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Hwang S, Chang D, Saxena A, Oleen E, Lin Paing S, Atkins J, Lee H. Characterization of Human Shoulder Joint Stiffness Across 3D Arm Postures and Its Sex Differences. IEEE Trans Biomed Eng 2024; 71:2833-2841. [PMID: 38691430 DOI: 10.1109/tbme.2024.3395587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
Understanding the characteristics of shoulder joint stiffness can offer insights into how the shoulder joint contributes to arm stability and assists in various arm postures and movements. This study aims to characterize posture-dependent shoulder stiffness in a three-dimensional (3D) space and investigate its potential sex differences. A multi-degree-of-freedom, parallel-actuated shoulder exoskeleton robot was used' to perturb the participant's shoulder joint and measure the resulting torque responses while participants relaxed their shoulder muscles. The group average results of 40 healthy individuals (20 males and 20 females) revealed that arm postures significantly affect shoulder stiffness, particularly in postures involving shoulder flexion/extension and horizontal flexion/extension. Shoulder stiffness consistently increased as the shoulder flexion angle decreased and the shoulder horizontal flexion/extension approached the limit of its range of motion. The comparative group results between males and females indicated that shoulder stiffness in males was greater than that in females across all 15 arm postures measured in this study. Even after normalizing the data by subject body mass, the female group showed significantly lower stiffness than the male group in 12 out of the 15 arm postures. The results highlight that 3D arm postures and sex significantly affect shoulder stiffness even under relaxed muscles. This study provides valuable foundations for future studies aimed at characterizing shoulder stiffness in the context of active muscles and dynamic movement tasks, evaluating changes in shoulder stiffness following neuromuscular injuries, and formulating rehabilitative training protocols for individuals suffering from shoulder problems.
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Glover MA, Fiegen AP, Bullock GS, Nicholson KF, Trasolini NA, Waterman BR. Management of Shoulder Instability in the Overhead Athletes. Clin Sports Med 2024; 43:683-703. [PMID: 39232574 DOI: 10.1016/j.csm.2024.03.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2024]
Abstract
Overhead athletes with anterior, posterior, and multidirectional shoulder instability present with a wide range of symptoms, especially considering the injury mechanism and affected supportive structures. As such, the management of shoulder instability is widely variable and relies on rehabilitation, operative management, and sport-specific considerations, such as positional and seasonal demands on the athlete. Biomechanical analysis may further aid in the recovery process or serve as a predictive tool to identify an increased risk for injury.
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Affiliation(s)
- Mark A Glover
- Wake Forest University School of Medicine, Winston Salem, NC, USA.
| | - Anthony P Fiegen
- Department of Orthopaedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Garrett S Bullock
- Department of Orthopaedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Kristen F Nicholson
- Department of Orthopaedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Nicholas A Trasolini
- Department of Orthopaedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Brian R Waterman
- Department of Orthopaedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Lawrence RL, Nicholson L, Lee ECS, Napier K, Zmistowski B, Rainbow MJ. Geometric accuracy of low-dose CT scans for use in shoulder musculoskeletal research applications. Med Eng Phys 2024; 130:104214. [PMID: 39160033 DOI: 10.1016/j.medengphy.2024.104214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 06/21/2024] [Accepted: 07/31/2024] [Indexed: 08/21/2024]
Abstract
Computed tomography (CT) imaging is frequently employed in a variety of musculoskeletal research applications. Although research studies often use imaging protocols developed for clinical applications, lower dose protocols are likely possible when the goal is to reconstruct 3D bone models. Our purpose was to describe the dose-accuracy trade-off between incrementally lower-dose CT scans and the geometric reconstruction accuracy of the humerus, scapula, and clavicle. Six shoulder specimens were acquired and scanned using 5 helical CT protocols: 1) 120 kVp, 450 mA (full-dose); 2) 120 kVp, 120 mA; 3) 120 kVp, 100 mA; 4) 100 kVp, 100 mA; 5) 80 kVp, 80 mA. Scans were segmented and reconstructed into 3D surface meshes. Geometric error was assessed by comparing the surfaces of the low-dose meshes to the full-dose (gold standard) mesh and was described using mean absolute error, bias, precision, and worst-case error. All low-dose protocols resulted in a >70 % reduction in the effective dose. Lower dose scans resulted in higher geometric errors; however, error magnitudes were generally <0.5 mm. These data suggest that the effective dose associated with CT imaging can be substantially reduced without a significant loss of geometric reconstruction accuracy.
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Affiliation(s)
- Rebekah L Lawrence
- Program in Physical Therapy, Washington University School of Medicine, 4444 Forest Park Avenue, Campus Box 8502, St. Louis, MO 63108, USA.
| | - Lydia Nicholson
- Program in Physical Therapy, Washington University School of Medicine, 4444 Forest Park Avenue, Campus Box 8502, St. Louis, MO 63108, USA
| | - Erin C S Lee
- Department of Mechanical and Materials Engineering, Queen's University, McLaughlin Hall, 130 Stuart Street, Kingston, Ontario, Canada
| | - Kelby Napier
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 1 Barnes Jewish Hospital Plaza, St Louis, MO 63110, USA
| | - Benjamin Zmistowski
- Department of Orthopedics, Washington University School of Medicine, 660 S. Euclid Ave., Campus Box 8233, St. Louis, MO 63110, USA
| | - Michael J Rainbow
- Department of Mechanical and Materials Engineering, Queen's University, McLaughlin Hall, 130 Stuart Street, Kingston, Ontario, Canada
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Bell S, Nasr A, McPhee J. General Muscle Torque Generator Model for a Two Degree-of-Freedom Shoulder Joint. J Biomech Eng 2024; 146:081008. [PMID: 38470378 DOI: 10.1115/1.4065044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 03/04/2024] [Indexed: 03/13/2024]
Abstract
Muscle torque generators (MTGs) have been developed as an alternative to muscle-force models, reducing the muscle-force model complexity to a single torque at the joint. Current MTGs can only be applied to single Degree-of-freedom (DoF) joints, leading to complications in modeling joints with multiple-DoFs such as the shoulder. This study aimed to develop an MTG model that accounts for the coupling between 2-DoF at the shoulder joint: shoulder plane of elevation (horizontal abduction/adduction) and shoulder elevation (flexion/extension). Three different 2-DoF MTG equations were developed to model the coupling between these two movements. Net joint torques at the shoulder were determined for 20 participants (10 females and 10 males) in isometric, isokinetic, and passive tests. Curve and surface polynomial fitting were used to find the best general fit for the experimental data in terms of the different degrees of coupling. The models were validated against experimental isokinetic torque data. It was determined that implicit coupling that used interpolation between single-DoF MTGs resulted in the lowest root-mean-square percent error of 8.5%. The work demonstrated that general MTG models can predict torque results that are dependent on multiple-DoFs of the shoulder.
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Affiliation(s)
- Sydney Bell
- Systems Design Engineering Department, University of Waterloo, Waterloo, ON N2L 3G1, Canada
- University of Waterloo
| | - Ali Nasr
- Systems Design Engineering Department, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - John McPhee
- Systems Design Engineering Department, University of Waterloo, Waterloo, ON N2L 3G1, Canada
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Genter J, Croci E, Müller AM, Mündermann A, Baumgartner D. Influence of Critical Shoulder Angle and Rotator Cuff Tear Type on Load-Induced Glenohumeral Biomechanics: A Sawbone Simulator Study. Appl Bionics Biomech 2024; 2024:4624007. [PMID: 38983835 PMCID: PMC11233187 DOI: 10.1155/2024/4624007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/15/2024] [Accepted: 06/14/2024] [Indexed: 07/11/2024] Open
Abstract
Glenohumeral (GH) biomechanics after rotator cuff (RC) tears are not fully understood. The purpose of our study was to determine if the critical shoulder angle (CSA), type of RC tears, and level of weight bearing increase GH translation, instability based on the instability ratio, muscle forces and joint reaction force (JRF), and shifts the center of force (CoF) superiorly. A GH simulator with muscle-mimicking cable systems was used to simulate 30° abduction in the scapular plane. A Sawbone humerus and five specimen-specific scapular anthropometries were used to test six types of RC tears, three weight-bearing loads, and the native and adjusted (to different CSAs) deltoid origin sites. Linear mixed effects models (CSA, RC tear type, and weight bearing) with random effects (specimen and sex) were used to assess differences in GH biomechanics. With increasing CSA, GH translation increased, JRF decreased, and the CoF position was more inferior. RC tears did not significantly alter GH translation but shifted the CoF position superiorly, close to where glenoid erosion occurs in patients with RC tears with secondary osteoarthritis. Weight bearing significantly increased GH translation and JRF. RC and deltoid muscle forces increased with the presence of RC tears and increased weight bearing. The remaining RC muscles of intact tendons compensated for the torn RC tendons but not for the altered CoF position. GH translation remained comparable to shoulders with intact RC. These findings highlight the importance of early detection, clinical management, and targeted rehabilitation strategies for patients with RC tears.
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Affiliation(s)
- Jeremy Genter
- IMES Institute of Mechanical Systems Zurich University of Applied Sciences ZHAW, Winterthur, Switzerland
- Department of Biomedical Engineering University of Basel, Basel, Switzerland
- Department of Orthopaedics and Traumatology University Hospital Basel, Basel, Switzerland
| | - Eleonora Croci
- Department of Biomedical Engineering University of Basel, Basel, Switzerland
- Department of Orthopaedics and Traumatology University Hospital Basel, Basel, Switzerland
| | - Andreas M Müller
- Department of Orthopaedics and Traumatology University Hospital Basel, Basel, Switzerland
| | - Annegret Mündermann
- Department of Biomedical Engineering University of Basel, Basel, Switzerland
- Department of Orthopaedics and Traumatology University Hospital Basel, Basel, Switzerland
- Department of Clinical Research University of Basel, Basel, Switzerland
| | - Daniel Baumgartner
- IMES Institute of Mechanical Systems Zurich University of Applied Sciences ZHAW, Winterthur, Switzerland
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Tazawa T, Yasui M, Otsuka S, Hatayama N, Naito M, Ohshima S, Yokota H. Development of a musculoskeletal shoulder model considering anatomic joint structures and soft-tissue deformation for dynamic simulation. Anat Sci Int 2024; 99:278-289. [PMID: 38698275 DOI: 10.1007/s12565-024-00773-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/15/2024] [Indexed: 05/05/2024]
Abstract
The shoulder joint has a high degree of freedom and an extremely complex and unstable kinematic mechanism. Coordinated contraction of the rotator cuff muscles that stop around the humeral head and the deltoid muscles and the extensibility of soft tissues, such as the joint capsule, labrum, and ligaments, contribute to shoulder-joint stability. Understanding the mechanics of shoulder-joint movement, including soft-tissue characteristics, is important for disease prevention and the development of a device for disease treatment. This study aimed to create a musculoskeletal shoulder model to represent the realistic behavior of joint movement and soft-tissue deformation as a dynamic simulation using a rigid-body model for bones and a soft-body model for soft tissues via a spring-damper-mass system. To reproduce the muscle-contraction properties of organisms, we used a muscle-expansion representation and Hill's mechanical muscle model. Shoulder motion, including the movement of the center of rotation in joints, was reproduced, and the strain in the joint capsule during dynamic shoulder movement was quantified. Furthermore, we investigated narrowing of the acromiohumeral distance in several situations to induce tissue damage due to rotator cuff impingement at the anterior-subacromial border during shoulder abduction. Given that the model can analyze exercises under disease conditions, such as muscle and tendon injuries and impingement syndrome, the proposed model is expected to help elucidate disease mechanisms and develop treatment guidelines.
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Affiliation(s)
- Taku Tazawa
- Department of Mechanical Engineering, Meijo University, 1-501 Shiogamaguchi, Tempaku-Ku, Nagoya-Shi, Aichi, Japan
- ASAHI INTECC CO., LTD., Aichi, Japan
| | - Masaya Yasui
- Department of Judo Seifuku and Health Sciences, Tokoha University, 1230 Miyakodacho, Kita-ku, Hamamatsu-shi, Shizuoka, Japan
| | - Shun Otsuka
- Department of Anatomy, Aichi Medical University, 1-1 Yazakokarimata, Nagakute-shi, Aichi, Japan
| | - Naoyuki Hatayama
- Department of Anatomy, Aichi Medical University, 1-1 Yazakokarimata, Nagakute-shi, Aichi, Japan
| | - Munekazu Naito
- Department of Anatomy, Aichi Medical University, 1-1 Yazakokarimata, Nagakute-shi, Aichi, Japan
| | - Shigemichi Ohshima
- Department of Mechanical Engineering, Meijo University, 1-501 Shiogamaguchi, Tempaku-Ku, Nagoya-Shi, Aichi, Japan
| | - Hiroki Yokota
- Department of Mechanical Engineering, Meijo University, 1-501 Shiogamaguchi, Tempaku-Ku, Nagoya-Shi, Aichi, Japan.
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Malíř R, Chrudimský J, Provazník A, Třebický V. Are the shoulder joint function, stability, and mobility tests predictive of handstand execution? PLoS One 2024; 19:e0302922. [PMID: 38739595 PMCID: PMC11090318 DOI: 10.1371/journal.pone.0302922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 04/15/2024] [Indexed: 05/16/2024] Open
Abstract
Handstand is a basic element common across gymnastic disciplines and physical education classes that is frequently evaluated for quality in competition or skill acquisition. The correct handstand execution relies on maintaining balance, for which the shoulders seem particularly important. This study explores the relationship between shoulder joint function and the quality of handstand execution in novice college athletes (n = 111; aged 19-23 years). We assessed the shoulder joint function using standardized field tests (Upper Quarter Y Balance Test and Closed Kinetic Chain Upper Extremity Stability Test) and evaluated handstand execution on official rating scale. Ordinal logistic regression models showed no relationship between the quality of handstand execution (E-score) and measures of shoulder joint stability or mobility in our sample (POR = 0.97 [0.91, 1.03] and 1.00 [0.91, 1.09] for E-score). Two major factors may have caused an observed pattern of results. Firstly, the standardized tests assess shoulder joints in different loads and ranges of motion compared to handstands. Secondly, our novice sample was not able to perform the handstand sufficiently well. In our sample of novice college athletes, shoulder function seems not related to handstand execution as other latent factors hindered their performance.
