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Conte da Silva A, Aily JB, Mattiello SM. Ischemic compression associated with joint mobilization does not promote additional clinical effects in individuals with rotator cuff related shoulder pain: A randomized clinical trial. J Bodyw Mov Ther 2023; 36:335-342. [PMID: 37949581 DOI: 10.1016/j.jbmt.2023.08.002] [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] [Received: 02/24/2023] [Revised: 07/09/2023] [Accepted: 08/08/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE The objective of this study was to verify which are the additional effects of the ischemic compression (IC) technique associated with joint mobilization techniques on pain, morphological aspects of myofascial trigger points (MTrPs), function, and psychological aspects in individuals with rotator cuff-related shoulder pain (RCRSP). METHODS Sixty individuals with RCRSP were randomly allocated intervention sessions the Mobilization Group (MG, n = 20), only joint mobilizations of the shoulder complex; intervention sessions Compression Group (CG, n = 20), with the same mobilizations associated with the IC over MTrPs; and Placebo Group (PG, n = 20), with the same mobilizations associated with placebo of IC. All interventions performed 2 per week, for 6-weeks. Pain was assessed by Visual Analogue Scale and function by the Disabilities of the Arm, Shoulder and Hand questionnaire. The kinesiophobia, pain catastrophizing, perception of improvement, mobility, pain threshold and area the MTrPs were also evaluated at baseline (week-0), after 6-weeks and after 10-weeks. RESULTS There were no between-group difference in pain: CG-MG 0.8 (95% CI 0.4 to 1.2), CG-PG 0.5 (95% CI 0.0 to 0.9), MG-PG -0.3 (95% CI -0.8 to 0.1) after 6-weeks and CG-MG 0.1 (95% CI -0.2 to 0.5), CG-PG -0.7 (95% CI -0.9 to -0,4), MG-PG -0,8 (95% CI -1.07 to 0.5) at 10-weeks. Similar effects were observed on function, characteristics of MTrPs and psychological aspects. CONCLUSION The IC technique on the MTrPs of the upper trapezius muscle associated with joint mobilization techniques has no additional effect on pain in individuals with RCRSP. TRIAL REGISTRATION RBR-44v8y7.
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Affiliation(s)
| | - Jéssica Bianca Aily
- Physiotherapy Department, Federal University of São Carlos, São Carlos, SP, Brazil.
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López-de-Celis C, Caudevilla-Polo S, Pérez-Bellmunt A, González-Rueda V, Bueno-Gracia E, Estébanez-de-Miguel E. Effect of Scapular Fixation on Lateral Movement and Scapular Rotation during Glenohumeral Lateral Distraction Mobilisation. Healthcare (Basel) 2023; 11:1829. [PMID: 37444663 DOI: 10.3390/healthcare11131829] [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: 05/08/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Glenohumeral lateral distraction mobilisation (GLDM) is used in patients with shoulder mobility dysfunction. No one has examined the effect of scapular fixation during GLDM. The aim was to measure and compare the lateral movement of the humeral head and the rotational movement of the scapula when three different magnitudes of forces were applied during GLDM, with and without scapular fixation. METHODS Seventeen volunteers were recruited (n = 25 shoulders). Three magnitudes of GLDM force (low, medium, and high) were applied under fixation and non-fixation scapular conditions in the open-packed position. Lateral movement of the humeral head was assessed with ultrasound, and a universal goniometer assessed scapular rotation. RESULTS The most significant increase in the distance between the coracoid and the humeral head occurred in the scapular fixation condition at all three high-force magnitudes (3.72 mm; p < 0.001). More significant scapular rotation was observed in the non-scapular fixation condition (12.71°). A difference in scapula rotation (10.1°) was observed between scapular fixation and non-scapular fixation during high-force application. CONCLUSIONS Scapular fixation resulted in more significant lateral movement of the humeral head than in the non-scapular fixation condition during three intensities of GLDM forces. The scapular position did not change during GLDM with the scapular fixation condition.
