Rotation Rotation Range Of Motion Research Articles

Humeral Torsion in Relation to Shoulder Range of Motion in Elite Field Hockey Players.

Sport-specific adaptations in shoulder rotation range of motion (ROM) and the relationship with humeral torsion have been described in overhead-throwing sports. However, information is lacking for other shoulder-loading sports such as field hockey. Therefore, this study's purpose was to evaluate humeral torsion in elite, male field hockey players and explore its association with shoulder ROM. Cross-sectional study. Twenty-five male, elite field hockey players were included. Humeral torsion and shoulder external and internal rotation ROM were evaluated bilaterally by ultrasound and an inclinometer smartphone application, respectively. Field hockey players showed a significantly increased humeral retroversion on the dominant compared with the nondominant side (P < .001; Cohen d = 1.75), along with a significantly increased external (P = .004; Cohen d = -0.64) and decreased internal rotation ROM (P = .003; Cohen d = 0.65). This finding illustrates a shift in total shoulder rotational ROM arc. Correlation analysis showed a significant moderate association between the increased humeral retroversion and decreased internal rotation ROM on the dominant side (r = .523). Elite male field hockey athletes show sport-specific adaptations regarding humeral torsion and shoulder rotation ROM, similar to throwing athletes. These findings increase our insight into the field hockey athlete's shoulder, which is essential to optimize performance and assist in correctly interpreting shoulder rotational ROM measurements.

Participants with restricted dominant shoulder internal rotation range of motion demonstrate no side-to-side difference in humeral head translation; and no difference before and after joint mobilization: a pilot study.

[Purpose] To compare humeral head translation (HHT) during shoulder elevation between dominant and non-dominant shoulders in participants with limited dominant shoulder internal rotation range of motion (ROM). To determine if joint mobilization alters HHT, and if relationships exist between the bicipital forearm angle and HHT. [Participants and Methods] Fifteen (9 female) participants (age 25.7 ± 6.8 years) with a minimum 15-degree dominant shoulder internal rotation ROM deficit compared to the opposite shoulder participated. All participants underwent bicipital forearm angle (BFA) measurements and ultrasound imaging to measure acromiohumeral and posterior glenohumeral distances in 3 positions: Resting, 90 degrees of shoulder flexion, and 60 degrees of shoulder abduction with full external rotation. Ultrasound images were used to calculate HHT. Participants' dominant shoulders underwent posterior glide mobilization, followed immediately by repeated ultrasound images and ROM measures. [Results] There was no dominant to non-dominant shoulder, or before and after mobilization HHT differences. No correlations existed between bicipital forearm angles and HHT or ROM gains after mobilization. [Conclusion] Participants with internal rotation ROM loss demonstrated symmetrical HHT. Joint mobilization increased ROM, but HHT was unchanged. No relationships existed between BFA and HHT.

Superior Capsular Reconstruction Combined With Lower Trapezius Tendon Transfer Improves the Biomechanics in Posterosuperior Massive Rotator Cuff Tears

Background: Surgical treatments for chronic posterosuperior massive rotator cuff tear (MRCT) are still controversial. Superior capsular reconstruction (SCR), which provides a static stabilizer to decrease superior humeral head translation, and lower trapezius tendon transfer (LTTT) with centralization of the humeral head, which prevents superior humeral head migration, are potential surgical options. To date, SCR combined with LTTT has not been fully investigated. Hypothesis: Restoration of static stabilizer and dynamic stabilizer together would effectively improve shoulder kinematics in posterosuperior MRCT. Study Design: Controlled laboratory study. Methods: A custom-made shoulder mechanics testing system was used to test 8 fresh-frozen cadaveric shoulders. The testing conditions were as follows: (1) intact; (2) posterosuperior MRCT (supraspinatus and infraspinatus removed); (3) SCR using the fascia lata; (4) LTTT; and (5) SCR combined with LTTT. The total rotational range of motion (ROM), superior translation, anteroposterior translation, and peak subacromial contact pressure were evaluated at 0°, 30°, and 60° of shoulder abduction. Repeated-measures analysis of variance and Tukey post hoc tests were performed. Results: The total rotational ROM, superior translation, anteroposterior translation, and peak subacromial contact pressure increased in posterosuperior MRCTs (all, P < .05). The rotational ROM, superior translation, anteroposterior translation, and peak subacromial contact pressure at 0° and 30° of shoulder abduction decreased in SCR (all, P < .05). However, there was no significant improvement in rotational ROM, superior translation, and peak subacromial contact pressure at 60° of shoulder abduction (P > .05). LTTT resulted in a significant decrease in the superior translation, anteroposterior translation, and peak subacromial contact pressure at 0°, 30°, and 60° of shoulder abduction (P < .05). SCR combined with LTTT restored the total rotational ROM, superior translation, anteroposterior translation, and peak subacromial contact pressure at 0°, 30°, and 60° of shoulder abduction (all, P < .05). Conclusion: In the cadaveric model, SCR combined with LTTT showed improved shoulder kinematics and contact pressures in the posterosuperior MRCT model compared with SCR or LTTT alone. Clinical Relevance: SCR combined with LTTT may be regarded as an alternative surgical procedure for posterosuperior MRCTs.

