External Rotation Range Of Motion Research Articles

Use of a Nanofiber Resorbable Scaffold During Rotator Cuff Repair: Surgical Technique and Results After Repair of Small- to Medium-Sized Tears.

Background:The rate of retear after primary rotator cuff failure remains unacceptably high (up to 36% for small- to medium-sized tears). Augmentation of cuff repair with scaffold devices has been reported to improve healing after cuff repair.Purpose/Hypothesis:To describe the surgical technique of using an interpositional nanofiber scaffold during rotator cuff repair and report on a retrospective series of patients regarding functional outcomes and postoperative healing on magnetic resonance imaging (MRI). We hypothesized that augmentation of cuff repair with an interpositional scaffold would result in a high rate of tendon healing and excellent functional outcomes.Study Design:Case series; Level of evidence, 4.Methods:A total of 33 patients underwent arthroscopic rotator cuff repair augmented with a nanofiber, bioresorbable polymer patch secured as an inlay between the tendon and underlying bone. Patients were evaluated preoperatively and postoperatively with the Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons (ASES) shoulder score, and active range of motion (ROM) measurements. Postoperative MRI was used to evaluate repair status.Results:At a minimum follow-up of 6 months, the patients showed significant improvement on SST and ASES scores (P < .0001 for both). ROM in forward flexion, abduction, internal rotation, and external rotation significantly improved at 6 months postoperatively (P < .05 for all). MRI at an average of 11 months postoperatively showed healing in 91% of patients; one patient had a recurrent tear with transtendon failure, and another patient had retear at the insertional site. The patch was not visible on postoperative imaging, suggesting complete resorption in all patients. No adverse events were associated with the patch.Conclusion:Our results demonstrate the preliminary safety and efficacy of a novel, bioresorbable synthetic scaffold for rotator cuff repair. The use of the scaffold resulted in a 91% tendon healing rate and significant improvements in functional and patient-reported outcome measures. The results are promising for improving the current unacceptably high rate of rotator cuff repair failure.

Effects of sequential approach of positional release for subscapularis and OLA Grimsby technique on shoulder external rotation in adhesive.

A sample of 34 patients was randomly assigned to two Groups A and B (17 in each group). Positional release of subscapularis technique to Group A participants and Proprioceptive Neuromuscular Facilitation (PNF) (hold-relax) and anterior mobilisation technique were simultaneously applied to Group B participants. Data was collected from Nusrat Abdul Rauf Centre for Enablement and Faisal Hospital, Faisalabad, from August 30, 2018 to November 27, 2018. The duration of the treatment was four weeks with three sessions per week. The main outcome measures were Numeric Pain Rating Scale (NPRS), Shoulder Pain and Disability Index (SPADI), and shoulder external rotation range of motion. The differences between Ola Grimsby group (Group B) and subscapularis release group (Group A) were statistically significant for pain, disability and shoulder range of motion (p-value<0.05) with higher mean values for Ola Grimsby group. This study concluded that the sequential effects of Ola Grimsby technique are better as compared to positional release of subscapularis in terms of reducing pain and improving shoulder external rotation range of motion.

Evaluation of Coraco-Humeral Ligament Thickness in Adhesive Capsulitis – A Case Control Study

Background: Coracohumeral ligament thickness plays an important role in maintaining shoulder range of motion and stability. It is essential to evaluate its thickness and also to find out its role in limiting shoulder range of motion in adhesive capsulitis. Aim of the study is to evaluate the coracohumeral thickness in adhesive capsulitis by ultrasonic scan and also to find out the relationship of its thickness with shoulder abduction and external rotation range of motion. Study design: Case – control study. Sixty-seven adhesive capsulitis patients and age and BMI matched controls were selected. The coracohumeral thickness was evaluated by ultrasound scanning. Shoulder abduction and external rotation range of motion was also recorded. The coracohumeral ligament thickness was compared between groups by independent sample ‘t’ test. The relationship between coracohumeral ligament thickness and shoulder abduction and external rotation was studied by Pearson’s correlation coefficient. Result: The mean coracohumeral thickness was 2.940.14 mm in adhesive capsulitis and it was significantly higher than in controls, mean = 1.92 0.19 mm

Effectiveness of graded motor imagery in subjects with frozen shoulder: a pilot randomized controlled trial.

