Arthroscopic anatomy of the subdeltoid space

Reliability of a simple physical therapist screening tool to assess errors during resistance exercises for musculoskeletal pain

The main objective was to investigate the intra- and intertester reliability of a simple screening tool assessing errors in exercise execution by visual observation. 38 participants with no previous resistance exercise experience practiced for two weeks four typical upper limb exercises using elastic tubing. At 2-week follow-up, the participants were invited for a test-retest assessment on errors in technical execution. The assessment was based on ordinal deviation of joint position from neutral of the shoulder, elbow, and wrist in a single plane by visual observation. Moderate intratester reliability weighted kappa (wΚ) score ranging from 0.50 (0.21–0.71) to 0.57 (0.24–0.82) for observer 1 and a fair to moderate intratester reliability wΚ score ranging from 0.27 (0.09–0.43) to 0.52 (0.15–0.86) for observer 2 across the four exercises was observed. For intertester reliability moderate to substantial mean wΚ scores were found between the two observers, slightly improving from round one to round two ranging from 0.40 (0.20–0.59) to 0.68 (0.45–0.91) in round one to 0.52 (0.20–0.80) to 0.69 (0.39–0.86) in round two. The exercise error assessment demonstrated fair to substantial intratester and intertester reliability, which is congruent with previously published studies. Hence the simplicity of defining a neutral joint position for each of the involved joints in the exercise and categorizing the deviation in “some deviation” and “substantial deviation” to either side in a single plane is a viable and inexpensive solution when assessing for errors during exercise.

Effect of video-based versus personalized instruction on errors during elastic tubing exercises for musculoskeletal pain: a randomized controlled trial

Workplace interventions have shown beneficial results of resistance training for chronic pain in the neck, shoulder, and arm. However, studies have relied on experienced exercise instructors, which may not be an available resource at most workplaces. The objective of this study is to evaluate the technical performance level of upper limb rehabilitation exercises following video-based versus personalized exercise instruction. We recruited 38 laboratory technicians and office workers with neck/shoulder pain for a two-week exercise training period receiving either (1) personal and video or (2) video only instruction in four typical neck/shoulder/arm rehabilitation exercises using elastic tubing. At a 2-week follow-up, the participants' technical execution was assessed by two blinded physical therapists using a reliable error assessment tool. The error assessment was based on ordinal deviation of joint position from the ideal position of the shoulder, elbow, and wrist in a single plane by visual observation. Of the four exercises only unilateral shoulder external rotation had a higher normalized error score in the V group of 22.19 (9.30) to 12.64 (6.94) in the P group (P = 0.002). For the remaining three exercises the normalized error score did not differ. In conclusion, when instructing simple exercises to reduce musculoskeletal pain the use of video material is a cost-effective solution that can be implemented easily in corporations with challenging work schedules not allowing for a fixed time of day to go see a personal trainer.