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Affiliation(s)
- Roman Malíř
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Jan Chrudimský
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Adam Provazník
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Vít Třebický
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
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Nolte AK, Jäger S, Seifert MM, Bülhoff M, Schiltenwolf M, Schonhoff M, Raiss P, Renkawitz T, Kretzer JP, Panzram B. Capsule elongation occurs after first time shoulder dislocation A biomechanical in-vitro investigation on human cadaveric specimen. J Orthop 2024; 51:130-136. [PMID: 38384727 PMCID: PMC10878837 DOI: 10.1016/j.jor.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 02/09/2024] [Indexed: 02/23/2024] Open
Abstract
Purpose As capsule elongation is assumed to weaken the static stability of the shoulder joint, the purpose of this biomechanical study was to demonstrate that capsule elongation occurs immediately after a first-time shoulder dislocation and not just after recurrent dislocation events. We hypothesize an increment in joint clearance due to joint capsule elongation after a first-time dislocation. Methods An experimental in-vitro study was conducted on 6 paired fresh frozen human shoulders (4 females; 2 males; 12 specimen) with a mean age of 80 (Range 67-89) years. The shoulder joint with the articular capsule was exposed and an inferior static tension force of 2.5 N was applied to the humerus prior to dislocation. Next, the humeral head was dislocated and was then immediately reduced back into the start position. The joint gap as well as joint capsule deformation was assessed using optical techniques. Results The radiographic joint gap increased from 13.7 ± 6.9 mm (prior to dislocation) to 18.1 ± 6.5 mm (post dislocation) (p < .001). The increase in joint clearance was 4.4 mm. The joint capsule elongated from 5.9 ± 0.005 % (prior to dislocation) to 9.4 ± 0.007 % (post dislocation) (p < .001). The mean increase in joint capsule elongation was 3.5 %. Conclusions Capsule elongation was observed immediately after a simulated first-time shoulder dislocation in an in-vitro model of elderly human cadavers. It might therefore not only be a phenomenon of recurrent dislocation events.
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Affiliation(s)
- Anna-Katharina Nolte
- Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany
| | - Sebastian Jäger
- Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany
- Laboratory of Biomechanics and Implant Research, Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany
| | - Maxime Marie Seifert
- Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany
| | - Matthias Bülhoff
- Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany
| | - Marcus Schiltenwolf
- Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany
| | - Mareike Schonhoff
- Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany
- Laboratory of Biomechanics and Implant Research, Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany
| | - Patric Raiss
- OCM (Orthopadische Chirurgie Munchen), Steinerstraße 6, 81369, Munich, Germany
| | - Tobias Renkawitz
- Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany
| | - J. Philippe Kretzer
- Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany
- Laboratory of Biomechanics and Implant Research, Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany
| | - Benjamin Panzram
- Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany
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Assila N, Begon M, Duprey S. Finite Element Model of the Shoulder with Active Rotator Cuff Muscles: Application to Wheelchair Propulsion. Ann Biomed Eng 2024; 52:1240-1254. [PMID: 38376768 DOI: 10.1007/s10439-024-03449-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/09/2024] [Indexed: 02/21/2024]
Abstract
The rotator cuff is prone to injury, remarkably so for manual wheelchair users. To understand its pathomechanisms, finite element models incorporating three-dimensional activated muscles are needed to predict soft tissue strains during given tasks. This study aimed to develop such a model to understand pathomechanisms associated with wheelchair propulsion. We developed an active muscle model associating a passive fiber-reinforced isotropic matrix with an activation law linking calcium ion concentration to tissue tension. This model was first evaluated against known physiological muscle behavior; then used to activate the rotator cuff during a wheelchair propulsion cycle. Here, experimental kinematics and electromyography data was used to drive a shoulder finite element model. Finally, we evaluated the importance of muscle activation by comparing the results of activated and non-activated rotator cuff muscles during both propulsion and isometric contractions. Qualitatively, the muscle constitutive law reasonably reproduced the classical Hill model force-length curve and the behavior of a transversally loaded muscle. During wheelchair propulsion, the deformation and fiber stretch of the supraspinatus muscle-tendon unit pointed towards the possibility for this tendon to develop tendinosis due to the multiaxial loading imposed by the kinematics of propulsion. Finally, differences in local stretch and positions of the lines of action between activated and non-activated models were only observed at activation levels higher than 30%. Our novel finite element model with active muscles is a promising tool for understanding the pathomechanisms of the rotator cuff for various dynamic tasks, especially those with high muscle activation levels.
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Affiliation(s)
- Najoua Assila
- School of Kinesiology and Exercise Sciences, Faculty of Medicine, University of Montréal, Montréal, QC, Canada.
- Research Center of the Sainte-Justine University Hospital Center, Montréal, QC, Canada.
- Univ Lyon, Univ Gustave Eiffel, Univ Claude Bernard Lyon 1, LBMC UMR T_9406, 69622, Lyon, France.
| | - Mickaël Begon
- School of Kinesiology and Exercise Sciences, Faculty of Medicine, University of Montréal, Montréal, QC, Canada
- Research Center of the Sainte-Justine University Hospital Center, Montréal, QC, Canada
| | - Sonia Duprey
- Univ Lyon, Univ Gustave Eiffel, Univ Claude Bernard Lyon 1, LBMC UMR T_9406, 69622, Lyon, France
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Malmberg C, Jensen SE, Michaud B, Andreasen KR, Hölmich P, Barfod KW, Bencke J. Three-dimensional measurements of scapular kinematics: Interrater reliability and validation of a skin marker-based model against an intracortical pin model. Heliyon 2024; 10:e29414. [PMID: 38644878 PMCID: PMC11033140 DOI: 10.1016/j.heliyon.2024.e29414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 03/15/2024] [Accepted: 04/08/2024] [Indexed: 04/23/2024] Open
Abstract
A skin marker-based motion capture model providing measures of scapular rotations was recently developed. The aim of this study was to investigate the concurrent validity and the interrater reliability of the model. Shoulder range of motion (RoM) and activities of daily living (ADL) were tested in healthy volunteers with reflective markers on the scapula and thorax. To investigate the validity, the model was compared to simultaneous data collection from markers on a scapular intracortical pin. The interrater reliability was tested by comparing the skin marker-based protocol performed by two investigators. The mean root mean square error (RMSE) and the intraclass correlation coefficient (ICC(2,1)) were calculated to determine the validity and the interrater reliability, respectively. Eight subjects were included in the validity test: female/male = 2/6, mean (SD) age 35.0 (3.0) and BMI 23.4 (3.3). The mean RMSE of all scapular rotations ranged 2.3-6.7° during shoulder RoM and 2.4-7.6° during ADL. The highest errors were seen during sagittal and scapular plane flexions, hair combing and eating. The reliability test included twenty subjects: female/male = 8/12, mean (SD) age 31.4 (4.9) and BMI 22.9 (1.7). The ICC(2,1) for measuring protraction ranged 0.07-0.60 during RoM and 0.27-0.69 for ADL, for upward rotation the corresponding ICC(2,1) ranged 0.01-0.64 and 0.38-0.60, and anterior tilt 0.25-0.83 and 0.25-0.62. The validity and interrater reliability of the model are task dependent, and interpretation should be made with caution. The model provides quantitative measurements for objective assessment of scapular movements and can potentially supplement the clinical examination in certain motion tasks.
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Affiliation(s)
- Catarina Malmberg
- Sports Orthopedic Research Center – Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital Amager & Hvidovre, Kettegård Allé 30, 2650, Hvidovre, Denmark
| | - Stefan E. Jensen
- Human Movement Analysis Laboratory, Department of Orthopedic Surgery, Copenhagen University Hospital Amager & Hvidovre, Kettegård Allé 30, 2650, Hvidovre, Denmark
| | - Benjamin Michaud
- Laboratoire de simulation et modélisation du mouvement (S2M), École de kinésiologie et des sciences de l'activité physique, Université de Montréal, 2100 Edouard Montpetit Blvd, Montreal, Québec, Canada
| | - Kristine R. Andreasen
- Sports Orthopedic Research Center – Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital Amager & Hvidovre, Kettegård Allé 30, 2650, Hvidovre, Denmark
| | - Per Hölmich
- Sports Orthopedic Research Center – Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital Amager & Hvidovre, Kettegård Allé 30, 2650, Hvidovre, Denmark
| | - Kristoffer W. Barfod
- Sports Orthopedic Research Center – Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital Amager & Hvidovre, Kettegård Allé 30, 2650, Hvidovre, Denmark
| | - Jesper Bencke
- Human Movement Analysis Laboratory, Department of Orthopedic Surgery, Copenhagen University Hospital Amager & Hvidovre, Kettegård Allé 30, 2650, Hvidovre, Denmark
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11
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Erber B, Hesse N, Goller S, Reidler P. [Pathologies of the shoulder joint : Anatomy and examination techniques]. RADIOLOGIE (HEIDELBERG, GERMANY) 2024; 64:101-109. [PMID: 38085326 DOI: 10.1007/s00117-023-01246-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/17/2023] [Indexed: 01/27/2024]
Abstract
CLINICAL ISSUE The movements and stability of the human shoulder are a complex dynamic interaction between several joints, muscles and ligaments, which on the one hand enable extensive mobility and on the other hand must provide the necessary stability. Furthermore, the complexity of the shoulder is increased by a large number of normal variants. This article aims to explain the relevant anatomical structures and the radiological examination techniques necessary to visualize them. STANDARD RADIOLOGICAL PROCEDURES Various modalities contribute to the examination of the shoulder. These include X‑rays, computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound. METHODOLOGICAL INNOVATION It is important to use the various procedures appropriately. Especially with MRI arthrography, it is necessary to pay attention to suitable sequences and possibly additional examination positions. PRACTICAL RECOMMENDATION The multimodal examination of the shoulder can contribute to the diagnosis of numerous clinical pictures. Anatomical and methodological foundations are essential for this.
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Affiliation(s)
- B Erber
- Klinik und Poliklinik für Radiologie, LMU Klinikum, LMU München, Marchioninistr. 15, 81377, München, Deutschland.
| | - N Hesse
- Klinik und Poliklinik für Radiologie, LMU Klinikum, LMU München, Marchioninistr. 15, 81377, München, Deutschland
| | - S Goller
- Klinik und Poliklinik für Radiologie, LMU Klinikum, LMU München, Marchioninistr. 15, 81377, München, Deutschland
- Radiologie, Universitätsklinik Balgrist, Forchstr. 340, 8008, Zürich, Schweiz
| | - P Reidler
- Klinik und Poliklinik für Radiologie, LMU Klinikum, LMU München, Marchioninistr. 15, 81377, München, Deutschland
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Kibler WB, Sciascia AD, Grantham WJ. The shoulder joint complex in the throwing motion. J Shoulder Elbow Surg 2024; 33:443-449. [PMID: 37499784 DOI: 10.1016/j.jse.2023.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 06/07/2023] [Accepted: 06/24/2023] [Indexed: 07/29/2023]
Abstract
The shoulder joint complex in the overhead athlete is organized to effectively transfer the proximally generated forces distally into the arm. The organization also protects the joints and anatomic structures against the repetitive high velocities, large ranges of motions, and compressive, shear, translational, and distraction loads in the overhead motion while placing the hand in the "launch window." Coupling of the movements of the scapula, clavicle, and humerus results in scapulohumeral rhythm (SHR). Effective SHR requires the clavicle and scapula-and, at times, the mechanically linked claviscapular segment-to move the arm into the task-specific position and motion and requires the humerus to move through the ranges of motion to achieve the specific task in the throwing motion. Alterations in SHR can negatively affect effective shoulder joint complex function in the overhead throwing motion and increase injury risk. There are 4 phases of clavicular, scapular, and claviscapular motion that are coupled with arm motion in SHR. The first 3 phases occur in arm elevation motions from 0°-90° and result in the claviscapula and humerus being placed in task-specific positions. The fourth phase is coupling of claviscapular motion with humeral motion to maintain ball-and-socket kinematics throughout the throwing motion. Alterations in this composite motion are termed "scapular dyskinesis." The dyskinesis is considered an impairment of the efficient mobility of the claviscapular segment of the shoulder complex. The most prevalent problem with scapular dyskinesis is the association of scapular protraction and consequent glenoid antetilt with alterations in humeral rotation and posterior humeral head translation to produce shoulder joint internal impingement. Task effectiveness in overhead throwing is also based on and determined by humeral range of motion, precision of humeral motion, and velocity of humeral motion, as well as humeral and arm position in 3-dimensional space. This activity requires maximum ball-and-socket kinematics to create the highest amount of concavity-compression that creates stability for the joint. There are bony and soft-tissue contributions to this stability. Injuries to the glenoid labrum are among the most common deficits that alter concavity-compression. Clinical evaluation of the shoulder joint complex in the injured throwing athlete should be comprehensive and systematic, following an evaluation pathway for proximal and distal causative factors and including observation of humeral motion. This type of evaluation can result in intervention protocols that address the pathoanatomic, pathophysiological, and pathomechanical deficits identified.
