%) were males and 14 (35%) were females. Seventeen participants (42.5%) were diabetic, two (5%) had impaired glucose tolerance and 21 (52.5%) patients were non-diabetic. Mean disability scores (SPADI) were 51 ± 15.5 in diabetic and 57 ± 16 in non-diabetic persons. The differences in pain and disability level were not statistically significance (respectively, p = 0.24 and p = 0.13 at 95% confidence interval). Conclusions No difference was found in level of pain and disability level between frozen shoulder patients with and without diabetes. PMID:25983497

  16. Presentation of frozen shoulder among diabetic and non-diabetic patients.

    Science.gov (United States)

    Uddin, Mohammad Moin; Khan, Aminuddin A; Haig, Andrew J; Uddin, Mohammad Kafil

    2014-12-01

    The literature is inconsistent regarding the level of pain and disability in frozen shoulder patients with or without diabetes mellitus. The aim of this study is to evaluate some demographic features of frozen shoulder patients and to look into the disparity of information by comparing the level of pain and disability due to frozen shoulder between diabetic and non-diabetic people. This is a prospective comparative study. People with frozen shoulder attending an outpatient department were selected by consecutive sampling. Disability levels were assessed by the Shoulder Pain & Disability Index (SPADI). Means of pain and disability scores were compared using unpaired t-test. Among 140 persons with shoulder pain 99 (71.4%) had frozen shoulder. From the participating 40 frozen shoulder patients, 26 (65%) were males and 14 (35%) were females. Seventeen participants (42.5%) were diabetic, two (5%) had impaired glucose tolerance and 21 (52.5%) patients were non-diabetic. Mean disability scores (SPADI) were 51 ± 15.5 in diabetic and 57 ± 16 in non-diabetic persons. The differences in pain and disability level were not statistically significance (respectively, p = 0.24 and p = 0.13 at 95% confidence interval). No difference was found in level of pain and disability level between frozen shoulder patients with and without diabetes.

  17. Safety zone for posterosuperior shoulder access: study on cadavers

    Directory of Open Access Journals (Sweden)

    Miguel Pereira Costa

    2016-08-01

    Full Text Available ABSTRACT OBJECTIVE: The posterosuperior shoulder access used in surgical treatment for acromioclavicular dislocation was constructed through dissection of 20 shoulders from 10 recently chilled adult cadavers, and the distances from this route to the nearby neurovascular structures were analyzed. METHODS: A Kirschner wire was introduced into the top of the base of the coracoid process through the posterosuperior shoulder access, in the area of the origin of the conoid and trapezoid ligaments, thus reproducing the path for inserting two anchors for anatomical reconstruction of the coracoclavicular ligaments. The smallest distance from the insertion point of the Kirschner wire to the suprascapular nerve and artery/vein was measured. RESULTS: The mean distance from the suprascapular nerve to the origin of the coracoclavicular ligaments at the top of the base of the coracoid process was 18.10 mm (range: 13.77-22.80 in the right shoulder and 18.19 mm (range: 12.59-23.75 in the left shoulder. The mean distance from the suprascapular artery/vein to the origin of the coracoclavicular ligaments was 13.10 mm (range: 9.28-15.44 in the right shoulder and 14.11 mm (range: 8.83-18.89 in the left shoulder. Comparison between the contralateral sides did not show any statistical difference. CONCLUSION: The posterosuperior shoulder access route for anatomical reconstruction of the coracoclavicular ligaments in treating acromioclavicular dislocation should be performed respecting the minimum limit of 8.83 mm medially.

  18. Design of a Lightweight Soft Robotic Arm Using Pneumatic Artificial Muscles and Inflatable Sleeves.

    Science.gov (United States)

    Ohta, Preston; Valle, Luis; King, Jonathan; Low, Kevin; Yi, Jaehyun; Atkeson, Christopher G; Park, Yong-Lae

    2018-04-01

    As robots begin to interact with humans and operate in human environments, safety becomes a major concern. Conventional robots, although reliable and consistent, can cause injury to anyone within its range of motion. Soft robotics, wherein systems are made to be soft and mechanically compliant, are thus a promising alternative due to their lightweight nature and ability to cushion impacts, but current designs often sacrifice accuracy and usefulness for safety. We, therefore, have developed a bioinspired robotic arm combining elements of rigid and soft robotics such that it exhibits the positive qualities of both, namely compliance and accuracy, while maintaining a low weight. This article describes the design of a robotic arm-wrist-hand system with seven degrees of freedom (DOFs). The shoulder and elbow each has two DOFs for two perpendicular rotational motions on each joint, and the hand has two DOFs for wrist rotations and one DOF for a grasp motion. The arm is pneumatically powered using custom-built McKibben type pneumatic artificial muscles, which are inflated and deflated using binary and proportional valves. The wrist and hand motions are actuated through servomotors. In addition to the actuators, the arm is equipped with a potentiometer in each joint for detecting joint angle changes. Simulation and experimental results for closed-loop position control are also presented in the article.

  19. A Longitudinal Comparison of Arm Morbidity in Stage I-II Breast Cancer Patients Treated with Sentinel Lymph Node Biopsy, Sentinel Lymph Node Biopsy Followed by Completion Lymph Node Dissection, or Axillary Lymph Node Dissection

    NARCIS (Netherlands)

    Kootstra, Jan J.; Hoekstra-Weebers, Josette E. H. M.; Rietman, Johan S.; de Vries, Jakob; Baas, Peter C.; Geertzen, Jan H. B.; Hoekstra, Harald J.

    Background. Long-term shoulder and arm function following sentinel lymph node biopsy (SLNB) may surpass that following complete axillary lymph node dissection (CLND) or axillary lymph node dissection (ALND). We objectively examined the morbidity and compared outcomes after SLNB, SLNB + CLND, and

  20. A longitudinal comparison of arm morbidity in stage I-II breast cancer patients treated with sentinel lymph node biopsy, sentinel lymph node biopsy followed by completion lymph node dissection, or axillary lymph node dissection

    NARCIS (Netherlands)

    Kootstra, Jan J.; Hoekstra-Weebers, Josette E.; Rietman, Johan Swanik; de Vries, Jakob; Baas, Peter C.; Geertzen, Jan H.B.; Hoekstra, Harald J.