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Affiliation(s)
- Carlos López-de-Celis
- Faculty of Medicine and Health Sciences, Universitat International de Catalunya, 08195 Barcelona, Spain
- ACTIUM Functional Anatomy Group, 08195 Barcelona, Spain
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
| | | | - Albert Pérez-Bellmunt
- Faculty of Medicine and Health Sciences, Universitat International de Catalunya, 08195 Barcelona, Spain
- ACTIUM Functional Anatomy Group, 08195 Barcelona, Spain
| | - Vanessa González-Rueda
- Faculty of Medicine and Health Sciences, Universitat International de Catalunya, 08195 Barcelona, Spain
- ACTIUM Functional Anatomy Group, 08195 Barcelona, Spain
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
| | - Elena Bueno-Gracia
- Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
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Gutiérrez-Espinoza H, Pinto-Concha S, Sepúlveda-Osses O, Araya-Quintanilla F. Effectiveness of scapular mobilization in people with subacromial impingement syndrome: A randomized controlled trial. Ann Phys Rehabil Med 2023; 66:101744. [PMID: 37030191 DOI: 10.1016/j.rehab.2023.101744] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 12/12/2022] [Accepted: 01/23/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Scapular mobilization is a manual therapy technique widely used in the management of musculoskeletal disorders of the shoulder. OBJECTIVE To determine the effects of scapular mobilization in addition to an exercise program in people with subacromial impingement syndrome (SIS). METHODS Seventy-two adults with SIS were randomly allocated to 1 of 2 groups. The control group (n=36) participated in a 6-week exercise program, and the intervention group (n = 36) participated in the same exercise program plus passive manual scapular mobilization. Both groups were assessed at baseline and 6 weeks (end of treatment). The primary outcome measure was upper limb function assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Secondary outcome measures were the Constant-Murley questionnaire, pain (visual analog scale [VAS]), and scapular upward rotation. RESULTS All participants completed the trial. The between-group difference in DASH was -1.1 points (Cohen d = 0.05; p = 0.911), Constant-Murley 2.1 points (Cohen d = 0.08; p = 0.841), VAS rating of pain at rest -0.1 cm (Cohen d = 0.05; p = 0.684), and VAS rating of pain during movement -0.2 cm (Cohen d = 0.09; p = 0.764); scapular upward rotation at rest (arm by the side) was 0.6° (Cohen d = 0.09; p = 0.237), at 45° shoulder abduction was 0.8° (Cohen d = 0.13; p = 0.096), at 90° was 0.1° (Cohen d = 0.04; p = 0.783), and at 135° was 0.1° (Cohen d = 0.07; p = 0.886). Most differences were in favor of the intervention group; however, the effect sizes were weak and not statistically significant. CONCLUSIONS In the short-term, the addition of scapular mobilization did not provide significant clinical benefits in terms of function, pain or scapular motion in participants with SIS. TRIAL REGISTRATION Brazilian registry of clinical trials UTN number U1111-1226-2081. Registered February 25, 2019.
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The Effect of Scapular Fixation on Scapular and Humeral Head Movements during Glenohumeral Axial Distraction Mobilization. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58030454. [PMID: 35334630 PMCID: PMC8954647 DOI: 10.3390/medicina58030454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/13/2022] [Accepted: 03/18/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Glenohumeral axial distraction mobilization (GADM) is a usual mobilization technique for patients with shoulder dysfunctions. The effect of scapular fixation on the movement of the scapula and the humeral head during GADM is unknown. To analyze the caudal movement of the humeral head and the rotatory movement of the scapula when applying three different intensities of GADM force with or without scapular fixation. Materials and Methods: Fifteen healthy subjects (mean age 28 ± 9 years; 73.3% male) participated in the study (twenty-eight upper limbs). Low-, medium- and high-force GADM in open-packed position were applied in scapular fixation and non-fixation conditions. The caudal movement of humeral head was evaluated by ultrasound measurements. The scapular rotatory movement was assessed with a universal goniometer. The magnitude of force applied during GADM and the region (glenohumeral joint, shoulder girdle, neck or nowhere) where subjects felt the effect of GADM mobilization were also recorded. Results: A greater caudal movement of the humeral head was observed in the non-scapular fixation condition at the three grades of GADM (p < 0.008). The rotatory movement of the scapula in the scapular fixation condition was practically insignificant (0.05−0.75°). The high-force GADM rotated scapula 18.6° in non-scapular fixation condition. Subjects reported a greater feeling of effect of the techniques in the glenohumeral joint with scapular fixation compared with non-scapular fixation. Conclusions: The caudal movement of the humeral head and the scapular movement were significantly greater in non-scapular fixation condition than in scapular fixation condition for the three magnitudes of GADM force.