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Affiliation(s)
- W Ben Kibler
- Shoulder Center of Kentucky, Lexington Clinic, Lexington, KY, USA
| | - Aaron D Sciascia
- Institute for Clinical Outcomes and Research, Lexington Clinic, Lexington, KY, USA.
| | - W Jeff Grantham
- Shoulder Center of Kentucky, Lexington Clinic, Lexington, KY, USA
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13
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Calamita AG, Stimolo D, Puccini S, Innocenti M, Campanacci DA. Garrè Sclerosing Osteomyelitis of the Clavicle: Clinical Results after Clavicular Resection. Healthcare (Basel) 2024; 12:202. [PMID: 38255092 PMCID: PMC10815155 DOI: 10.3390/healthcare12020202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/27/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
(1) Background: Chronic non-bacterial osteomyelitis (CNO), also known as sclerosing osteomyelitis of Garrè, is a rare inflammatory bone disease with a specific clinical picture, uncertain pathogenesis, and no consensus on an effective treatment. Most frequently affecting other long bones, CNO may rarely involve the clavicle. The aim of this study was to present the results of a series of patients affected by CNO of the clavicle treated with total and partial clavicula resection. In addition, a literature review of different types of treatment of CNO was performed. (2) Methods: We retrospectively reviewed three patients with Sclerosing Osteomyelitis of Garre' of the clavicle treated with partial resection of the clavicle (one) and with total clavicular resection (two). (3) Results: Patients (two female and one male) were an average age of 35.7 years at the time of the operation. At the 4-year follow-up, the mean active ROM was: 143° forward flexion, 133° abduction, 42° external rotation with an internal rotation of two patients at the interscapular level and one patient at the lumbosacral junction. The mean ASES score was 92/100 (range 87-100). In the literature review, after screening the abstracts and full texts for eligibility, 34 studies met the inclusion criteria. Conclusions: Partial or total clavicular resection resulted an effective treatment of CNO of the clavicle. The procedure seems to be particularly indicated after the failure of more conservative treatments.
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Affiliation(s)
- Andrea Gabriele Calamita
- Department of Orthopaedic Oncology, Careggi University Hospital, 50134 Firenze, Italy; (D.S.); (M.I.); (D.A.C.)
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Ahmed NA, Narendran K, Ahmed NA, A P, Holebasu B, Kalawatia M, Dudeja K, Kamble P, Prasad R, Mittal G, Sangoi R. Comparison of the Glenoid Index by Computed Tomography With Magnetic Resonance Imaging. Cureus 2024; 16:e51914. [PMID: 38333443 PMCID: PMC10851955 DOI: 10.7759/cureus.51914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 01/08/2024] [Indexed: 02/10/2024] Open
Abstract
Introduction Anterior shoulder instability results in labral and osseous glenoid injuries. With a large osseous defect, there is a risk of recurrent dislocation of the joint, and therefore the patient has to undergo surgical correction. An MRI evaluation of the patient helps to assess the soft tissue injury. Currently, the volumetric three-dimensional (3D) reconstructed CT image is the standard for measuring glenoid bone loss and the glenoid index. However, it has the disadvantage of exposing the patient to radiation and additional expenses. This study aims to compare the values of the glenoid index using MRI and CT. Methodology The present study was a two-year cross-sectional study of patients with shoulder pain, trauma, and dislocation in a tertiary hospital in Karnataka. The sagittal proton density (PD) section of the glenoid and enface 3D reconstructed images of the scapula were used to calculate glenoid bone loss and the glenoid index. The baseline data were analyzed using descriptive statistics, and the Chi-square test was used to test the association of various complications with selected variables of interest. Results The glenoid index calculated in the current study using 3D volumetric CT images and MR sagittal PD images was 0.95±0.01 and 0.95±0.01, respectively. The CT and MRI glenoid bone loss was 5.41±0.65% and 5.38±0.65%, respectively. When compared, the glenoid index and bone loss calculated by MRI and CT revealed a high correlation and significance with a p-value of <0.001. Conclusions The study concluded that MRI is a reliable method for glenoid measurement. The sagittal PD sequence combined with an enface glenoid makes it possible to identify osseous defects linked to glenohumeral joint damage and dislocation. The values derived from 3D CT are identical to the glenoid index and bone loss determined using the sagittal PD sequence in MRI.
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Affiliation(s)
- Nida A Ahmed
- Trauma and Orthopaedics, Barnsley Hospital NHS foundation Trust, Barnsley, GBR
| | | | - Nishath A Ahmed
- Pediatrics, Dr. B.R. Ambedkar Medical College and Research Institute, Bangalore, IND
| | - Prashanth A
- Physiology, Mahatma Gandhi Institute of Medical Sciences, Wardha, IND
| | - B Holebasu
- Radiodiagnosis, Gadag Institute of Medical Sciences, Gadag, IND
| | | | - Kunal Dudeja
- Physiology, Maharjah's Institute of Medical Sciences, Nellimarla, IND
| | | | - Roshan Prasad
- Medicine and Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Gaurav Mittal
- Research and Development, Rotract Club Of Indian Medicos, Mumbai, IND
- Research, Students Network Organization, Mumbai, IND
- Internal Medicine, Mahatma Gandhi Institute of Medical Sciences, Wardha, IND
| | - Ravi Sangoi
- Internal Medicine, Punyashlok Ahilyadevi Holkar Government Medical College and General Hospital, Baramati, IND
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15
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Lee HR, Hwang CJ, Seok SY, Gwak HW, Cho JH, Lee DH, Lee CS. Can We Control Lateral Shoulder Balance Through Proximal Thoracic Curve Correction in Lenke Type 2 Adolescent Idiopathic Scoliosis? J Pediatr Orthop 2024; 44:28-36. [PMID: 37815292 DOI: 10.1097/bpo.0000000000002544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
BACKGROUND Proximal thoracic curve (PTC) correction has been considered to prevent lateral shoulder imbalance in Lenke Type 2 adolescent idiopathic scoliosis (AIS) patients; however, postoperative shoulder imbalance (PSI) commonly occurs despite these strategies with PTC correction. We investigated the hypothesis that PTC correction would not directly affect PSI in the majority of Lenke type 2 AIS cases. Furthermore, we investigated the risk factors for lateral PSI after corrective surgery. METHODS This study examined the records for AIS patients with Lenke type 2 who underwent corrective surgery and followed up for >2 years. Patients were categorized into PSI (-); radiologic shoulder height (RSH)<15 mm, and PSI (+); RSH≥15 mm. Repeated measures analysis of variance was performed at preoperatively, postoperatively, 1 month, and final follow-up. Postoperative lateral shoulder imbalance was predicted by the identification of univariate analysis and multivariate analysis. RESULTS Among the 151 patients reviewed, 29 (19.2%) showed PSI at final follow-up. Lateral shoulder balance parameters showed different directionalities between PSI (-) and (+) groups at postoperatively, 1 month, and final follow-up ( P <0.01 each). Preoperative PTC, middle thoracic curve (MTC) curve and MTC correction showed strong correlations with the RSH ( P =0.01, 0.03, and 0.04, respectively). However, PTC correction did not show a significant correlation with the RSH. Moreover, only a smaller MTC curve and larger MTC correction rate were related to lateral PSI in multivariate analysis. CONCLUSIONS In Lenke type 2 AIS curves, the MTC curve and its correction predominantly influence lateral shoulder imbalance after corrective surgery, irrespective of the PTC correction extent. Consequently, overemphasizing the correction of the PTC curve may not necessarily lead to an improved lateral shoulder balance. When MTC curve is smaller, surgeons should be more careful for MCT overcorrection leading to a lateral shoulder imbalance. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Hyung Rae Lee
- Department of Orthopedic Surgery, Uijeongbu Eulji Medical Center, Uijeongbusi, Gyeonggido
| | - Chang Ju Hwang
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine
| | - Sang Yun Seok
- Department of Orthopedic Surgery, Daejeon Eulji Medical Center, Daejeon, Republic of Korea
| | | | - Jae Hwan Cho
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine
| | - Dong-Ho Lee
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine
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Belli I, Joshi S, Prendergast JM, Beck I, Della Santina C, Peternel L, Seth A. Does enforcing glenohumeral joint stability matter? A new rapid muscle redundancy solver highlights the importance of non-superficial shoulder muscles. PLoS One 2023; 18:e0295003. [PMID: 38033021 PMCID: PMC10688910 DOI: 10.1371/journal.pone.0295003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 11/14/2023] [Indexed: 12/02/2023] Open
Abstract
The complexity of the human shoulder girdle enables the large mobility of the upper extremity, but also introduces instability of the glenohumeral (GH) joint. Shoulder movements are generated by coordinating large superficial and deeper stabilizing muscles spanning numerous degrees-of-freedom. How shoulder muscles are coordinated to stabilize the movement of the GH joint remains widely unknown. Musculoskeletal simulations are powerful tools to gain insights into the actions of individual muscles and particularly of those that are difficult to measure. In this study, we analyze how enforcement of GH joint stability in a musculoskeletal model affects the estimates of individual muscle activity during shoulder movements. To estimate both muscle activity and GH stability from recorded shoulder movements, we developed a Rapid Muscle Redundancy (RMR) solver to include constraints on joint reaction forces (JRFs) from a musculoskeletal model. The RMR solver yields muscle activations and joint forces by minimizing the weighted sum of squared-activations, while matching experimental motion. We implemented three new features: first, computed muscle forces include active and passive fiber contributions; second, muscle activation rates are enforced to be physiological, and third, JRFs are efficiently formulated as linear functions of activations. Muscle activity from the RMR solver without GH stability was not different from the computed muscle control (CMC) algorithm and electromyography of superficial muscles. The efficiency of the solver enabled us to test over 3600 trials sampled within the uncertainty of the experimental movements to test the differences in muscle activity with and without GH joint stability enforced. We found that enforcing GH stability significantly increases the estimated activity of the rotator cuff muscles but not of most superficial muscles. Therefore, a comparison of shoulder model muscle activity to EMG measurements of superficial muscles alone is insufficient to validate the activity of rotator cuff muscles estimated from musculoskeletal models.
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Affiliation(s)
- Italo Belli
- Cognitive Robotics Department, Technische Universiteit Delft, Delft, Zuid Holland, The Netherlands
- Biomechanical Engineering Department, Technische Universiteit Delft, Delft, Zuid Holland, The Netherlands
| | - Sagar Joshi
- Cognitive Robotics Department, Technische Universiteit Delft, Delft, Zuid Holland, The Netherlands
- Biomechanical Engineering Department, Technische Universiteit Delft, Delft, Zuid Holland, The Netherlands
| | - J. Micah Prendergast
- Cognitive Robotics Department, Technische Universiteit Delft, Delft, Zuid Holland, The Netherlands
| | - Irene Beck
- Biomechanical Engineering Department, Technische Universiteit Delft, Delft, Zuid Holland, The Netherlands
| | - Cosimo Della Santina
- Cognitive Robotics Department, Technische Universiteit Delft, Delft, Zuid Holland, The Netherlands
- Robotics and Mechatronics Department, German Aerospace Center (DLR), Munich, Germany
| | - Luka Peternel
- Cognitive Robotics Department, Technische Universiteit Delft, Delft, Zuid Holland, The Netherlands
| | - Ajay Seth
- Biomechanical Engineering Department, Technische Universiteit Delft, Delft, Zuid Holland, The Netherlands
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17
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Chu H, Kim W, Joo S, Park E, Kim YW, Kim CH, Lee S. Validity and Reliability of POM-Checker for Measuring Shoulder Range of Motion in Healthy Participants: A Pilot Single-Center Comparative Study. Methods Protoc 2023; 6:114. [PMID: 38133134 PMCID: PMC10745328 DOI: 10.3390/mps6060114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND The aim of this study was to compare shoulder movement measurements between a Kinect-based markerless ROM assessment device (POM-Checker) and a 3D motion capture analysis system (BTS SMART DX-400). METHODS This was a single-visit clinical trial designed to evaluate the validity and reliability of the POM-Checker. The primary outcome was to assess the equivalence between two measurement devices within the same set of participants, aiming to evaluate the validity of the POM-Checker compared to the gold standard device (3D Motion Analysis System). As this was a pilot study, six participants were included. RESULTS The intraclass correlation coefficient (ICC) and the corresponding 95% confidence intervals (CIs) were used to assess the reproducibility of the measurements. Among the 18 movements analyzed, 16 exhibited ICC values of >0.75, indicating excellent reproducibility. CONCLUSION The results showed that the POM-checker is reliable and validated to measure the range of motion of the shoulder joint.
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Affiliation(s)
- Hongmin Chu
- Department of Internal Medicine and Neuroscience, College of Korean Medicine, Wonkwang University, Iksan 54538, Republic of Korea;
| | - Weonjin Kim
- Team Elysium Inc. R&D Center, Seoul 06682, Republic of Korea; (W.K.); (S.J.); (E.P.); (Y.W.K.)
| | - Seongsu Joo
- Team Elysium Inc. R&D Center, Seoul 06682, Republic of Korea; (W.K.); (S.J.); (E.P.); (Y.W.K.)
| | - Eunsik Park
- Team Elysium Inc. R&D Center, Seoul 06682, Republic of Korea; (W.K.); (S.J.); (E.P.); (Y.W.K.)
| | - Yeong Won Kim
- Team Elysium Inc. R&D Center, Seoul 06682, Republic of Korea; (W.K.); (S.J.); (E.P.); (Y.W.K.)
| | - Cheol-Hyun Kim
- Department of Internal Medicine and Neuroscience, College of Korean Medicine, Wonkwang University, Iksan 54538, Republic of Korea;
- Stroke Korean Medicine Research Center, Wonkwang University, Iksan 54538, Republic of Korea
| | - Sangkwan Lee
- Department of Internal Medicine and Neuroscience, College of Korean Medicine, Wonkwang University, Iksan 54538, Republic of Korea;
- Stroke Korean Medicine Research Center, Wonkwang University, Iksan 54538, Republic of Korea
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18
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Khandare S, Vidt ME. Development of a more biofidelic musculoskeletal model with humeral head translation and glenohumeral ligaments. Comput Methods Biomech Biomed Engin 2023; 26:1549-1556. [PMID: 36165581 DOI: 10.1080/10255842.2022.2127319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/30/2022] [Accepted: 09/16/2022] [Indexed: 11/03/2022]
Abstract
Computational musculoskeletal modeling is useful for understanding upper extremity biomechanics, especially when in vivo tests are unfeasible. A musculoskeletal model of the upper limb with increased biofidelity was developed by including humeral head translation (HHT) and ligaments. The model was validated and ligament contribution and effect of shoulder (thoracohumeral) elevation on HHT was evaluated. Humerus translated superiorly with increased elevation, with translations closely matching (avg. difference 2.83 mm) previous in vitro studies. HHT and ligament inclusion in the model will improve biomechanical predictions of upper extremity movements and study of conditions, like subacromial impingement, rotator cuff tear, or shoulder instability.