    2010-01-01

    Background: Long-term shoulder and arm function following sentinel lymph node biopsy (SLNB) may surpass that following complete axillary lymph node dissection (CLND) or axillary lymph node dissection (ALND). We objectively examined the morbidity and compared outcomes after SLNB, SLNB + CLND, and

  1. Counterrotating-Shoulder Mechanism for Friction Stir Welding

    Science.gov (United States)

    Nunes, Arthur C., Jr.

    2007-01-01

    A counterrotating-shoulder mechanism has been proposed as an alternative to the mechanism and fixtures used in conventional friction stir welding. The mechanism would internally react most or all of the forces and torques exerted on the workpiece, making it unnecessary to react the forces and torques through massive external fixtures. In conventional friction stir welding, a rotating pin tool is inserted into, and moved along, a weld seam. As the pin tool moves, it stirs together material from the opposite sides of the seam to form the weld. A large axial plunge force must be exerted upon the workpiece through and by the pin tool and a shoulder attached above the pin tool in order to maintain the pressure necessary for the process. The workpiece is secured on top of an anvil, which supports the workpiece against the axial plunge force and against the torque exerted by the pin tool and shoulder. The anvil and associated fixtures must be made heavy (and, therefore, are expensive) to keep the workpiece stationary. In addition, workpiece geometries must be limited to those that can be accommodated by the fixtures. The predecessor of the proposed counterrotating-shoulder mechanism is a second-generation, self-reacting tool, resembling a bobbin, that makes it possible to dispense with the heavy anvil. This tool consists essentially of a rotating pin tool with opposing shoulders. Although the opposing shoulders maintain the necessary pressure without need to externally apply or react a large plunge force, the torque exerted on the workpiece remains unreacted in the absence of a substantial external fixture. Depending on the RPM and the thickness of the workpiece, the torque can be large. The proposed mechanism (see figure) would include a spindle attached to a pin tool with a lower shoulder. The spindle would be coupled via splines to the upper one of three bevel gears in a differential drive. The middle bevel gear would be the power-input gear and would be coupled to the

  2. Development and Control of a Robotic Exoskeleton for Shoulder, Elbow and Forearm Movement Assistance

    Directory of Open Access Journals (Sweden)

    Mohammad Habibur Rahman

    2012-01-01

    Full Text Available World health organization reports, annually more than 15 million people worldwide suffer a stroke and cardiovascular disease, among which 85% of stroke patients incur acute arm impairment, and 40% of victims are chronically impaired or permanently disabled. This results a burden on the families, communities and to the country as well. Rehabilitation programs are the main way to promote functional recovery in these individuals. Since the number of such cases is constantly growing and that the duration of treatment is long, an intelligent robot could significantly contribute to the success of these programs. We therefore developed a new 5DoFs robotic exoskeleton named MARSE-5 (motion assistive robotic-exoskeleton for superior extremity that supposed to be worn on the lateral side of upper arm to rehabilitate and ease the shoulder, elbow and forearm movements. This paper focused on the design, modeling, development and control of the proposed MARSE-5. To control the exoskeleton, a nonlinear sliding mode control (SMC technique was employed. In experiments, trajectory tracking that corresponds to typical passive rehabilitation exercises was carried out. Experimental results reveal that the controller is able to maneuver the MARSE-5 efficiently to track the desired trajectories.

  3. Low-field MR arthrography of the shoulder joint: technique, indications, and clinical results

    International Nuclear Information System (INIS)

    Kreitner, K.-F.; Thelen, M.; Loew, R.; Runkel, M.; Zoellner, J.

    2003-01-01

    In the age of cost containment and urgent reductions in health care expenditures, new options have to be explored to satisfy both diagnostic requirements and economic limitations. The introduction of low-field MR systems for assessment of joint disorders seemed to be an option for lower costs. The purpose of this article is to summarize available experiences with low-field MR arthrography of the glenohumeral joint with respect to image quality and diagnostic accuracy in detecting labral and rotator cuff lesions. Up to now, there has been only a limited number of studies available dealing with low-field MR arthrography of the glenohumeral joint. They reveal that, despite a minor image quality in comparison with high-field imaging, low-field MR arthrography of the shoulder allows for sufficient evaluation of intra- and extra-articular structures in the detection of major abnormalities such as glenohumeral instability or rotator cuff disease. Furthermore, open-configured MR scanners enable kinematic studies: Besides the analysis of normal motion, pathological findings in patients with instabilities and impingement syndrome can be delineated. They further offer the possibility for performing MR imaging-guided arthrography of the shoulder. This was first described using an open C-arm scanner with a vertically oriented magnetic field so that MR arthrography may be performed in one setting. (orig.)

  4. Posture and isokinetic shoulder strength in female water polo players

    African Journals Online (AJOL)

    Kathryn van Boom

    pathological injuries, such as rotator cuff tendinitis, shoulder instability and shoulder ... and specific postural characteristics, which will be useful in future studies. ... concentric and eccentric IR and ER shoulder muscle strength in 15 club-level ...

  5. The Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH can measure the impairment, activity limitations and participation restriction constructs from the International Classification of Functioning, Disability and Health (ICF

    Directory of Open Access Journals (Sweden)

    McQueen Margaret

    2008-08-01

    Full Text Available Abstract Background The International Classification of Functioning, Disability and Health (ICF model of the consequences of disease identifies three health outcomes, impairment, activity limitations and participation restrictions. However, few orthopaedic health outcome measures were developed with reference to the ICF. This study examined the ability of a valid and frequently used measure of upper limb function, namely the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH, to operationalise the ICF. Methods Twenty-four judges used the method of Discriminant Content Validation to allocate the 38 items of the DASH to the theoretical definition of one or more ICF outcome. One-sample t-tests classified each item as measuring, impairment, activity limitations, participation restrictions, or a combination thereof. Results The DASH contains items able to measure each of the three ICF outcomes with discriminant validity. The DASH contains five pure impairment items, 19 pure activity limitations items and three participation restriction items. In addition, seven items measured both activity limitations and participation restrictions. Conclusion The DASH can measure the three health outcomes identified by the ICF. Consequently the DASH could be used to examine the impact of trauma and subsequent interventions on each health outcome in the absence of measurement confound.