Effect of Indian clubbell exercises on cricket fast bowlers' shoulder kinematics.

The glenohumeral joint's rotational range of motion (ROM) and muscle strength are essential to execute the cricket bowling action. Performing shoulder rotation exercises may increase the rotator cuff muscle strength and rotational ROM. The aim of this study was to test the effect of a six-week exercise programme on shoulder rotational ROM and muscle strength. Twenty-one healthy male cricket fast bowlers were recruited, ranked and pair-matched on initial shoulder rotator muscle strength and assigned to either a shoulder exercise (SE) group or cricket training (CT) only group. The SE group incorporated Indian clubbell exercises in addition to their cricket training. Bowlers in both groups displayed a large increase on the dominant shoulder's internal rotation (IR) ROM, but only the SE group's bowlers displayed ROM improvements (p<0.001) bilaterally for both internal and external rotation. The CT group's fast bowler's non-dominant shoulder IR ROM significantly decreased (p=0.02) during the six weeks. Between groups, only the SE group's bowler's internal rotator muscle strength improved (p<0.001) bilaterally. The observed kinematic changes were statistically significantly greater at a 5% level for the SE group's bowlers (bilateral internal rotators muscle strength, non-dominant shoulder IR ROM and horizontal adduction ROM). Maintenance of the shoulder's rotational ROM and muscle strength is vital for a fast bowler. Cricket bowlers who perform regular clubbell exercises might increase their shoulder's ROM and internal rotator cuffs' muscle strength, which may aid in stabilising their glenohumeral joint while bowling.

Acute Effects of Ice Hockey on Hip Range of Motion, Strength, and Pelvic Tilt in Competitive Male Players.

Ice hockey players are at high risk for hip and groin injury. Several risk factors have been identified or proposed, including lower hip rotation range of motion (ROM), lower hip adductor strength, lower ratio of hip adductor to abductor strength, and lower pelvic tilt angle. It is not known how these risk factors change acutely with ice hockey participation. Acute exposure to ice hockey will result in a reduction in ROM, strength, and pelvic tilt angle in competitive male players. Controlled cohort study. Level 3. Risk factors for hip and groin injury, including isometric hip adductor strength at 0° of flexion, the ratio of hip adductor to abductor strength, total hip rotation passive ROM in supine, and the resting pelvic tilt angle, were assessed immediately before, immediately after, and 24 hours after an ice hockey exposure in 42 competitive male ice hockey players. Rating of perceived exertion (RPE) was collected to identify the intensity of the exposure. There was a significant decrease in total hip rotation ROM (-7.32°, P < 0.01 (-3.91, -10.70)) and hip adductor strength (-4.41 kg, P < 0.01 (-2.81, -6.00) immediately after the exposure, and a significant decrease in total hip rotation ROM (-18.54°, P < 0.01 (-14.35, -22.73)), hip adductor strength (-6.56 kg, P < 0.01 (-4.58, -8.61)), and the ratio of hip adductor to abductor strength (-0.12, P < 0.01 (-0.21, -0.45)) 24 hours after. There was no significant change in pelvic tilt found in this study immediately after or 24 hours after. There was a moderate relationship between changes in hip adductor strength and changes in the ratio of hip adductor to abductor strength (r = 0.433, P < 0.01). RPE was not significantly correlated to any of the changes observed. Risk factors for hip and groin injury in ice hockey players are modifiable after a single ice hockey exposure. The identified fluctuation of injury risk factors for hip and groin injury in ice hockey players has implications for injury risk profiling, rehabilitation, and return-to-competition decision-making.

