Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SHOULDER”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 829 records · Page 46Linked to original sources
PubMed1993

Electromyographic activity of selected shoulder muscles in commonly used therapeutic exercises.

BACKGROUND AND PURPOSE: The purpose of this study was to evaluate and compare the muscle activity of the supraspinatus, infraspinatus, teres minor, and lower trapezius muscles during commonly prescribed therapeutic exercises in subjects with and without shoulder pathology. SUBJECTS: Twenty healthy subjects (9 male, 11 female) and 20 subjects with recurrent unilateral shoulder pain and weakness (14 male, 6 female), aged 18 to 40 years (mean = 28, SD = 5.8), participated in this study. METHODS: Subjects performed each of the following exercises using a hand-held weight: prone lateral (external) rotation, sidelying lateral rotation, and arm elevation in the scapular plane. Indwelling fine-wire electrodes recorded electromyographic (EMG) activity during each exercise. The EMG activity in five phases of concentric contraction of each exercise was averaged and divided into three equal time intervals. Mean EMG values normalized to maximal activity for the entire phase of concentric contraction and for each of the three intervals were used in subsequent analyses. RESULTS: Two-way repeated-measures analyses of variance (ANOVAs) revealed between-group differences only in the prone lateral rotation exercise. Compared with subjects without shoulder pathology, subjects with shoulder pain showed significantly greater EMG activity in the infraspinatus muscle and less activity in the supraspinatus muscle during this exercise. CONCLUSION AND DISCUSSION: These results suggest that the pattern of muscle activation during specific shoulder movements in patients with shoulder pain may be related to pathology. Future studies are needed to determine whether an imbalance in neuromuscular control is a factor contributing directly to shoulder dysfunction or whether such an imbalance is secondary to some pathology.

Adolescent↗
PubMed2005

Prevalence and incidence of adults consulting for shoulder conditions in UK primary care; patterns of diagnosis and referral.

OBJECTIVES: To estimate the national prevalence and incidence of adults consulting for a shoulder condition and to investigate patterns of diagnosis, treatment, consultation and referral 3 yr after initial presentation. METHODS: Prevalence and incidence rates were estimated for 658469 patients aged 18 and over in the year 2000 using a primary care database, the IMS Disease Analyzer-Mediplus UK. A cohort of 9215 incident cases was followed-up prospectively for 3 yr beyond the initial consultation. RESULTS: The annual prevalence and incidence of people consulting for a shoulder condition was 2.36% [95% confidence interval (CI) 2.32-2.40%] and 1.47% (95% CI 1.44-1.50%), respectively. Prevalence increased linearly with age whilst incidence peaked at around 50 yr then remained static at around 2%. Around half of the incident cases consulted once only, while 13.6% were still consulting with a shoulder problem during the third year of follow-up. During the 3 yr following initial presentation, 22.4% of patients were referred to secondary care, 30.8% were prescribed non-steroidal anti-inflammatory drugs and 10.6% were given an injection by their general practitioner (GP). GPs tended to use a limited number of generalized codes when recording a diagnosis; just five of 426 possible Read codes relating to shoulder conditions accounted for 74.6% of the diagnoses of new cases recorded by GPs. CONCLUSIONS: The prevalence of people consulting for shoulder problems in primary care is substantially lower than community-based estimates of shoulder pain. Most referrals occur within 3 months of initial presentation, but only a minority of patients are referred to orthopaedic specialists or rheumatologists. GPs may lack confidence in applying precise diagnoses to shoulder conditions.

Adolescent↗
PubMed2001

Ipsilateral shoulder pain after thoracotomy with epidural analgesia: the influence of phrenic nerve infiltration with lidocaine.