  6. Driving Simulator Study of Effect of Inside Shoulder on Vehicle Operation

    Directory of Open Access Journals (Sweden)

    Han Ding

    2015-02-01

    Full Text Available According to the Chinese Design Specification for Highway Alignment (JTG D20-2006, eight-lane expressways should be paved with an inside shoulder of 2.5 m; however, this regulation is rarely obeyed in engineering practice. On the basis of driving simulator experiment, this research examined the impacts of inside shoulder on vehicle operation with and without the speed limitation. A virtual scenario, consisting of five expressways with different inside shoulder widths, was created and displayed in driving simulator, and vehicle operational data—speed and lane position—were recorded. Authors used analysis of variance (ANOVA and contrast analysis to examine whether inside shoulder width had statistically significant effects on travel speed and lane position. Analytical results indicated that there is a kind of quadratic relationship between inside shoulder width and driver's speed choice, while driver's speed choice is not significantly affected by inside shoulder width. What is more, inside shoulder width has statistically significant effects on vehicle's lane positions, and vehicle's lane position is negatively correlated to inside shoulder width. Specifically, the vehicle can be maintained at the center of lane when the inside shoulder width is 2.5 m.

  7. Shoulder arthroplasty in osteoarthritis: current concepts in biomechanics and surgical technique

    Science.gov (United States)

    Merolla, G; Nastrucci, G; Porcellini, G

    Shoulder arthroplasty is a technically demanding procedure to restore shoulder function in patients with severe osteoarthritis of the glenohumeral joint. The modern prosthetic system exploit the benefits of modularity and the availibility of additional sizes of the prosthetic components. In this paper we describe the biomechanics of shoulder arthroplasty and the technique for shoulder replacement including total shoulder arthroplasty (TSA) with all-polyethylene and metal-backed glenoid component, humeral head resurfacing and stemless humeral replacement. PMID:24251240

  8. Shoulder arthroplasty. Part 1: Prosthesis terminology and classification

    International Nuclear Information System (INIS)

    Sheridan, B.D.; Ahearn, N.; Tasker, A.; Wakeley, C.; Sarangi, P.

    2012-01-01

    Shoulder arthroplasty is the third most common joint replacement procedure in the UK, and there are a number of different implant options available to surgeons to treat a variety of shoulder disorders. With an increasing burden placed on clinical follow-up, more patients are remaining under the care of their general practitioners and musculoskeletal triage assessment services and are not necessarily being seen by specialists. Referrals to orthopaedic specialists are therefore often prompted by radiological reports describing evidence of implant failure. This article is the first of two reviews on shoulder arthroplasty, concentrating on implant features and the indications for their use. The second article will address the modes of failure of shoulder arthroplasty and describe the relevant associated radiological features.

  9. Shoulder arthroplasty. Part 1: Prosthesis terminology and classification

    Energy Technology Data Exchange (ETDEWEB)

    Sheridan, B.D., E-mail: bdsheridan@hotmail.com [Department of Orthopaedic Surgery, Bristol Royal Infirmary, Bristol (United Kingdom); Ahearn, N.; Tasker, A.; Wakeley, C.; Sarangi, P. [Department of Orthopaedic Surgery, Bristol Royal Infirmary, Bristol (United Kingdom)

    2012-07-15

    Shoulder arthroplasty is the third most common joint replacement procedure in the UK, and there are a number of different implant options available to surgeons to treat a variety of shoulder disorders. With an increasing burden placed on clinical follow-up, more patients are remaining under the care of their general practitioners and musculoskeletal triage assessment services and are not necessarily being seen by specialists. Referrals to orthopaedic specialists are therefore often prompted by radiological reports describing evidence of implant failure. This article is the first of two reviews on shoulder arthroplasty, concentrating on implant features and the indications for their use. The second article will address the modes of failure of shoulder arthroplasty and describe the relevant associated radiological features.

  10. Multi-muscle FES force control of the human arm for arbitrary goals.

    Science.gov (United States)

    Schearer, Eric M; Liao, Yu-Wei; Perreault, Eric J; Tresch, Matthew C; Memberg, William D; Kirsch, Robert F; Lynch, Kevin M

    2014-05-01

    We present a method for controlling a neuroprosthesis for a paralyzed human arm using functional electrical stimulation (FES) and characterize the errors of the controller. The subject has surgically implanted electrodes for stimulating muscles in her shoulder and arm. Using input/output data, a model mapping muscle stimulations to isometric endpoint forces measured at the subject's hand was identified. We inverted the model of this redundant and coupled multiple-input multiple-output system by minimizing muscle activations and used this inverse for feedforward control. The magnitude of the total root mean square error over a grid in the volume of achievable isometric endpoint force targets was 11% of the total range of achievable forces. Major sources of error were random error due to trial-to-trial variability and model bias due to nonstationary system properties. Because the muscles working collectively are the actuators of the skeletal system, the quantification of errors in force control guides designs of motion controllers for multi-joint, multi-muscle FES systems that can achieve arbitrary goals.