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Azarsa MH, Mirbagheri A, Hosseini SR, Shadmehr A, Karimi N. Objective measurement of Inferior-Directed stiffness in glenohumeral joint using a specially designed robotic device in healthy shoulders; Within- and Between-Session reliability. J Biomech 2021; 127:110663. [PMID: 34454330 DOI: 10.1016/j.jbiomech.2021.110663] [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: 11/20/2020] [Revised: 07/25/2021] [Accepted: 07/28/2021] [Indexed: 11/26/2022]
Abstract
Clinical assessment of capsuloligamentous structures of the glenohumeral joint has been qualitative and subjective in nature, as demonstrated by limited intra- and inter-rater reliability. Robotic devices were utilized to develop a clinically objective measurement technique for glenohumeral joint stiffness. The purpose of this study was to quantify the amount of inferior-direction stiffness of the glenohumeral joint using a safe clinical device in the asymptomatic individuals, and to determine between trial and between session reliability of the robotic device. Twenty healthy subjects were recruited via convenience sampling. Inferior-directed translation and applying force were measured using displacement and force sensors of a robotic device. The stiffness values were calculated as the mean of the slopes of the linear portions of the force-displacement curves for the cycles obtained after familiarization and preconditioning. Four trials for each measurement occasion were averaged to determine the stiffness value for each subject in one session. Repeatability of glenohumeral joint stiffness measurements for between trials and between two sessions was determined using intraclass correlation values and standard error of the measurements. The mean stiffness value was 1.50 N/mm (±0.40) and 1.52 N/mm (±0.40), respectively. The robotic device for stiffness assessment was reliable for repeated measures of stiffness in one session, and between sessions with ICC equal 0.96 (95% CI 0.93-0.98), and 0.97 (95% CI 0.95-0.99), respectively. The SEM between the trials was in each session 0.08 N/mm. The results of this study provide that our robotic technique for quantifying glenohumeral joint stiffness is precise and reproducible.
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Affiliation(s)
- Mohammad Hassan Azarsa
- Department of Medical Physics and Biomedical Engineering, School of Medicine and joint affiliated with Research Center for Biomedical Technologies and Robotics (RCBTR), Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Alireza Mirbagheri
- Department of Medical Physics and Biomedical Engineering, School of Medicine and joint affiliated with Research Center for Biomedical Technologies and Robotics (RCBTR), Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | | | - Azadeh Shadmehr
- School of Rehabilitation, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Noureddin Karimi
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Pozsgai M, Kövesdi E, Németh B, Kiss I, Farkas N, Atlasz T, Váczi M, Nusser N. Clinical Effect of End-range Maitland Mobilization in the Management of Knee Osteoarthritis - A Pilot Study. In Vivo 2021; 35:1661-1668. [PMID: 33910850 DOI: 10.21873/invivo.12425] [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: 01/05/2021] [Revised: 03/18/2021] [Accepted: 03/14/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Different manual therapy techniques and conservative therapy have been used separately for alleviation of pain and improvement of physical function in patients with knee osteoarthritis (KOA). However, no study has reported the effect of combination of these treatment modalities in the management of KOA. Our aim was to test the feasibility of the study design and to compare the effect of end-range Maitland mobilization to conservative therapy in KOA. PATIENTS AND METHODS Fifteen patients (conservative therapy group: CG) received conservative therapy alone, fifteen patients (Maitland plus conservative therapy group: M+CG) received additionally end-range Maitland mobilization during the 3-week study period. Outcomes were pain intensity, measured with visual analogue scale (VAS) in general and during functional activities, passive range of motion (PROM) and peak muscle force during knee flexion and extension, Timed Up and Go test and 6-Minute Walk Test (6MWT). RESULTS All outcomes improved significantly in both groups. Magnitude of changes was significantly greater in M+CG compared to CG regarding all VAS pain scores, flexion PROM of both knees, right hamstring peak muscle force and 6MWT. CONCLUSION With few modifications, this study design seems feasible for the comparison of end-range Maitland mobilization with conservative therapy in KOA. Moreover, end-range Maitland mobilization in addition to conservative therapy appeared more effective in relief of pain and improvement of functional status than conservative therapy alone in KOA.
