Shoulder Extension Research Articles

Pole Exercise Causes Body Changes in Physical Flexibility and Exercise Function

Background: Theoretical mode of spinal stability and core stability has been introduced previously, which has proceeded to rehabilitative approaches. We have focused on physical flexibility and exercise function, and firstly devised an original pole exercise in sitting position that can be done simply and cost-effectively.Subjects and Methods: The subjects 11 healthy young adults, 27.0 ± 5.6 years old. Methods included the intervention of pole exercise with Exercise of the thorax, lower thoracic vertebrae and pelvis, upper thoracic vertebrae and pelvis. Before and after the exercise, we investigated examinations. Tests of physical flexibility were Wing Test, Thomas Test, Shoulder Extension Test, straight leg raise (SLR), Body warp prone position, Heel Buttock Distance (HBD) and Finger Floor Distance (FFD). Tests of exercise functions were Back Muscle Strength (BMS), Weight Bearing Index (WBI), Functional Reach Test (FRT) and closed eye leg standing time.Results: The data of 7 flexibility tests and 4 exercise function tests revealed the significant differences between before and after the pole exercise (p<0.05). These tests would cover detail aspects of several human abilities in physiotherapy.Discussion and Conclusion: In current study, pole exercise seems to be clinically simple and easy method to perform. These results suggested that pole exercise including 6 movements would have clinical efficacy as to physical flexibility and exercise function in short period. Currently obtained data could become fundamental data for clinical application and research development in the future.

Comparisons of the isokinetic extension and flexion strength between light and heavy weight class Ssireum athletes

This study was conducted to compare the difference between left and right extension and flexion isokinetic muscular strength of the knee, shoulder, and trunk to compare absolute and relative strength in lightand heavy weight Ssireum athletes. Fourteen professional Ssireum athletes were divided into the light (Taebaek and Geumgang) and heavy (Halla and Baekdu) groups according to the body weight. Anthropometric measurements and isokinetic strength (knee: 60o/sec, shoulder: 30o/sec, and trunk: 30o/sec) were assessed for the absolute and relative peak torque values. Left (227.6±48.7 vs 247.0± 23.1 Nm, p=0.05) and right knee (233.7±32.0 vs 266.1±20.5, p=0.05) extension strength in absolute values were significantly different between the groups. Trunk’s extension (318.7±37.9 vs 351.2±57.4 Nm, p=0.03) and flexion (249.8±33.0 vs 302.1±42.4 Nm, p=0.03) strength also showed significant difference between the groups. Significant differences were observed for all relative values except for the left knee and trunk flexion. As for the flexion and extension strength ratios, the shoulder extension to flexion ratios of the light group was 1.32 (p=0.02) times and the heavy group was 1.01-0.98 (p=0.34). The trunk extension strength was 3.6 times that of the body weight in the light group and 2.8 times that of the body weight in the heavy group. Heavy Ssireum athletes’ absolute flexor peak torques were higher in the knee and trunk than in the light athletes. Also, the weight per weight of light athletes had relatively higher strength than the heavy athletes. In addition, the muscle strength ratio was higher in the light athletes. This study suggests that isokinetic strength is different in heavy and light weight class Ssireum athletes.

Kinematics and pushrim kinetics in adolescents propelling high-strength lightweight and ultra-lightweight manual wheelchairs

