The neurodevelopmental profile of HIV-infected pre-school aged children receiving highly active antiretroviral therapy (HAART) in Johannesburg, South Africa

Abstract

Purpose: The purpose of this study was to compare the effectiveness of two pectoralis minor stretching methods that have been considered to be effective. Methods: Subjects were recruited by personal contact. Thirty-four high school baseball players were recruited in this study. The study design was a cross-over design with a two-week washout period. Outcomes were pectoralis minor muscle length, scapular position and glenohumeral range of motion. Pectoralis minor muscle length was measured as the distance from the coracoid process to Rib4 sternocostal joint. Scapular position measurements included acromial distance, scapular index, scapular upward rotation, and posterior tilting angles with the arm abducted 0◦, 60◦, 90◦and 120◦ at the scapular plane. Glenohumeral range of motion was measured as internal and external rotations passively with the arm abducted 90◦ and elbow flexed 90◦. Interventions were two pectoralisminor stretchingmethods called “doorway stretch” and “retraction 30◦ stretch”. Each of the stretching methods was performed manually for 30 seconds and repeated 5 times. There were rest periods of 10 seconds with the arm in a relaxed position between stretches. Two-way ANOVA was used for statistical analysis. Results: Rib4 to CP distance, acromial distance, scapular index, and upward rotation angle with the arm abducted 120◦ were increased significantly compared with those before intervention. Glenohumeral internal rotation angle was increased significantly, but external rotation angle was not increased significantly.Compared to thosewith the retraction 30◦ stretch, Rib4 to CP distance and acromial distance increased significantly with the doorway stretch. Scapular upward rotation angles with the arm abducted 0◦, 60◦, 90◦ and posterior tilt angle were not increased significantly. Conclusion(s): Both doorway stretch and retraction 30◦ stretch increased pectoralisminormuscle length and changed scapular position. Results of this study suggest that doorway stretch may be more effective than retraction 30◦ stretch. It is thought that increased pectoralis minor muscle length leads to scapular position change. Increased glenohumeral internal rotation angle suggests that glenohumeral range of motion may be affected by scapular position. Implications: The results of this study may be helpful for making clinical decisions regarding treatment of shoulder injuries in overhead athletes. Doorway stretch should be used if a patient who needs pectoral minor stretching can perform it. For patients who cannot perform doorway stretch should be used retraction 30◦ stretch.