UNLABELLED: Patients receiving effective thoracic epidural analgesia for postthoracotomy pain may still complain of severe ipsilateral shoulder pain. The etiology of this pain is unclear. In this randomized, double-blinded, placebo-controlled study, we investigated the effect of phrenic nerve infiltration with lidocaine or saline on postoperative shoulder pain in 48 patients. After completion of a lung resection, patients received either 10 mL of 1% lidocaine or 10 mL of 0.9% saline infiltrated into the periphrenic fat pad at the level of the diaphragm. Shoulder pain was experienced by 33% of patients receiving lidocaine, compared with 85% of patients receiving saline (P < 0.008). Overall pain scores were lower with lidocaine (P < 0.05). PaCO(2) values were not significantly higher with lidocaine in the first 2 h. We conclude that pain transmitted via the phrenic nerve and referred to the shoulder is the most likely explanation for the ipsilateral shoulder pain experienced by patients receiving epidural analgesia for postthoracotomy pain. IMPLICATIONS: Ipsilateral shoulder pain after thoracotomy is common and may be severe, even in the presence of a functioning thoracic epidural. We have shown that infiltration of the phrenic nerve with local anesthetic significantly and safely reduces this shoulder pain, potentially allowing the ideal goal of a pain-free thoracotomy.

Aged↗
PubMed1996

Role of proprioception in pathoetiology of shoulder instability.

Proprioception is a specialized sensory modality that gives information about extremity position and direction of movement. This kind of afferent sensory feedback is probably important in mediating muscular control of the shoulder joint. As this articulation is minimally constrained, such a coordinated dynamic control of muscles about the joint is necessary for stability during arm motion. The authors evaluated proprioception in individuals with normal shoulders, unstable shoulders, and after surgical stabilization, by assessing threshold to detection of passive motion and the ability to passively reposition the arm in space. In normal shoulders there is no difference between the dominant and nondominant shoulder, though in unstable shoulders there is a significantly decreased proprioceptive ability. Surgical stabilization normalizes proprioception of the shoulder.

Adult↗
PubMed1997

Shoulder fusion for paralyzed upper limb.

Fusion of the shoulder joint after a brachial plexus injury is a well known procedure in cases of flail shoulder in combination with normal motor and sensory function in the band. However, in combination with modern orthoses to stabilize the elbow, fusion of the shoulder in cases of a totally flaccid and afunctional arm might be more beneficial. In a retrospective study the impact of shoulder fusion on daily abilities in a population with a completely flaccid arm caused by a brachial plexus injury was investigated. Compared with a similar population, consisting of 16 patients with an afunctional unstable shoulder, all 12 patients who underwent shoulder fusion proved to perform at a higher functional level. Shoulder fusion in combination with an elbow stabilizing orthosis for a completely flaccid upper limb is a beneficial procedure that leads to less disability and results in a better quality of life.

Brachial Plexus↗
PubMed1995

Shoulder abduction strength measurement in football players: reliability and validity of two field tests.

Musculoskeletal and neurologic injuries affecting shoulder strength are common in contact sports. Full-strength recovery is desired before resumption of competition. On-field assessment of shoulder strength is usually done by manual muscle testing, which lacks sensitivity and reliability. Our objective was to determine the reliability and validity of two field instruments capable of quantifying shoulder abduction strength. Twenty junior football players underwent bilateral isokinetic (60 degrees/s) and isometric shoulder abduction strength measurements using a Cybex 340 isokinetic dynamometer. Test-retest measurements of both shoulders of each player were made using strain gauge (SG) and handheld dynamometer (HHD) instruments. Players were tested during rested and competition conditions. Within and between session reliabilities were calculated using the intraclass coefficient, and validity was assessed using Pearson's correlation coefficient. Overall reliability for each device was calculated using Lisrel analysis. SG was found to be superior to HHD in overall reliability and validity. Within-session reliability in the rested and competition states was 0.75 and 0.78, respectively, for SG and 0.60 and 0.81, respectively, for HHD. Between-session reliability in the rested and competition states dropped to 0.51 and 0.63, respectively, for SG and 0.55 and 0.70, respectively, for HHD. Validity was 0.41 and 0.70 for SG when correlated with Cybex at 0 degree and 60 degrees/s respectively. Validity for HHD was 0.28 and 0.42 for Cybex speeds of 0 degree and 60 degrees/s, respectively. SG reliability and validity were similar when testing was done one shoulder at a time or both shoulders concurrently.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2004

A retrospective radiographic review of hemophilic shoulder arthropathy.