BackgroundSubjects with frozen shoulder (FS) might not be comfortable with vigorous physical therapy. Clinical trials assessing the effect of graded motor imagery (GMI) in FS are lacking. The aim of this study was to determine the effect of GMI as an adjunct to conventional physiotherapy in individuals with painful FS.MethodsTwenty subjects aged 40–65 years having stage I and II of FS were randomly divided into two study groups. The conventional physiotherapy group (n = 10) received electrotherapy and exercises while the GMI group (n = 10) received GMI along with the conventional physiotherapy thrice a week for 3 weeks. Pre- (Session 1) and post- (Session 9) intervention analysis for flexion, abduction, and external rotation range of motion (ROM) using a universal goniometer, fear of movement using the fear avoidance belief questionnaire (FABQ), pain with the visual analogue scale, and functional disability using the shoulder pain and disability index (SPADI) was done by a blinded assessor.ResultsStatistically significant difference was seen within both the groups for all the outcomes. In terms of increasing abduction ROM as well as reducing fear of movement, pain, and functional disability, the GMI group was significantly better than control group. However, both groups were equally effective for improving flexion and external rotation ROM.ConclusionsAddition of GMI to the conventional physiotherapy proved to be superior to conventional physiotherapy alone in terms of reducing pain, kinesiophobia, and improving shoulder function for stage I and II of FS.

Relationships Among Shoulder Rotational Strength, Range of Motion, Pitching Kinetics, and Pitch Velocity in Collegiate Baseball Pitchers.

Cross, JA, Higgins, AW, Dziuk, CC, Harris, GF, and Raasch, WG. Relationships among shoulder rotational strength, range of motion, pitching kinetics, and pitch velocity in collegiate baseball pitchers. J Strength Cond Res 37(1): 129-135, 2023-Throwing shoulder injuries are the most common type of injury experienced by baseball pitchers. Weakness in the shoulder musculature and insufficient throwing arm range of motion are both risk factors for developing a shoulder injury. The goal of this study was to determine correlations among shoulder rotational strength, range of motion, pitching kinetics, and pitch velocity in collegiate pitchers. Thirteen uninjured male college pitchers were evaluated. Clinical measures included shoulder internal and external rotation range of motion, peak isokinetic internal and external rotator strength, and peak isometric internal and external rotator strength. Three-dimensional biomechanics were assessed as subjects threw from an indoor pitching mound to a strike zone net at regulation distance. Pearson's correlations were used to assess the associations among the clinical measures and throwing metrics. Five significant correlations were found between peak shoulder compressive force and strength, and 4 significant correlations were found between pitching velocity and strength ( p < 0.05). No significant correlations were found between range of motion and pitching kinetics or velocity. Our results suggest that as shoulder rotational strength increases, the peak shoulder compressive force and pitch velocity both increase. Knowledge of relationships between strength metrics and pitching biomechanics may allow for improved strength training routines with the goal of increasing velocity without increasing injury risk.

Examining the Dynamic Nature of Anterior Cruciate Ligament Injury Risk Factors in Women's Collegiate Soccer.

Anterior cruciate ligament (ACL) injuries are a common and devastating injury in women's soccer. Several risk factors for ACL injury have been identified, but have not yet been examined as potentially dynamic risk factors, which may change throughout a collegiate soccer season. Prospective cohort study. Nine common clinical screening assessments for ACL injury risk, consisting of range of motion, movement quality, and power, were assessed in 29 Division I collegiate women's soccer players. Preseason and midseason values were compared for significant differences. Change scores for each risk factor were also correlated with cumulative training loads during the first 10weeks of a competitive soccer season. Hip external rotation range of motion and power had statistically significant and meaningful differences at midseason compared with preseason, indicating they are dynamic risk factors. There were no significant associations between the observed risk factor changes and cumulative training load. Hip external rotation range of motion and power are dynamic risk factors for ACL injury in women's collegiate soccer athletes. Serial screening of these risk factors may elucidate stronger associations with injury risk and improve prognostic accuracy of screening tools.

Muscle Tendon Transfers Around the Shoulder: Diagnosis, Treatment, Surgical Techniques, and Outcomes.