Effect of Clubbell Exercises on Shoulder Kinematics in Female Handball Players

Background: Clubbells were popular shoulder exercise equipment used during the 17-18th centuries. Currently there is a resurgence in the use of clubbells to strengthen the shoulder rotators, but there are no studies to prove their effectiveness on shoulder kinematics. Therefore, this study aimed to find out if clubbell exercises had any effect on glenohumeral rotational range of motion (ROM) and shoulder rotator strength. Methods: Using a randomised control study design, female handball athletes (n=15) were voluntarily recruited and were assigned randomly to either a handball training only group (HT) (n = 8, age 25±7 y, height 1.77 ± 0.11m, mass 76 ± 15 kg,) or a shoulder exercise group (SE) (n = 7, age 27±8 y, height 1.78 ± 0.12m, mass 79 ± 15 kg). The SE group underwent an exercise programme (8 weeks, 3 days/week, 20 min/day) using clubbells. The ROM and muscle strength were assessed at baseline and at the end of weeks 2, 4, 6 and 8. Results: After eight weeks, comparison between groups showed that the SE group’s dominant arm internal rotators muscle strength improved (28±5 to 33±7 Nm) significantly (p0.05). Within the SE group, internal rotation ROM, internal rotators, and external rotators muscle strength all significantly (p0.05) improved. Conclusions: Clubbell exercises increases internal rotation ROM and shoulder rotators muscle strength. Therefore, it is suggested that handball athletes could use clubbell exercises to improve their shoulder rotational ROM and strengthen the shoulder rotators whereby reducing shoulder injury risk.

Assessment of Hip Range of Motion Limitations in Cases with Low Back Pain Based on the Classified Movement System Impairment.

The hip joint's limitation causes lumbopelvic compensatory motions, accumulating tissue stress on the lumbar spines. It is essential and valuable to evaluate hip rotation range of motion (ROM) in different low back pain (LBP) classifications to understand them and plan the best exercise program. This study aimed to compare hip rotation ROM between subjects with and without LBP classified in movement system impairment (MSI). In this cross-sectional study, 100 subjects with LBP were classified into different MSI subgroups (mean age of 41.66 ± 7.82 years), and 100 healthy subjects (mean age of 38.96 ± 8.84 years) participated. Passive and active hip medial and lateral rotations ROM in prone and supine positions for dominant and non-dominant lower limbs were measured. Generally, in the LBP group, minimal lateral rotation as compared to controls in movement tests measuring hip rotation ROM actively and passively, in prone and sitting positions, and for dominant and non-dominant limbs (P < 0.05). There were no significant differences among the LBP subgroups (P > 0.05). Due to LBP, regardless of the MSI categories, remarkably restricted hip lateral rotation ROM.

Association of Shoulder Dysfunction with Mobility Limitation Among Older Adults in the Baltimore Longitudinal Study of Aging.

Association between lower extremity dysfunction and mobility limitation in older adults is well-established; whereas, the impact of upper extremity dysfunction on mobility remains unclear. Since lower extremity dysfunction does not explain all mechanisms that contribute to mobility limitation, more holistic hypotheses that explain reduced mobility in older populations are needed. The shoulders facilitate dynamic stability for ambulation, but the impact of shoulder dysfunction on mobility is poorly understood. This study examined the cross-sectional association of restricted shoulder elevation and external rotation range of motion (ROM) with poor lower extremity function and walking endurance capacity among 613 older adults aged 60 years and older in the Baltimore Longitudinal Study of Aging. Results showed that persons with abnormal shoulder elevation or external rotation ROM were 2.5 to 4.5 times more likely to perform poorly on the expanded Short Physical Performance Battery (p < .050) and the fast-paced 400 m walk test (p < .050), relative to participants with normal shoulder ROM. These findings provide nascent preliminary evidence that shoulder dysfunction is associated with mobility limitation and suggest that future studies are needed to clarify its impact on mobility and to develop novel interventions to improve prevention or mitigation of age-related declines in mobility.