Bleeding into large joints is the most common orthopaedic manifestation of hemophilia. Involvement of the shoulder rarely is reported, lending to its relative neglect in the orthopaedic literature. Through retrospective chart and radiographic reviews, the incidence and progression of radiographic and clinical changes that occur in the shoulder of patients with hemophilia is described. We retrospectively reviewed 822 patient charts and found 93 patients with symptomatic shoulders. Seventy-nine of these 93 patients were rated according to Pettersson's scoring method. The clinical charts were reviewed for the presence of shoulder symptoms and dysfunction. A spectrum of radiographic changes was seen beginning with mild subchondral irregularity and greater tuberosity cyst formation progressing to joint space narrowing, osteophyte formation, marginal erosion, and deformity. Of the 54 patients for whom an adequate shoulder history was available, the severity of symptoms correlated with the Pettersson score. The current study is the largest to date examining the type and progression of radiographic changes caused by hemophilic shoulder arthropathy. We observed a consistent pattern of radiographic changes, the severity of which correlated directly with shoulder symptoms.

Adolescent↗
PubMed2005

MRI findings in throwing shoulders: abnormalities in professional handball players.

Shoulders of throwing athletes are highly stressed joints and likely to have more structural abnormalities seen on magnetic resonance imaging scans. Prevalence and type of structural abnormalities, especially abnormalities of the rotator cuff tendons and the superolateral humeral head, and correlation of magnetic resonance imaging findings with symptoms and clinical tests, are not well known. Throwing and nonthrowing (symptomatic and asymptomatic) shoulders of 30 fully competitive professional handball players and 20 dominant shoulders of randomly selected volunteers were evaluated for comparison clinically and with magnetic resonance imaging. An average of seven abnormal magnetic resonance imaging findings was observed in the throwing shoulders; more than in the nonthrowing and the control shoulders. Although 93% of the throwing shoulders had abnormal magnetic resonance imaging findings, only 37% were symptomatic. Partial rotator cuff tears and mainly superolateral osteochondral defects of the humeral head were identified as typical throwing lesions. Symptoms correlated poorly with abnormalities seen on magnetic resonance imaging scans and findings from clinical tests. This suggests that the evaluation of an athlete's throwing shoulder should be done very thoroughly and should not be based mainly on abnormalities seen on magnetic resonance imaging scans.

Adult↗
PubMed2003

The weight of schoolbags and the occurrence of neck, shoulder, and back pain in young adolescents.

STUDY DESIGN: A cross-sectional study of 745 young adolescents in the area of two Regional Health Centers in the Netherlands. OBJECTIVES: To assess the occurrence of neck and/or shoulder and back complaints in young adolescents and examine relationships with type and weight of schoolbags and other physical and psychologic risk factors. SUMMARY OF BACKGROUND DATA: The occurrence of back pain in children and adolescents varies from 8% to 74% in the literature. Age, gender, and certain psychological factors appear to be important risk factors. An association with heavy schoolbags has been presumed but without clear scientific evidence. METHODS: A questionnaire was used, asking about complaints of back, neck, and/or shoulders and about potential risk factors including psychosomatic factors. Length and weight of the children were determined. Schoolbags were weighed, and the relative weight of the schoolbag was calculated. RESULTS: Neck and/or shoulder complaints and also back complaints were reported by about 45% of young adolescents. Severe complaints of neck and/or shoulder were reported by 6%, and severe back complaints by 7% of the schoolchildren. The (relative) weight of schoolbags was not related to complaints of neck and/or shoulder and back. Psychosomatic factors showed the strongest association with the occurrence of neck and/or shoulder and back complaints. CONCLUSION: Psychosomatic factors appear to be more strongly related to the occurrence of neck and/or shoulder and back complaints than the type and weight of the schoolbag and other physical factors. The role of psychosomatic factors should be further explored in future longitudinal research.

Adolescent↗
PubMed1990

Evaluation of shoulder movement as a command control source.