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Affiliation(s)
- Miklós Pozsgai
- Harkány Thermal Rehabilitation Centre, Harkány, Hungary; .,Medical School, University of Pécs, Pécs, Hungary
| | - Erzsébet Kövesdi
- Institute of Physiology, Medical School, University of Pécs, Pécs, Hungary
| | - Balázs Németh
- Department of Public Health Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - István Kiss
- Department of Public Health Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Nelli Farkas
- Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary
| | - Tamás Atlasz
- Institute of Sport Sciences and Physical Education, University of Pécs, Pécs, Hungary
| | - Márk Váczi
- Institute of Sport Sciences and Physical Education, University of Pécs, Pécs, Hungary
| | - Nóra Nusser
- Harkány Thermal Rehabilitation Centre, Harkány, Hungary.,Medical School, University of Pécs, Pécs, Hungary
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Ruiz Ibán MA, Alonso Güemes S, Ruiz Díaz R, Asenjo Gismero CV, Lorente Gomez A, Diaz Heredia J. Evaluation of the inter and intraobserver reproducibility of the GRASP method: a goniometric method to measure the isolated glenohumeral range of motion in the shoulder joint. J Exp Orthop 2021; 8:37. [PMID: 33993351 PMCID: PMC8124032 DOI: 10.1186/s40634-021-00352-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 04/08/2021] [Indexed: 11/15/2022] Open
Abstract
Purpose To evaluate the intra and interobserver reproducibility of a new goniometric method for evaluating the isolated passive range of motion of the glenohumeral joint in an outpatient setting. Methods This is a prospective observational study on healthy subjects. The Glenohumeral ROM Assessment with Scapular Pinch (GRASP) method is a new method for assessing the isolated range of motion (ROM) of the glenohumeral joint (GH) by a single examiner with a clinical goniometer. It measures the isolated glenohumeral passive abduction (GH-AB), passive external rotation (GH-ER) and internal rotation (GH-IR) with the arm at 45º of abduction. These three GH ROM parameters were measured in both shoulders of 30 healthy volunteers (15 males/15 females, mean age:41.6[SD = 10.3] years). The full shoulder passive abduction, passive external rotation and internal rotation 45º of abduction were measured by the same examiners with a goniometer for comparison. One examiner made two evaluations and a second examiner made a third one. The primary outcome was the intra- and interobserver reproducibility of the measurements assessed with intraclass correlation coefficients (ICC) and the Bland–Altman plot. Results The intra-observer ICC for isolated glenohumeral ROM were: 0.84 ± 0.07 for GH-ABD, 0.63 ± 0.09 for GH-ER, and 0.61 ± 0.14 for GH-IR. The inter-observer ICC for isolated glenohumeral ROM were: 0.86 ± 0.06 for GH-ABD, 0.68 ± 0.12 for GH-ER, and 0.62 ± 0.14 for GH-IR. These results were similar to those obtained for full shoulder ROM assessment with a goniometer. Conclusion The GRASP method is reproducible for quick assessment of isolated glenohumeral ROM. Level of evidence III Supplementary Information The online version contains supplementary material available at 10.1186/s40634-021-00352-z.
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Affiliation(s)
- Miguel Angel Ruiz Ibán
- Unidad de Hombro y Codo, Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain.
| | - Susana Alonso Güemes
- Unidad de Hombro y Codo, Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain
| | - Raquel Ruiz Díaz
- Unidad de Hombro y Codo, Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain
| | | | - Alejandro Lorente Gomez
- Unidad de Hombro y Codo, Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain
| | - Jorge Diaz Heredia
- Unidad de Hombro y Codo, Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain
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Witt DW, Talbott NR. The effect of shoulder position on inferior glenohumeral mobilization. J Hand Ther 2019; 31:381-389. [PMID: 28285837 DOI: 10.1016/j.jht.2017.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 02/07/2017] [Accepted: 02/09/2017] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Cross-sectional clinical measurement study. INTRODUCTION Inferior mobilizations are used to treat patients with shoulder dysfunctions. Common positions recommended for promoting an inferior glide include: (1) an open-packed position (OPP) in which the shoulder is in 55° of abduction, 30° of horizontal adduction, and no rotation; (2) neutral position (NP) of the shoulder; and (3) position of 90° of shoulder abduction (ABDP). Studies comparing the impact of position on inferior mobilization are lacking. PURPOSE OF THE STUDY To determine the effect of shoulder position on humeral movement and mobilization force during inferior mobilizations. METHODS Twenty-three subjects were tested bilaterally. Subjects were placed in the OPP, and an ultrasound transducer placed over the superior glenohumeral joint. As inferior mobilization forces were applied through a dynamometer, ultrasound images were taken at rest and during 3 grades of inferior mobilization. This process was repeated in the NP and the ABDP. RESULTS In the NP, movements during grade 1, 2, and 3 mobilizations were 1.8, 3.8, and 4.5 mm, respectively. Movements measured in the OPP (1.0, 2.4, and 3.6 mm, respectively) and in the ABDP (1.0, 2.2, and 2.3 mm, respectively) were less. Forces were higher in the NP during grade 1, 2, and 3 mobilizations (51.8, 138.7, and 202.1 N, respectively) than in the OPP (37.2, 91.2, and 139.9 N, respectively) and the ABPD (42.5, 115.3, and 165.5 N, respectively). DISCUSSION Mobilization position altered the movement and force during inferior mobilizations. CONCLUSIONS Shoulder position should be considered when utilizing inferior mobilizations. LEVEL OF EVIDENCE NA.
