Motor alterations in the kinetic chain in individuals with chronic shoulder pain

Abstract

BackgroundShoulder pain may be related to biomechanical dysfunctions in the kinetic chain. ObjectiveTo compare the mobility and muscular endurance of thoracolumbar spine and hip, and the neuromuscular control of the lower extremity of individuals with and without shoulder pain and to determine the discriminative capacity between groups of these variables. DesignA cross-sectional study. MethodOne hundred and two individuals with and without shoulder pain were evaluated to range of motion (ROM) of the thoracolumbar spine and hips, the muscular endurance time of the thoracolumbar spine and hips muscles, and the neuromuscular control of the lower extremity, by the Star Excursion Balance Test (SEBT). ResultsIndividuals with shoulder pain presented lower ROM and muscular endurance time in all tests evaluated (p < 0.01–p = 0.03), greater perception of pain during all ROM and muscle endurance (p < 0.01–p = 0.04) evaluations, and less neuromuscular control of the lower extremity in the compound reach (p < 0.01–p = 0.01), anterior and posteromedial (p < 0.01–p = 0.04) directions of the SEBT on both sides. The anterior reach direction of the SEBT of the contralateral limb to the shoulder pain (AUC=0.80, cut-off point=47.7%) presented excellent capacity to discriminate individuals with shoulder pain, while the other variables showed between acceptable and small capacity (AUC=0.58–0.76). ConclusionIndividuals with chronic shoulder pain presented alterations in joint mobility, muscular endurance time of the thoracolumbar spine and hips and neuromuscular control of the lower extremity. The anterior reach of the SEBT of the contralateral limb showed excellent discriminative capacity.