  11. Radiotherapy for shoulder impingement; Bestrahlung beim Impingementsyndrom des Schultergelenks

    Energy Technology Data Exchange (ETDEWEB)

    Adamietz, B. [Universitaetsklinikum Erlangen (Germany). Inst. fuer Radiologie; Sauer, R.; Keilholz, L. [Universitaetsklinikum Erlangen (Germany). Strahlentherapeutische Klinik

    2008-05-15

    Background and Purpose: Up to now, degenerative shoulder diseases were summarized by the term 'periarthritis humeroscapularis'. Actual shoulder diseases can be differentiated etiopathologically according to a primary and secondary impingement syndrome. Narrowing of the subacromial space, which is caused by an osseous shape variant, leads to primary impingement. Secondary impingement develops, when the subacromial space is reduced by swelling tissue below the osseous shoulder roof. This study aimed for the exact diagnosis to indicate therapy and to classify the results according to the Constant score. Patients and Methods: From August 1999 to September 2002, 102 patients with 115 shoulder joint conditions underwent radiation therapy (RT). All joints received two RT series (6 x 0.5 Gy/series) applied in two to three weekly fractions, totaling a dosage of 6.0 Gy (250 kV, 15 mAs, 1-mm Cu filter). The second RT course started 6 weeks after the end of the first. 115 shoulders were examined before RT, 6 weeks after the second RT course and, finally, during the follow-up from January to May 2003. Results: Pain relief was achieved in 94/115 shoulder joints (82%) after 18-month follow-up (median). A significant difference existed between secondary impingement and primary/non-impingement according to response. Tendinosis calcarea, bursitis subdeltoidea, tendovaginitis of the long biceps tendon, and capsulitis adhaesiva responded well to therapy. Conclusion: Shoulder diseases of secondary impingement demonstrate a good response to RT. Less or no benefit was found in primary impingement syndrome or complete rotator cuff disruption and acute shoulder injuries, respectively. (orig.)

  12. Shoulder injuries in professional rugby: a retrospective analysis

    OpenAIRE

    Horsley, Ian G; Fowler, Elizabeth M; Rolf, Christer G

    2013-01-01

    Background In the literature, little is known about the level and pattern of rugby injuries. Of the shoulder injuries reported, 51% of these are caused during a tackle, and 65% of all match injuries affected the shoulder. Objective The study aims to describe a sport-specific unique intra-articular shoulder pathology of professional rugby players, who presented with persistent pain and dysfunction despite physiotherapeutic treatment and rest. Method This study is a retrospective analysis set a...

  13. Radiography of the acutely injured shoulder

    International Nuclear Information System (INIS)

    Neep, M.J.; Aziz, A.

    2011-01-01

    Routine radiological examination of the acute shoulder has been unchanged in radiology departments for many years. At UCLH (University College London Hospitals, UK) this examination consists of two projections, an AP (antero-posterior) and an LS (lateral scapula). Following a review of the related literature and the possible advantages of an axial style projection, a study was performed to evaluate whether a new projection named modified trauma axial (MTA) shoulder projection could replace the existing LS projection in the routine examination of the acute shoulder. A retrospective analysis of 244 acute shoulder examinations over a 5-month period was performed. AP, LS and MTA projections were taken with paired AP and LS, and AP and MTA radiographs were reported separately. 97 traumatic abnormalities were reported using AP and MTA whilst only 64 abnormalities were reported using AP and LS views. The MTA projection demonstrated it was significant for evaluating articular surfaces of the humeral head and glenoid, defects in the humeral head, greater tuberosity fractures, glenoid fractures and fractures of the acromion. It was established that if the LS projection was replaced with the MTA view no traumatic pathologies would have been overlooked and in fact there was a 52% increase in traumatic abnormalities detected. Use of a chi-squared test demonstrated a highly significant difference in the number of traumatic abnormalities detected between the two pairs of projection combinations (p = 0.0004). Based on this study and the examined literature the routine examination of the acutely injured shoulder is recommended to include the AP and MTA projections only.

  14. Protocol for Shoulder function training reducing musculoskeletal pain in shoulder and neck: a randomized controlled trial

    DEFF Research Database (Denmark)

    Andersen, Christoffer H; Andersen, Lars L; Mortensen, Ole S

    2011-01-01

    treated by physical therapists. The exact mechanism of neck pain is rarely revealed by clinical examination and the treatment has varied from passive rest to active treatments. Active treatments have often been divided into either training of the painful area or the surrounding musculature avoiding direct...... training of the painful area. Our study investigates the effect of the latter approach. METHODS/DESIGN: A randomized controlled trial of 10 weeks duration is currently being conducted. Employed office workers with severe neck-shoulder pain are randomized to 3 × 20 min shoulder function training...... with training supervision or to a reference group receiving advice to stay physically active. Shoulder function training primarily focuses on the serratus anterior and lower trapezius muscle with only minimal activation the upper trapezius.An announcement was sent to the administrative section of the university...

  15. What is the effect of a shoulder-strengthening program to prevent shoulder pain among junior female team handball players?

    Science.gov (United States)

    Sommervold, Maria; Østerås, Håvard

    2017-01-01

    Excessively high stresses are applied to the shoulder joint of handball players, mainly caused by overhead throwing. Shoulder pain is a significant problem among junior female team handball players and both male and female top-level team handball players in Norway. A randomized selection was performed among the best female junior teams (J 16) in the Trøndelag region of Norway in the 2014-2015 season. Three teams were randomized to the intervention group and three teams to the control group. Players in the intervention group (n=53) participated in a seven-month, three-times-a-week shoulder-muscle strength-training program, while those in the control group (n=53) participated in a comparable handball training, but did not conduct any specific strength training during the season. A strength-training program had no effect on the prevention of shoulder pain. Overall, the players reported shoulder pain, but graded the pain low on visual analog scale (VAS). Both the intervention group and the control group reported pain under 1 on VAS at baseline and posttest, and there was no significant difference within or between the groups when it came to the intensity of pain reported on VAS. A significant difference ( p handball. The intervention group was significantly stronger ( p handball players.