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Affiliation(s)
- Dexter W Witt
- Department of Rehabilitation Sciences, University of Cincinnati, Cincinnati, OH, USA.
| | - Nancy R Talbott
- Department of Rehabilitation Sciences, University of Cincinnati, Cincinnati, OH, USA
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9
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Nichols CW, Brismée JM, Hooper TL, Bertrand-Grenier A, Gilbert KK, St-Pierre MO, Kapila J, Sobczak S. Glenohumeral joint capsular tissue tension loading correlates moderately with shear wave elastography: a cadaveric investigation. Ultrasonography 2019; 39:114-120. [PMID: 31786904 PMCID: PMC7065991 DOI: 10.14366/usg.19032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 08/01/2019] [Indexed: 12/23/2022] Open
Abstract
Purpose The purpose of this study was to investigate changes in the mechanical properties of capsular tissue using shear wave elastography (SWE) and a durometer under various tensile loads, and to explore the reliability and correlation of SWE and durometer measurements to evaluate whether SWE technology could be used to assess tissue changes during capsule tensile loading. Methods The inferior glenohumeral joint capsule was harvested from 10 fresh human cadaveric specimens. Tensile loading was applied to the capsular tissue using 1-, 3-, 5-, and 8-kg weights. Blinded investigators measured tissue stiffness and hardness during loading using SWE and a durometer, respectively. Intraobserver reliability was established for SWE and durometer measurements using intraclass correlation coefficients (ICCs). The Pearson product-moment correlation was used to assess the associations between SWE and durometer measurements. Results The ICC3,5 for durometer measurements was 0.90 (95% confidence interval [CI], 0.79 to 0.96; P<0.001) and 0.95 (95% CI, 0.88 to 0.98; P<0.001) for SWE measurements. The Pearson correlation coefficient values for 1-, 3-, and 5-kg weights were 0.56 (P=0.095), 0.36 (P=0.313), and -0.56 (P=0.089), respectively. When the 1- and 3-kg weights were combined, the ICC3,5 was 0.72 (P<0.001), and it was 0.62 (P<0.001) when the 1-, 3-, and 5-kg weights were combined. The 8-kg measurements were severely limited due to SWE measurement saturation of the tissue samples. Conclusion This study suggests that SWE is reliable for measuring capsular tissue stiffness changes in vitro at lower loads (1 and 3 kg) and provides a baseline for the non-invasive evaluation of effects of joint loading and mobilization on capsular tissues in vivo.