Effects of Thoracic Spine Self-mobilization on Patients with Low Back Pain and Lumbar Hypermobility: A Randomized Controlled Trial.

This study used magnetic resonance imaging (MRI) to investigate the effects of thoracic spine self-mobilization on patients with low back pain (LBP) and lumbar hypermobility. Twenty-four patients (15 men, 9 women) with LBP were randomly allocated to a thoracic spine self-mobilization group or sham group. The thoracic spine self-mobilization group performed thoracic spine active flexion and extension activities using two tennis balls fixed with athletic tape. Outcome measures were collected pre-intervention and after 4 weeks and included the Visual Analog Scale (VAS) for pain, the Oswestry Disability Index, lumbar rotation angle measured using MRI taken in the lateral position with 45° of trunk rotation, thoracolumbar rotation range of motion (ROM) in the sitting position, and stiffness of the erector spinae muscles. The effects of the intervention were analyzed using two-way repeated-measures analysis of variance (ANOVA), followed by multiple comparisons. The significance level was set at 5%. The results of the two-way repeated measures ANOVA indicated that the main effect of the group was significant (P<0.05) for VAS, the sum of the lumbar rotation angle, and the thoracolumbar rotation ROM. A significant group-by-time interaction was found for the sum of lumbar rotation angles. The results of the multiple comparison tests for VAS, sum of the lumbar rotation angle from L1 to S1, and thoracolumbar rotation ROM were significantly different after 4 weeks. This study revealed a decrease in lumbar segmentation after thoracic spine mobilization. Thoracic spine mobilization may be effective in patients with LBP and hypermobility.

Prediction of Scapular Dyskinesis through Strength and Range of Motion of Shoulder Joint Rotation in Competitive Boxers

Background and Aims This study investigated the relationship between shoulder rotation Range of Motion (ROM), shoulder rotation strength, and sports history with scapular dyskinesia in competitive boxers. Methods The present study was a descriptive correlational study performed on 60 male boxers (age: 24/01±3/90 years; weight: 74/61±6/73 kg; height: 176/97±6/06 cm; and sports history: 5/16±1/84 years) in Guilan. Scapular dyskinesia by lateral scapular slide test, shoulder rotation ROM using a manual goniometer, and shoulder rotation strength using a manual dynamometer were measured. Data were analyzed by Pearson and Spearman correlations and multiple regression analysis. Results There were significant correlations between sports history (p= 0.001; r=0.589), shoulder internal rotation ROM (p=0.040; r=-0.255), shoulder external rotation ROM (p=0.001; r=0.486), shoulder internal rotation strength (p= 0.009; r=0.334), and shoulder external rotation strength (p=0.001; r=-0.620) and scapular dyskinesia. Regression analysis showed that 63.1% of scapular dyskinesia changes were related to the independent variables mentioned in this study. Conclusion It can be concluded that there is a significant relationship between shoulder rotation ROM, shoulder rotation strength, sports history, and scapular dyskinesia. Therefore, by strengthening and improving the scapular stabilizing muscles and consequently improving the shoulder rotation strength and shoulder rotation ROM in boxers, scapular dyskinesia or its intensification can be prevented.

Comparison of Shoulder Total Rotational Range of Motion and External to Internal Rotation Strength Ratio between Assembly Line Workers with and without Subacromial Pain Syndrome

Background Subacromial pain syndrome (SAPS) is one of the causes of shoulder pain in workers performing repetitive upper extremity movements. However, there have been no studies on physical characteristics such as shoulder total rotational range of motion (ROM) and external to internal rotation muscle strength ratio of workers. Purpose The purpose of this study was to compare the total rotational ROM and external to internal rotation muscle strength ratio in workers with and without SAPS. Study design A cross-sectional study Methods This study included 35 workers with SAPS and 32 workers without SAPS. The total rotational ROM were measured using Smart KEMA motion sensor, and external to internal rotation muscle strength were measured using Smart KEMA pulling sensor. Results The results showed that there were significant differences in the total rotation ROM between the groups (<italic>p</italic>&lt;0.05). However, no significant difference was found in the external to internal rotation muscle strength ratio (<italic>p</italic>&gt;0.05). Conclusions Assembly line workers with SAPS had limited total rotational ROM. However, the ratio of external to internal rotation muscle strength ratio was not different for workers without SAPS. These characteristics can be considered factors that should be considered in evaluating workers with SAPS and establishing a treatment plan.