  16. Shoulder functionality after manual therapy in subjects with shoulder impingement syndrome: a case series.

    Science.gov (United States)

    Heredia-Rizo, Alberto Marcos; López-Hervás, Antonia; Herrera-Monge, Patricia; Gutiérrez-Leonard, Ana; Piña-Pozo, Fernando

    2013-04-01

    The aim of the study was to identify the differences in functionality of the upper limb in subjects suffering from shoulder impingement syndrome after intervention by two manual therapy protocols. Randomized, single-blind study with a sample of 22 subjects (58 ± 10.86 years old) divided into two groups. The conventional-group (n = 11) received mobilizations of the shoulder and the experimental-group (n = 11) was treated with soft tissue techniques in the cervical and upper thoracic regions. These two groups received electrotherapy and postural advices. The treatment lasted three weeks (15 daily sessions of 1 h and 30 min). Both active and passive range of motion (ROM) and self-perceived functionality of the upper limb (DASH questionnaire) were measured. The experimental group showed a significant improvement in the DASH scores and both groups improved mobility in the intra-group comparison pre-intervention versus post-intervention (p .05). Our results suggest that a combined treatment with electrotherapy, postural hygiene and manual therapy, regardless of the protocol, improves shoulder mobility and functionality. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Severe refractory hypertension during shoulder arthroscopy

    Directory of Open Access Journals (Sweden)

    R O Abrons

    2016-01-01

    Full Text Available The use of epinephrine-containing saline irrigating solutions during arthroscopic shoulder surgery gained popularity after it was reported that the addition of epinephrine reduced bleeding and improved visualization without adverse cardiovascular effects. We share a case of a patient undergoing shoulder arthroscopy who received a standard intra-articular infusion of epinephrine-containing normal saline (1 mcg/mL and experienced severe hemodynamic consequences.

  18. Axillary artery injury secondary to inferior shoulder dislocation.

    Science.gov (United States)

    Plaga, Brad R; Looby, Peter; Feldhaus, Steven J; Kreutzmann, Karl; Babb, Aaron

    2010-11-01

    Dislocation injuries of the glenohumeral joint are common in the general public and generally are corrected without complication. One serious complication with shoulder dislocations, or the subsequent reduction, is a lesion to the axillary artery. This specific complication is most frequently seen in the elderly population, where vascular structures have become less flexible. Also, these injuries are most common in association with anterior dislocations of the shoulder. To bring awareness to the possibility of axillary artery injury with inferior dislocation of the shoulder, the treatment options, and a review. We report a 15-year-old male athlete who inferiorly dislocated his shoulder during wrestling practice. The injury was reduced at the scene with manual traction and the patient was transferred to our clinic for evaluation. The patient was determined to have a pseudoaneurysm of the axillary artery, and the history and treatment of the illness are presented. Axillary artery injuries secondary to shoulder dislocations are rare, especially in the young athlete, and proper recognition and treatment offer patients a full recovery. Copyright © 2010. Published by Elsevier Inc.

  19. Association of fetal cranial shape with shoulder dystocia.

    Science.gov (United States)

    Belfort, M A; White, G L; Vermeulen, F M

    2012-03-01

    To evaluate whether fetal cranial shape is related to shoulder dystocia. We compared shoulder dystocia cases (n = 18) with controls (normal vaginal deliveries, n = 18) in a retrospective matched-pairs observational study. Subjects were matched for known maternal and fetal risk factors and then evaluated for fetal biometric differences, which were measured by ultrasound near delivery. We tested multivariable risk models to predict shoulder dystocia by logistic regression. Cases had a smaller estimated occipitofrontal diameter (OFD) (P = 0.02) and a larger biparietal diameter/estimated OFD ratio (P = 0.003). A multivariable model including estimated fetal weight, estimated OFD, maternal weight and diabetes mellitus had sensitivity and specificity of 86% and 95%, respectively, and positive and negative likelihood ratios of 18.9 and 0.15, respectively. Estimated OFD significantly increased the predictive value of the model. A small estimated OFD is a risk factor for shoulder dystocia in the presence of other significant risk factors. A multivariable model including estimated OFD can predict shoulder dystocia in a clinically useful range. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

  20. [Posterosuperior impingement of the shoulder in the athlete: results of arthroscopic debridement in 75 patients].

    Science.gov (United States)

    Riand, N; Boulahia, A; Walch, G

    2002-02-01

    The painful shoulder is a well-recognized clinical entity in throwers although the pathogenic mechanisms involved are still debated. In 1991 Walch then Jobe developed the concept of posterosuperior impingement to explain lesions observed arthroscopically. This impingement between the deep aspect of the supraspinatus tendon and the glenoid occurs during loaded arm movements. The purpose of this work was to study the different types of lesions observed arthroscopically and to analyse outcome after arthroscopic debridement. Our series included 75 thrower athletes who had shoulder pain for loaded arm movements. Pain was situated in the dominant shoulder in all cases. Clinically, the Jobe manipulation provoked pain in 52 patents, expression of a supraspinous disorder. After failure of conservative treatment, the patients underwent arthroscopy for assessment and debridement. At the time of arthroscopy, the patients had suffered pain for two years (mean 22.3 months). All 75 patients were seen for clinical and radiological assessment at least two years after arthroscopy. Among the 75 arthroscopies, there were 67 (89%) partial tears involving the deep aspect of the cuff, associated in 90% of the cases with a labral lesion. Tears involved the supraspinatus in 40 cases, the supraspinatus and the infraspinatus in 24 and the infraspinatus alone in three. Eight patients were free of tendon lesions at arthroscopy. There were no full thickness tears. The labrum had a meniscal (45%) or non-meniscal aspect (55%) and appeared normal (18%), fringed (38%) or fissured (52%). The very large majority of the labral fissures were found behind the biceps insertion. Fissures of the labrum were found in front of the biceps insertion in only three cases (slap lesion). Arthroscopy demonstrated glenoid damage (soft cartilage, fissure, abrasion, wear). The humeral head also exhibited lesions of the cartilage facing the insertion of the infraspinatus. At last follow-up (minimum > 2 years), eight

  1. Diagnosis of shoulder instability in dogs and cats: a retrospective study

    International Nuclear Information System (INIS)

    Bardet, J.F.