Purpose: The purpose of this study is to describe and compare pushrim forces, propulsive work cost, and upper body kinematics in adolescents propelling (1) a standard high strength lightweight wheelchair, and (2) an ultra-lightweight wheelchair with adjustable main axle positioning, on a level tiled floor (“Tile”), ascending a ramp (“Ramp”), and across a foam mat (“Mat”).Methods: A within-subjects repeated measures study design was used. Eight adolescent manual wheelchair users propelled the standard and ultra-lightweight wheelchairs across the three conditions. Average pushrim tangential force, propulsive power and work per unit distance travelled, as well as upper body kinematic angles, were analyzed.Results: Average pushrim tangential force (1.80 ± 0.7 N, p = .042) and propulsive work per unit distance travelled (8.3 ± 1.7 J·m− 1, p = .002) were higher for the standard lightweight wheelchair, whereas average speed was lower (0.12 ± 0.03 m/s, p = .006). Maximum shoulder (9.2 ± 2.0°, p = .003) and elbow flexion (8.0 ± 2.2°, p = .009) were higher for the ultra-lightweight wheelchair. Compared with Tile, propulsion on Mat and Ramp was associated with higher average tangential force, work per unit distance, power, and maximum flexion of the neck and trunk, whereas shoulder extension and average speed were lower for Mat and Ramp.Conclusions: Compared with the standard lightweight wheelchair, ultra-lightweight wheelchair propulsion was associated with lower pushrim forces, lower energy costs, higher self-selected speeds, and increased shoulder and elbow flexion. These variables have been linked to injury risk and mobility efficiency, and the results provided evidence that differences in weight and configuration options are both contributors. Findings can inform decision-making in the prescription of manual wheelchairs for pre-adult populations.Implications for RehabilitationA significant proportion of manual wheelchair users are children and adolescents, and due to the early onset of use they may be especially predisposed to the development of chronic overuse injuries.The study reports differences in energy costs, pushrim forces, and upper body kinematics measured when adolescents propelled standard and ultra-lightweight wheelchairs across three trial conditions.In the ultra-lightweight wheelchair, reduced energy cost is linked to more efficient mobility, and lower forces may be linked to lower risk of chronic injury.Significant differences in elbow and shoulder kinematics are also reported, and the findings support the importance of both weight and setup options in the selection of manual wheelchairs.

An evaluation of two types of exercise classes, containing shoulder exercises or a combination of shoulder and thoracic exercises, for the treatment of nonspecific shoulder pain: A case series

Study DesignA case series was carried out. IntroductionThere is a lack of evidence exploring the effectiveness of group exercise classes for people with nonspecific shoulder pain (NSSP). Also, there is a lack of research that measures potential reductions in thoracic kyphosis after exercise interventions in people with NSSP. Purpose of the StudyTo observe changes in shoulder pain, disability, and thoracic kyphosis in 2 groups of people with NSSP, after 2 different types of group exercise classes. MethodsPeople with NSSP received a 6-week block of exercises classes containing either shoulder exercises alone (shoulder group, n = 20) or a mixture of shoulder and thoracic extension exercises (thoracic group, n = 19). The Disabilities of the Arm, Shoulder and Hand questionnaire for disability and the Numeric Rating Scale for pain were measured at baseline, 6 weeks, and 6 months. Thoracic kyphosis was measured at baseline and 6 weeks using the manual inclinometer. ResultsSignificant and clinically meaningful improvements in Numeric Rating Scale and Disabilities of the Arm, Shoulder and Hand were demonstrated in both groups at 6-week and 6-month follow-up (P < .001). Effect sizes ranged from 0.78–1.16 in the shoulder group and 0.85–1.88 in the thoracic group. Thoracic kyphosis did not change beyond measurement error in either group. Discussion/ConclusionGroup exercise classes can improve shoulder pain and disability in people with NSSP. Resting thoracic kyphosis did not change after either exercise intervention, which suggests that the treatment effect was not due to a change in static thoracic spine posture.

Upper extremity motor training of a subject with initially motor complete chronic high tetraplegia using constraint-induced biofeedback therapy.

The purpose of this case study was to determine if a subject with chronic high tetraplegia (C3 AIS A) could learn to use an initially paralyzed upper extremity on the basis of training procedures alone. Initially, an AIS examination revealed no purposive movement below the neck other than minimal shoulder movement. Training was carried out weekly over 39 months. Training began based on electromyographic biofeedback; the electrical activity of a muscle (biceps or triceps) was displayed visually on a computer monitor and the subject was encouraged to progressively increase the magnitude of the response in small increments on a trial-by-trial basis (i.e., shaping). When small, overt movements began to appear; these were, in turn, shaped so that their excursion progressively increased. Training then progressed to enable lifting the arm with the aid of the counterweight of a Swedish Help Arm. Mean movement excursions in the best session were: internal rotation 52.5 cm; external rotation 26.9 cm; shoulder extension 22.1 cm; shoulder flexion 15.2 cm; pronation/supination 120°; extension of index finger (D2) 2.5 cm. Movements were initially saltatory, becoming smoother over time. With the Swedish Help Arm, the subject was able to lift her hand an average of 24.3 cm in the best session with 0.7 kg counterweight acting at the wrist (1.9 J of work). Results suggest in preliminary fashion the effectiveness of this approach for improving upper extremity function after motor complete high tetraplegia. Thus, future studies are warranted. Possible mechanisms are discussed.