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Affiliation(s)
- Charles W Nichols
- Department of Physical Therapy, School of Health Professions, University of North Texas Health Science Center, Ft. Worth, TX, USA
| | - Jean-Michel Brismée
- Department of Rehabilitation Sciences, Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Troy L Hooper
- Department of Rehabilitation Sciences, Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Antony Bertrand-Grenier
- Centre Intégré Universitaire de Santé et de Services Sociaux de la Mauricie-et-du-Centre-du-Québec (CIUSSS MCQ), TroisRivières, Québec, Canada.,Centre Hospitalier Affilié Universitaire Régional, Centre Intégré Universitaire de Santé et de Services Sociaux de la Mauricie-et-du-Centre-du-Québec (CIUSSS MCQ), Trois-Rivières, Québec, Canada.,Département de Chimie, Biochimie et Physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Kerry K Gilbert
- Department of Rehabilitation Sciences, Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Marc-Olivier St-Pierre
- Département d'Anatomie, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Jeegisha Kapila
- Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Stéphane Sobczak
- Département d'Anatomie, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada.,Unité de Recherche en Anatomie Clinique et Fonctionnelle (URACEF), Trois-Rivires, Québec, Canada
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Shirzadi Z, Rojhani-Shirazi Z, Hemmati L. A Comparison Between the Effects of Scapulothoracic Mobilization Plus Physical Therapy With Physical Therapy Alone in Patients With Mechanical Neck Pain: A Randomized Clinical Trial. J Chiropr Med 2019; 17:237-243. [PMID: 30846916 DOI: 10.1016/j.jcm.2018.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 04/09/2018] [Accepted: 04/09/2018] [Indexed: 02/04/2023] Open
Abstract
Objective The purpose of this study was to compare the effects of scapulothoracic (ST) mobilization plus physical therapy (PT) with PT alone in patients with mechanical neck pain. Methods This double-blinded randomized clinical trial was conducted at Shiraz School of Rehabilitation Sciences and involved 46 patients with mechanical neck pain and scapular dyskinesia. The patients were randomly assigned to the ST mobilization + PT group (scapulothoracic mobilization and physical therapy) or the PT group (physical therapy treatment) by a computer-generated randomized table of numbers. Both groups received 5 sessions of treatment during 1 week. Pain intensity and grip strength were evaluated 3 times: baseline, after the first session, and after the fifth session. Furthermore, functional disability of the upper limbs and the neck were evaluated before and at the fifth session. Results The results showed that the pain intensity was reduced and grip strength increased significantly after the first session (P = .01) and at the end of the treatment (P = .01) in the ST mobilization + PT group in comparison with the PT group. Also, the mean difference of upper limb (P = .01) and neck disability (P = .02) decreased significantly in the ST mobilization + PT group in comparison with the PT group. Conclusion Scapulothoracic mobilization in combination with physical therapy may be superior to physical therapy alone in reducing pain intensity, maximizing grip strength, and reducing upper limb and neck disability in mechanical neck pain.
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Affiliation(s)
- Zeinab Shirzadi
- Physiotherapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Zahra Rojhani-Shirazi
- Physiotherapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Ladan Hemmati
- Physiotherapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
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11
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Effects of an anteroposterior mobilization of the glenohumeral joint in overhead athletes with chronic shoulder pain: A randomized controlled trial. Musculoskelet Sci Pract 2018; 38:91-98. [PMID: 30359870 DOI: 10.1016/j.msksp.2018.09.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 09/13/2018] [Accepted: 09/19/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Passive oscillatory mobilizations are often employed by physiotherapists to reduce shoulder pain and increase function. However, there is little data about the neurophysiological effects of these mobilizations. OBJECTIVES To investigate the initial effects of an anteroposterior (AP) shoulder joint mobilization on measures of pain and function in overhead athletes with chronic shoulder pain. DESIGN Double-blind, controlled, within-subject, repeated-measures design. METHOD Thirty-one overhead athletes with chronic shoulder pain participated. The effects of a 9-min, AP mobilization of the glenohumeral joint were compared with manual contact and no-contact interventions. Self-reported pain, pressure pain threshold (PPT), range of movement (ROM), muscle strength, and disability were measured immediately before and after each intervention. RESULTS/FINDINGS No significant differences were found among the treatment conditions in any of the variables investigated. A significantly greater mean decrease in self-reported shoulder pain was observed following treatment condition [0.63 (0.12, 1.14); p = 0.01]. PPT at the affected shoulder increased significantly following both the treatment [0.23 (-0.43, 0.02); p = 0.02] and manual contact [0.28 (-0.51, 0.04); p = 0.01] conditions. Shoulder AP joint mobilization also increased PPT at a distal, non-painful site [0.42 (-0.85, 0.01); p = 0.04]. No changes were observed in shoulder ROM or muscle strength. CONCLUSIONS This study found no superior effects in various pain or function-related outcome measures of a passive oscillatory anteroposterior mobilization applied to the glenohumeral joint compared to manual contact and no-contact interventions in overhead athletes with chronic shoulder pain. Some ability to modulate shoulder pain and local and widespread pain sensitivity was observed in the short term after the passive oscillatory anteroposterior mobilization.