Muscle tendon transfers (MTTs) are effective surgical procedures for reducing pain and for improving active shoulder range of motion and patient-reported outcomes for a wide range of pathologies, including serratus anterior and trapezius muscle palsy, irreparable subscapularis tears, irreparable posterosuperior rotator cuff tears, irreparable posterior rotator cuff tears in the setting of reverse shoulder arthroplasty, and symptomatic complete deltoid deficiency. The principles of MTT include ensuring that the transferred muscle is expendable, the muscle tendon unit has similar excursion, the line of pull of the transferred tendon and of the recipient muscle are similar in terms of biomechanical force, and the transferred muscle should replace at least 1 grade of strength of the deficient recipient muscle. When MTT procedures are considered, patients must have exhausted all nonoperative management, have preserved passive range of motion, and have an understanding of the postoperative expectations and potential complications. For patients with scapulothoracic abnormal motion (STAM) due to long thoracic nerve palsy, the indirect or direct pectoralis major tendon transfer is an effective procedure for reducing pain and improving active forward elevation. For patients with STAM due to spinal accessory nerve palsy, the Eden-Lange or the triple tendon transfer procedures reduce pain and improve active forward elevation and abduction as well as patient-reported clinical outcomes. Both pectoralis major and latissimus dorsi transfer procedures for isolated irreparable subscapularis deficiency without anterosuperior humeral head escape result in improvement with respect to pain, patient-reported outcomes, and forward elevation, with the pectoralis major tendon transfer demonstrating durable long-term outcomes. The latissimus dorsi or lower trapezius tendon transfer procedures for irreparable posterosuperior rotator cuff tears reliably improve patient-reported outcomes, forward elevation, abduction, and external rotation range of motion. Additionally, latissimus dorsi transfer with or without teres major transfer can be used to restore active external rotation, both in the native shoulder and in the setting of reverse shoulder arthroplasty. The complications of MTTs include infection, hematoma, and failure of tendon transfer healing; therefore, it is recommended that these complex procedures be performed by shoulder surgeons with appropriate training.

Effectiveness of a Shoulder Exercise Program in Division I Collegiate Baseball Players During the Fall Season.

BackgroundDeficits in shoulder range of motion (ROM) and strength are associated with risk of arm injury in baseball players.PurposeThe purpose of this study was to assess the effectiveness of a standardized exercise program, during the fall season, on shoulder ROM and rotational strength in collegiate baseball players.Study DesignProspective cohort studyMethodsPassive shoulder internal rotation (IR), external rotation (ER), and horizontal adduction ROM were measured with an inclinometer. Shoulder IR and ER strength was assessed using a hand-held dynamometer and normalized to body weight. Players performed a program of shoulder stretching and strengthening exercises, three times/week for one month and then one time/week for two months. Paired sample t-tests compared pre-intervention to post-intervention outcome measures.ResultsDivision I baseball players (n=43; 19.6±1.2years, 185.8±5.5cm, 90.5±7.0kg) volunteered. From pre- to post-intervention, there were increases in horizontal adduction ROM in the throwing (Mean Difference (MD)=6.1°, 95%CI=3.7,8.5; p<0.001) and non-throwing arm (MD=8.0°, 95%CI=5.6,10.3; p<0.001), and a decrease in non-throwing arm ER ROM (MD=2.8°, 95%CI= 0.2,5.5; p=0.039). The ER ROM surplus (throwing – non-throwing) increased (MD=5.6°, 95%CI= 1.1,10.2; p=0.016). Throwing arm (MD=1.3%BW, 95%CI=0.5-2.1, p=0.003) and non-throwing arm (MD=1.2%BW, 95%CI=0.4,2.0; p=0.004) ER strength decreased. A notable, but non-significant increase in IR strength on the throwing arm (MD=1.6%BW, 95%CI=0.1,3.0; p=0.055) and decrease on the non-throwing arm (MD=1.2%BW, 95%CI=0.0,2.4; p=0.055) occurred. Additionally, throwing arm ER:IR strength ratio (MD=0.16, 95%CI=0.08,0.25; p<0.001) also decreased.ConclusionChanges in shoulder horizontal adduction ROM, IR strength and relative ER surplus on the throwing arm were noted at the end of the season. The lack of change in IR and ER ROM and may be related to the lack of deficits at the start of the fall season.Level of Evidence2.

Extracorporeal Shockwave Therapy as an Adjunctive Therapy for Frozen Shoulder: A Systematic Review and Meta-analysis.