Biomechanical Evaluation of 4 Suture Techniques for Hip Capsular Closure.

Background:The most reliable suture technique for capsular closure after a capsulotomy remains unknown.Purpose:To determine which suture technique best restores native stability after a 5-cm interportal capsulotomy.Study Design:Controlled laboratory study.Methods:Ten human cadaveric hip specimens were tested using a 6-degrees-of-freedom robotic arm in 7 states: intact, capsular laxity, 5-cm capsulotomy, standard suture, shoelace, double shoelace, and Quebec City slider (QCS). Rotational range of motion (ROM) was measured across 9 tests: flexion, extension, abduction, abduction at 45° of flexion, adduction, external rotation, internal rotation, anterior impingement, and log roll. Distraction (ie, femoral head translation [FHT]) was measured across a range of flexion and abduction angles.Results:When compared with the native state, the 5-cm capsulotomy state showed the largest laxity increases on all tests, specifically in external rotation ROM (+13.4°), extension ROM (+11.5°), and distraction FHT (+4.5 mm) (P < .001 for all). The standard suture technique was not significantly different from the 5-cm capsulotomy on any test and demonstrated significantly more flexion ROM than the double shoelace suture (+1.41°; P = .049) and more extension ROM (+5.51°; P = .014) and external rotation ROM (+6.03°; P = .021) than the QCS. The standard suture also resulted in significantly higher distraction FHT as compared with the shoelace suture (+1.0 mm; P = .005), double shoelace suture (+1.4 mm; P < .001), and QCS (+1.1 mm; P = .003). The shoelace, double shoelace, and QCS techniques significantly reduced hip laxity when compared with the 5-cm capsulotomy state, specifically in external rotation ROM (respectively, –8.1°, –7.8°, and –10.2°), extension ROM (–6.3°, –7.3°, and –8.1°), and distraction FHT (–1.8, –2.2, and –1.9 mm) (P ≤ .003 for all). These 3 techniques restored native stability (no significant difference from intact) on some but not all tests, and no significant differences were observed among them on any test.Conclusion:Hip capsule closure with the standard suture technique did not prevent postoperative hip instability after a 5-cm capsulotomy, and 3 suture techniques were found to be preferable; however, none perfectly restored native stability at time zero.Clinical Relevance:The shoelace, double shoelace, and QCS suture techniques are recommended when closing the hip capsule.

Capsular repair is not an important part of the Latarjet-Walch procedure

Patte etal noted that the Latarjet procedure works by the triple blocking effect of (1) the conjoint tendon sling effect, (2) the bone block effect, and (3) the capsular repair. However, no clinical study has specifically investigated the role of capsular repair in the Latarjet procedure. The primary aim was to compare (1) the external rotation range of motion (ROM) achieved after the Latarjet procedure with and without the capsule to coracoacromial (CA-CAL) repair. The secondary aims were to compare the functional outcomes, forward elevation ROM, and internal rotation ROM after the Latarjet procedure with and without the CA-CAL repair. A prospective cohort of 30 patients who underwent the Latarjet-Walch procedure with a CA-CAL repair between October 2018 and February 2020 was compared with the preceding group of 31 patients who underwent the Latarjet-Walch procedure without any capsular repair between October 2016 and September 2018, at a minimum of 1-year of follow-up. External rotation with the elbow abducted at 90° (ER2) deficit (compared to the normal opposite side) was significantly larger after the CA-CAL repair augmentation of the Latarjet procedure (mean difference = 6°, P = .03) than that after no repair. External rotation with the elbow adducted (ER1) deficit after the CA-CAL repair augmentation was not significantly different from that after no repair. ER2 deficit of more than 15° (minimum clinically important difference) was observed in 11 patients (38%) in the CA-CAL repair group and 3 patients (10%, P = .015) in the no repair group. Walch-Duplay score, Rowe score, and Subjective Shoulder Value were not significantly different between the CA-CAL repair group and the no repair group. Covariates of hand dominance, overhead sports, and glenoid defect size did not significantly affect the ER2 deficit and ER1 deficit outcomes. This study disproved the long-held belief that capsular repair is an essential step of the Latarjet-Walch procedure. Capsular repair to the coracoacromial ligament in the Latarjet procedure leads to a clinically insignificant restriction of external rotation (with the arm abducted), no restriction of external rotation (with the arm adducted), but functional outcomes similar to those after Latarjet without a capsular repair in a nonoverhead athlete.

