Objective: To compare, in terms of their demonstration of tears of the anterior glenoid labrum, oblique axial MR arthrography obtained with the patient's shoulder in the abduction and external rotation (ABER) position, with conventional axial MR arthrography obtained with the patient's arm in the neutral position. Materials and Methods: MR arthrography of the shoulder, including additional oblique axial sequences with the patient in the ABER position, was performed in 30 patients with a clinical history of recurrent anterior shoulder dislocation. The degree of anterior glenoid labral tear or defect was evaluated in both the conventional axial and the ABER position by two radiologists. Decisions were reached by consensus, and a three-point scale was used: grade 1=normal; grade 2=probable tear, diagnosed when subtle increased signal intensity in the labrum was apparent; grade 3=definite tear/defect, when a contrast material-filled gap between the labrum and the glenoid rim or deficient labrum was present. The scores for each imaging sequence were averaged and to compare conventional axial and ABER position scans, Student's t test was performed. Results: In 21 (70%) of 30 patients, the same degree of anterior instability was revealed by both imaging sequences. Eight (27%) had a lower grade in the axial position than in the ABER position, while one (3%) had a higher grade in the axial position. Three whose axial scan was grade 1 showed only equivocal evidence of tearing, but their ABER-position scan, in which a contrast material-filled gap between the labrum and the glenoid rim was present, was grade 3. The average grade was 2.5 (SD=0.73) for axial scans and 2.8 (SD=0.46) for the ABER position. The difference between axial and ABER-position scans was statistically significant (p<0.05). Conclusion: MR arthrography with the patient's shoulder in the ABER position is more efficient than conventional axial scanning in revealing the degree of tear or defect of the anterior glenoid labrum. When equivocal features are seen at conventional axial MR arthrography, oblique axial imaging in the ABER position is helpful.
Purpose: The purpose of this study was to compare the influence of external scapular stabilization on the isometric strength of shoulder flexor muscle in subjects with and without scapular winging and conditions with and without external scapular stabilization. Methods: A total of 30 subjects with and without scapular winging were enrolled. Two groups were classified using clinical and diagnostic tests to divide the groups with and without scapular winging (15 with scapular winging 15 without scapular winging). The isometric strength of the shoulder flexor was measured using a tensiometer. The isometric strength was evaluated in the sitting position with and without an external scapular stabilization. The external scapular stabilization was provided with the examiner's hand to fix scapular winging during shoulder flexion. The changing value was calculated to determine the isometric strength difference between shoulder flexion with and without the external scapular stabilization in each group. The changing value between isometric strength of shoulder flexor with and without scapular winging was compared using the independent t-test. Statistical significance was set at 0.05. Results: In the group with scapular winging, the shoulder flexor isometric strength in the sitting position was greater with an external scapular stabilization than without an external scapular stabilization (p<0.05). There was no significant difference in the shoulder flexor isometric strength in the subjects without scapular winging between conditions with or without an external scapular stabilization (p>0.05). Conclusion: The external scapular stabilization in the individuals with scapular winging may increase shoulder flexor isometric strength in the sitting position.
Park, So-Young;Kim, Min-Ji;Seol, So-Eun;Hwang, Chan;Hong, Ji-Su;Kim, Ho;Shin, Won-Seob
Physical Therapy Rehabilitation Science
/
v.9
no.4
/
pp.269-274
/
2020
Objective: There are many cases of applying various taping methods to prevent muscle damage and to assist with movement. The purpose of this study was to investigate and to compare the effects of dynamic taping on joint position sense and to find out the difference in error values during various degrees of shoulder flexion. Design: Cross-sectional study. Methods: A total of 20 subjects participated in this study with a randomized cross-over design. The order of taping was adjusted by randomly proceeding with dynamic taping, sham taping, and no taping. After the taping, the proprioception of the shoulder joint was evaluated. The evaluation of proprioceptive sensation was performed by evaluating joint position sensation. The sequence was adjusted by randomly performing joint position tests at each shoulder flexion of 50, 90, and 110 degrees. All angles were repeated 3 times. Results: There was a significant difference between dynamic taping and no taping in 50 degrees of shoulder flexion. There was a significant difference between sham taping and no taping in 90 degrees of shoulder flexion (p<0.05). No significant difference was found in 110 degrees of shoulder flexion. Conclusions: In this study, it was confirmed that dynamic taping is effective in improving the joint position sense in 50 degrees of shoulder flexion. In the future, it is expected that further studies will be conducted on patients with shoulder dysfunction with decreased proprioception.