    1998-01-01

    The glenohumeral joint is a remarkable articulation providing the greatest range of motion of any joint in the body. Glenohumeral stabilityresults from several mechanisms, including those that do not require expenditure of energy by muscle ('''passive mechanisms'') and those that do (''active mechanisms''). Glenohumeral instability has been recognized in 47 shoulders of 45 dogs and one cat. Cases are presented because of chronic foreleg lameness. Shoulder joint pain is obviated by theorthopedic examination. Only 57% of the involved shoulders presented with degenerative joint disease. Signs of instability are recognized under anesthesia using a craniocaudal or mediolateral drawer sign or both. This report describes the radiographic and arthroscopic findings of shoulder instability. Arthroscopy of the shoulder joint allows identification of all intra-articular pathologies. Shoulder instability notfully recognized in the past, appears to be the most common cause of shoulder lameness in the dog

  2. Frozen shoulder or missed posterior dislocation? | Leijnen | South ...

    African Journals Online (AJOL)

    South African Journal of Sports Medicine ... has similarities with an idiopathic frozen shoulder masking proper diagnosis at the time of injury. ... shoulder pain which demonstrates the importance of correct initial diagnosis and management.

  3. Predictors of shoulder dystocia at the time of operative vaginal delivery.

    Science.gov (United States)

    Palatnik, Anna; Grobman, William A; Hellendag, Madeline G; Janetos, Timothy M; Gossett, Dana R; Miller, Emily S

    2016-11-01

    It remains uncertain whether clinical factors known prior to delivery can predict which women are more likely to experience shoulder dystocia in the setting of operative vaginal delivery. We sought to identify whether shoulder dystocia can be accurately predicted among women undergoing an operative vaginal delivery. This was a case-control study of women undergoing a low or outlet operative vaginal delivery from 2005 through 2014 in a single tertiary care center. Cases were defined as women who experienced a shoulder dystocia at the time of operative vaginal delivery. Controls consisted of women without a shoulder dystocia at the time of operative vaginal delivery. Variables previously identified to be associated with shoulder dystocia that could be known prior to delivery were abstracted from the medical records. Bivariable analyses and multivariable logistic regression were used to identify factors independently associated with shoulder dystocia. A receiver operating characteristic curve was created to evaluate the predictive value of the model for shoulder dystocia. Of the 4080 women who met inclusion criteria, shoulder dystocia occurred in 162 (4.0%) women. In bivariable analysis, maternal age, parity, body mass index, diabetes, chorioamnionitis, arrest disorder as an indication for an operative vaginal delivery, vacuum use, and estimated fetal weight >4 kg were significantly associated with shoulder dystocia. In multivariable analysis, parity, diabetes, chorioamnionitis, arrest disorder as an indication for operative vaginal delivery, vacuum use, and estimated fetal weight >4 kg remained independently associated with shoulder dystocia. The area under the curve for the generated receiver operating characteristic curve was 0.73 (95% confidence interval, 0.69-0.77), demonstrating only a modest ability to predict shoulder dystocia before performing an operative vaginal delivery. While risk factors for shoulder dystocia at the time of operative vaginal delivery

  4. The analysis of spatial relationship between the rotator cuff and the subacromial space in different arm positions

    International Nuclear Information System (INIS)

    Zou Yuefen; Wang Dehang; Wang Xiaoning; Li Shener

    2003-01-01

    Objective: To explore the distance between the acromion and the humerus head at different arm abduction to observe whether it changes or not, to determine at which position the distance is smallest, and to evaluate the relationship between the subacromial space and the rotator cuff. Methods: Fifteen normal volunteers were examined with MRI in six arm positions, and the coronal thin images were obtained with a spin echo sequence. Using a special positioning device, the arm was placed at 0 degree, 30 degree, 60 degree, 90 degree, 120 degree and 150 degree arm abduction, respectively. Of them, 0 degree-90 degree positions were not rotated, while 120 degree and 150 degree positions were slight internal rotated. The minimal distance of acromion-humerus (A-H) and clavicle-humerus (C-H), and the spatial relationship between the rotator cuff and the subacromial space were measured and observed. Results: The values of A-H and C-H at 60 degree - 150 degree arm abduction were obviously smaller than those at 0 degree-30 degree arm abduction (P 0.05). The rotator cuff (mainly supraspinatus tendon) just went through between the acromion and the humerus at 60 degree - 120 degree arm positions but not at 0 degree, 30 degree and 150 degree arm positions. So at 60 degree - 120 degree arm positions, rotator cuff between the humerus and the acromion was often impinged. Conclusion: The closest contact between the supraspinatus tendon and subacromial space occurs at 60 degree - 120 degree abduction. The findings testify that the patients with impingement syndrome have shoulder pain at 60 degree - 120 degree abduction in clinic from etiology and pathology. In the future, MRI-based analyses should allow investigating the morphological basis of the impingement syndrome, choosing the appropriate therapy, and minimizing failure rates of surgery

  5. Association of head circumference and shoulder dystocia in macrosomic neonates.

    Science.gov (United States)

    Larson, Austin; Mandelbaum, David E

    2013-04-01

    To determine whether asymmetric macrosomia (disproportionately large body size in comparison to head circumference) could be demonstrated in a population of infants suffering shoulder dystocia during delivery relative to those that did not suffer from shoulder dystocia. A case-control study was conducted as a retrospective chart review over 3 years at a large maternity hospital in an urban setting. Among infants over 4,000 g, those that suffered from shoulder dystocia during delivery had a smaller mean head circumference than infants of a similar size that did not suffer from shoulder dystocia. A statistically significant difference was also present when cases of documented gestational diabetes were excluded. Asymmetric macrosomia is more likely to be present in a population of infants who suffered shoulder dystocia during delivery. This knowledge could be used in designing tools to predict which pregnancies are at highest risk for shoulder dystocia during delivery.

  6. Imaging of bursae around the shoulder joint

    International Nuclear Information System (INIS)

    Bureau, N.J.; Dussault, R.G.; Keats, T.E.