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Affiliation(s)
- Sujata Khandare
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
| | - Meghan E Vidt
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
- Physical Medicine & Rehabilitation, Penn State College of Medicine, Hershey, PA, USA
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19
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Perry NPJ, Omonullaeva NK, Bacevich BM, Nascimento RJ, O'Donnell EA, Price MD, Mazzocca AD. Acromioclavicular Joint Anatomy and Biomechanics: The Significance of Posterior Rotational and Translational Stability. Clin Sports Med 2023; 42:557-571. [PMID: 37716721 DOI: 10.1016/j.csm.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/18/2023]
Abstract
The shoulder girdle extends from the sternoclavicular joint to the scapular stabilizing muscles posteriorly. It consists of 3 joints and 2 mobile regions. The shoulder girdle is statically stabilized by the acromioclavicular and coracoclavicular capsuloligamentous structures and dynamically stabilized by the trapezius, deltoid, and deltotrapezial fascia. During humerothoracic elevation, the clavicle elevates, protracts, and rotates posteriorly through the sternoclavicular joint while the scapula tilts posteriorly and rotates upward. The purpose of this article is to review the anatomy and biomechanics of the acromioclavicular joint and the shoulder girdle.
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Affiliation(s)
- Nicholas P J Perry
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard School of Medicine, Massachusetts General Brigham, Boston, MA 02115, USA; Sports Medicine, Mass General Hospital, 175 Cambridge Street, 4th Floor, Boston, MA 02114, USA.
| | - Nozimakhon K Omonullaeva
- Sports Medicine, Mass General Hospital, 175 Cambridge Street, 4th Floor, Boston, MA 02114, USA; Nova Southeastern University, College of Osteopathic Medicine, 3301 College Avenue, Fort Lauderdale, FL 33314, USA
| | - Blake M Bacevich
- Sports Medicine, Mass General Hospital, 175 Cambridge Street, 4th Floor, Boston, MA 02114, USA; Harvard Medical School, Boston, MA 02115, USA
| | - Robert J Nascimento
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard School of Medicine, Massachusetts General Brigham, Boston, MA 02115, USA; Sports Medicine, Mass General Hospital, 175 Cambridge Street, 4th Floor, Boston, MA 02114, USA
| | - Evan A O'Donnell
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard School of Medicine, Massachusetts General Brigham, Boston, MA 02115, USA; Sports Medicine, Mass General Hospital, 175 Cambridge Street, 4th Floor, Boston, MA 02114, USA
| | - Mark D Price
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard School of Medicine, Massachusetts General Brigham, Boston, MA 02115, USA; Sports Medicine, Mass General Hospital, 175 Cambridge Street, 4th Floor, Boston, MA 02114, USA
| | - Augustus D Mazzocca
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard School of Medicine, Massachusetts General Brigham, Boston, MA 02115, USA; Sports Medicine, Mass General Hospital, 175 Cambridge Street, 4th Floor, Boston, MA 02114, USA
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20
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MacLean KFE, Langenderfer JE, Dickerson CR. A comparative probabilistic analysis of human and chimpanzee rotator cuff functional capacity. J Anat 2023; 243:431-447. [PMID: 37186281 PMCID: PMC10439372 DOI: 10.1111/joa.13882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 05/17/2023] Open
Abstract
Computational musculoskeletal modeling represents a valuable approach to examining biological systems in physical anthropology. Probabilistic modeling builds on computational musculoskeletal models by associating mathematical distributions of specific musculoskeletal features within known ranges of biological variability with functional outcomes. The purpose of this study was to determine if overlap in rotator cuff muscle force predictions would occur between species during the performance of an evolutionarily relevant horizontal bimanual arm suspension task. This necessitated creating novel probabilistic models of the human and chimpanzee glenohumeral joint through augmentation of previously published deterministic models. Glenohumeral musculoskeletal features of anthropological interest were probabilistically modeled to produce distributions of predicted human and chimpanzee rotator cuff muscle force that were representative of the specific anatomical manipulations. Musculoskeletal features modeled probabilistically included rotator cuff origins and deltoid insertion, glenoid inclination, and joint stability. Predicted human rotator cuff muscle force distributions were mostly limited to alternating between infraspinatus and teres minor, with both 100% and 0% muscle force predicted for both muscles. The chimpanzee model predicted low-to-moderate muscle force across all rotator cuff muscles. Rotator cuff muscle force predictions were most sensitive to changes of muscle origins and insertions. Results indicate that functional rotator cuff overlap is unlikely between chimpanzees and humans without greater modifications of the glenohumeral musculoskeletal phenotypes. The results also highlight the low efficacy of the human upper extremity in overhead, weight-bearing tasks, and propensity for rotator cuff injury.
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21
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Dickerson CR, McDonald AC, Chopp-Hurley JN. Between Two Rocks and in a Hard Place: Reflecting on the Biomechanical Basis of Shoulder Occupational Musculoskeletal Disorders. HUMAN FACTORS 2023; 65:879-890. [PMID: 31961724 DOI: 10.1177/0018720819896191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The aim was to review the biomechanical origins of occupational shoulder damage, while considering the complexity of shoulder mechanics and musculoskeletal consequences of diverse task demands. BACKGROUND Accessible measures of physical exposures are the primary focus of occupational shoulder assessments and analyses. This approach has led to guidelines and intervention strategies that are often inadequate for mitigating shoulder disorders amongst the complexity of modern workplace demands. Integration of complex shoulder mechanics into occupational assessments, analyses, and interventions is critical for reducing occupational shoulder injury risk. METHOD This narrative review describes shoulder biomechanics in the context of common injury mechanisms and consequent injuries, with a particular focus on subacromial impingement syndrome. Several modulators of shoulder injury risk are reviewed, including fatigue, overhead work, office ergonomics considerations, and pushing and pulling task configurations. RESULTS Relationships between work requirements, muscular demands, fatigue, and biomechanical tissue loads exist. This review highlights that consideration of specific workplace factors should be integrated with our knowledge of the intricate arrangement and interpersonal variability of the shoulder complex to proactively evaluate occupational shoulder demands and exposures. CONCLUSION A standard method for evaluating shoulder muscle exposures during workplace tasks does not exist. An integrated approach is critical for improved work design and prevention of shoulder tissue damage and accompanying disability. APPLICATION This review is particularly relevant for researchers and practitioners, providing guidance for work design and evaluation for shoulder injury prevention by understanding the importance of the unique and complex mechanics of the shoulder.
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Mulla DM, Keir PJ. Neuromuscular control: from a biomechanist's perspective. Front Sports Act Living 2023; 5:1217009. [PMID: 37476161 PMCID: PMC10355330 DOI: 10.3389/fspor.2023.1217009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/21/2023] [Indexed: 07/22/2023] Open
Abstract
Understanding neural control of movement necessitates a collaborative approach between many disciplines, including biomechanics, neuroscience, and motor control. Biomechanics grounds us to the laws of physics that our musculoskeletal system must obey. Neuroscience reveals the inner workings of our nervous system that functions to control our body. Motor control investigates the coordinated motor behaviours we display when interacting with our environment. The combined efforts across the many disciplines aimed at understanding human movement has resulted in a rich and rapidly growing body of literature overflowing with theories, models, and experimental paradigms. As a result, gathering knowledge and drawing connections between the overlapping but seemingly disparate fields can be an overwhelming endeavour. This review paper evolved as a need for us to learn of the diverse perspectives underlying current understanding of neuromuscular control. The purpose of our review paper is to integrate ideas from biomechanics, neuroscience, and motor control to better understand how we voluntarily control our muscles. As biomechanists, we approach this paper starting from a biomechanical modelling framework. We first define the theoretical solutions (i.e., muscle activity patterns) that an individual could feasibly use to complete a motor task. The theoretical solutions will be compared to experimental findings and reveal that individuals display structured muscle activity patterns that do not span the entire theoretical solution space. Prevalent neuromuscular control theories will be discussed in length, highlighting optimality, probabilistic principles, and neuromechanical constraints, that may guide individuals to families of muscle activity solutions within what is theoretically possible. Our intention is for this paper to serve as a primer for the neuromuscular control scientific community by introducing and integrating many of the ideas common across disciplines today, as well as inspire future work to improve the representation of neural control in biomechanical models.
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23
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Genter J, Croci E, Ewald H, Müller AM, Mündermann A, Baumgartner D. Ex vivo experimental strategies for assessing unconstrained shoulder biomechanics: A scoping review. Med Eng Phys 2023; 117:104003. [PMID: 37331756 DOI: 10.1016/j.medengphy.2023.104003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 05/22/2023] [Accepted: 05/27/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Biomechanical studies of the shoulder often choose an ex vivo approach, especially when investigating the active and passive contribution of individual muscles. Although various simulators of the glenohumeral joint and its muscles have been developed, to date a testing standard has not been established. The objective of this scoping review was to present an overview of methodological and experimental studies describing ex vivo simulators that assess unconstrained, muscular driven shoulder biomechanics. METHODS All studies with ex vivo or mechanical simulation experiments using an unconstrained glenohumeral joint simulator and active components mimicking the muscles were included in this scoping review. Static experiments and humeral motion imposed through an external guide, e.g., a robotic device, were excluded. RESULTS Nine different glenohumeral simulators were identified in 51 studies after the screening process. We identified four control strategies characterized by: (a) using a primary loader to determine the secondary loaders with constant force ratios; (b) using variable muscle force ratios according to electromyography; (c) calibrating the muscle path profile and control each motor according to this profile; or (d) using muscle optimization. CONCLUSION The simulators with the control strategy (b) (n = 1) or (d) (n = 2) appear most promising due to its capability to mimic physiological muscle loads.
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Affiliation(s)
- Jeremy Genter
- IMES Institute of Mechanical Systems, Zurich University of Applied Sciences ZHAW, Winterthur, Switzerland; Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland.
| | - Eleonora Croci
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | - Hannah Ewald
- University Medical Library, University of Basel, Basel, Switzerland
| | - Andreas M Müller
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | - Annegret Mündermann
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Daniel Baumgartner
- IMES Institute of Mechanical Systems, Zurich University of Applied Sciences ZHAW, Winterthur, Switzerland
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Bethell MA, Anastasio AT, Taylor JR, Tabarestani TQ, Klifto CS, Anakwenze O. Evaluating the Distribution, Quality, and Educational Value of Videos Related to Shoulder Instability Exercises on the Social Media Platform TikTok. J Am Acad Orthop Surg Glob Res Rev 2023; 7:01979360-202306000-00003. [PMID: 37285512 PMCID: PMC10247212 DOI: 10.5435/jaaosglobal-d-23-00034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/26/2023] [Accepted: 04/02/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Because of the lack of scientific oversight, the quality, applicability, and consistency of healthcare-related TikTok videos have become a focus of research exploration. The orthopaedic surgery literature lags behind other medical fields in analyzing the widespread utilization of TikTok videos for medical information delivery. METHODS TikTok was queried using the hashtag #shoulderstabilityexercises, and 109 videos were included. The videos were collected by two authors and independently evaluated using DISCERN (a well-validated informational analysis tool) and shoulder stability exercise education score (a self-designed tool for the evaluation of shoulder instability-related exercises). RESULTS DISCERN scores of videos uploaded by general users had significantly lower scores in all four categories than those uploaded by healthcare professionals (P < 0.001, P = 0.005, P = 0.002, and P < 0.001). For the shoulder stability exercise education score, general users had a significantly lower score than the healthcare professionals at 3.36 and 4.91 on a 25-point scale, respectively (P = 0.034). General users had more videos graded as very poor (84.2%) in comparison to the number of videos uploaded by healthcare professionals deemed very poor (51.5%). However, the remainder of healthcare professionals had their videos graded as poor (48.5%). CONCLUSION Despite slightly improved video quality from healthcare professionals, the overall educational of the videos related to shoulder instability exercises was poor.
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Affiliation(s)
- Mikhail A. Bethell
- From the Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC
| | - Albert T. Anastasio
- From the Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC
| | - Joshua R. Taylor
- From the Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC
| | - Troy Q. Tabarestani
- From the Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC
| | - Christopher S. Klifto
- From the Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC
| | - Oke Anakwenze
- From the Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC
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Geurkink TH, Overbeek CL, Marang-van de Mheen PJ, Nagels J, Nelissen RGHH, de Groot JH. Ageing and joint position sense of the asymptomatic shoulder: An observational study. J Electromyogr Kinesiol 2023; 71:102792. [PMID: 37267894 DOI: 10.1016/j.jelekin.2023.102792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/08/2023] [Accepted: 05/24/2023] [Indexed: 06/04/2023] Open
Abstract
PURPOSE This study aimed to quantify the extent to which age was associated with joint position sense (JPS) of the asymptomatic shoulder as measured by joint position reproduction (JPR) tasks and assess the reproducibility of these tasks. METHODS 120 Asymptomatic participants aged 18-70 years each performed 10 JPR-tasks. Both contralateral and ipsilateral JPR-tasks were evaluated on accuracy of JPR under active- and passive conditions at two levels within the shoulder forward flexion trajectory. Each task was performed three times. In a subgroup of 40 participants, the reproducibility of JPR-tasks was assessed one week after initial measurement. Reproducibility of JPR-tasks was evaluated by both reliability (intra-class correlation coefficients (ICC's)) and agreement (standard error of measurement (SEM)) measures. RESULTS Age was not associated with increased JPR-errors for any of the contralateral or ipsilateral JPR-tasks. ICC's ranged between 0.63 and 0.80 for contralateral JPR-tasks, and from 0.32 to 0.48 for ipsilateral tasks, except for one ipsilateral task where the reliability was similar to contralateral tasks (0.79). The SEM was comparable and small for all JPR-tasks, ranging between 1.1 and 2.1. CONCLUSION No age-related decline in JPS of the asymptomatic shoulder was found, and good agreement between test and re-test measurements for all JPR-tasks as indicated by the small SEM.