The purpose of this study was to evaluate the use of scapular shoulder movement as a command control source. The focus of this study was on the evaluation of movement signals from quadriplegic subjects as well as on the processing of these signals for use as command inputs to a functional neuromuscular stimulation (FNS) hand-grasp system. The shoulder movement of three C5-level quadriplegic and nine normal subjects was studied using externally mounted two-degree-of-freedom transducers overlying the sternum and clavicles. The C5-level quadriplegic subjects tested had a considerably poorer range of motion than the normal subjects. The range of motion was greatest in elevation but was coupled with a significant component of retraction. The vertical command resolution of the quadriplegic subjects ranged from eight to 13 command levels, whereas the horizontal range contained four or fewer command levels. Normal subjects were able to produce 26 to 79 command levels along the vertical axis and 18 to 85 along the horizontal axis. Subjects were able to maintain a static command level to within several percent of their range in trials lasting from 10 to 30 s. The quadriplegic subjects performed poorly in tasks where they were required to move to a point along the horizontal or vertical central axis and then along the opposite axis. The normal subjects were readily able to perform these tasks. The interference with the command signal due to movement of the opposite extremity was significant, with a maximum error ranging between 25 and 86% along the vertical axis and between 38 and 105% along the horizontal axis. Rise time and normalized velocity (velocity divided by the size of the movement) were found to be suitable for distinguishing different types of shoulder movements independent of the size of the movement. Shoulder movement in quadriplegics is suitable as a command control source for a FNS hand-grasp system requiring one proportional command signal and at least one logical command signal with appropriate processing of the signals. The available transducers are cosmetically acceptable and are easy to don and doff. Use of shoulder movement as a command control source does not interfere with other activities of the user such as eating or talking. Shoulder movement also provides a command control source that is easy for the user to learn and provides some feedback to the user through shoulder proprioception.

Adult↗
PubMedDate not supplied

Treatment of dogs diagnosed with medial shoulder instability using radiofrequency-induced thermal capsulorrhaphy.

OBJECTIVE: To report clinical findings and outcome in dogs diagnosed with medial shoulder instability (MSI) treated with radiofrequency-induced thermal capsulorrhaphy (RITC). STUDY DESIGN: Retrospective study. ANIMALS: Dogs (n=43) with MSI. METHODS: Medical records from consecutive cases with MSI based on orthopedic examination, palpation of shoulder abduction angles, and arthroscopic findings were used to determine clinical findings and long-term (> or = 1 year) outcome of RITC. RESULTS: Forty-three dogs met the criteria for inclusion; 2 dogs had bilateral MSI. The most common clinical findings were chronic unilateral weight-bearing lameness, large (> 45 degrees) shoulder abduction angles, and spinatus muscle atrophy in the affected limb. Mean preoperative abduction angle (50.7 degrees +/- 4.8 degrees) in affected shoulders was significantly larger than in the unaffected shoulders (32.5 degrees +/- 2.1 degrees). Mean postoperative abduction angle in affected shoulders was not significantly different from unaffected shoulders when measured immediately, 8, 16-20 weeks, and approximately 1 year after surgery. Follow-up evaluation ranged from 1 to 6.2 years. RITC treatment resulted in improved clinical function in 40 cases (93%) with 34 cases (79%) considered excellent; 3 cases (7%) were considered failures. CONCLUSIONS: RITC was a safe and effective method of treatment of MSI in most dogs studied. CLINICAL RELEVANCE: RITC can be considered as a viable option for surgical treatment of selected cases of MSI in dogs.

Animals↗
PubMed1998

Bioabsorbable tacks for arthroscopic treatment of recurrent anterior shoulder dislocation.