    1996-01-01

    The authors present a review of the anatomy of the major bursae around the shoulder joint and discuss the use of the different imaging modalities which demonstrate their radiologic features. The calcified subacromial-subdeltoid bursa has a characteristic appearance on plain radiographs. When inflamed it can be visualized by ultrasound and magnetic resonance imaging. Calcific bursitis may involve the subcoracoid bursa. This bursa may mimic adhesive capsulitis of the shoulder or complete rotator cuff tear when injected inadvertently during shoulder arthrography. Less well known are three coracoclavicular ligament bursae. These are also subject to calcific bursitis and have a typical radiologic appearance. (orig.). With 6 figs

  7. Imaging of bursae around the shoulder joint

    Energy Technology Data Exchange (ETDEWEB)

    Bureau, N.J. [Department of Radiology, Hotel-Dieu de Montreal Hospital, Montreal, Quebec (Canada); Dussault, R.G. [Department of Radiology, Health Sciences Center, University of Virginia, Charlottesville, Virginia (United States); Keats, T.E. [Department of Radiology, Health Sciences Center, University of Virginia, Charlottesville, Virginia (United States)

    1996-08-01

    The authors present a review of the anatomy of the major bursae around the shoulder joint and discuss the use of the different imaging modalities which demonstrate their radiologic features. The calcified subacromial-subdeltoid bursa has a characteristic appearance on plain radiographs. When inflamed it can be visualized by ultrasound and magnetic resonance imaging. Calcific bursitis may involve the subcoracoid bursa. This bursa may mimic adhesive capsulitis of the shoulder or complete rotator cuff tear when injected inadvertently during shoulder arthrography. Less well known are three coracoclavicular ligament bursae. These are also subject to calcific bursitis and have a typical radiologic appearance. (orig.). With 6 figs.

  8. Shoulder arthroplasty with the Neer Mark-II prosthesis

    DEFF Research Database (Denmark)

    Frich, Lars Henrik; Møller, B.N.; Sneppen, O.

    1988-01-01

    Total shoulder joint replacement was used as primary intervention in 50 shoulders--35 with rheumatoid arthritis, eight with osteoarthritis, and seven with traumatic arthritis. Follow-up time was 27 (12-42) months. The primary indication for the operation was chronic severe pain; improvements...... in motion and function were secondary objectives. Relief of pain was obtained in 46 of 50 shoulders. The best results regarding pain, motion, and function were obtained in the osteoarthritic group. The majority of patients with rheumatoid arthritis obtained pain relief and the largest increase in range...... of motion occurred in this group, although full range of motion was never regained. The results in patients with traumatic arthritis seemed unpredictable. Two shoulders were complicated by glenoid loosening, one by humeral subluxation, and one by musculocutaneous nerve palsy....

  9. Initial results of shoulder MRI in external rotation after primary shoulder dislocation and after immobilization in external rotation

    International Nuclear Information System (INIS)

    Pennekamp, W.; Nicolas, V.; Gekle, C.; Seybold, D.

    2006-01-01

    Purpose: A change in the strategy for treating primary anterior traumatic dislocation of the shoulder has occurred. To date, brief fixation of internal rotation via a Gilchrist bandage has been used. Depending on the patient's age, a redislocation is seen in up to 90% of cases. This is due to healing of the internally rotated labrum-ligament tear in an incorrect position. In the case of external rotation of the humerus, better repositioning of the labrum ligament complex is achieved. Using MRI of the shoulder in external rotation, the extent of the improved labrum-ligament adjustment can be documented, and the indication of immobilization of the shoulder in external rotation can be derived. The aim of this investigation is to describe the degree of position changing of the labrum-ligament tear in internal and external rotation. Materials and Methods: 10 patients (9 male, 1 female, mean age 30.4 years, range 15-43 years) with a primary anterior dislocation of the shoulder without hyper laxity of the contra lateral side and labrum-ligament lesion substantiated by MRI were investigated using a standard shoulder MRI protocol (PD-TSE axial fs, PD-TSE coronar fs, T2-TSE sagittal, T1-TSE coronar) by an axial PD-TSE sequence in internal and external rotation. The dislocation and separation of the anterior labrum-ligament complex were measured. The shoulders were immobilized in 10 external rotation for 3 weeks. After 6 weeks a shoulder MRI in internal rotation was performed. Results: In all patients there was a significantly better position of the labrum-ligament complex of the inferior rim in external rotation, because of the tension of the ventral capsule and the subscapular muscle. In the initial investigation, the separation of the labrum-ligament complex in internal rotation was 0.44±0.27 mm and the dislocation was 0.45±0.33 mm. In external rotation the separation was 0.01±0.19 mm and the dislocation was -0.08±0.28 mm. After 6 weeks of immobilization in 10 external

  10. Comparative study of total shoulder arthroplasty versus total shoulder surface replacement for glenohumeral osteoarthritis with minimum 2-year follow-up

    NARCIS (Netherlands)

    Kooistra, B.W.; Willems, W.J.H.; Lemmens, E.; Hartel, B.P.; Bekerom, M.P. van den; Deurzen, D.F.P. van

    2017-01-01

    BACKGROUND: Compared with total shoulder arthroplasty (TSA), total shoulder surface replacement (TSSR) may offer the advantage of preservation of bone stock and shorter surgical time, possibly at the expense of glenoid component positioning and increasing lateral glenohumeral offset. We hypothesized

  11. Magnetic resonance imaging of the shoulder: Rationale and current applications

    International Nuclear Information System (INIS)

    Holt, R.G.; Helms, C.A.; Steinbach, L.; Neumann, C.; Munk, P.L.; Genant, H.K.

    1990-01-01

    Because it can demonstrate a wide range of tissue contrast with excellent resolution, magnetic resonance (MR) imaging has revolutionized imaging in many areas of the musculoskeletal system and has generated excitement among those interested in the painful shoulder. Shoulder impingement syndrome and glenohumeral instability constitute the two major categories of shoulder derangements. Correct diagnosis requires the use of appropriate pulse sequences and imaging planes, proper patient positioning, and a satisfactory surface coil. In addition the imager must have a thorough understanding of shoulder anatomy and pathology. We present a summary of the current status of MR imaging of the shoulder including technical, anatomic, and pathologic considerations and a review of the pertinent literature. (orig.)