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Affiliation(s)
- Timon H Geurkink
- Department of Orthopaedics, Leiden University Medical Center, Postzone J-11-R, PO Box 9600, 2300RC Leiden, The Netherlands; Laboratory for Kinematics and Neuromechanics, Department of Orthopaedics and Rehabilitation, Leiden University Medical Center, Leiden, The Netherlands.
| | - Celeste L Overbeek
- Department of Orthopaedics, Leiden University Medical Center, Postzone J-11-R, PO Box 9600, 2300RC Leiden, The Netherlands; Laboratory for Kinematics and Neuromechanics, Department of Orthopaedics and Rehabilitation, Leiden University Medical Center, Leiden, The Netherlands
| | - Perla J Marang-van de Mheen
- Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
| | - Jochem Nagels
- Department of Orthopaedics, Leiden University Medical Center, Postzone J-11-R, PO Box 9600, 2300RC Leiden, The Netherlands; Laboratory for Kinematics and Neuromechanics, Department of Orthopaedics and Rehabilitation, Leiden University Medical Center, Leiden, The Netherlands
| | - Rob G H H Nelissen
- Department of Orthopaedics, Leiden University Medical Center, Postzone J-11-R, PO Box 9600, 2300RC Leiden, The Netherlands; Laboratory for Kinematics and Neuromechanics, Department of Orthopaedics and Rehabilitation, Leiden University Medical Center, Leiden, The Netherlands
| | - Jurriaan H de Groot
- Laboratory for Kinematics and Neuromechanics, Department of Orthopaedics and Rehabilitation, Leiden University Medical Center, Leiden, The Netherlands
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Kask G, Laitinen MK, Parry MC, Albergo JI, Stevenson JD, Farfalli G, Aponte-Tinao L, Grimer R, Sumathi V, Jeys LM. Chondrosarcoma of the Proximal Humerus: Does the Margin Affect Survival? Cancers (Basel) 2023; 15:cancers15082337. [PMID: 37190265 DOI: 10.3390/cancers15082337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/26/2023] [Accepted: 04/04/2023] [Indexed: 05/17/2023] Open
Abstract
Chondrosarcoma (CS) is the second most common primary malignant bone tumour and, in the absence of reliable chemotherapy and radiotherapy, is effectively a surgical disease. Overall disease specific survival (DSS) is affected by tumour grade, whilst resection margin contributes to local recurrence free survival (LRFS). The aim of this study was to investigate factors that affect the local and systemic prognoses for conventional central CSs arising from the proximal humerus. A multi-centre, retrospective study from three international collaborative sarcoma centres identified 110 patients between 1995 and 2020 undergoing treatment for a conventional central CS of the proximal humerus; 58 patients (53%) had a grade 1 tumour, 36 (33%) had a grade 2 tumour, and 16 patients (13%) had a grade 3 CS. The mean age of patients was 50 years (range 10-85). The incidence of local recurrence (LR) was 9/110 (8.2%), and the disease specific mortality was 6/110 (5.5%). The grade was a statistically significant factor for LRFS (p < 0.001). None of the grade 1 tumours developed LR. The DSS was affected by the grade (p < 0.001) but not by the LR (p = 0.4). Only one patient with a grade 2 tumour died from the disease. The proximal humeral grade 1 CS behaved as a benign tumour, having no cases of LR nor death due to disease. Grade 2 CSs of the proximal humerus behaved in a more indolent way when compared with comparable grade tumours elsewhere in the appendicular skeleton, being locally aggressive with a higher LR rate than grade 1 CSs but still having very low mortality and a high rate of DSS. The LR in grade 2 CSs did not affect the DSS; therefore, surgical management in proximal humeral grade 2 CSs should have a greater emphasis on preserving function whilst maintaining an adequate margin for resection. The proximal humeral grade 3 CS was, as elsewhere in the skeleton, an aggressive, high-grade tumour. Therefore, surgical management should include en bloc resection with clear margins to avoid LR.
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Affiliation(s)
- Gilber Kask
- Department of Orthopaedics and Traumatology, Helsinki University Hospital, University of Helsinki, 00100 Helsinki, Finland
| | - Minna K Laitinen
- Department of Orthopaedics and Traumatology, Helsinki University Hospital, University of Helsinki, 00100 Helsinki, Finland
| | - Michael C Parry
- Royal Orthopaedic Hospital, Birmingham and Aston University Medical School, Aston University, Birmingham B4 7ET, UK
| | - Jose I Albergo
- Department of Orthopaedics, Hospital de Italiano, Buenos Aires C1199, Argentina
| | - Jonathan D Stevenson
- Royal Orthopaedic Hospital, Birmingham and Aston University Medical School, Aston University, Birmingham B4 7ET, UK
| | - German Farfalli
- Department of Orthopaedics, Hospital de Italiano, Buenos Aires C1199, Argentina
| | - Luis Aponte-Tinao
- Department of Orthopaedics, Hospital de Italiano, Buenos Aires C1199, Argentina
| | - Robert Grimer
- Unit of Oncology, Royal Orthopaedic Hospital, Birmingham B31 2AP, UK
| | - Vaiyapuri Sumathi
- Unit of Oncology, Royal Orthopaedic Hospital, Birmingham B31 2AP, UK
| | - Lee M Jeys
- Royal Orthopaedic Hospital, Faculty of Health Sciences, Aston University, Birmingham B4 7ET, UK
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27
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Xu HR, Zhang YH, Mao Y, Ngo TL, Zhang Q, He G, Feng Z, Sun W, Wang XQ. Validity and reliability of upper extremity star excursion balance test in adolescent swimmers. J Exerc Sci Fit 2023; 21:210-217. [PMID: 36923209 PMCID: PMC10009542 DOI: 10.1016/j.jesf.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
Background Upper limb balance is one of the important physical fitness parameters for all populations, especially overhead athletes like swimmers. Upper extremity star excursion balance test (UESEBT) is a comprehensive dynamic balance assessment, this study aims to explore the reliability and validity of UESEBT among adolescent swimmers. Methods This cross-sectional study recruited 70 adolescent swimmers. All participants were required to complete UESEBT, upper quarter Y-balance test (UQYBT), maximal isometric strength (MIS) tests in upper limb, closed kinetic chain upper extremity stability test (CKCUEST), trunk flexor endurance test (TFET) and lateral trunk endurance test (LTET). The intra- and inter-operator reliability and the correlation of UESEBT with other physical performances were conducted. Results For reliability, the intra- and inter-operator reliability of all directions and composite score were high-to-excellent (ICC = 0.706-1.000) among all participants. For validity, the UESEBT has a moderate-to-strong correlation with UQYBT (r = 0.42-0.72, p < 0.001), and a weak-to moderate one with CKCUEST (r = 0.25-0.42, p < 0.05). Furthermore, the UESEBT performance showed weak-to-moderate correlations with MIS (r = 0.24-0.44, p < 0.05). UESEBT was correlated to LTET (r = 0.24-0.33, p < 0.05) whereas no relationship was found with TFET. Conclusions UESEBT was a reliable and valid tool to screen upper extremity dynamic balance among adolescent swimmers. UESEBT provides more detailed information in eight directions to assess the upper limb sport performance. Further study should explore the prediction ability of UESEBT for injury.
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Key Words
- Adolescent
- CKC, closed kinetic chain
- CKCUEST, closed kinetic chain upper extremity stability test
- D, dominant limb as stance limb
- Dynamic balance
- ICC, intraclass correlation coefficients
- LQYBT, lower quarter Y-balance test
- LTET, lateral trunk endurance test
- MDC, minimum detectable change
- MIS, maximal isometric strength
- ND, non-dominant limb as stance limb
- Reliability
- SEM, standard error of measurement
- Swim
- TFET, trunk flexor endurance test
- UESEBT, upper extremity star excursion balance test
- UQYBT, upper quarter Y-balance test
- Validity
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Affiliation(s)
- Hao-Ran Xu
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yong-Hui Zhang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yuan Mao
- Graduate School, Xi'an Physical Education University, Xi'an, China
| | - Thanh Luan Ngo
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Qiong Zhang
- Shanghai Changning Youth Amateur Sports School, Shanghai, China
| | - Gang He
- Shanghai Changning Youth Amateur Sports School, Shanghai, China
| | - Zhimin Feng
- Shanghai Changning Youth Amateur Sports School, Shanghai, China
| | - Wenjia Sun
- Shanghai Changning Youth Amateur Sports School, Shanghai, China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China.,Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
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Milosis DC. Validity of Gymnastics-Specific Assessment of Neuromuscular Function of Shoulder Flexor and Extensor Muscles to Predict Performance in Gymnastics Skills. J Strength Cond Res 2023; 37:652-660. [PMID: 36165978 DOI: 10.1519/jsc.0000000000004302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Milosis, DC. Validity of gymnastics-specific assessment of neuromuscular function of shoulder flexor and extensor muscles to predict performance in gymnastics skills. J Strength Cond Res 37(3): 652-660, 2023-This study examined the relationships between gymnastics-specific laboratory measurements of neuromuscular function of the shoulder flexor and extensor muscles and performance in specific gymnastics skills. Fifteen highly competitive male gymnasts and 18 male students (age 20.41 ± 2.51 years, body mass 69.7 ± 7.07 kg; mean ± SD ) participated voluntarily. The electromyogram (EMG) was used to assess muscle activation of 3 flexor and 3 extensor shoulder muscles during isometric (45, 90, and 135°) and isokinetic (concentric and eccentric 60, 180, and 300°/s) flexion-extension of the shoulder. Peak torque (PT), neuromuscular efficiency (NME: torque to EMG ratio), and antagonist coactivation index (CI) were evaluated. Furthermore, performance in specific gymnastics skills was evaluated. The results supported the ecological validity of the measurements. Specifically, significant correlations emerged between the shoulders' neuromuscular function parameters and the performance in the gymnastics skills (PT: r = 0.798, p < 0.001, NME: r = 0.576, p < 0.001, CI: r = -0.351, p < 0.05). In addition, according to the results of the regression analysis, neuromuscular function of the shoulder flexor and extensor muscles predicted gymnastics performance. Specifically, the model that was produced significantly predicted the dependent variable (performance in specific gymnastics skills) in all steps and explained a total variance of 64.4% ( p < 0.001). Based on beta coefficients, PT had the higher contribution to the prediction of performance. The insight gained on these relationships could help coaches to plan the training of their gymnasts and to monitor the longitudinal changes in neuromuscular function of shoulder muscles induced by training more effectively.
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Affiliation(s)
- Dimitrios C Milosis
- Laboratory of Evaluation of Human Biological Performance, Department of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Safran O, Beyth S, Milgrom C, Milgrom Y, Nir D, Finestone AS. At long-term follow-up many first-time male traumatic shoulder dislocators remain symptomatic. J Sci Med Sport 2023:S1440-2440(23)00046-4. [PMID: 36997416 DOI: 10.1016/j.jsams.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/27/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVES To assess the status at 13 to 17 years follow-up of a cohort of young male traumatic shoulder dislocators. STUDY DESIGN Prospective cohort study. METHODS A prospective study of first-time young male traumatic shoulder dislocators, began in 2004. Subjects were evaluated by the apprehension test after completing rehabilitation 6 to 9 weeks post dislocation. Between March 2021 and July 2022, a telephone questionnaire was administered to ascertain their current shoulder status. Subjects were questioned about avoidance of activities of daily living and sport, participation in sports, current instability, and self-assessed shoulder function by the SANE score. RESULTS 50/53 (94.3%) of the study subjects, mean age 20.4 years, completed a mean follow-up of 181.8 ± 12 months. The non-redislocation survival was 13% for those with a positive apprehension test and 49% for those with a negative test (p = 0.007). SANE scores were 64.3 ± 23.7 for those with a positive apprehension test and 83.7 ± 19.7 for those with a negative test (p = 0.001). In the year before the follow-up, 33.3% of those treated conservatively and 42.9% treated surgically experienced subluxation (p = 0.5). Fifty-seven percent of those who were treated conservatively and 56% of those who underwent surgery avoided some ADL or sports because of their shoulder. CONCLUSIONS For young male first time traumatic shoulder dislocators a positive apprehension test after rehabilitation is associated with a high risk for reoccurrence and poorer long-term results. Most subjects were still dealing with shoulder symptoms at long-term follow-up.
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Affiliation(s)
- Ori Safran
- Department of Orthopedics, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Shaul Beyth
- Department of Orthopedics, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Charles Milgrom
- Military Track, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, 911200, Israel.
| | - Yael Milgrom
- Department of Medicine, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Israel
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30
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Ben Kibler W, Lockhart JW, Cromwell R, Sciascia A. Managing Scapular Dyskinesis. Phys Med Rehabil Clin N Am 2023; 34:427-451. [PMID: 37003662 DOI: 10.1016/j.pmr.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Scapular dyskinesis, the impairment of optimal scapular position and motion, is common in association with shoulder injury. A comprehensive evaluation process can show the causative factors and lead to effective treatment protocols. The complexity of scapular motion and the integrated relationship between the scapula, humerus, trunk, and legs suggest a need to develop rehabilitation programs that involve all segments working as a unit rather than isolated components. This is best accomplished with an integrated rehabilitation approach that includes rectifying deficits in mobility, strength, and motor control but not overtly focusing on any one area.