Kinematic analysis of the standing long jump in children 6- to 12-years-old

ABSTRACTThe purpose of this study was to analyze the kinematic variables that determine the performance of the standing long jump in children 6- to 12-years-old. There were 121 healthy children (58 girls) recorded while they performed the standing long jump test. All kinematic variables showed a significant correlation with calculated jump distance and measured jump distance, except for the knee joint angle at maximum shoulder extension angle, ankle joint angle at maximum shoulder extension angle, and shoulder joint angle at maximum knee flexion angle. Stepwise multiple regression analysis showed that sex, age, and body mass index accounted for 51.1% of the jump distance variance. Among all the kinematic variables, take-off distance and take-off speed were accounted for the most of the variation in the jump distance. Physical education teachers and coaches should consider special attention to these anthropometrics and kinematic aspects in improving the standing long jump performance in children.

Dynamic and static shoulder strength relationship and predictive model

Static strength is typically used to standardize occupational tasks in an effort to limit over-exertion injuries; however, workplace tasks are commonly dynamic in nature. The purpose of this investigation was to assess factors influencing isokinetic shoulder strength and to develop predictive equations for isokinetic shoulder flexion and extension strength using isometric strength. Fifteen women performed a set of concentric isokinetic and isometric shoulder flexion and extension maximal exertions across a series of movement planes, angular velocities, and grip types. Data were used to generate two stepwise multiple regression models for predicting isokinetic shoulder flexion and exertion strength across the various exertion parameters. The final regression models explained a high degree of variance in predicting isokinetic shoulder flexion (R2 = 0.59) and extension (R2 = 0.67) with a subset of four and five inputs, respectively. The predictive equations can help establish acceptable force limits for workplace tasks requiring dynamic actions using more easily attainable static forces.

Muscle activity of upper and lower trapezius and serratus anterior during unloaded and maximal loaded shoulder flexion and extension

Altered scapular muscle activity is mostly described under unloaded and submaximal loaded conditions in impingement patients. However, there is no clear evidence on muscle activity with respect to movement phases under maximum load in healthy subjects. Therefore, this study aimed to investigate scapular muscle activity under unloaded and maximum loaded isokinetic shoulder flexion and extension in regard to the movement phase. Fourteen adults performed unloaded (continuous passive motion [CPM]) as well as maximum loaded (concentric [CON], eccentric [ECC]) isokinetic shoulder flexion (Flex) and extension (Ext). Simultaneously, scapular muscle activity was measured by EMG. Root mean square was calculated for the whole ROM and four movement phases. Data were analyzed descriptively and by two-way repeated measures ANOVA. CPMFlex resulted in a linear increase of muscle activity for all muscles. Muscle activity during CONFlex and ECCFlex resulted in either constant activity levels or in an initial increase followed by a plateau in the second half of movement. CPMExt decreased with the progression of movement, whereas CONExt and ECCExt initially decreased and either levelled off or increased in the second half of movement. Scapular muscle activity of unloaded shoulder flexion and extension changed under maximum load showing increased activity levels and an altered pattern over the course of movement.

Quantification of Long Head of the Biceps Tendon Motion After Loop ‘N’ Tack Suprapectoral Biceps Tenodesis