  12. Shoulder arthography in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Reinbold, W.D.; Hehne, H.J.; Rau, W.S.; Freiburg Univ.

    1983-01-01

    Shoulder arthrography in a patient with rheumatoid arthritis is performed to differentiate between a rheumatoid flare and limitation of motion secondary to tear in the rotator cuff. Accurate diagnosis is important because of the therapeutic implications. The arthrographic findings characteristic of rheumatoid involvement of the shoulder joint are nodular filling defects of the joint, the subacromial and subdeltoideal bursa in case of rotator cuff tear, irregular capsular attachment, contracted joint space and visualized lymphatic drainage. A dilatation of the biceps tendon sheath has not been shown. (orig.) [de

  13. Bicycle-Related Shoulder Injuries: Etiology and the Need for Protective Gear.

    Science.gov (United States)

    Goldstein, Yariv; Dolkart, Oleg; Kaufman, Ehud; Amar, Eyal; Sharfman, Zachary T; Rath, Ehud; Mozes, Gavriel; Maman, Eran

    2016-01-01

    The popularity of bicycle riding for recreation, exercise and transportation has grown enormously in recent years, which has led to an increased incidence of bicycle-related injuries. While these injuries involve mainly the musculoskeletal system, data on shoulder-specific injuries incurred while bike riding are lacking. Classifying these shoulder injuries may provide insight and assistance in the creation and implementation of effective protective gear and measures. To investigate the types and mechanisms of shoulder injuries among cyclists. This study retrospectively examined all cyclists who incurred shoulder injuries while riding and were admitted to the emergency department and shoulder clinic between January 2008 and November 2013. The study included 157 subjects with various bicycle-related shoulder injuries treated with either conservative or surgical measures. Eighty-four percent of injuries were caused by a direct blow to the shoulder, 7% by falling on an outstretched hand, 6% were traction injuries, and 3% were due to hyperabduction. Nine different clinical types of injury were observed; the most common injuries were clavicle fractures (32%), followed by acromioclavicular joint dislocations (22%), rotator cuff tears (22%), and humeral fractures (8%). Fifty-one percent of subjects were managed with conservative care and the remaining patients required surgical interventions. Shoulder injuries incurred while riding a bicycle span the entire spectrum of shoulder injuries and often result in debilitating conditions. Although the use of helmets is increasing, there is currently no effective protective gear or measures to prevent riders from suffering shoulder injuries.

  14. Association between Propionibacterium acnes and frozen shoulder: a pilot study.

    Science.gov (United States)

    Bunker, Tim D; Boyd, Matthew; Gallacher, Sian; Auckland, Cressida R; Kitson, Jeff; Smith, Chris D

    2014-10-01

    Frozen shoulder has not previously been shown to be associated with infection. The present study set out to confirm the null hypothesis that there is no relationship between infection and frozen shoulder using two modern scientific methods, extended culture and polymerase chain reaction (PCR) for bacterial nucleic acids. A prospective cohort of 10 patients undergoing arthroscopic release for stage II idiopathic frozen shoulder had two biopsies of tissue taken from the affected shoulder joint capsule at the time of surgery, along with control biopsies of subdermal fat. The biopsies and controls were examined with extended culture and PCR for microbial nucleic acid. Eight of the 10 patients had positive findings on extended culture in their shoulder capsule and, in six of these, Propionibacterium acnes was present. The findings mean that we must reject the null hypothesis that there is no relationship between infection and frozen shoulder. More studies are urgently needed to confirm or refute these findings. If they are confirmed, this could potentially lead to new and effective treatments for this common, painful and disabling condition. Could P. acnes be the Helicobacter of frozen shoulder?

  15. Rates of surgery for frozen shoulder: an experience in England.

    Science.gov (United States)

    Kwaees, Tariq A; Charalambous, Charalambos P

    2015-01-01

    the aim of this study was to identify the incidence of surgical treatment for frozen shoulder in a western population. patients included in this study all resided within a well-defined area in the North West of England, all had surgery for frozen shoulder over a 3-year period and were identified from theatre logbooks of two local hospitals. Cases having surgery for shoulder stiffness other than frozen shoulder were excluded. Local and national population size estimates were based on data obtained from the UK Office for National Statistics. 117 patients underwent surgery for frozen shoulder during the period examined; of these 101 had arthroscopic arthrolysis and 16 had manipulation under anaesthesia. The overall incidence of frozen shoulder surgery was calculated at 2.67 procedures per 10,000 general population per year, and at 7.55 for those aged 40-60. surgical intervention for frozen shoulder is common, estimated at over 14,180 cases per year in England. Given the variation in costs associated with arthroscopic arthrolysis and manipulation under anaesthesia, comparative studies of the cost effectiveness of the two procedures would be of great value. 2C (outcome research).

  16. A Simple Technique for Shoulder Arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Berna-Serna, J.D.; Redondo, M.V.; Martinez, F.; Reus, M.; Alonso, J.; Parrilla, A.; Campos, P.A. [Virgen de la Arrixaca Univ. Hospital, El Palmar, Murcia (Spain). Dept. of Radiology

    2006-09-15

    Purpose: To present a systematic approach to teaching a technique for arthrography of the shoulder. Using an adhesive marker-plate with radiopaque coordinates, precise sites for puncture can be identified and the need for fluoroscopic guidance obviated. Material and Methods: Forty-six glenohumeral arthrograms were performed in 45 patients; in 1 case involving examination of both shoulders. The stages of the technique are described in detail, as are the fundamental aspects of achieving an effective glenohumeral injection. Pain intensity was measured in all patients using a verbal description scale. Results: Shoulder arthrography was successful in all cases. Average time taken for the procedure was 7 min, with no difference in the respective times required by an experienced radiologist and a resident. The