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At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, patient self-report section: reliability, validity, and responsiveness.

The purpose of this study was to examine the psychometric properties of the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), patient self-report section. Patients with shoulder dysfunction (n = 63) completed the ASES, The University of Pennsylvania Shoulder Score, and the Short Form-36 during the initial evaluation, 24 to 72 hours after the initial visit, and after 3 to 4 weeks of physical therapy. The test-retest reliability (intraclass correlation coefficient[1-way random-effects], 0.84; 95% CI lower limit, 0.75) and internal consistency (Cronbach alpha, 0.86) values were acceptable. The standard error of the measure was 6.7 ASES points (90% CI, 11.0). Construct and discriminant validity was demonstrated. Responsiveness was demonstrated with a standardized response mean of 1.5 and an effect size of 1.4. The minimal detectable change was 9.7 ASES points (90% CI, 16), and the minimal clinically important difference was 6.4 ASES points. The results indicate that the ASES is a reliable, valid, and responsive outcome tool.

Adult↗
PubMedDate not supplied

Analysis of collagen and elastic fibers in shoulder capsule in patients with shoulder instability.

This study examined collagen cross-links, collagen fibril diameter and density, amino acid composition, and elastic fibers in shoulder capsule and skin in four patient groups: 1) unidirectional anterior instability (N = 8); 2) multidirectional instability/primary surgery (N = 6); 3) multidirectional instability/revision surgery (N = 6); and 4) no history of instability (N = 5). Compared with normal capsule, capsule from groups 1 and 2 had more stable and reducible collagen cross-links, significantly greater mean collagen fibril diameter, more cysteine, and a higher density of elastin staining. Compared with shoulder capsule in groups 1 and 2, shoulder capsule from group 3 contained significantly more reducible cross-links, smaller-diameter collagen fibrils, decreased collagen fibril density, and an increased density of elastin staining. There were no significant differences in any parameters between groups 1 and 2. We hypothesized that repeated capsular deformation in patients with shoulder instability results in changes in the capsule that increase its strength and resistance to stretching. Skin analyses demonstrated a significantly smaller mean collagen fibril diameter in skin from group 2 compared with group 1, suggesting the possibility of an underlying connective tissue abnormality.

Adolescent↗
PubMed2006

The reverse shoulder prosthesis (Delta III) in acute shoulder fractures: technical considerations with respect to stability.

The reverse shoulder prosthesis reverses the relationship between the scapular and humeral component, resulting in a mechanical advantage as the deltoid muscle is able to compensate for the rotator cuff deficiency. Based on this mechanical advantage, the reverse shoulder prosthesis has become an accepted alternative for the treatment of complex proximal humeral fractures. The purpose of this article is to discuss technical considerations related to stability in the use of the reverse shoulder prosthesis in acute shoulder fractures, based on clinical experience.

Humans↗
PubMed1994

The effects of functional electrical stimulation on shoulder subluxation, arm function recovery, and shoulder pain in hemiplegic stroke patients.

The purpose of this study was to evaluate the effectiveness of a functional electrical stimulation (FES) treatment program designed to prevent glenohumeral joint stretching and subsequent subluxation and shoulder pain in stroke patients. Twenty-six recent hemiplegic stroke patients with shoulder muscle flaccidity were randomly assigned to either a control group (n = 13; 5 female, and 8 male) or experimental group (n = 13; 6 female, and 7 male). Both groups received conventional physical therapy. The experimental group received additional FES therapy where two flaccid/paralyzed shoulder muscles (supraspinatus and posterior deltoid) were induced to contract repetitively up to 6 hours a day for 6 weeks. Duration of both the FES session and muscle contraction/relaxation ratio were progressively increased as performance improved. The experimental group showed significant improvements in arm function, electromyographic activity of the posterior deltoid, range of motion, and reduction in subluxation (as indicated by x-ray) compared with the control group. We concluded that the FES program was effective in reducing the severity of shoulder subluxation and pain, and possibly facilitating recovery of arm function.

Aged↗
PubMed1998

[Results of anterior shoulder decompression surgery according to Neer for shoulder impingement syndrome; little effect on fitness for work].