Background:The best nonsurgical treatment for frozen shoulder is still unclear. Extracorporeal shockwave therapy (ESWT) is an innovative adjunctive treatment for frozen shoulder, but its effect is still unclear.Purpose:To evaluate the published literature regarding the potential of ESWT as an adjunctive therapy for frozen shoulder.Study Design:Systematic review; Level of evidence, 1.Methods:Searches were conducted in the PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), and VIP Information databases for relevant studies between inception and November 2020. Included were randomized controlled trials (RCTs) for frozen shoulder that compared ESWT with routine treatments to controls. There were no restrictions on the treatment period, type of ESWT, or severity of symptoms. At least 1 of the following outcome indices was assessed: visual analog scale (VAS) for pain, Constant-Murley score (CMS) for shoulder function assessment, or external rotation range of movement (ER ROM). RevMan 5.3 software was used to evaluate the bias and quality of the included studies. For continuous variables, the mean difference (MD) or standardized MD (SMD) with the 95% CI was extracted. For dichotomous data, event ratios and sample sizes were extracted.Results:Overall, 20 studies were included. The ESWT used as an adjunct to other interventions had better outcomes compared with control groups regarding immediate and short-term analgesic effects (immediate: MD, –1.10 [95% CI, –1.27 to –0.92], P < .00001; short-term: MD, –0.72 [95% CI, –0.94 to –0.50], P < .00001) as well as immediate function (SMD, 1.54 [95% CI, 1.19 to 1.89], P < .00001], I 2 = 0%). There was significant heterogeneity between studies for long-term analgesia (MD, –0.90 [95% CI, –1.40 to –0.41], P < .00001, I 2 = 89%) and ER ROM (MD, 10.31 [95% CI, 3.46 to 17.17], P < .003, I 2 = 93%).Conclusion:ESWT seems to be beneficial to patients with frozen shoulder by alleviating pain and improving function. ESWT could be used as an adjunct therapy to routine treatments, although the quality of the included RCTs was hampered by significant heterogeneity regarding long-term analgesia and joint ROM.

The influence of growth and development on shoulder rotators strength in young male and female elite tennis players.

Tennis practice requires a lot of technical, physical and mental qualities that have to be trained from the youngest age. The important number of hours spent on the court can lead, medium-to-long term to strength or flexibility adaptations, even in the youngest players. The current study aimed to explore the developmental consequences of repetitively playing tennis on shoulder range of motion and shoulder rotators' strength in elite male and female tennis players. Eigthy four painfree elite tennis players were assessed during preseason between 2009 and 2019. Clinical assessment included internal and external rotation range of motion and forward shoulder posture while maximal internal and external rotators strength were assessed with an isokinetic dynamometer in concentric and in eccentric modes (at 60°/s and 240°/s). In male players, growth and maturation induced an increase in forward shoulder posture. Absolute peak torque and bodyweight peak torque of internal and external rotators in concentric and eccentric mode were also significantly increased during with age while ER/IR concentric ratios were significantly decreased. In the female players, only absolute peak torque of internal and external rotators in concentric mode and eccentric strength of external rotators were significantly influenced by the development. Specific adaptations were found in male and female players with age and practice. The important variability in the results within the different age categories and the gender strengthens the importance of regular screening (and isokinetic evaluations) in young tennis players in order to highlight potential atypical profiles, which could have a negative influence on performance or increase the risk of injuries during the development of the player.

Is there an association between joint range of motion and muscle strength in young female dancers? And, does it depend on the effects of age and menarche?

ABSTRACT Aiming to determine the association between joint range of motion (ROM) and muscle strength; and, the effect of age and menarche on those two factors; 132 pre-and post-menarche dancers, aged 12–14 years were assessed for joint ROM and for muscle strength at the hip, knee and ankle and foot joints. En-pointe ROM was significantly correlated with ankle plantar-flexors’ (r = −.184) and with ankle dorsiflexors’ muscle strength (r = −.221). Hip external rotation ROM was significantly correlated with knee extensors’ strength (r = −.263). Pre-menarche dancers had higher joint ROM compared with post-menarche dancers; yet, dancers at post-menarche were stronger compared to dancers at pre-menarche. The slope coefficient was negative at the age of 12 in hip external rotation and in en-pointe (−0.80 and −0.52, respectively) and became steeper with age (age 13: −3.52 and −3.28, respectively; age 14: −6.31 and −4.42, respectively). Along maturation, dancers with high joints ROM showed reduced muscle strength. Pre-menarche dancers have higher joint ROM, yet reduced muscle strength, compared with post-menarche dancers. As the association between joint ROM and muscle strength might be involved with growth and development, young dancers should be screened along pubertal stages in order to decide the correct curricula and to prevent future injuries.