Objectives:Lesions of the long head of the biceps are one of the most frequent causes of shoulder pain, and they can be successfully treated with biceps tenotomy or tenodesis. The advantage of a biceps tenodesis is avoiding the potential development of a cosmetic deformity (“Popeye sign”) or cramping muscle pain that can remain after tenotomy. Proponents of a subpectoral tenodesis believe that “groove pain” may remain a problem after suprapectoral tenodesis due to persistent motion of the biceps tendon within the bicipital groove. The objective of this study was to evaluate the motion of the biceps tendon within the bicipital groove before and after a suprapectoral tenodesis performed using the Loop ‘N’ Tack technique. Our hypothesis was that there would be minimal to no motion of the biceps tendon within the bicipital groove after the tenodesis.Methods:Six fresh-frozen cadaveric arms were obtained and dissected to expose the long head of biceps tendon and the bicipital groove from the transverse humeral ligament to the pectoralis major insertion. The scapula and ulna were affixed with inclinometers to measure motion in multiple planes. The biceps tendon and bicipital groove were marked with fiducials, which were tracked by two cameras focused on this region. The shoulder and elbow were taken through a full range of motion including scapular abduction, forward flexion, extension, internal rotation, and external rotation and elbow flexion and extension with a supinated, neutral, or pronated forearm. The translation of the biceps tendon was quantified as a function of scapular or forearm motion in each plane. A suprapectoral biceps tenodesis was then performed using the Loop ‘N’ Tack technique. The scapula and forearm were taken through the same motions, and the translation of the biceps tendon was quantified. A paired t-test was performed for each motion to determine if maximum biceps tendon translation in the bicipital groove was a function of tendon condition (native vs post-tenodesis).Results:There was minimal translation of the biceps tendon during elbow flexion and extension, both before and after tenodesis. There was significant translation of the biceps tendon in all planes of scapular motion in the native state, and the largest amount of translation was 20.73mm +/- 8.21mm during shoulder flexion and extension (Table 1). The translation of the biceps tendon after tenodesis was significantly reduced in every plane of scapular motion compared to the native state (p = 0.01 or p < 0.01 in all planes of motion). The largest amount of translation in any plane after tenodesis was 1.57mm +/- 0.98mm, which occured during shoulder flexion and extension (Table 1).Conclusion:In the native state, the translation of the biceps tendon within the bicipital groove ranges from 5.14mm - 20.73mm with scapular motion. There is statistically significant reduction in translation of the biceps tendon in all planes of scapular motion after the Loop ‘N’ Tack tenodesis (Figure 1), with a maximum translation of only 1.57mm. These data suggest that motion of the biceps tendon within the bicipital groove is essentially eliminated and should not be a cause of persistent pain. The Loop ‘N’ Tack biceps tenodesis is a simple, all-arthroscopic technique for patients with proximal biceps pathology. It is a viable alternative to subpectoral tenodesis, essentially eliminating all motion of the biceps tendon within the bicipital groove, and it should not lead to persistent “groove pain”.Table 1.NativePost-TenodesisResultsAverage (mm)S.D. (mm)Average (mm)S.D. (mm)P-ValueElbow Flexion: Supination1.851.660.560.370.15Elbow Flexion: Neutral1.731.430.830.640.30Elbow Flexion: Pronation3.031.550.720.240.01Glenohumeral: Internal/External Rot.9.371.701.320.78<0.01Glenohumeral: Flexion/Extension20.738.211.570.98<0.01Glenohumeral: Full Flexion10.322.600.750.47<0.01Glenohumeral: Abduction5.142.671.261.170.01

Isometric shoulder strength in young swimmers.

The prevalence of shoulder pain in young swimmers is high. Shoulder rotation strength and the ratio of internal to external rotation strength have been reported as potential modifiable risk factors associated with shoulder pain. However, relative strength measures in elevated positions, which include flexion and extension, have not been established for the young swimmer. The aim of this study was to establish clinically useful, normative shoulder strength measures and ratios for swimmers (14-20 years) without shoulder pain. Cross-sectional, observational study. Swimmers (N=85) without a recent history of shoulder pain underwent strength testing of shoulder flexion and extension (in 140° abduction); and internal and external rotation (in 90° abduction). Strength tests were performed in supine using a hand-held dynamometer and values normalised to body weight. Descriptive statistics were calculated for strength and strength ratios (flexion:extension and internal:external rotation). Differences between groups (based on gender, history of pain, test and arm dominance) were explored using independent and paired t tests. Normative shoulder strength values and ratios were established for young swimmers. There was a significant difference (p<0.002) in relative strength between males and females for all tests with no differences in strength ratios. Relative strength of the dominant and non-dominant shoulders (except for extension); and for swimmers with and without a history of shoulder pain was not significantly different. A normal shoulder strength profile for the young swimmer has been established which provides a valuable reference for the clinician assessing shoulder strength in this population.

