The Journal of Korean Academy of Orthopedic Manual Physical Therapy (대한정형도수물리치료학회지)

Korean Academy of Orthopedic Manual Physical Therapy (대한정형도수물리치료학회)
권호 표지

The Effect of Novel Stretching on the Range of Motion and Acromio-Humeral Distance in Patients with Glenohumeral Internal Rotation Deficits with Posterior Shoulder Tightness

노벨 스트레칭과 관절가동술이 어깨 후방 뻣뻣함으로 인한 어깨관절 안쪽돌림 결핍 환자의 관절가동범위와 봉우리-위팔뼈 거리에 미치는 영향

  • Yong-Tae, Kim (Dept. of Physical Therapy, Graduate of Natural Science, Namseoul University) ;
  • Sang-Bin, Lee (Dept. of Physical Therapy, College of Natural Science, Namseoul University)
  • 김용태 (남서울대학교 일반대학원 물리치료학과) ;
  • 이상빈 (남서울대학교 자연과학대학 물리치료학과)
  • Received : 2022.11.06
  • Accepted : 2022.11.29
  • Published : 2022.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: The cross-body and the sleeper stretches have been used to improve posterior shoulder tightness (PST). However, such stretching techniques may not always help achieve scapular stability and may even aggravate patient's symptoms. Therefore, a new stretching technique (passive glenohumeral internal rotation with bridging) was developed as a more effective method that may allow for greater scapular stability without aggravating the symptoms. Thus, this study aimed to examine and compare this novel stretching technique to determine its effect on the range of motion (ROM) and acromio-humeral distance (AHD) in patients with glenohumeral internal rotation deficits (GIRD) with posterior shoulder tightness. Methods: A total of 30 symptomatic patients with asymmetrical GIRD were randomly assigned to two groups: the novel stretching group (n=15) and the joint mobilization group (n=15). The intervention was conducted twice a week for a total of four weeks. The ROM of shoulder internal rotation was measured by a goniometer and the AHD was evaluated by an X-ray before and after the intervention. Results: Both the treatments improved ROM and AHD in patients with GIRD (p<.05). However, the improvements in internal rotation ROM and AHD in the novel stretching group were significantly greater than that of the subjects in the mobilization group. There was a significant difference between the two groups (p<.05). Conclusion: These results show that both novel stretching and joint mobilization improved ROM and AHD in patients with GIRD with PST. However, novel stretching was more effective than joint mobilization.