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Effect of intraarticular pressure on glenohumeral kinematics during a simulated abduction motion: a cadaveric study. BMC Musculoskelet Disord 2023; 24:105. [PMID: 36750786 PMCID: PMC9906871 DOI: 10.1186/s12891-023-06127-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 01/02/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND The current understanding of glenohumeral joint stability is defined by active restrictions and passive stabilizers including naturally-occurring negative intraarticular pressure. Cadaveric specimens have been used to evaluate the role of intraarticular pressure on joint stability, although, while the shoulder's negative intraarticular pressure is universally acknowledged, it has been inconsistently accounted for. HYPOTHESIS During continuous, passive humeral abduction, releasing the native intraarticular pressure increases joint translation, and restoring this pressure decreases joint translations. STUDY DESIGN Descriptive Laboratory Study. METHODS A validated shoulder testing system was used to passively abduct the humerus in the scapular plane and measure joint translations for seven (n = 7) cadaveric specimens. The pressure within the glenohumeral joint was measured via a 25-gauge needle during passive abduction of the arm, which was released and subsequently restored. During motion, the rotator cuff muscles were loaded using stepper motors in a force feedback loop and electromagnetic sensors were used to continuously measure the position of the humerus and scapula. Joint translation was defined according to the instant center of rotation of the glenohumeral head according to the recommendations by the International Society of Biomechanics. RESULTS Area under the translation versus abduction angle curve suggests that releasing the pressure within the capsule results in significantly less posterior translation of the glenohumeral head as compared to intact (85-90˚, p < 0.05). Posterior and superior translations were reduced after 70˚ of abduction when the pressure within the joint was restored. CONCLUSION With our testing system employing a smooth continuous passive motion, we were able to show that releasing intraarticular pressure does not have a major effect on the path of humeral head motion during glenohumeral abduction. However, both violating the capsule and restoring intraarticular pressure after releasing alter glenohumeral translations. Future studies should study the effect of simultaneous external rotation and abduction on the relationship between joint motion and IAP, especially in higher degrees of abduction. CLINICAL RELEVANCE Thoroughly simulating the glenohumeral joint environment in the cadaveric setting may strengthen the conclusions that can be translated from this setting to the clinic.
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Lim JW, Campbell DM, Clift BA. Proximal humerus fractures in adolescents: Experience from East of Scotland. Surgeon 2023; 21:31-39. [PMID: 35292214 DOI: 10.1016/j.surge.2022.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/09/2022] [Accepted: 02/17/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND The management of proximal humerus fractures (PHF) in adolescent has not been agreed upon. We aim to investigate the outcomes of PHF managed conservatively in adolescents. METHODS All shoulder radiographs performed in patients aged from 10 to 18 years and from 2008 to 2015 were reviewed. The radiological parameters, including anatomical side, Neer and Horwitz displacement grade, angulation and any residual deformities were recorded. Mail questionnaires based on the modified 15-Upper Extremities Functional Index (15-UEFI), with a maximum of 59 points, were sent out. The return of the completed anonymized questionnaire was considered as implied consent. RESULTS 118 patients with a median age of 12 at the time of fracture were identified. The majority of the fractures were Neer and Horwitz grade I displacement and 3 children had Neer and Horwitz grade III and IV displacement. The median angulation was 25°. The median follow-up length was 26 days. 55 patients had residual angulation and 25 patients had worsened angulation. No non-union was identified. No patients underwent subsequent corrective surgeries. 35 patients responded to the questionnaire. The median 15-UEFI was 59 points. None of the patients have contacted the research or clinical team regarding any concerns. CONCLUSION The vast majority of non-displaced and minimally displaced PHF in adolescent were managed conservatively in our unit. The functional outcomes for this cohort remain excellent even for those with residual deformities in the follow-up radiographs. Further large prospective multicenter studies on adolescent cohort with significantly displaced PHF are warranted.
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Affiliation(s)
- Jun Wei Lim
- Department of Orthopaedics and Trauma, Aberdeen Royal Infirmary, Foresterhill Health Campus, Aberdeen, AB25 2ZN, UK.
| | - Donald M Campbell
- Department of Orthopaedics and Trauma, Ninewells Hospital, Dundee, DD1 9SY, UK
| | - Benedict A Clift
- Department of Orthopaedics and Trauma, Ninewells Hospital, Dundee, DD1 9SY, UK
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Choi M, Chung J. Biomechanical and functional analysis of the shoulder complex and thoracic spine in patients with subacromial impingement syndrome: A case control study. Medicine (Baltimore) 2023; 102:e32760. [PMID: 36705396 PMCID: PMC9875974 DOI: 10.1097/md.0000000000032760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The motions of the shoulder are mainly carried out through the glenohumeral joint, but are also assisted by the scapulothoracic joint. Therefore, changes in the biomechanics of the thoracic spine and scapula affect the function of the shoulder. However, there is limited information on the biomechanical and functional characteristics of the shoulder complex and thoracic spine in patients with subacromial impingement syndrome (SIS). In this study, the biomechanical and functional characteristics of the shoulder complex and thoracic spine were analyzed in patients with SIS compared to healthy individuals. A total of 108 participants were included in this study. Participants were classified into 2 groups, the SIS (n = 55) and healthy (n = 53) groups. The shoulder and thoracic range of motion (ROM), scapular position, and isokinetic shoulder strength were measured in all participants. The shoulder ROM was significantly decreased in the SIS group compared to the healthy group (P < .001). The thoracic spine ROM showed significantly limited extension in the SIS group (P < .001). The scapular position showed significantly increased anterior tilting (P = .005), internal rotation (P = .032), protraction (P < .001), and decreased upward rotation (P = .002) in the SIS group. The isokinetic shoulder external rotation (P < .001) and abduction (P < .001) strength were significantly lower in the SIS group. Patients with SIS showed reduced shoulder ROM and end-range extension of the thoracic spine compared to healthy individuals, and the scapula was in a more anterior-tilted, protracted, and downward rotated position. In addition, it showed lower external rotation and abduction strength. These results suggest the need for interventions to improve the limited thoracic extension and altered scapular position, which may affect shoulder ROM and muscle strength in the rehabilitation of patients with SIS.
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Affiliation(s)
- Moonyoung Choi
- Department of Sports Science Convergence, Dongguk University, Seoul, Republic of Korea
| | - Jinwook Chung
- Department of Sports Science Convergence, Dongguk University, Seoul, Republic of Korea
- * Correspondence: Jinwook Chung, Department of Sports Science Convergence, Dongguk University, 30, Pildong-ro 1-gil, Jung-gu, Seoul 04620, Republic of Korea (e-mail: )
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Rothier PS, Fabre AC, Clavel J, Benson RBJ, Herrel A. Mammalian forelimb evolution is driven by uneven proximal-to-distal morphological diversity. eLife 2023; 12:81492. [PMID: 36700542 PMCID: PMC9908075 DOI: 10.7554/elife.81492] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/24/2023] [Indexed: 01/27/2023] Open
Abstract
Vertebrate limb morphology often reflects the environment due to variation in locomotor requirements. However, proximal and distal limb segments may evolve differently from one another, reflecting an anatomical gradient of functional specialization that has been suggested to be impacted by the timing of development. Here, we explore whether the temporal sequence of bone condensation predicts variation in the capacity of evolution to generate morphological diversity in proximal and distal forelimb segments across more than 600 species of mammals. Distal elements not only exhibit greater shape diversity, but also show stronger within-element integration and, on average, faster evolutionary responses than intermediate and upper limb segments. Results are consistent with the hypothesis that late developing distal bones display greater morphological variation than more proximal limb elements. However, the higher integration observed within the autopod deviates from such developmental predictions, suggesting that functional specialization plays an important role in driving within-element covariation. Proximal and distal limb segments also show different macroevolutionary patterns, albeit not showing a perfect proximo-distal gradient. The high disparity of the mammalian autopod, reported here, is consistent with the higher potential of development to generate variation in more distal limb structures, as well as functional specialization of the distal elements.
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Affiliation(s)
- Priscila S Rothier
- Département Adaptations du Vivant, Muséum National d'Histoire NaturelleParisFrance
| | - Anne-Claire Fabre
- Naturhistorisches Museum BernBernSwitzerland
- Institute of Ecology and Evolution, University of BernBernSwitzerland
- Life Sciences Department, Vertebrates Division, Natural History MuseumLondonUnited Kingdom
| | - Julien Clavel
- Life Sciences Department, Vertebrates Division, Natural History MuseumLondonUnited Kingdom
- Université Claude Bernard Lyon 1, CNRS, ENTPE, UMR 5023VilleurbanneFrance
| | - Roger BJ Benson
- Department of Earth Sciences, University of OxfordOxfordUnited Kingdom
| | - Anthony Herrel
- Département Adaptations du Vivant, Muséum National d'Histoire NaturelleParisFrance
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Daher B, Hunter J, Athwal GS, Lalone EA. How does computed tomography inform our understanding of shoulder kinematics? A structured review. Med Biol Eng Comput 2023; 61:967-989. [PMID: 36692800 DOI: 10.1007/s11517-022-02755-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 12/22/2022] [Indexed: 01/25/2023]
Abstract
The objective of this structured review was to review how computed tomography (CT) scanning has been used to measure the kinematics of the shoulder. A literature search was conducted using Evidence-based Medicine Reviews (Embase) and PubMed. In total, 29 articles were included in the data extraction process. Forty percent of the studies evaluated healthy participants' shoulder kinematics. The glenohumeral joint was the most studied, followed by the scapulothoracic, acromioclavicular, and sternoclavicular joints. Three-dimensional computed tomography (3DCT) and 3DCT with biplane fluoroscopy are the two primary imaging techniques that have been used to measure shoulder joints' motion under different conditions. Finally, many discrepancies in the reporting of the examined motions were found. Different authors used different perspectives and planes to report similar motions, which results in confusion and misunderstanding of the actual examined motion. The use of 3DCT has been widely used in the examination of shoulder kinematics in a variety of populations with varying methods employed. Future work is needed to extend these methodologies to include more diverse populations, to examine the shoulder complex as a whole, and to standardize their reporting of motion examined to make study to study comparisons possible.
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Affiliation(s)
- Baraa Daher
- Faculty of Engineering, School of Biomedical Engineering, Western University, London, Canada.,Department of Mechanical and Materials Engineering, The University of Western Ontario, Thompson Engineering Building, Room 353, London, ON, N6A 5B9, Canada.,Bone and Joint Institute, Western University, London, Canada
| | - James Hunter
- Faculty of Engineering, School of Biomedical Engineering, Western University, London, Canada.,Department of Mechanical and Materials Engineering, The University of Western Ontario, Thompson Engineering Building, Room 353, London, ON, N6A 5B9, Canada
| | - George S Athwal
- Bone and Joint Institute, Western University, London, Canada.,Department of Surgery, Western University, London, Canada.,Roth
- McFarlane Hand and Upper Limb Centre, St. Joseph's Health Care, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada
| | - Emily A Lalone
- Faculty of Engineering, School of Biomedical Engineering, Western University, London, Canada. .,Department of Mechanical and Materials Engineering, The University of Western Ontario, Thompson Engineering Building, Room 353, London, ON, N6A 5B9, Canada. .,Bone and Joint Institute, Western University, London, Canada. .,Department of Surgery, Western University, London, Canada. .,Roth
- McFarlane Hand and Upper Limb Centre, St. Joseph's Health Care, London, ON, Canada. .,Lawson Health Research Institute, London, ON, Canada.
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Nicolozakes CP, Sohn MH, Baillargeon EM, Lipps DB, Perreault EJ. Stretch reflex gain scaling at the shoulder varies with synergistic muscle activity. J Neurophysiol 2022; 128:1244-1257. [PMID: 36224165 PMCID: PMC9662809 DOI: 10.1152/jn.00259.2022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/07/2022] [Accepted: 10/12/2022] [Indexed: 11/22/2022] Open
Abstract
The unique anatomy of the shoulder allows for expansive mobility but also sometimes precarious stability. It has long been suggested that stretch-sensitive reflexes contribute to maintaining joint stability through feedback control, but little is known about how stretch-sensitive reflexes are coordinated between the muscles of the shoulder. The purpose of this study was to investigate the coordination of stretch reflexes in shoulder muscles elicited by rotations of the glenohumeral joint. We hypothesized that stretch reflexes are sensitive to not only a given muscle's background activity but also the aggregate activity of all muscles crossing the shoulder based on the different groupings of muscles required to actuate the shoulder in three rotational degrees of freedom. We examined the relationship between a muscle's background activity and its reflex response in eight shoulder muscles by applying rotational perturbations while participants produced voluntary isometric torques. We found that this relationship, defined as gain scaling, differed at both short and long latencies based on the direction of voluntary torque generated by the participant. Therefore, gain scaling differed based on the aggregate of muscles that were active, not just the background activity in the muscle within which the reflex was measured. Across all muscles, the consideration of torque-dependent gain scaling improved model fits (ΔR2) by 0.17 ± 0.12. Modulation was most evident when volitional torques and perturbation directions were aligned along the same measurement axis, suggesting a functional role in resisting perturbations among synergists while maintaining task performance.NEW & NOTEWORTHY Careful coordination of muscles crossing the shoulder is needed to maintain the delicate balance between the joint's mobility and stability. We provide experimental evidence that stretch reflexes within shoulder muscles are modulated based on the aggregate activity of muscles crossing the joint, not just the activity of the muscle in which the reflex is elicited. Our results reflect coordination through neural coupling that may help maintain shoulder stability during encounters with environmental perturbations.