Validity and reliability of a smartphone goniometer application for measuring hip range of motions.

Mobile applications which are designed to assess the range of motion (ROM) are widely used. The aim of this cross-sectional observational study was to determine the inter-observer and intra-observer reliability of a smartphone application "PT Goniometer" (PTG) and determine the correlation between PTG and universal goniometer (UG) regarding active ROMs of the hip in healthy participants. Thirty-four healthy young participants were included in the study. Two physiotherapists performed active hip flexion, abduction, internal rotation and external rotation ROM measurements of dominant legs of the participants by using PTG and UG. Intraclass correlation coefficients (ICC) were calculated to determine the intra-observer and inter-observer reliability. Level of correlations between PTG and UG were used to establish concurrent validity of PTG. The PTG demonstrated excellent inter-observer and intra-observer reliability (ICC > 0.90) for all measured hip movements. The minimum detectable change (MDC95) was ranged from 3.29° to 5.1° for the intra-observer reliability, and from 2.55° to 3.21° for the inter-observer reliability. Additionally, the concurrent validity was found excellent (r = 0.91-0.93). The results of the present study suggest that PTG is a valid and reliable mobile technology for measuring hip ROMs.

Range of motion and muscle function on shoulder joints of young handball athletes.

The detection of primary risk factors through the assessment of shoulder range of motion (ROM) and muscle function could prevent injuries in the initial stages of the handball (HB) practice. To compare shoulder ROM, muscle strength and muscle extensibility between throwing and non-throwing shoulders in young HB athletes and between non-HB athletes. A cross-sectional study was designed. Participants aged between 14-16 years that practice physical activity regularly were included and divided in two groups. The HB group included volunteers who practiced HB, the control group included volunteers who practiced other activities. The variables measured were internal rotation and external rotation ROM, maximum isometric strength, and extensibility of the tissues of the posterior part of the throwing and non-throwing shoulder. Thirty-seven subjects were included. The HB group (n= 19) showed greater ROM in both shoulders compared to the control group (n= 18) (p< 0.05). The throwing shoulder of the HB group showed less internal rotation ROM, greater external rotation ROM and greater internal rotation strength when compared to the non-throwing shoulder (p< 0.05). The results of the study suggest that young HB athletes present differences in shoulder ROM compared to non-HB athletes. Also, HB athletes showed differences in ROM and strength between the TS and non-TS. Hence, the assessment of the shoulder ROM and muscle function should be taken into consideration to avoid injuries in this population.

The Contribution of Posterior Capsule Hypertrophy to Soft Tissue Glenohumeral Internal Rotation Deficit in Healthy Pitchers

Background: The relationship between posterior capsule adaptations and soft tissue glenohumeral internal rotation deficit (GIRD) in healthy pitchers remains unclear. Purpose/Hypothesis: This study aimed to identify if posterior capsule thickness (PCT) was associated with soft tissue GIRD in healthy pitchers. We hypothesized that there would be a positive relationship between soft tissue GIRD and PCT in the dominant arm, no relationship between soft tissue GIRD and PCT in the nondominant arm, and a strong positive relationship between soft tissue GIRD and the bilateral difference in PCT (posterior capsule hypertrophy [PCH]). Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 45 healthy collegiate and professional pitchers were included. Glenohumeral internal rotation and external rotation range of motion, humeral retroversion, and PCT were measured bilaterally. PCT was determined for unilateral posterior capsule measurements, and PCH of the throwing shoulder was calculated as the bilateral difference in PCT. Soft tissue GIRD was calculated as the sum of clinical GIRD and the bilateral difference in humeral retroversion. Pearson correlation coefficients were determined to evaluate the relationships between dominant arm PCT, nondominant arm PCT, and PCH and soft tissue GIRD. Results: Pearson correlations showed that both dominant arm PCT (R = −0.13; P = .378) and nondominant arm PCT (R = 0.21; P = .165) were not related to soft tissue GIRD. However, Pearson correlations did show that the amount of PCH was moderately related to soft tissue GIRD (R = 0.40; P = .007). Therefore, as the posterior capsule hypertrophied, soft tissue GIRD moderately increased. Conclusion: Increased PCH was associated with an increase in soft tissue GIRD in healthy pitchers. If PCT measurements are feasible, clinicians should consider performing bilateral ultrasound assessments to isolate posterior capsule adaptations (ie, PCH). This will allow clinicians to identify pitchers with potentially maladaptive structural adaptations and optimize management strategies throughout the season to counteract them.