Skin deformation during shoulder movements and upper extremity activities

BackgroundThe necessity of sternal precautions for patients following cardiac surgery with median sternotomy has been questioned by clinicians, researchers, and even patients. The primary purpose was to determine if sternal skin deformation during shoulder movements and upper extremity activities is compressive or distractive and if there are any significant differences between the skin deformation at different positions during shoulder movements and upper extremity activities. The secondary purpose was to determine if sternal skin deformation is correlated with scapular stabilizer muscle strength. MethodsThe research design was a cross-sectional non-experimental descriptive study. A 3D electromagnetic tracking system was used to measure sternal skin deformation quantified by strain. FindingsThe sternal skin strain was −10.8 (SD 6.2) % and −9.8 (SD 6.1) % at 90 and 180° flexion (P=0.45), −2.7 (SD 3.4) % and −10.4 (SD 7.9) % at 90 and 180° abduction (P<0.01), −3.6 (SD 4.1) %, −4.9 (SD 6.4) %, and −6.8 (SD 5.2) % when lifting 0, 5, and 10lb weights (P=0.07), 0.7 (SD 2.5) % for extension, and −1.1 (SD 5.0) % for pushing up from a chair. There is a trend of strain magnitude decrease with the increase of rhomboid strength without significant association (R=0.14). InterpretationOur data does not support the restriction for most of the shoulder movements and upper extremity activities following cardiac surgery. The only exception is bilateral shoulder extension. We propose a strategy for preoperative physical therapy to stabilize scapular muscles to decrease mechanical loading translated from shoulder to sternum.

Acute Effects of Two Different Foam Rollers on Range of Motion

Self-myofascial release via foam rolling does not yield significant acute effects on muscular performance, but it can yield benefits to range of motion (ROM) similar to static streching, without the negative effects to muscular performance. Additionally, exercising through larger ROM during resistance training will produce superior chronic benefits. PURPOSE: Therefore, the aim of this study was to determine if differences existed between the acute effects two different foam rollers had on hip and shoulder ROM. METHODS: Ten college students participated in a random cross over design study. Participants’ hip and shoulder ROM were measured with a goniometer pre and post three different conditions: control, supernova (SN), and grid. The first session consisted of taking pre ROM measurements followed by 10 minutes of rest and post ROM measurements (control). Then the participants were familiarized with the foam rolling procedures that were used for the next two sessions. During the next two sessions the control trial procedures were repeated, except instead of resting between pre and post testing the participants foam rolled using one of the foam rollers. RESULTS: Repeated measures ANOVA followed by protected dependent t tests revealed that significant (p<.05) differences existed between control and SN, control and grid, but not between SN and grid (p>.05). Effect sizes revealed that when comparing mean differences from pre to post for SN and grid: a large effect was seen for shoulder extension (d = -.80) in favor of SN, moderate effects were observed for shoulder flexion (d = -.50) in favor of SN, hip flexion (d = -.62) in favor of SN, and hip abduction (d = .57) in favor of grid. CONCLUSION: Both foam rollers produced similar acute improvements to hip and shoulder ROM, which were significantly better than the control condition. When improvements to ROM are desired prior to resistance training, the use of either foam roller in this study would be preferred over static stretching or no mobility exercises. Supported by UCO Student Research, Creative, and Scholarly Activities (RCSA) Grant

Reproducibility of scapular muscle activity in isokinetic shoulder flexion and extension

Repetitive overhead movements have been identified as a main risk factor to develop shoulder complaints with scapular muscle activity being altered. Reliable assessment of muscle activity is essential to differentiate between symptomatic and asymptomatic individuals. Therefore, the present study aimed to investigate the intra- and inter-session reliability of scapular muscle activity during maximal isokinetic shoulder flexion and extension. Eleven asymptomatic adults performed maximum effort isokinetic shoulder flexion and extension (concentric and eccentric at 60°/s) in a test-retest design. Muscle activity of the upper and lower trapezius and serratus anterior was assessed by sEMG. Root Mean Square was calculated for whole ROM and single movement phases of absolute and normalized muscle activity. Absolute (Bland-Altman analysis (Bias, LoA), Minimal detectable change (MDC)) and relative reliability parameters (Intraclass correlation coefficient (ICC), coefficient of variation (CV)/test-retest variability (TRV)) were utilized for the evaluation of reproducibility. Intra-session reliability revealed ICCs between 0.56 and 0.98, averaged CVs of 18% and average MDCs of 81mV. Inter-session reliability resulted in ICCs between 0.13 and 0.93, averaged TRVs of 21%, average MDCs of 15% and systematic and random error between −8±60% and 12±36%. Scapular muscle activity assessed in overhead movements can be measured reliably under maximum load conditions, though variability is dependent on the movement phase. Measurement variability does not exceed magnitudes of altered scapular muscle activities as reported in previous studies. Therefore, maximum load application is a promising approach for the evaluation of changes in scapular control related to pathologies.