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Affiliation(s)
- Constantine P Nicolozakes
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois
- Shirley Ryan AbilityLab, Chicago, Illinois
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - M Hongchul Sohn
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois
- Shirley Ryan AbilityLab, Chicago, Illinois
- Department of Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Emma M Baillargeon
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois
- Shirley Ryan AbilityLab, Chicago, Illinois
- Department of Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - David B Lipps
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan
- Biomedical Engineering, University of Michigan, Ann Arbor, Michigan
| | - Eric J Perreault
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois
- Shirley Ryan AbilityLab, Chicago, Illinois
- Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Özyürek S, Cansu Kalkan A, Doğan E, Melike Bülbül H, Akif Kamar M, Balci A, Ömer İkiz A, Keskinoğlu P, Genç A. Decreased muscle strength and scapular muscle endurance associated with shoulder function after neck dissection. J Back Musculoskelet Rehabil 2022; 36:347-355. [PMID: 36278334 DOI: 10.3233/bmr-210270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Shoulder disability is a common problem following neck dissection. Even if nerve structures are preserved, this may occur after the surgery. OBJECTIVE The primary aim was to research changes in rotator cuff and scapular muscles strength, and scapular muscle endurance after neck dissection in patients with head and neck cancer. The secondary aim was to investigate the relationship between these changes and postoperative shoulder function. METHODS This cross-sectional and prospective follow-up study included 14 patients who underwent neck dissection (9 unilateral and 5 bilateral). Evaluations were performed preoperatively and at 3 months postoperatively. Muscle strength measurements, including trapezius, serratus anterior, and rotator cuff muscles, were obtained using a handheld dynamometer. The scapular muscle endurance test was used for muscle endurance assessment. Postoperative shoulder function was evaluated using Constant-Murley shoulder score. RESULTS A decrease in muscle strength and the scapular muscle endurance test was found at 3 months postoperatively, except for the subscapularis muscle strength (p< 0.05). There were moderate to strong correlations between Constant-Murley shoulder score and percentage changes in muscle strength and the scapular muscle endurance test, except for the upper trapezius muscle strength (p< 0.05). CONCLUSIONS Muscle strength and scapular muscle endurance may reduce following neck dissection. These reductions are associated with postoperative shoulder function. Thus, muscle strength and endurance training may be beneficial for early postoperative rehabilitation in patients with head and neck cancer.
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Affiliation(s)
- Seher Özyürek
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | | | - Ersoy Doğan
- Department of Otorhinolaryngology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Hande Melike Bülbül
- Department of Radiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Mehmet Akif Kamar
- Department of Radiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Ali Balci
- Department of Radiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Ahmet Ömer İkiz
- Department of Otorhinolaryngology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Pembe Keskinoğlu
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Arzu Genç
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
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Kim HJ, Choi W, Jung J, Park S, Joo Y, Lee S, Lee S. Efficacy of radial extracorporeal shockwave therapy in rehabilitation following arthroscopic rotator cuff repair: A STROBE compliant study. Medicine (Baltimore) 2022; 101:e30053. [PMID: 36107497 PMCID: PMC9439771 DOI: 10.1097/md.0000000000030053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Rotator cuff tear is a common cause of shoulder pain and disability. Arthroscopic rotator cuff repair (ARCR) is performed to treat a torn tendon. Postoperative joint immobilization is essential, but it is a problem that needs to be addressed in the rehabilitation process. This study aimed to evaluate the effects of radial extracorporeal shock wave therapy (rESWT) in patients who underwent ARCR and required active movement after the immobilization period. This study was an open-label, prospective, single-arm trial of 30 inpatients aged >18 years who underwent ARCR. A total of 6 rESWT sessions, along with the conventional rehabilitation program for ARCR patients, were provided at the hospital's sports rehabilitation center for 2 weeks. The application sites of rESWT are periscapular muscles (supraspinatus, infraspinatus, teres minor, and rhomboid). Evaluations were conducted 3 time points-baseline, immediately after the first session of rESWT, and after 2 weeks of intervention. The outcome measures were the numeric pain rating scale for pain, and shoulder flexion, scaption flexion, abduction, horizontal adduction, external rotation, and internal rotation for shoulder range of motion. For shoulder function, disabilities of the arm, shoulder and hand, shoulder pain and disability index, and simple shoulder test were used, and muscle strength was expressed by grip strength. supraspinatus and infraspinatus evaluated thickness, tone, and stiffness. The muscle strength (95% CI, -3.554 to -0.073) and supraspinatus tone (P = .017) showed significant changes immediately after the first session of rESWT. Further, there was significant improvement in ROM (P < .01); shoulder function (P < .01); and muscle strength (95% CI, -3.561 to -0.625), supraspinatus stiffness (95% CI, -67.455 to -26.345), and infraspinatus stiffness (P = .045) after 2 weeks of intervention. However, muscle thickness and tone were significantly improved only in supraspinatus (P = .044, P = .040). Rehabilitation with radial extracorporeal shock wave therapy additionally applied to the periscapular muscles in patients who started active movement in rehabilitation after arthroscopic rotator cuff repair is effective for shoulder function and muscle properties (muscle strength, thickness, tone, and stiffness). However, a randomized controlled trial is needed to further assess the effects of radial extracorporeal shock wave therapy alone.
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Affiliation(s)
- Hyun-Joong Kim
- Sports Rehabilitation Center, The Better Hospital, Gwangju, Republic of Korea
- Department of Physical Therapy, Graduate School, Sahmyook University, Seoul, Republic of Korea
| | - Wonjae Choi
- Department of Physical Therapy, Joongbu University, Chungcheongnam-do, Republic of Korea
| | - JiHye Jung
- Department of Physical Therapy, Graduate School, Sahmyook University, Seoul, Republic of Korea
- Institute of SMART Rehabilitation Sahmyook University, Seoul, Republic of Korea
| | - SunGeon Park
- Department of Physical Therapy, Graduate School, Sahmyook University, Seoul, Republic of Korea
| | - YoungLan Joo
- Department of Physical Therapy, Graduate School, Sahmyook University, Seoul, Republic of Korea
| | - Sangbong Lee
- Department of Physical Therapy, Graduate School, Sahmyook University, Seoul, Republic of Korea
| | - Seungwon Lee
- Department of Physical Therapy, Sahmyook University, Seoul, Republic of Korea
- *Correspondence: Seungwon Lee, Department of Physical Therapy, Sahmyook University, 815 Hwarang-ro, Nowon-gu, Seoul 01795, Republic of Korea (e-mail: )
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Gurnani N, Willems WJ, van Deurzen DFP, Weening AA, Bouwer J, Janssen TWJ, Veeger DHEJ. Shoulder kinematics and muscle activity following latissimus dorsi transfer for massive irreparable posterosuperior rotator cuff tears in shoulders with pseudoparalysis. J Shoulder Elbow Surg 2022; 31:1357-1367. [PMID: 35172211 DOI: 10.1016/j.jse.2022.01.121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 01/05/2022] [Accepted: 01/09/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the thoracohumeral (TH) and glenohumeral (GH) motion with muscle activity after latissimus dorsi transfer (LDT) in a shoulder with a massive irreparable posterosuperior rotator cuff tear (MIRT) and pseudoparalysis compared with the asymptomatic contralateral shoulder (ACS). METHODS We recruited and evaluated 13 patients after LDT in a shoulder with preoperative clinical pseudoparalysis and an MIRT on magnetic resonance imaging, with a minimum follow-up period of 1 year, and with a Hamada stage of 3 or less. Three-dimensional electromagnetic tracking was used to assess shoulder active range of motion in both the LDT shoulder and the ACS. The maximal active elevation of the shoulder (MAES) was assessed and consisted of forward flexion, scapular abduction, and abduction in the coronal plane. Maximal active internal rotation and external rotation were assessed separately. Surface electromyography (EMG) was performed to track activation of the latissimus dorsi (LD) and deltoid muscles during shoulder motion. EMG was scaled to its maximal isometric voluntary contraction recorded in specified strength tests. RESULTS In MAES, TH motion of the LDT shoulder was not significantly different from that of the ACS (F1,12 = 1.174, P = .300) but the GH contribution was significantly lower in the LDT shoulder for all motions (F1,12 = 11.230, P = .006). External rotation was significantly greater in the ACS (26° ± 10° in LDT shoulder vs. 42° ± 11° in ACS, P < .001). The LD percentage EMG maximum showed no significant difference between the LDT shoulder and ACS during MAES (F1,11 = 0.005, P = .946). During maximal active external rotation of the shoulder, the LDT shoulder showed a higher percentage EMG maximum than the ACS (3.0% ± 2.9% for LDT shoulder vs. 1.2% ± 2.0% for ACS, P = .006). CONCLUSIONS TH motion improved after LDT in an MIRT with pseudoparalysis and was not different from the ACS except for external rotation. However, GH motion was significantly lower after LDT than in the ACS in active-elevation range of motion. The LD was active after LDT but not more than in the ACS except for active external rotation, which we did not consider relevant as the activity did not rise above 3% EMG maximum. The favorable clinical results of LDT do not seem to be related to a change in LD activation and might be explained by its effect in preventing proximal migration of the humeral head in active elevation.
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Affiliation(s)
- Navin Gurnani
- Department of Orthopaedic Surgery, Spaarne Gasthuis, Hoofddorp, the Netherlands.
| | - W Jaap Willems
- Department of Orthopaedic Surgery, DC Expert Centre, Amsterdam, the Netherlands
| | | | - Alexander A Weening
- Department of Orthopaedic Surgery, Diakonesse Hospital, Utrecht, the Netherlands
| | - Joran Bouwer
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Thomas W J Janssen
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - DirkJan H E J Veeger
- Faculty of Behavioural and Movement Sciences, Delft University of Technology, Delft, the Netherlands
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40
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A textile exomuscle that assists the shoulder during functional movements for everyday life. NAT MACH INTELL 2022. [DOI: 10.1038/s42256-022-00495-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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41
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Fukuhara A, Gunji M, Masuda Y. Comparative anatomy of quadruped robots and animals: a review. Adv Robot 2022. [DOI: 10.1080/01691864.2022.2086018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Akira Fukuhara
- Research Institute of Electrical Communication, Tohoku University, Sendai, Japan
| | - Megu Gunji
- Department of Life Sciences, Faculty of Life Sciences, Toyo University, Gunma, Japan
| | - Yoichi Masuda
- Department of Mechanical Engineering, Osaka University, Osaka, Japan
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42
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Gómez M, Casado A, de Diego M, Pastor JF, Potau JM. Anatomical and molecular analyses of the deltoid muscle in chimpanzees (Pan troglodytes) and modern humans (Homo sapiens): Similarities and differences due to the uses of the upper extremity. Am J Primatol 2022; 84:e23390. [PMID: 35561001 DOI: 10.1002/ajp.23390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/22/2022] [Accepted: 04/25/2022] [Indexed: 11/12/2022]
Abstract
In the deltoid muscles of Pan troglodytes and Homo sapiens, we have analyzed the muscle architecture and the expression of the myosin heavy chain (MHC) isoforms. Our aim was to identify differences between the two species that could be related to their different uses of the upper limb. The deltoid muscle of six adult Pan troglodytes and six adult Homo sapiens were dissected. The muscle fascicle length (MFL) and the physiological cross-sectional area (PCSA) of each muscle were calculated in absolute and normalized values. The expression pattern of the MHC-I, MHC-IIa and MHC-IIx isoforms was analyzed in the same muscles by real-time polymerase chain reaction. Only the acromial deltoid (AD) presented significant architectural differences between the two species, with higher MFL values in humans and higher PCSA values in chimpanzees. No significant differences in the expression pattern of the MHC isoforms were identified. The higher PCSA values in the AD of Pan troglodytes indicate a greater capacity of force generation in chimpanzees than in humans, which may be related to a greater use of the upper limb in locomotion, specifically in arboreal locomotion like vertical climbing. The functional differences between chimpanzees and humans in the deltoid muscle are more related to muscle architecture than to a differential expression of MHC isoforms.
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Affiliation(s)
- Mónica Gómez
- Department of Surgery and Surgical Specializations, Unit of Human Anatomy and Embryology, University of Barcelona, Barcelona, Spain
| | - Aroa Casado
- Department of Surgery and Surgical Specializations, Unit of Human Anatomy and Embryology, University of Barcelona, Barcelona, Spain.,Institut d'Arqueologia de la Universitat de Barcelona (IAUB), Faculty of Geography and History, University of Barcelona, Barcelona, Spain
| | - Marina de Diego
- Department of Surgery and Surgical Specializations, Unit of Human Anatomy and Embryology, University of Barcelona, Barcelona, Spain
| | | | - Josep Maria Potau
- Department of Surgery and Surgical Specializations, Unit of Human Anatomy and Embryology, University of Barcelona, Barcelona, Spain.,Institut d'Arqueologia de la Universitat de Barcelona (IAUB), Faculty of Geography and History, University of Barcelona, Barcelona, Spain
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Disabled Throwing Shoulder 2021 Update: Part 1-Anatomy and Mechanics. Arthroscopy 2022; 38:1714-1726. [PMID: 35307240 DOI: 10.1016/j.arthro.2022.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/15/2021] [Accepted: 02/03/2022] [Indexed: 02/02/2023]
Abstract
The purpose of this article is to provide updated information for sports health care specialists regarding the Disabled Throwing Shoulder (DTS). A panel of experts, recognized for their experience and expertise in this field, was assembled to address and provide updated information on several topics that have been identified as key areas in creating the DTS spectrum. Each panel member submitted a concise presentation on one of the topics within these areas, each of which were then edited and sent back to the group for their comments and consensus agreement in each area. Part 1 presents the following consensus conclusions and summary findings regarding anatomy and mechanics, including: 1) The current understanding of the DTS identifies internal impingement, resulting from a combination of causative factors, as the final common pathway for the great majority of the labral pathoanatomy; 2) intact labral anatomy is pivotal for glenohumeral stability, but its structure does not control or adapt well to shear or translational loads; 3) the biceps plays an active role in dynamic glenohumeral stability by potentiating "concavity compression" of the glenohumeral joint; 4) the ultimate function of the kinetic chain is to optimize the launch window, the precise biomechanical time, and position for ball release to most effectively allow the ball to be thrown with maximum speed and accuracy, and kinetic chain function is most efficient when stride length is optimized; 5) overhead throwing athletes demonstrate adaptive bony, capsular, and muscular changes in the shoulder with repetitive throwing, and precise measurement of shoulder range of motion in internal rotation, external rotation, and external rotation with forearm pronation is essential to identify harmful and/or progressive deficits. LEVEL OF EVIDENCE: Level V, expert opinion.