Effect of IFT with Anterior Glide versus Posterior Glide Joint Mobilisation Technique on Shoulder External Rotation Rom in Patients with Adhesive Capsulitis: Comparative Study

Background: Adhesive capsulitis is a clinical diagnosis made from a history of the gradual onset of severe shoulderpain with the progressive limitation of active and passive glenohumeral movements. The most significant loss ofmovement is in the external rotation of the joint. Traditionally physical therapists have used an anterior glide ofthe humeral head on the glenoid technique to improve external rotation range of motion a choice based on ‘convexon concave’ concept of joint surface motion.Aim &amp; objective of the study: To compare the effect of IFT with anterior glide versus posterior glide jointmobilization technique on shoulder external rotation ROM in patients with adhesive capsulitis.Data Analysis and Results: This study results shows that there is statistically significant improvement in thevariables of shoulder pain and disability index (SPADI) and Shoulder External Rotation ROM between pre and postmean values in both control and experimental group with p&lt;0.05. The Post mean values of SPADI and ShoulderExternal Rotation ROM in degrees with p values p&lt;0.05 in Control group when compared to Experimental Group.Conclusion: This study concluded that both anterior glide and posterior glide with Interferential therapy reducethe pain and improve the external rotation range of motion in adhesive capsulitis. Meanwhile, interferentialtherapy with anterior glide is more effective than the interferential therapy with posterior glide in reducing thepain and improving the external rotation range of motion in adhesive capsulitis.

Flexibility, Position, and Strength of the Shoulder Complex in Pediatric and Adult Amateur Tennis Athletes.

Understanding the musculoskeletal adaptations in the shoulder complex of varying ages of tennis athletes may suggest preventive protocols and conditioning and rehabilitation programs to this population. This study aimed to generate a bilateral descriptive profile of shoulder flexibility, scapular and clavicular position, and muscle strength in pediatric and adult amateur tennis athletes. The outcome measures were compared between groups and sides. The number and percentage of athletes "at risk" according to cutoff values for shoulder range of motion (ROM) were also analyzed. Cross-sectional study. 36 pediatric and 28 adult amateur tennis athletes were tested. Outcome measures were ROM of shoulder flexion, abduction, internal and external rotation, posterior capsule tightness, pectoralis minor index (PMI), scapular upward rotation, clavicular elevation, and strength of the external rotators, serratus anterior, and lower trapezius of the dominant/nondominant sides. Pediatric athletes had greater dominant side external rotation (P = .01) and total ROM (P = .04), increased Low Flexion test (P = .01), and decreased PMI (P = .01) compared with the adults. Bilaterally, the pediatric athletes had greater dominant side external rotation ROM (P < .01) and decreased PMI (P = .002) as compared with their nondominant side, whereas the adults displayed lower values on posterior capsule tightness (P = .01) and decreased PMI (P = .02) on their dominant side compared with their nondominant side. For the remaining outcomes, no interaction effects were observed. The cutoff values for shoulder ROM showed that several athletes were "at risk" of shoulder problems. Upper extremity adaptations at the shoulder are present in both pediatric and adult tennis athletes. These data can assist clinicians in better understanding the biomechanical adaptations in the shoulder of amateur tennis athletes in different age groups.

Functional outcomes of modified constraint-induced movement therapy versus Kinesio taping in children with Erb’s palsy

IntroductionFunctional improvement is the primary goal in chronic cases with neurological deficits. The aim of this study was to compare using modified constraint-induced movement therapy and Kinesio taping to improve functional outcomes in children with Erb’s palsy.MethodsThe study investigated 46 children with Erb’s palsy aged 5–7 years. They were randomly classified into 2 equal groups. Patients in group A engaged in a modified constraint-induced movement therapy program which included restraining of the movement of the non-involved upper extremity, while those in group B received a selected rehabilitative program based on the Kinesio taping method. The treatment programs were conducted 5 times per week for 6 successive weeks. Measurements obtained included active range of motion of shoulder flexion, abduction, and external rotation, as well as modified Mallet scale scores. These measurements were recorded before and after the application of the treatment program in both groups.ResultsThere was a significant improvement in external rotation range of motion and forearm supination when comparing pre- and post-treatment mean values in each study group. There were no differences between the groups regarding any of the measured variables.ConclusionsAccording to the applied procedures and collected data, there was no evidence for a superiority of modified constraint-induced movement therapy when compared with Kinesio taping in improving functional outcomes in children with Erb’s palsy.