Keywords

References

  1. Bach HG, Goldberg BA. Posterior capsular contracture of the shoulder. J Am Acad Orthop Surg. 2006;14(5):265-277. https://doi.org/10.5435/00124635-200605000-00002
  2. Borstad JD, Dashottar A. Quantifying strain on posterior shoulder tissues during 5 simulated clinical tests: A cadaver study. J Orthop Sports Phys Ther. 2011;41(2):90-99. https://doi.org/10.2519/jospt.2011.3357
  3. Borstad JD, Mathiowetz KM, Minday LE, et al. Clinical measurement of posterior shoulder flexibility. Man Ther. 2007;12(4):386-389. https://doi.org/10.1016/j.math.2006.07.014
  4. Gharisia O, Lohman E, Daher N, et al. Effect of a novel stretching technique on shoulder range of motion in overhead athletes with glenohumeral internal rotation deficits: A randomized controlled trial. BMC Musculoskelet Disord. 2021;30;22(1):402. https://doi.org/10.1186/s12891-021-04292-8
  5. Goutallier D, Le Guilloux P, Postel JM, et al. Acromio humeral distance less than six millimeter: its meaning in full-thickness rotator cuff tear. Orthop Traumatol Surg Res. 2011;97(3):246-251. https://doi.org/10.1016/j.otsr. 2011.01.010
  6. Gruber G, Bernhardt GA, Clar H, et al. Measurement of the acromiohumeral interval on standardized anteroposterior radiographs: A prospective study of observer variability. J Shoulder Elbow Surg. 2010;19(1):10-13. https://doi.org/10.1016/j.jse.2009.04.010
  7. Harryman DT 2nd, Sidles JA, Clark JM, et al. Translation of the humeral head on the glenoid with passive glenohumeral motion. J Bone Joint Surg Am. 1990;72(9):1334-1343. https://doi.org/10.2106/00004623-199072090-00009
  8. Izumi T, Aoki M, Muraki T, et al. Stretching positions for the posterior capsule of the glenohumeral joint: Strain measurement using cadaver specimens. Am J Sports Med. 2008;36(10):2014-2022. https://doi.org/10.1177/0363546508318196
  9. Johnson JE, Fullmer JA, Nielsen CM, et al. Glenohumeral Internal Rotation Deficit and Injuries: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2018;22;6(5):2325967118773322. https://doi.org/10.1177/2325967118773322
  10. Kaltenborn FM, Evjenth O, Kaltenborn TB, et al. Manual Mobilization of Joints: The Kaltenborn Method of Joint examination and treatment : The spine. Norli. 2003.
  11. Kim SY, Weon JH, Jung DY, et al. Effect of the scapula-setting exercise on acromio-humeral distance and scapula muscle activity in patients with subacromial impingement syndrome. Phys Ther Sport. 2019;37:99-104. https://doi.org/10.1016/j.ptsp.2019.03.006
  12. Laudner KG, Sipes RC, Wilson JT. The acute effects of sleeper stretches on shoulder range of motion. J Athl Train. 2008;43(4):359-363. https://doi.org/10.4085/1062-6050-43.4.359
  13. Lundberg A, Malmgren K, Schomburg ED. Role of joint afferents in motor control exemplified by effects on reflex pathways from Ib afferents. J Physiol.1978;284:327-343. https://doi.org/10.1113/jphysiol.1978. sp012543
  14. Maitland GD, Hengeveld E, Banks K, et al. Maitland's Vertebral Manipulation, 7th ed. Butterworth Heinemann. Ltd. 472, 2005.
  15. Manske RC, Meschke M, Porter A, et al. A randomized controlled single-blinded comparison of stretching versus stretching and joint mobilization for posterior shoulder tightness measured by internal rotation motion loss. Sports Health. 2010;2(2):94-100. https://doi.org/10.1177/1941738109347775
  16. McClure P, Balaicuis J, Heiland D, et al. A randomized controlled comparison of stretching procedures for posterior shoulder tightness. J Orthop Sports Phys Ther. 2007;37(3):108-114. https://doi.org/10.2519/jospt.2007.2337
  17. Moon G, Lim J, Kim T, et al. The effects of joint mobilization and stretching on the muscle activity and internal rotation of shoulder joint in patients with impingement syndrome with posterior shoulder tightness. Korean Research Society of Physical Therapy. 2020;27:38-44. http://dx.doi.org/10.12674/ptk.2020.27.1.38
  18. Muraki T, Yamamoto N, Zhao KD, et al. Effect of posteroinferior capsule tightness on contact pressure and area beneath the coracoacromial arch during pitching motion. Am J Sports Med. 2010;38(3):600-607. https://doi.org/10.1177/0363546509350074
  19. Razmjou H, Palinkas V, Christakis M, et al. Diagnostic value of acromiohumeral distance in rotator cuff pathology: Implications for advanced-practice physiotherapists. Physiother Can. 2020;72(1):52-62. https://doi.org/10.3138/ptc-2018-0084
  20. Riddle DL, Rothstein JM, Lamb RL. Goniometric reliability in a clinical setting. Shoulder measurements. Phys Ther. 1987;67(5):668-673. https://doi.org/10.1093/ ptj/67.5.668
  21. Steuri R, Sattelmayer M, Elsig S, et al. Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement: A systematic review and meta-analysis of RCTs. Br J Sports Med. 2017;51(18):1340-1347. https://doi.org/10.1136/bjsports-2016-096515
  22. Werner CM, Conrad SJ, Meyer DC, et al. Intermethod agreement and interobserver correlation of radiologic acromiohumeral distance measurements. J Shoulder Elbow Surg. 2008;17(2):237-240. https://doi.org/10.1016/j.jse.2007.06.002
  23. Wilk KE, Hooks TR, Macrina LC. The modified sleeper stretch and modified cross-body stretch to increase shoulder internal rotation range of motion in the overhead throwing athlete. J Orthop Sports Phys Ther. 2013;43(12):891-894. https://doi.org/10.2519/jospt.2013.4990