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44
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Tanioka R, Ito H, Takase K, Kai Y, Sugawara K, Tanioka T, Locsin R, Tomotake M. Usefulness of 2D Video Analysis for Evaluation of Shoulder Range of Motion during Upper Limb Exercise in Patients with Psychiatric Disorders. THE JOURNAL OF MEDICAL INVESTIGATION 2022; 69:70-79. [PMID: 35466149 DOI: 10.2152/jmi.69.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Aging and its associated problems related to movement impacts the care of people with psychiatric disorders. This study sought to clarify the usefulness of 2D video analysis for evaluating shoulder range of motion (ROM) during upper limb exercises in patients with psychiatric disorders. Subjects (N=54) were patients with psychiatric disorders categorized as the following:having either a high or low activities of daily living (ADL) score using the Barthel Index;experiencing shoulder ROM limitation, and whether or not compensatory movements were exhibited. Compensatory movement was also considered in patients with Parkinsonism, cerebrovascular disease, and cognitive dysfunction. Shoulder joint ROM was measured using a goniometer and active ROM was captured using ImageJ. No significant difference between passive ROM measured by a goniometer and active ROM measured by ImageJ considering disease groups, ADL level, and shoulder ROM limitation was found. Factoring in compensatory movements, however, significant differences were found between passive and active ROM:existence compensatory movement group, left side (z=-2.30, p=0.02);nonexistence compensatory movement group, right side (z=-2.63, p<0.001). Image-evaluating devices help assess ROM in patients with psychiatric disorders, enhancing the development of physical rehabilitation programs to regain critical ADL, sustaining self-care capabilities. J. Med. Invest. 69 : 70-79, February, 2022.
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Affiliation(s)
- Ryuichi Tanioka
- Graduate School of Health Sciences, Lifelong Health and Medical Science, Tokushima University, Tokushima, Japan
| | - Hirokazu Ito
- Institute of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Kensaku Takase
- Department of Rehabilitation, Anan Medical Center, Tokushima, Japan
| | - Yoshihiro Kai
- Department of Mechanical Engineering, Tokai University, Kanagawa, Japan
| | - Kenichi Sugawara
- Department of Physical Therapy, Kanagawa University of Human Service, Kanagawa, Japan
| | - Tetsuya Tanioka
- Institute of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Rozzano Locsin
- Institute of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Masahito Tomotake
- Institute of Biomedical Sciences, Tokushima University, Tokushima, Japan
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45
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Kim M, Kuruma H, Thawisuk C. Effectiveness of elongation band exercise on the upper limb strength and range of motion among older adults. J Exerc Rehabil 2022; 18:110-116. [PMID: 35582685 PMCID: PMC9081408 DOI: 10.12965/jer.2244080.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 02/25/2022] [Indexed: 11/22/2022] Open
Abstract
An elongation band (EB) is used to improve the physical strength of older adults. However, the evidence of its effect on the upper limb is a deficiency. This study investigated the effectiveness of EB exercises on upper limb function in the elderly. Participants were divided into two groups: EB (n=16) and control (n=14). The EB group performed exercises in a sitting position using an EB while the control group performed active stretching exercises without bands. The exercise regimen consisted of four shoulder joint movements. Each group performed the exercise for 20 min per day, 5 days per week over a period of 2 months. Measurements included upper limb muscle strength, shoulder joint range of motion, and grip strength. Measurements were performed at baseline, and 1 and 2 months after the intervention. Analysis of covariance was used to compare differences between the groups. The EB group demonstrated significant increases in muscle strength (upper trapezius, deltoid, middle trapezius muscle), shoulder joint range of motion (right shoulder flexion, internal rotation, external rotation, left shoulder joint extension), and grip strength. In conclusion, EB exercises increased upper limb muscle strength, shoulder joint range of motion, and grip strength in older adults.
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Affiliation(s)
- Minjoon Kim
- Department of Rehabilitation, Tokyo General Hospital, Tokyo,
Japan
- Department of Physical Therapy, Graduate School of Human Health Science, Tokyo Metropolitan University, Tokyo,
Japan
| | - Hironobu Kuruma
- Department of Physical Therapy, Tokyo Metropolitan University, Tokyo,
Japan
| | - Chirathip Thawisuk
- Department of Occupational Therapy, Graduate School of Human Health Science, Tokyo Metropolitan University, Tokyo,
Japan
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46
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Dupuis F, Sole G, Mercier C, Roy JS. Impact of fatigue at the shoulder on the contralateral upper limb kinematics and performance. PLoS One 2022; 17:e0266370. [PMID: 35363812 PMCID: PMC8975159 DOI: 10.1371/journal.pone.0266370] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 03/18/2022] [Indexed: 12/03/2022] Open
Abstract
Background Altered movement patterns have been proposed as an etiological factor for the development of musculoskeletal pain. Fatigue influences upper limb kinematics and movement performance which could extend to the contralateral limb and potentially increasing risk of injury. The aim of this study was to investigate the impact of fatigue at the dominant arm on the contralateral upper limb movement. Methods Forty participants were randomly assigned to one of two groups: Control or Fatigue Group. All participants completed a reaching task at the baseline and post-experimental phase, during which they reached four targets with their non-dominant arm in a virtual reality environment. Following the baseline phase, the Fatigue Group completed a shoulder fatigue protocol with their dominant arm only, while the Control Group took a 10-minute break. Thereafter, the reaching task was repeated. Upper limb and trunk kinematics (joint angles and excursions), spatiotemporal (speed and accuracy) and surface electromyographic (sEMG) activity (sEMG signal mean epoch amplitude and median frequency of the EMG power spectrum) were collected. Two-way repeated-measures ANOVA were performed to determine the effects of Time, Group and of the interaction between these factors. Results There was a significant Time x Group interaction for sternoclavicular elevation range of motion (p = 0.040), movement speed (p = 0.043) and accuracy (p = 0.033). The Fatigue group showed higher contralateral sternoclavicular elevation and increased movement error while experiencing fatigue in the dominant arm. Moreover, the Control group increased their speed during the Post-experimental phase compared to baseline (p = 0.043), while the Fatigue group did not show any speed improvement. There was no EMG sign of fatigue in any of the muscles evaluated. Conclusion This study showed that fatigue at the dominant shoulder impacts movement at the contralateral upper limb. Such changes may be a risk factor for the development of shoulder pain in both the fatigued and non-fatigued limbs.
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Affiliation(s)
- Frédérique Dupuis
- Faculty of Medicine, Université Laval, Quebec City, Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Canada
| | - Gisela Sole
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Catherine Mercier
- Faculty of Medicine, Université Laval, Quebec City, Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Canada
| | - Jean-Sébastien Roy
- Faculty of Medicine, Université Laval, Quebec City, Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Canada
- * E-mail:
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Lavallée-Bourget MH, Campeau-Lecours A, Tittley J, Bielmann M, Bouyer LJ, Roy JS. The use of a three-dimensional dynamic arm support prevents the development of muscle fatigue during repetitive manual tasks in healthy individuals. PLoS One 2022; 17:e0266390. [PMID: 35363820 PMCID: PMC8975113 DOI: 10.1371/journal.pone.0266390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 03/20/2022] [Indexed: 11/19/2022] Open
Abstract
Work-related upper extremity disorders are costly to society due to resulting medical costs, presenteeism and absenteeism. Although their aetiology is likely multifactorial, physical workplace factors are known to play an important role in their development. Promising options for preventing work-related upper extremity disorders include assistive technologies such as dynamic arm supports designed to follow the movement of the arm while compensating for its weight. The objective of this study was to assess the effects of a dynamic arm support on perceived exertion, muscle activity and movement patterns of the upper limb during repetitive manual tasks in healthy individuals. Thirty healthy right-handed individuals were allocated either a static or a dynamic task to perform with and without a dynamic arm support. During the task, surface electromyographic activity (anterior and middle deltoid, upper trapezius) and upper limb kinematics (elbow, shoulder, sternoclavicular) were measured using surface EMG and inertial sensors. Results showed that the dynamic arm support significantly reduced perceived exertion during the tasks and limited the development of muscular fatigue of the anterior and middle deltoid as demonstrated by EMG signal mean epoch amplitudes and median frequency of the EMG power spectrum. The dynamic arm support also prevented a decrease in shoulder elevation and an increase in total shoulder joint excursion during static and dynamic task, respectively. These results denote the potential benefits of dynamic arm supports in work environments. Further studies should focus on their efficacy, acceptability and implementability in work settings.
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Affiliation(s)
- Marie-Hélène Lavallée-Bourget
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Québec City, Canada
- Faculty of Medicine, Université Laval, Québec City, Canada
| | - Alexandre Campeau-Lecours
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Québec City, Canada
- Faculty of Science and Engineering, Université Laval, Québec City, Canada
| | - Jean Tittley
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Québec City, Canada
| | - Mathieu Bielmann
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Québec City, Canada
- Faculty of Medicine, Université Laval, Québec City, Canada
| | - Laurent J. Bouyer
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Québec City, Canada
- Faculty of Medicine, Université Laval, Québec City, Canada
| | - Jean-Sébastien Roy
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Québec City, Canada
- Faculty of Medicine, Université Laval, Québec City, Canada
- * E-mail:
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Meinders E, Pizzolato C, Gonçalves B, Lloyd DG, Saxby DJ, Diamond LE. Activation of the deep hip muscles can change the direction of loading at the hip. J Biomech 2022; 135:111019. [DOI: 10.1016/j.jbiomech.2022.111019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/27/2022] [Accepted: 02/21/2022] [Indexed: 11/28/2022]
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Kibler WB, Grantham WJ, Pike JSM, Sciascia AD. Glenoid Labral Injuries Are More Common Posteriorly Than Superiorly and Are Combined Across Multiple Areas of the Glenoid. Arthrosc Sports Med Rehabil 2022; 4:e535-e544. [PMID: 35494307 PMCID: PMC9042739 DOI: 10.1016/j.asmr.2021.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Purpose To categorize arthroscopically observed labral injuries to include location on the glenoid and frequency of the injuries in each location. Methods Patients undergoing arthroscopic labral surgery between January 2018 and June 2020 were reviewed. Inclusion criteria for labral injury were consistently applied and included history, clinical examination and imaging findings, and failure of rehabilitation. Exclusion criteria included arthritis, adhesive capsulitis, and previous surgery. Injury locations were categorized into superior, anterior, and/or posterior areas on the glenoid and as isolated in one area or combined in more than one area. Injury patterns also were evaluated. Interrater and intrarater agreement was assessed between 2 raters for injury location and tear pattern for 22 randomly assigned cases. Results In total, 167 cases met the inclusion criteria. Injuries were found in all areas. Combined injuries were found almost twice as often as isolated injuries (63.5% vs 37.5%). Isolated posterior injuries had the greatest frequency of all specific injury types (26.3%). Isolated superior injuries (SLAP 2-4) had a frequency of 7.2%. Tear patterns included peel back, separation/split, insubstance injury, peripheral rim flattening, and extension into the posterior inferior glenohumeral ligament. Interrater was excellent for all tear locations (intraclass correlation coefficient ≥0.85) whereas intrarater agreement was good to excellent (intraclass correlation coefficient ≥0.63). Conclusions Labral injuries that are associated with clinical symptoms can occur as isolated or combined types in the superior, anterior, and posterior glenoid areas and can display multiple injury patterns. Combined types of injuries are almost twice as common as those that are isolated in one area. Posterior injuries, isolated or combined, are frequent but superior injuries are less common Level of Evidence Level IV, therapeutic case series.
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A Gravity-Compensated Upper-Limb Exoskeleton for Functional Rehabilitation of the Shoulder Complex. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12073364] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In the last decade, several exoskeletons for shoulder rehabilitation have been presented in the literature. Most of these devices focus on the shoulder complex and limit the normal mobility of the rest of the body, forcing the patient into a fixed standing or sitting position. Nevertheless, this severely limits the range of activities that can potentially be simulated during the rehabilitation, preventing the execution of occupational therapy which involves the execution of tasks based on activities of daily living (ADLs). These tasks involve different muscular groups and whole-body movements, such as, e.g., picking up objects from the ground. To enable whole-body functional rehabilitation, the challenge is to shift the paradigm of robotic rehabilitation towards machines that can enable wide workspaces and high mobility. In this perspective, here we present Float: an upper-limb exoskeleton designed to promote and accelerate the motor and functional recovery of the shoulder joint complex following post-traumatic or post-surgical injuries. Indeed, Float allows the patient to move freely in a very large workspace. The key component that enables this is a passive polyarticulated arm which supports the total exoskeleton weight and allows the patient to move freely in space, empowering rehabilitation through a deeper interaction with the surrounding environment. A characterization of the reachable workspace of both the exoskeleton and the polyarticulated passive arm is presented. These results support the conclusion that a patient wearing Float can perform a wide variety of ADLs without bearing its weight.
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