Seventy-eight patients (82 shoulders) with symptomatic, recurrent anterior post-traumatic shoulder instability and Bankart lesions were operated on with bioabsorbable tacks (Suretac fixators). All the patients were followed by an independent observer, with a median follow-up period of 27 (21-63) months. The recurrence rate was 8/82 (10%). The median Rowe score was 93 (37-100) points. The median Constant score for the index shoulders was 90 (34-100) points, compared with 93 (80-100) points for 59 non-operated healthy shoulders from the same cohort (P=0.03). The external rotation in abduction was 93 (50-135) degrees compared with 105 (75-145) degrees for the control shoulders (P=0.0018). Arthroscopic shoulder stabilization using bioabsorbable Suretac fixators appears to produce reliable results if used in patients with post-traumatic shoulder instability and a Bankart lesion.

Absorbable Implants↗
PubMed2006

Decreased shoulder function and pain common in recreational badminton players.

The aim of this study was to describe the prevalence and consequences of painful conditions in the shoulder region in recreational badminton players. A questionnaire study was performed on 99 players, of whom 57 were also assessed with Constant score. Previous or present pain in the dominant shoulder was reported by 52% of the players. Sixteen percent of the players had on-going shoulder pain associated with badminton play. A majority of these players reported that their training habits were affected by the pain. Total Constant score was lower in the painful shoulders. Furthermore, range of active pain-free shoulder abduction was decreased. However, isometric shoulder strength test showed no differences when compared with pain-free shoulders. Even though the pain caused functional problems, the players were still playing with on-going symptoms. The diagnoses were mostly unknown, although history and clinical tests indicate problems resembling subacromial impingement.

Adult↗
PubMed2006

Swimmers' painful shoulder arthroscopic findings and return rate to sports.

Shoulder pain is the most common musculo-skeletal complaint in competitive swimmers. It remains one of the shoulder pain syndromes in overhead athletes where no golden standard of treatment exists. Eighteen competitive swimmers who all had undergone shoulder arthroscopy for therapy-resistant shoulder pain were retrospectively evaluated with respect to operative findings and ability to return to their sport after the operation. The most common finding at arthroscopy was labral pathology in 11 (61%) and subacromial impingement in five shoulders (28%). Operative procedures included debridement in 11 swimmers, partial release of the coraco-acromial ligament in four, and bursectomy in four. Sixteen (89%) responded to the follow-up evaluation. Nine swimmers (56%) were able to compete at preinjury level after 4 (2-9) months. Findings at arthroscopy suggest that the term "Swimmer's shoulder" covers a variety of pathologies including labral wearing and subacromial impingement. Arthroscopic debridement of labral tears or bursectomy in swimmers with shoulder pain has a low success rate with regard to return to sport. Further understanding and investigation of this syndromes complex pathophysiology is needed.

Adolescent↗
PubMed2006

The effect of the loading condition corresponding to functional shoulder activities on trabecular architecture of glenoid.

There is little information on bone morphology as it relates to shoulder activities. This study investigated how loads corresponding to functional shoulder activities affect the trabecular architecture of the glenoid. Two different protocols were used. Protocol 1 investigated the material and morphological characteristics of the glenoid by analyzing digitized trabecular bone images obtained from 12 cadaver scapula specimens. Protocol 2 used a finite element analysis (FEA) to compute the principal stress trajectories acting within the glenoid. The principal stresses were derived for five loading conditions, which represent typical functional shoulder activities. The study showed that shoulder activity involved in carrying a light load makes the greatest contribution to the trabecular architecture compared with other shoulder activities considered in this study (p<0.05). With all of the activities considered in this study, the lateral region, particularly in the anterior and posterior portions, showed greater deviation and greater sensitivity to variation under loading conditions than did the other regions (p<0.05). These results suggest that owing to the extra sensitivity of the anterior and posterior parts of the lateral region, these regions may be more informative in the analysis of the trabecular architecture following shoulder musculoskeletal injuries. These results may provide essential design information for shoulder prostheses and contribute to an understanding of morphological changes resulting from injury.

Activities of Daily Living↗
PubMed2001

Shoulder and hand displacements during hitting, reaching, and grasping movements in hemiparetic cerebral palsy.

