Abstract
There is limited evidence regarding the effects of aquatic-based physiotherapy on shoulder proprioception following post-traumatic injury to the joint. The main aim of this study was to investigate the effects of additional aquatic-based rehabilitation to a land-based physiotherapy program on shoulder joint position sense (JPS) rehabilitation. Forty-four individuals (mean age 44.50 ± 10.11) who had suffered a post-traumatic shoulder injury less than five months previously were pseudo-randomly allocated equally into a control group (9 females, 13 males) and experimental group (6 females, 16 males). Both groups received individualized standard land-based physiotherapy on average for 50 min per session, with five sessions per week for four consecutive weeks. The experimental group received an additional 30 min of personalized aquatic-based therapy during each session. Shoulder JPS was assessed by flexion (60°), extension (25°), abduction (60°), internal rotation (35°) and external rotation (35°) positions prior, halfway through, and after the intervention. Shoulder JPS improved significantly for all positions for both the control group (p < 0.03) and the experimental group (p < 0.01). No significant differences between the control group and the experimental group were found for change in shoulder JPS over time. Our results indicate that shoulder JPS can be significantly improved among individuals with post-traumatic injury to the joint through four weeks of personalized physiotherapy. The addition of aquatic-based exercises to standard land-based therapy did not, however, show significant benefits, and thus cannot be recommended for the improvement of shoulder JPS based on our findings.
Highlights
The subject of proprioception lies at the border between neurophysiology and neuropsychology
The aims of this study were to (1) investigate the effects of personalized physiotherapy on shoulder joint position sense (JPS) among individuals with post-traumatic injury to the joint and (2) investigate whether additional aquatic-based therapy would have significant effects on shoulder JPS compared with only land-based rehabilitation
We hypothesized that personalized physiotherapy would significantly improve shoulder JPS and that additional aquatic therapy would improve shoulder JPS significantly more than land-based therapy alone
Summary
The subject of proprioception lies at the border between neurophysiology and neuropsychology. Given the importance of proprioception on performing movements in a coordinated manner, we can see a strong association between various musculoskeletal disorders and their negative influence on proprioception [7,8,9,10] When it comes to the shoulder joint, due to the high degree of mobility, the synchronization of active and passive structures has a major role in its stability [11,12,13]. For this reason, shoulder neuromuscular control plays an important role by coordinating muscle activity during voluntary functional movements, which involve the co-activation of the shoulder muscles, reflexes, and the regulation of strength and endurance [14]. Due to joint instability, is correlated with joint rhythm disorders and neuromuscular disorders [8]
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