Implant characteristics affect in vivo shoulder kinematics during multiplanar functional motions after reverse shoulder arthroplasty

The purpose of this study was to determine how implant characteristics affect in vivo shoulder kinematics after reverse shoulder arthroplasty (RSA). Kinematics of the affected upper limb were measured in 32 participants during five motions (scapular plane abduction, hand-to-head, hand-to-back, internal/external rotation at 90° abduction, and circumduction) using optical motion capture. Shoulder abduction, plane of elevation, and internal/external rotation range of motion (ROM), peak angles, and continuous kinematics waveforms were calculated for each motion. Multiple regression was used to identify associations between kinematics and implant characteristics of lateralization, humeral retroversion, glenosphere size, glenosphere tilt, glenoid eccentricity, and implant neck-shaft angle (135° or 145°). Less humeral retroversion was associated with greater shoulder rotation ROM (p = 0.036) and greater plane of elevation ROM (p = 0.024) during circumduction, while less eccentricity was associated with more posterior plane of elevation during hand-to-back (p = 0.021). The 145° implant was associated with greater internal/external shoulder rotation ROM (p < 0.001), greater internal shoulder rotation (p = 0.002), and greater plane of elevation ROM (p = 001) during the hand-to-back. The 145° implant was also associated with more internal/external rotation ROM (p = 0.043) during shoulder rotation and more abduction ROM during circumduction (p = 0.043). During the hand-to-back motion, individuals having 135° neck-shaft angle implants were more abducted from 21 to 51% of the motion and were less internally rotated from 70 to 100% of the motion, while more lateralization was associated with less internal rotation from 90 to 100% of the motion. Retroversion and implant neck-shaft angle are the primary implant characteristics associated with in vivo shoulder kinematics during complex motions after RSA.

Eccentric and Isometric Shoulder Rotation Strength and Range of Motion: Normative Values for Adolescent Competitive Tennis Players

The aim of this cross-sectional study was to investigate isometric internal rotation (IR), external rotation (ER), abduction (ABD), and eccentric external rotation (eccER) shoulder strength and rotational range of motion (ROM) in adolescent male and female competitive tennis players. Additional aims of the study were to provide a tennis-specific normative database based on a large sample of players to deepen the knowledge regarding shoulder strength and ROM for adolescent competitive tennis players, and to discuss differences based on sex, age, and level of play. Shoulder strength and ROM was assessed in 301 adolescent competitive tennis players, 176 boys and 125 girls with a mean age of 14.6 and 14.4 years, respectively. Outcome variables of interest were isometric IR and ER strength, ABD strength, eccER shoulder strength, intermuscular strength ratios ER/IR and eccER/IR, IR ROM, ER ROM, and total range of motion (TROM). A General Linear Model two-way ANOVA was used to analyze differences in sex, age, and level of play. The findings of this study demonstrated age, side, and sex differences in the shoulder isometric strength, the eccER strength and ROM in adolescent competitive tennis players. Furthermore, when strength was expressed as ratios ER/IR and eccER/IR both sexes showed a lower ratio for eccER/IR in national players (0.95 ± 0.22 and 0.95 ± 0.23) compared to regional players (1.01 ± 0.32 and 1.07 ± 0.29) for male and female players, respectively. In conclusion, this paper presents a tennis-specific normative database for shoulder rotation strength and ROM in adolescent male and female competitive players. The key points in this evaluation are strength values normalized to body mass, intermuscular ratios, and TROM.