In this study, we examined the degree and timing of shoulder displacements during hitting, reaching, and grasping movements performed by young adults with hemiparetic cerebral palsy. The participants performed unimanual and bimanual arm movements towards targets and objects of different sizes. On the basis of the assumption that shoulder displacement due to trunk translation and rotation is a successful adaptive reaction to reduced joint mobility in the affected arm, the fluency of hand displacements was expected to remain invariant under variations of shoulder displacement as is also the case in healthy participants. The results point in this direction. With respect to the timing of shoulder displacement, prior research suggested that hemiparetic movements can be characterized by inconsistent motion-timing patterns-that is, the timing of the of shoulder and hand-displacement onsets varied between trials. Therefore, the within-subject variability of the movement-onset asynchrony between hand and ipsilateral shoulder displacement was expected to be larger on the impaired side than on the unimpaired side. This prediction was not confirmed, which challenges these earlier conclusions. Additionally, we also examined the peak-velocity asynchrony of the hand and shoulder. Contrary to the onset asynchrony, the peak asynchrony varied between the hitting and reaching task and between the hitting and grasping task. For the reaching and grasping tasks, there were also significant differences between hands. Again, variability of the (peak-velocity) asynchrony was not significantly increased when comparing the impaired hand with the unimpaired hand. The results suggests that the hemiparetic participants were capable of flexibly recruiting and sequencing the various degrees of freedom of their impaired side required for successful task completion, albeit in different magnitudes and sequenced differently.

Adolescent↗
PubMed2006

Responsiveness of the shoulder function assessment scale in patients with rheumatoid arthritis.

OBJECTIVES: To investigate the responsiveness of the Shoulder Function Assessment scale (SFA) in patients with rheumatoid arthritis (RA). METHODS: In 35 patients with RA receiving a (peri-)articular injection because of local shoulder complaints the SFA, impact of shoulder function on activities of daily living, active shoulder range of motion (ROM), the 28 joint count Disease Activity Score (DAS28), and the Health Assessment Questionnaire (HAQ) were measured before and 4-6 weeks after treatment. Responsiveness was determined using the standardised response mean (SRM), effect size (ES), and responsiveness ratio (RR). RESULTS: Overall, significant improvement was seen according to the SFA (mean change 10.9 (95% confidence interval 6.5 to 15.3)), active shoulder ROM (except external rotation), and the impact of shoulder function on daily activities. In addition, the DAS28 and HAQ scores improved significantly. The responsiveness of the SFA was excellent, with the SRM, ES, and RR being -0.86, -1.16, and 1.28, respectively. CONCLUSIONS: In addition to its good validity and reliability, the SFA proved to have a high sensitivity to clinical changes in patients with RA who received local treatment for shoulder complaints.

Activities of Daily Living↗
PubMed2006

Shoulder strength profile in elite junior tennis players: horizontal adduction and abduction isokinetic evaluation.

OBJECTIVE: To establish normative data for muscle performance during isokinetic horizontal abduction and adduction of the shoulder in elite junior tennis players. METHODS: Thirty six tennis players were evaluated (23 male, 13 female; mean age 14 years (range 12-18)). An isokinetic dynamometer was used to test the shoulder horizontal abductors and adductors at 60 and 180 degrees/s. Absolute and relative peak torque (PT and PT/BW), total work (TW), endurance ratio (ER), and the ratio of the peak torque between horizontal abductors and adductors (HAB/HAD ratio) were recorded. Data were compared for the dominant and non-dominant shoulders, horizontal abductor and adductor muscles, and between players grouped according to age. RESULTS: The dominant shoulder was significantly (p<0.05) stronger than the non-dominant shoulder in all variables except ER and HAB/HAD ratio. The abductors were significantly (p<0.05) weaker than the adductors in all subjects. The type of backhand (one handed or two handed) did not influence the strength of the shoulder horizontal abductors on the dominant side. The number of years of tennis practice had an effect on muscle strength as evaluated by absolute data (PT and TW) but not relative measurements (PT/BW and TW/BW). CONCLUSION: The findings confirm that horizontal abduction and adduction are stronger in the dominant shoulder of junior tennis players. The clinical relevance of these findings is not established, and more studies are needed to compare tennis players with athletes from other sports and non-athletes.

Adolescent↗