Dynamic thoracohumeral kinematics are dependent upon the etiology of the shoulder injury.

Juan López-Pascual,Álvaro Page,Pilar Serra-Añó,Antoine Nordez

doi:10.1371/journal.pone.0183954

Abstract

Obtaining kinematic patterns that depend on the shoulder injury may be important when planning rehabilitation. The main goal of this study is to explore whether the kinematic patterns of continuous and repetitive shoulder elevation motions are different according to the type of shoulder injury in question, specifically tendinopathy or rotator cuff tear, and to analyze the influence of the load handled during its assessment. For this purpose, 19 individuals with tendinopathy and 9 with rotator cuff tear performed a repetitive scaption movement that was assessed with stereophotogrammetry. Furthermore, static range of motion (ROM) and isometric strength were evaluated with a goniometer and a dynamometer, respectively. Dynamic measurements of maximum elevation (Emax), variablility of the maximum angle (VMA), maximum angular velocity (Velmax), and time to maximum velocity (tmaxvel) were found to be significantly different between the tendinopathy group (TG) and the rotator cuff tear group (RTCG). No differences were found in the ROM assessed with goniometry and the isometric strength. The effect of increasing the load placed in the hand during the scaption movement led to significant differences in Emax, VMA, tmaxvel and repeatability. Therefore, only the dynamic variables showed sufficient capability of detecting differences in functional performance associated with structural shoulder injury. The differences observed in the kinematic variables between patients with tendinopathy and rotator cuff tear seem to be related to alterations in thoracohumeral rhythm and neuromuscular control. Kinematic analysis may contribute to a better understanding of the functional impact of shoulder injuries, which would help in the assessment and treatment of shoulder pain.

Highlights

The prevalence of shoulder pain is estimated to be 15.4% in men and 24.9% in women [1]
The goal of this study is to explore whether the kinematic pattern within a thoracohumeral scaption movement, such as range of motion (ROM), velocity, movement rhythm and variability differ if a Thoracic-humeral kinematics shoulder injury shoulder has either tendinopathy or rotator cuff tear
Kinematic variables derived from the scaption motion assessment allow us to establish significant differences between individuals with tendinopathy and rotator cuff tear and provide information about the functional impact of the shoulder injury

Summary

Introduction

The prevalence of shoulder pain is estimated to be 15.4% in men and 24.9% in women [1]. This high prevalence has led to the use of special tools for assessing structural injuries of the shoulder, such as magnetic resonance imaging, radiography or ultrasound, in order to identify. The treatment and rehabilitation of patients with shoulder pain involves knowing the diagnosis, and assessing the impact of the injury on joint function. Alterations in shoulder function have a critical impact on the performance of basic daily activities [2,3]. There is no consistent correlation between the injury itself and the patient’s functional status [4,5], the importance of having techniques to assess the evolution of a patient’s functional status in a clinical context [3,4]

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Conclusion