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Elhafez HM, Elhafez SM. Axillary Ultrasound and Laser Combined With Postisometric Facilitation in Treatment of Shoulder Adhesive Capsulitis: A Randomized Clinical Trial. J Manipulative Physiol Ther 2016; 39:330-338. [PMID: 27167367 DOI: 10.1016/j.jmpt.2016.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 06/04/2015] [Accepted: 06/17/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The purpose of this study was to compare axillary ultrasound, laser, and postisometric facilitation technique with standard care in the management of shoulder adhesive capsulitis. METHODS This is a randomized clinical trial study. Fifty-nine participants with shoulder adhesive capsulitis were selected and randomly assigned for eligibility. Forty-five participants were assigned into 3 equal groups of 15, and 14 participants were excluded from the study. The participants were blinded to their group allocation. Standard care group (A) received traditional physical therapy treatment in the form of pulsed ultrasound, scanning laser, supervised exercise program, and home exercise program; group B received the same physical therapy program as group A, except that the ultrasound and scanning laser were applied to the axillary region of the painful shoulder; and group C received the same modified physical therapy program as group B plus postisometric facilitation technique to the painful shoulder. All dependent variables were measured by the second author, who was blinded to the participant's intervention group. The first author administered treatment to all 3 groups. All participants received 12 sessions (3 times/wk for 4 weeks). Pain level and shoulder range of motion (ROM; flexion, abduction, and external rotation) were recorded 3 times (pretreatment, immediately posttreatment, and 4 weeks of treatment). RESULTS Mixed-design multivariate analysis of variance indicated significant pain reduction with significant ROM increase in all groups posttreatment and after 4 weeks. Post hoc analysis for within groups revealed that shoulder ROM and pain levels improved significantly posttreatment compared with pretreatment ROM in all groups, with the greatest improvement in group C. Between-group analysis revealed that pain-free shoulder flexion, abduction, external rotation, and pain level improved significantly in group C compared with groups A and B immediately after treatment and after 4 weeks of follow-up (P < .05). Improvements reported in group B is more than in group A, and C is more than in groups A and B. CONCLUSIONS Combining axillary ultrasound and laser with postisometric facilitation had a greater effect in reducing pain and improving shoulder ROM in patients with shoulder adhesive capsulitis compared with axillary ultrasound and laser with traditional exercise.
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Affiliation(s)
- Haytham M Elhafez
- Professor of Physical Therapy, Basic Sciences Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
| | - Salam M Elhafez
- Professor of Biomechanics and Head of Biomechanics Department, Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Talbott And NR, Witt DW. In vivo measurements of humeral movement during posterior glenohumeral mobilizations. J Man Manip Ther 2016; 24:269-276. [PMID: 27956820 DOI: 10.1179/2042618615y.0000000007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVES The purpose of this study was to quantify in vivo posterior translational movements occurring in the glenohumeral joint during posterior mobilizations and to determine the intratester reliability of those posterior translational movements. METHODS Twenty-eight individuals (17 females, 11 males) participated in this study. One physical therapist utilized a Kaltenborn approach to apply three grades of posterior humeral mobilization. A hand held dynamometer was used to quantify the force used during each grade of mobilization. Ultrasound imaging was used to visualize and measure posterior humeral movement. Statistical analysis included descriptive statistics for force and posterior movement, intraclass correlation coefficient (ICC) for intrarater reliability of force and posterior movement during each grade of mobilization and paired t-tests to compare movement and force between grades of mobilization. RESULTS Mean posterior movement (mm) measurements were 3.0, 8.2 and 10.7 for grade I, grade II and grade III mobilizations, respectively. Mean force (Newtons) measurements used during mobilization were 41.7, 121.5 and 209.4 for grade I, grade II and grade III mobilizations, respectively. The ICCs ranged from 0.849 to 0.905 for movement and from 0.717 to 0.889 for force. Force and measurement values were significantly different between grades of mobilization and between dominant and non-dominant arms. Gender was found to be significantly associated with force. DISCUSSION Mean movements and mean forces occurring during posterior mobilization increased with increasing grades. Intratester reliability was high for all grades of manual mobilization supporting the use of subjective feedback to determine appropriate force application. Quantification of forces and movements helps to clarify parameters that can serve as a reference for clinical practice.