Tracking of muscular strength and power from youth to young adulthood: Longitudinal findings from the Childhood Determinants of Adult Health Study.

Low muscular fitness levels have previously been reported as an independent risk factor for chronic disease outcomes. Muscular fitness tracking, the ability to maintain levels measured at one point in time to another point in time, was assessed from youth to adulthood to provide insight into whether early identification of low muscular fitness in youth is possible. Prospective longitudinal study. Study including 623 participants who had muscular fitness measures in 1985 (aged 9, 12 or 15 years) and again 20 years later in young adulthood. Measures of muscular fitness were strength (right and left grip, leg, shoulder extension and flexion measured by dynamometer, and a combined strength score) and power (standing long jump distance). Strength and power were relatively stable between youth and adulthood; the strongest tracking correlations were observed for the combined strength score (r=0.47, p≤0.001), right grip strength (r=0.43, p≤0.001) and standing long jump (r=0.43, p≤0.001). Youth in the lowest third of muscular fitness had an increased risk of remaining in the lowest third of muscular fitness in adulthood (strength: relative risk (RR)=4.70, 95% confidence interval (CI) (3.19, 6.92); power: RR=4.06 (2.79, 5.90)). Youth with low muscular fitness are at increased risk of maintaining a low muscular fitness level into adulthood. These findings warrant investigation into the long term effects of early interventions that focus on improving low muscular fitness levels in youth which could potentially improve adult muscular fitness and reduce future chronic disease outcomes.

The effects of walking speed on upper body kinematics during gait in healthy subjects

Patients undergoing a clinical gait analysis often walk slower than healthy people. However, data on how speed affects upper body movements, especially of the arms and shoulders, are scarce. Therefore, in this descriptive study, we examined how changes in walking speed affect upper-body kinematics and aspects of intersegmental coordination between upper and lower body during overground walking in a group of healthy adult subjects. Three-dimensional gait data were collected on 20 healthy subjects (aged between 22 and 31 years) walking at six speeds ranging from extremely slow to very fast. Our results showed significant speed-related changes of upper body kinematic movement curves in three aspects, namely in amplitude (curves for shoulder flexion and abduction, elbow flexion, pelvic obliquity and rotation), timing (curves for shoulder extension and abduction, elbow extension, pelvic rotation) and curve pattern (curves for shoulder and elbow flexion, shoulder rotation, pelvic tilt). The intersegmental coordination between the thorax and pelvis and arm and leg was also affected by a change of walking speed. Our data supplement the already available data in the literature examining the effects of walking speed on lower extremity motion. Furthermore, the data can be used as a reference for both basic biomechanical and clinical gait studies. The results will help in clinical practice to differentiate between effects caused by walking speed and underlying pathology.

Characteristics of upper extremity's muscle strength in Turkish national wheelchair basketball players team.

The objective of this study was to reveal characteristics of muscle strength of upper extremities of wheelchair (WC) basketball players and to ensure more-specific training program preparation. Isokinetic muscle strength of 12 WC basketball players were assessed by ISOMED 2000 device. The assessment protocol was evaluated at 60°/sec velocity with 5 times repeated force and at 240°/sec with 15 times repeated force. This protocol was carried out individually for shoulder flexion-extension and wrist flexion-extension movements at the right and left extremities. The flexion/extension ratio was determined to be outside of the ratios accepted as normal for primarily shoulder joint and for wrist joint. The extension movement was stronger than flexion movement in the shoulders at both velocities and the flexion movement was stronger than ex-tension movement in the wrist. The repeat times where the peak torque occurred were 2–3 repeats at 60°/sec velocity during flexion and extension movements for the wrist and shoulders, and the peak torque occurred at an average of 5–6 repeats in the shoulders at 240°/sec velocity and it occurred at 3–4 repeats in the wrist. The angles where the peak torque of the shoulder flexion and extension occurred varied between 80°–115° at both velocities, and it varied between 5°–30° angles for the wrist. As this study revealed, determination of muscle strength characteristics of WC athletes and especially using objective isokinetic devices will guide the planning of the appropriate training and exercise programs and preventing sports injuries in long term.