This study aimed to compare the characteristics of breast cancer surgery and shoulder surgery patients on the shoulder range of motion (ROM), degree of pain and dysfunction, and scapular position. This study was carried out with a total of 90 women: a breast cancer surgery group (BS, $n_1=30$), a shoulder surgery group (SS, $n_2=30$) and a control group ($n_3=30$). Shoulder ROM, the Quadruple Visual Analogue Scale (QVAS), the Shoulder Pain and Disability Index (SPADI), and the Scapular Index (SI) were used to assess shoulder function. Statistical analyses were performed using a one-way analysis of variance, crosstab test, and independent sample t-test. Post-hoc testing was carried out with Bonferroni test. There were significant differences in shoulder ROM when the BS and the SS were compared with the control group. However, there was no significant difference in ROM between the BS and SS. Furthermore, there was a significant difference in shoulder pain between both surgery groups, and there was greater shoulder dysfunction in the SS than in the BS. There was also a significant difference in upper extremity posture when the BS and the SS were compared to the control group. Finally, there was no significant difference in upper extremity posture between the BS and the SS. This study compared shoulder ROM, pain, dysfunction, and upper extremity postures between the BS and SS. While there were no significant differences in shoulder ROM, pain, and upper extremity posture between both surgery groups, the level of dysfunction was found to be significantly different. Therefore, health professionals managing for breast cancer surgery or shoulder surgery patients should consider these outcomes.
This study was carried out to investigate the scapular rhythm of normal persons. 16 persons was no disease, injury and after-effect in period for July 1, 1996 to July 14, 1996. The statistical measures were performed by SPSS/PC t-test for classification. The result of this study were as follow : 1. There was a significant difference between the body median line and scapular superior angle from the mean distance in 83.4 mm of male and 86.0 mm of female to shoulder neutral position(p<0.05). 2. The mean distance of body median line between scapular inferior angle was 97.9 mm of male and 92.0 mm of female to shoulder neutral position. 3. There was a significant difference between the body median line and scapular inferior angle from the mean distance with male and female to shoulder abduction $90^{\circ}$ position(p<0.05). 4. The mean angle of body median line between scapular angle was $6.4^{\circ}$ of male and $4.4^{\circ}$ of female with shoulder neutral position. 5. The mean ratio of scapular rhythm was 5.6 : 1 in shoulder abduction of $90^{\circ}$ and 5.1 : 1 in shoulder abduction of 180.
Kim Seung-Ho;Ha Kwon-Ick;Kim Hyeon-Sook;Kim Seon-Woo;Park Jong Hyuk;Kim Young-Min
Clinics in Shoulder and Elbow
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v.3
no.2
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pp.87-94
/
2000
Purpose : The purpose of this study was to evaluate the activity of the biceps brachii muscle in the vulnerable abduction and external rotation position of the shoulder in patients with anterior instability. Materials and Methods: This experimental study include a prospective analysis of the electromyographic(EMG) data on a group of patients with traumatic unilateral anterior instability of the shoulder. The EMG data of unstable shoulders was compared with those of opposite shoulders as control. The optimal sample size for the case-control study was calculated using an nQuery Advisor program(nQuery Adviser 3.0, Statisticl solutions Ltd., Ireland). The EMG analyses were conducted in 76 shoulders in 38 patients who had a traumatic anterior instability in one shoulder. The EMG records were obtained at different position of shoulder, which included 0° , 45° , 90° and 120° of shoulder abduction. In each angle of shoulder abduction, the arms were placed in an external rotation as tolerated by the anterior apprehension. The paired-sample T test was used to compare the difference of the root mean square(RMS) voltages between the stable and unstable shoulders in each degree of arm position. Results : The RMS voltage of the biceps muscle was significantly greater in the unstable shoulder than opposite stable shoulder in all position of the arm(p<0.001). The RMS voltage of the biceps was maximal at 90° and 120° of external rotation in the unstable shoulder(p<0.05). The RMS voltage of the supraspinatus muscle revealed no differences in any of the test conditions(p=0.904, 0.506, 0.119 and 0.781 in 0° , 45° , 90° and 120° , respectively) Conclusion: In the vulnerable abduction and external rotation position, the biceps muscle plays an active compensatory role in the unstable shoulder while not in the stable shoulder.