Immediate effect of combining glenohumeral and scapulothoracic mobilization with stretching on improving shoulder internal rotation in overhead throwing athletes with glenohumeral internal rotation deficit: A randomized clinical trial study

BACKGROUND: Posterior shoulder tightness as demonstrated by glenohumeral internal rotation deficit (GIRD) is a common contributor to many shoulder pathologies in overhead throwing athletes. PURPOSE: This study aimed to assess immediate effect of combining glenohumeral and scapulothoracic mobilization with stretching on improving internal rotation range of motion (ROM) in overhead athletes with GIRD METHODS: This study was a single-blind randomized controlled trial with parallel groups. The participants were 30 asymptomatic male volleyball players who had a loss of shoulder internal rotation ROM of 15 degrees or more on their dominant compared to their nondominant side. They were randomly assigned to 1 of 2 groups: stretching only (n = 15) or stretching plus joint mobilization (n = 15). Participants in the stretching group performed cross-body stretches, and those in stretching plus mobilization group were treated with both cross-body stretching and mobilization techniques for the glenohumeral and scapulothoracic joints. Both groups received the intervention every other day for 1 week. Shoulder internal and external ROM were measured before and after the intervention. RESULTS: Before the intervention, dominant-side deficits in internal rotation ROM compared to the nondominant side were 20.11±5.27 degrees in the stretching group and 21.87±8.06 degrees in the stretching plus mobilization group. After the intervention, internal rotation ROM deficit between the dominant and nondominant side decreased to 11.28±5.82 in the stretching group (P &lt; 0.001) and 10.85±9.19 in the stretching plus mobilization group (P &lt; 0.001). However, the between-group difference was not statistically significant (P = 0.389). External rotation ROM remained unchanged in both groups (P &gt; 0.05). CONCLUSION: Both interventions (stretching and stretching plus mobilization) can have the same beneficial effect in decreasing GIRD in asymptomatic overhead athletes.

Active Cervical Range of Motion in Babies with Positional Plagiocephaly: Analytical Cross-Sectional Study.

Positional plagiocephaly (PP) is a general term describing cranial distortion from pre- or postnatal forces on the infant head. Abnormal intrauterine forces, multiple births, primiparous mothers, obstetric interventions, prematurity, male sex, excessive time lying in the supine position, and mobility restrictions of the cervical spine have been considered as the main predisposing factors. The objective was to investigate the association between the severity of PP and the active cervical rotation and to analyze the influence of predisposing factors in babies with PP. An analytical cross-sectional study was performed on 74 babies with moderate PP. Clinical and demographic data, cranial vault asymmetry, and active cervical rotation range of motion (ROM) were measured. Associations were analyzed with generalized linear models. The mean age was 16.8 ± 5.0 weeks, and 56.8% were male. A restriction in the ROM of active cervical rotation, especially to the left side, was observed. Our models showed that cranial asymmetry was related with left active cervical rotation ROM (p = 0.034) and with being transported in a pushchair (p < 0.001). Conclusions: An increased severity of PP was related with being transported in a baby pushchair and with a reduced active cervical rotation ROM toward the most restricted side.

Effects of Lumbar Stability and Hip Joint Mobility Exercise with Pilates Devices on Pain Level and Muscle-Joint Function in Middle-Aged Women with Chronic Low Back Pain

PURPOSE: This study aimed to compare the effects of 10 weeks of lumbar stability and hip mobility exercises using Pilates devices on pain level and muscle joint function in middle-aged women with chronic low back pain (CLBP). Further, we aimed to investigate the efficacy of Pilates hip mobility exercise (HME) as an exercise for improving CLBP in middle-aged women by comparing the effectiveness of lumbar stability exercise (LSE) and HME.METHODS: Thirty-two middle-aged women with CLBP were enrolled and randomly divided and placed into two groups: the LSE group (n=16) and HME group (n=16). Both groups performed Pilates exercises for 50 minutes twice a week for 10 weeks.RESULTS: The Korean Oswestry Disability Index score in both the LSE and HME groups decreased at 5 weeks (p&lt;.05). Hip internal rotation range of motion (ROM) and external rotation ROM increased at 5 and 10 weeks in both the LSE and HME groups (p&lt;.01). Lumbar mobility increased at 5 weeks in both the LSE (p&lt;.01) and HME groups (p&lt;.001). Lumbar stability in the prone plank test significantly increased at 5 weeks in the LSE group (p&lt;.001) and at 5 and 10 weeks in the HME group (p&lt;.001). Lumbar stability by the side plank test significantly increased at 5 and 10 weeks in both the LSE and HME groups (p&lt;.001).CONCLUSIONS: We found that using Pilates to perform both LSE and HME helped relieve back pain and improve muscle joint function in middle-aged women with CLBP. There was no significant difference between LSE and HME in terms of efficacy. HME is a highly effective exercise for improving CLBP in middle-aged women.