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Witt DW, Talbott NR. In-vivo measurements of force and humeral movement during inferior glenohumeral mobilizations. ACTA ACUST UNITED AC 2016; 21:198-203. [DOI: 10.1016/j.math.2015.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 08/04/2015] [Accepted: 08/07/2015] [Indexed: 11/25/2022]
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Yu IY, Jung IG, Kang MH, Lee DK, Oh JS. Immediate effects of an end-range mobilization technique on shoulder range of motion and skin temperature in individuals with posterior shoulder tightness. J Phys Ther Sci 2015; 27:1723-5. [PMID: 26180306 PMCID: PMC4499969 DOI: 10.1589/jpts.27.1723] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 02/14/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study investigated the effects of an end-range mobilization technique on
the range of motion of the glenohumeral internal rotation and the skin temperature of the
shoulder in individuals with posterior shoulder tightness. [Subjects] Thirteen subjects
with posterior shoulder tightness who had glenohumeral internal rotation deficit ≥ 15°
participated. [Methods] All subjects underwent glenohumeral joint end-range mobilization
intervention. The internal rotation range of motion of the glenohumeral joint was measured
by a goniometer and the shoulder skin temperature was measured by a digital infrared
thermographic imaging device before and immediately after the intervention. Paired t-tests
were used to analyze the differences in these parameter pre and post-intervention.
[Results] The glenohumeral internal rotation range of motion and skin temperature of the
posterolateral shoulder in increased significantly post-intervention. [Conclusion] The
end-range mobilization technique is effective for increasing the glenohumeral internal
rotation range of motion and skin temperature of the shoulder in individuals with
posterior shoulder tightness.
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Affiliation(s)
- Il-Young Yu
- Department of Physical Therapy, Graduate School, Inje University, Republic of Korea
| | - In-Gui Jung
- Department of Physical Therapy, Graduate School, Inje University, Republic of Korea
| | - Min-Hyeok Kang
- Department of Rehabilitation Science, Graduate School, Inje University, Republic of Korea
| | - Dong-Kyu Lee
- Department of Rehabilitation Science, Graduate School, Inje University, Republic of Korea
| | - Jae-Seop Oh
- Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Republic of Korea
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Perdomo M, Sebelski CA, Davies C. Oncology Section Task Force on Breast Cancer Outcomes: Shoulder and Glenohumeral Outcome Measures. REHABILITATION ONCOLOGY 2013. [DOI: 10.1097/01893697-201331010-00005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gong W, Jeong H, Kim E. The Effects of Gongrsquo;s Mobilization Applied to the Shoulder Joint on Shoulder Medial Rotation. J Phys Ther Sci 2012. [DOI: 10.1589/jpts.24.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Wontae Gong
- Department of Physical Therapy, Korea Nazarene University
| | - Hyunja Jeong
- Department of Dental Hygiene, Daegu Health College
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Effectiveness of the end-range mobilization and scapular mobilization approach in a subgroup of subjects with frozen shoulder syndrome: a randomized control trial. ACTA ACUST UNITED AC 2011; 17:47-52. [PMID: 21944980 DOI: 10.1016/j.math.2011.08.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Revised: 08/16/2011] [Accepted: 08/30/2011] [Indexed: 10/17/2022]
Abstract
Treatment strategies targeting abnormal shoulder kinematics may prevent pathology or if the pathology develops, shorten its duration. We examined the effectiveness of the end-range mobilization/scapular mobilization treatment approach (EMSMTA) in a subgroup of subjects with frozen shoulder syndrome (FSS). Based on the kinematics criteria from a prediction method, 34 subjects with FSS were recruited. Eleven subjects were assigned to the control group, and 23 subjects who met the criteria were randomly assigned to the criteria-control group with a standardized physical therapy program or to the EMSMTA group. Subjects attended treatment sessions twice a week for 8 weeks. Range of motion (ROM), disability score, and shoulder complex kinematics were obtained at the beginning, 4 weeks, and 8 weeks. Subjects in the EMSMTA group experienced greater improvement in outcomes compared with the criteria-control group at 4 weeks (mean difference=0.2 of normalized hand-behind-back reach) and 8 weeks (mean difference=22.4 degrees humeral external rotation, 0.31 of normalized hand-behind-back reach, 7.5 disability, 5 degrees tipping and 0.32 rhythm ratio). Similar improvements were found between the EMSMTA group and control group. The EMSMTA was more effective than a standardized physical therapy program in a subgroup of subjects who fit the criteria from a prediction method.
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