The purpose of this study was to compare EMG activity for pectoralis major muscle during shoulder movement with various abduction angle and rotation position in supine position. Fifteen healthy subjects were recruited for this study. All subjects performed shoulder horizontal adduction holding a 2 kg dumbbell in shoulder abduction $40^{\circ}C$, $70^{\circ}C$, $90^{\circ}C$, $130^{\circ}C$, $160^{\circ}C$ with shoulder neutral, internal rotation (IR), and external rotation (ER). Surface EMG activity was recorded from pectoralis major clavicle part and pectoralis major sternum part for 5 seconds and EMG activity was normalized to the value of maximal voluntary isometric contraction (%MVIC). Dependent variables were examined with 3 (Neutral, IR, ER) ${\times}$ 5 ($40^{\circ}C$, $70^{\circ}C$, $90^{\circ}C$, $130^{\circ}C$, $160^{\circ}C$) analysis of variance with repeated measures. The EMG activity of pectoralis major muscle was significantly different between shoulder abduction angles and between shoulder rotation positions (p<.05). The highest value of EMG activity of pectoralis major clavicle part among shoulder abduction angles was in $70^{\circ}C$ and, $90^{\circ}C$ in that order. The highest value of EMG activity of pectoralis major sternum part among shoulder abduction angles was in $130^{\circ}C$ and, $90^{\circ}C$ in that order. According to the rotation degree, shoulder ER showed the highest value and IR showed the lowest value in both muscle parts. These results suggest that shoulder abduction $70^{\circ}C$, $90^{\circ}C$, $130^{\circ}C$ will be effective during manual muscle testing (MMT) and strengthening exercise for pectoralis major muscle. It is also supposed that shoulder ER is the efficient posture for strengthening of pectoralis major muscle.
Purpose: This study investigated the effects of shoulder protraction exercise according to weight by examining the surface electromyography (EMG) amplitude in the serratus anterior (SA), upper trapezius (UT), and pectoralis major (PM) as well as the activity ratio of each muscle. Methods: Twenty three winging scapula subjects participated in the study. The subjects performed scapula protraction at shoulder $90^{\circ}$ flexion and $60^{\circ}$ horizontal abduction with up to four (none, 1kg, 1.5kg, and 2kg) dumbbells in the supine position. The EMG data were collected from the dominant side muscles during a shoulder protraction exercise according to weight in the supine position. One way repeated measures analysis of variance (ANOVA) was used to compare the normalized activities of the SA, UT, and PM and the ratios of PM/SA and UT/SA. Results: The results showed that the activities of both the SA and UT were highest for the shoulder protraction exercise at 2kg in the supine position. The UT/SA ratio also was the lowest for exercise at 2kg. On the other hand, the activities of both the UT and PM/SA ratio were similar under all conditions. Conclusion: These results show that there is a need to selectively strengthen the SA muscle in the case of patients with the shoulder dysfunction. In particular, it is necessary to weigh 2kg when performing shoulder protraction exercises in the supine position to activate the SA muscle in patients with a winging scapula.
Journal of the Korean Society of Physical Medicine
/
v.12
no.1
/
pp.61-66
/
2017
PURPOSE: The purpose of this study was to investigate the effects of isometric upper limb contraction on the trunk and lower extremity muscles during the sit-to-stand activity in elderly females. METHODS: Eighteen healthy elderly females performed three directional isometric upper extremity contractions (flexion, extension, and horizontal abduction movements) using an elastic band during sit-to-stand activity. Electromyography signals were collected from the internal oblique, erector spinae, rectus femoris, and biceps femoris muscles. RESULTS: Internal oblique activity was greater in bilateral shoulder flexion and bilateral shoulder horizontal abduction than in neutral position (p<.05). Erector spinae and rectus femoris muscle activities in bilateral shoulder flexion was greater than in neutral position and bilateral shoulder extension (p<.05). Biceps femoris activity was significantly greater in bilateral shoulder flexion than in bilateral shoulder extension and horizontal abduction, and in neutral position compared to bilateral shoulder extension (p<.05). CONCLUSION: These results suggest that incorporating isometric upper limb contraction may be beneficial for enhancing the contribution of trunk and lower extremity muscle activities to trunk stabilization during sit-to-stand activity. Therefore, isometric upper limb contraction during sit-to-stand tasks, especially in flexion, may be used to elicit contraction of the lumbopelvic region muscles within a tolerable range, for developing endurance and strength in the elderly.
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