The Intra- and Inter-Rater Reliability of a Hip Rotation Range-of-Motion Measurement Using a Smartphone Application in Academy Football (Soccer) Players.

The clinical assessment of hip rotation range-of-motion (ROM) is important for managing hip and groin injuries in footballers. Previously published reliability studies on hip ROM have employed protocols that are difficult to replicate under everyday clinical conditions. This single trial, intra- and inter-rater reliability study included 41 male academy football (soccer) players, aged 14–15 years, from one European football academy. Passive hip internal rotation (IR) and external rotation (ER) ROM were measured in supine with hip and knee flexed to 90°. The ROM was determined using a smartphone application, with the smartphone attached to the lower leg. The tests were performed on two separate occasions, one week apart, by two different physiotherapists and on both sides (left and right hips). Reliability was evaluated using Intra-Class Correlation Coefficients (ICCs) and Minimal Detectable Change (MDC). Hip IR and ER ROM displayed moderate to good intra-rater agreement (ICCs 0.54–0.75), with MDCs ranging from 10.9° to 16.4°. Inter-rater reliability displayed poor to moderate reliability (ICCs 0.33–0.75), with MDCs ranging from 11.7° to 16.5°. A hip rotation ROM test using a smartphone application and a protocol closely reflecting everyday clinical conditions displayed moderate to good intra-rater reliability and poor to moderate inter-rater reliability. Due to the high MDCs, the practical applicability of this test procedure is limited and further refinement is necessary.

Acute effects of doorway stretch on the glenohumeral rotational range of motion and scapular position in high-school baseball players.

BackgroundPectoralis minor tightness has been thought to affect the scapular position. Despite the wide implementation of doorway stretch in clinical practice owing to its apparent effectiveness in stretching the pectoralis minor, limited studies have investigated its influence on the glenohumeral rotational range of motion (ROM). This study aimed to examine the acute effects of doorway stretch on the glenohumeral rotational ROM and the correlation between the scapular position and ROM.Materials and MethodsIn total, 34 male high-school baseball players participated in this study. Outcomes included the pectoralis minor muscle length, glenohumeral rotational ROM, and scapular position. The distance between the sternocostal joint of rib 4 and the coracoid process was measured as the pectoralis minor length. Internal and external rotation ROM with the shoulder abducted at 90° were measured. The scapular position was defined by the following two measurements: the distance between the surface and the posterolateral corner of the acromion as well as the scapular index. The participants performed doorway stretch by abducting and externally rotating the shoulder at 90° and flexing the elbow at 90°. The outcomes were compared before and after stretching. Furthermore, the correlation between these changes was investigated.ResultsPectoralis minor muscle length and glenohumeral internal rotation ROM was significantly higher after stretching than before, and the scapular position also significantly changed (P < .01 for both). A moderate correlation was found between the degree of change in the glenohumeral internal rotational ROM and scapular position (r = 0.44, P < .01).DiscussionOur results indicated that doorway stretch significantly increased the pectoralis minor muscle length and glenohumeral internal rotation ROM and significantly altered the scapular position. Furthermore, a significant correlation between the degree of change in the scapular position and glenohumeral internal rotation ROM was observed. These results suggest that doorway stretch could be beneficial for improving the scapular position and glenohumeral internal rotation ROM, which are considered the cause of throwing injuries. Furthermore, the glenohumeral ROM may be affected by the scapular position.