Effectiveness of extracorporeal shockwave therapy for frozen shoulder in perimenopausal diabetic women

Abstract Study aim: To evaluate the effectiveness of extracorporeal shockwave therapy (ESWT) for frozen shoulder in perimenopausal diabetic women. Materials and methods: A single blind randomized controlled trial was conducted on sixty-two perimenopausal women diagnosed with diabetic frozen shoulder. They were divided randomly into two groups. Group (A) received physiotherapy program in the form of maitland joint mobilization for shoulder joint, self-stretching exercises, range of motion exercises (ROM) and strengthening exercises. Sessions were held 3 times per week, for 4 weeks. Group (B) study group: received the same physiotherapy program in addition to ESWT, once per week, for 4 weeks. Visual analogue scale was used to measure pain intensity, shoulder pain and disability index (SPADI) was used to evaluate disability level, while an electrogoniometer was used to measure shoulder flexion, abduction and external rotation range of motion. All measurements were recorded pretreatment and posttreatment program. Results: For intragroup comparison, significant improvement in all treatment outcomes was noted in both groups (P &lt; 0.05). However, no significant differences were found between both groups regarding all outcome measures in case of intergroup comparison in the study (P &gt; 0.05). Conclusion: The use of ESWT have a positive effect in reducing pain and improving shoulder range of motion in perimenopausal women suffering from frozen.

INFLUENCE OF FEMORAL OFFSET ON FUNCTIONAL CAPACITY OF PATIENTS WITH TOTAL HIP ARTHROPLASTY.

ABSTRACTObjective: To correlate vertical (VFO) and horizontal (HFO) femoral offset with hip range of motion (ROM), peak muscle torque (PT), functional, capacity, and lower limb length in patients with total hip arthroplasty (THA).Methods: A cross-sectional case control study, in which 22 individuals (10 men and 12 women) - aged 61 (41-72), and within 23 (10-40) postoperative days - were evaluated for active hip ROM (fleximetry); Isometric PT (portable dynamometer); functional capacity (Timed up and Go test (TUG) and Harris Hip Score questionnaire); lower limb length (measuring tape); and VFO and HFO (radiographs).Results: The operated limb showed a reduction in length (p = 0.006), ROM for abduction (p = 0.001), flexion (p = 0.003), and external rotation (p = 0.003), as well as in all PT (p < 0.05) when compared with the contralateral limb. Moderate correlations were observed between VFO and external rotators (r = 0.487; p = 0.021); HFO and external rotators PT (r = −0.508; p = 0.016); and the difference between the VFO (operated and non-operated limb) and the TUG (r = −0.570; p = 0.006).Conclusion: Changes to the femoral offset seem to influence functional capacity, as well as the movement and external rotators PT of the hips in patients with THA, considering the postoperative period evaluated. Level of Evidence III, Case Control Study.

The effect of shoulder injury prevention program on glenohumeral range of motion and upper extremity performance in adolescent throwers: A pilot study

Background: The Oslo Sports Trauma Research Center (OSTRC) Shoulder Injury Prevention Program is an exercise program developed to increase the internal rotation (IR) range of motion (ROM), external rotator muscle strength and scapular muscle strength and to improve kinetic chain involvement and thoracic mobility. The purpose of this study is to investigate the effect of this program on glenohumeral ROM and upper extremity functional performance in adolescent throwers. Material and Methods: Ten adolescent throwers (discus, shot put and javelin throwers) were involved in the study. The OSTRC Shoulder Injury Prevention Program was applied three times a week for 8 weeks as a handball warm-up. Glenohumeral IR and external rotation (ER) ROM were evaluated with a goniometer. The Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) was used to evaluate the upper extremity functional performance. Results: It was found that there was a statistically significant difference in the dominant side IR ROM and CKCUEST between the pre-test and post-test (p&lt;0.05); however, there was no difference in terms of other parameters (p&gt;0.05). Conclusions: This study shows that the glenohumeral IR ROM and upper extremity functional performance increases after the 8-week OSTRC Shoulder Injury Prevention Program. For these purposes, physiotherapists and trainers can include this program in their training programs.