O efeito do Método Pilates de Solo na flexibilidade de idosas

Objetivo: avaliar o efeito do Método Pilates de Solo (MPS) na flexibilidade de quadril e cintura escapular de mulheres idosas após doze semanas de treinamento. Método: participaram do estudo 22 mulheres, divididas em grupo Pilates (GP; n=15; 61,93±5,35 anos), que foi submetido a 2 sessões de MPS por semana, durante 12 semanas e grupo controle (GC; n=7; 62,14±3,80 anos), que não realizou nenhum exercício físico regular nesse período. Avaliaram-se as articulações do ombro e quadril, utilizando goniometria e o teste de sentar e alcançar. Realizou-se uma análise estatística descritiva e inferencial dos dados. Resultados: após intervenção, o GP apresentou melhora nos movimentos de flexão de quadril (p

The effects of fast bowling fatigue and adhesive taping on shoulder joint position sense in amateur cricket players in Victoria, Australia

ABSTRACTThe impact that muscle fatigue and taping have on proprioception in an applied sporting context remains unclear. The purpose of this study was to investigate disturbances in position sense at the shoulder joint, and asses the effectiveness of adhesive tape in preventing injury and improving performance, after a bout of cricket fast bowling. Among amateur cricket players (N = 14), shoulder position sense, maximum voluntary contraction (MVC) force and bowling accuracy was assessed before and immediately after a fatiguing exercise bout of fast bowling. Participants were tested with the shoulder taped and untapped. Shoulder extension MVC force dropped immediately and 30 min after the exercise (P < 0.05 and P < 0.05, respectively). Position sense errors increased immediately after exercise (P < 0.05), shifting in the direction of shoulder extension for all measurements. Taping had no effect on position errors before exercise, but did significantly reduce position errors after exercise at mid-range shoulder flexion angles (45° and 60°; P < 0.05 and P < 0.05, respectively). Taping had no significant effect on bowling accuracy. These findings may be explained by a body map shift towards a gravity neutral position. Added cutaneous input from the tape is proposed to contribute more to shoulder position sense when muscles are fatigued.

The Relationship Between Maximum Isometric Strength and Ball Velocity in the Tennis Serve.

The aims of this study were to analyze the relationship between maximum isometric strength levels in different upper and lower limb joints and serve velocity in competitive tennis players as well as to develop a prediction model based on this information. Twelve male competitive tennis players (mean ± SD; age: 17.2 ± 1.0 years; body height: 180.1 ± 6.2 cm; body mass: 71.9 ± 5.6 kg) were tested using maximum isometric strength levels (i.e., wrist, elbow and shoulder flexion and extension; leg and back extension; shoulder external and internal rotation). Serve velocity was measured using a radar gun. Results showed a strong positive relationship between serve velocity and shoulder internal rotation (r = 0.67; p < 0.05). Low to moderate correlations were also found between serve velocity and wrist, elbow and shoulder flexion – extension, leg and back extension and shoulder external rotation (r = 0.36 – 0.53; p = 0.377 – 0.054). Bivariate and multivariate models for predicting serve velocity were developed, with shoulder flexion and internal rotation explaining 55% of the variance in serve velocity (r = 0.74; p < 0.001). The maximum isometric strength level in shoulder internal rotation was strongly related to serve velocity, and a large part of the variability in serve velocity was explained by the maximum isometric strength levels in shoulder internal rotation and shoulder flexion.

Nerve stress during reverse total shoulder arthroplasty: a cadaveric study

Neurologic lesions are relatively common after total shoulder arthroplasty. These injuries are mostly due to traction. We aimed to identify the arm manipulations and steps during reverse total shoulder arthroplasty (RTSA) that affect nerve stress. Stress was measured in 10 shoulders of 5 cadavers by use of a tensiometer on each nerve from the brachial plexus, with shoulders in different arm positions and during different surgical steps of RTSA. When we studied shoulder position without prostheses, relative to the neutral position, internal rotation increased stress on the radial and axillary nerves and external rotation increased stress on the musculocutaneous, median, and ulnar nerves. Extension was correlated with increase in stress on all nerves. Abduction was correlated with increase in stress for the radial nerve. We identified 2 high-risk steps during RTSA: humeral exposition, particularly when the shoulder was in a position of more extension, and glenoid exposition. The thickness of polyethylene humeral cups used was associated with increased nerve stress in all but the ulnar nerve. During humeral preparation, the surgeon must be careful to limit shoulder extension. Care must be taken during exposure of the glenoid. Extreme rotation and oversized implants should be avoided to minimize stretch-induced neuropathies.