OBJECTIVE: To evaluate the effect of surgical treatment of the impingement syndrome of the shoulder on the fitness for work. DESIGN: Retrospective. SETTING: Academic Hospital Groningen, department of Orthopaedics, the Netherlands. PATIENTS AND METHODS: A group of 31 patients who had undergone an anterior shoulder decompression between 1 January 1984 and 31 December 1993 because of shoulder symptoms due to impingement lasting more than one year, were subjected in January 1996 to a study of the effect of the treatment on the pain, fitness for work and participation in the labour process. The results were measured using an objectivated score list for pain and function and with a comparison of the labour situations before and after the operation as described by the patients. RESULTS: End results as measured with the score list were fair to good in 97 patients (74%). The numbers of those completely fit for work before operation and at follow-up were identical, viz. 45 out of 131 (34%). Thirty-four patients (26%) had other jobs or adjusted activities and 37 (28%) were completely unfit for work (together 71 patients: 54%); 15 patients (11%) had stopped working for reasons of age. The probability to be definitely rejected for work after the operation was increased significantly by a job causing shoulder overstrain and by having been on sick leave with pay prior to the operation. CONCLUSION: Although the objective results were reasonably good, the percentage of those completely fit for work was not changed appreciably by the surgical treatment.

Arthroplasty↗
PubMed1996

Humeral avulsion of the anterior shoulder stabilizing structures after anterior shoulder dislocation: demonstration by MRI and MR arthrography.

OBJECTIVE: To demonstrate the MRI findings of an anterior shoulder capsular avulsion from the humerus, with or without subscapularis rupture, after anterior dislocation or severe abduction external rotation injury. DESIGN AND PATIENTS: We retrospectively reviewed the MRI and MR arthrographic examinations of seven patients who were identified at surgery with avulsion of the anterior shoulder stabilizers from the humerus. MRI was correlated with clinical history and surgical results. RESULTS: MRI findings included: inhomogeneity or frank disruption of the anterior capsule at the humeral insertion (all), fluid intensity anterior to the shoulder (six patients), tear of the subscapularis tendon (six patients), dislocation of the biceps tendon (four patients), and a Hill-Sachs deformity (four patients). MR arthrography additionally found extravasation of contrast through the capsular defect (two patients). CONCLUSIONS: Our findings suggest that MRI is helpful for diagnosing humeral avulsion of the anterior glenohumeral capsule, especially when a tear of the subscapularis tendon insertion is present. MR arthrography may be of benefit for diagnosing capsular avulsion without associated subscapularis tendon abnormality.

Adult↗
PubMed2004

Dynamic shoulder dynamometry: a way to develop delay onset muscle soreness in shoulder muscles.

A dynamic shoulder dynamometer has been designed to develop a vertical downward force over a measured range of motion, i.e. scapular elevation. The dynamometer is force-controlled to apply a required force within the range of motion. Calibration procedures were performed to assess the reliability of the force and displacement measurements. The system is designed to operate in isometric or eccentric conditions. For eccentric exercise the dynamometer has, for the first time, provided possibilities to elicit delay onset muscle soreness in shoulder muscles. In future, the apparatus will enable investigations of sensory-motor interactions in the shoulder region.

Biomechanical Phenomena↗
PubMed2004

Shoulder capsule shrinkage and consequences on shoulder movements.

A study was designed to find landmarks to avoid restriction of range of motion or insufficient shortening of the ligaments after thermal shoulder capsule shrinkage. In 15 nonembalmed shoulders from cadavers, shrinkage was done in three steps: (1). the middle glenohumeral ligament, (2). the anterior part of the inferior glenohumeral ligament, and (3). the posterior part of the glenohumeral ligament. Before and after each step passive range of motion of the glenohumeral joint was studied. Results indicated that flexion and the external rotation were not affected. External rotation in the scapular plane with 45 degree elevation diminished after shrinkage of the middle glenohumeral ligament. External rotation in full abduction diminished after shrinkage of the anterior part of the inferior glenohumeral ligament. Abduction diminished after shrinkage of the anterior and posterior parts of the inferior glenohumeral ligament. Internal rotation in full abduction was restricted after shrinkage of the posterior part of the inferior glenohumeral ligament. These results show a constant relation between the reduction of a given movement and the shrunken area, by providing useful landmarks to reduce the passive hyperabduction that is constant in anterior shoulder instability and to control the immediate effects on the other ranges of motion. To control the immediate consequences of shrinkage may help avoid excessive restriction of motion or insufficient reduction of capsular redundancy.

Biomechanical Phenomena↗
PubMed2002

Shoulder joint capsule distension (hydroplasty): a case series of patients with "frozen shoulders" treated in a primary care office.

"Frozen shoulder," most often caused by adhesive capsulitis, is frequently treated with intra-articular steroid injections, physical therapy, and surgical manipulation under anesthesia. These therapies provide limited benefits. Hydraulic distension of the shoulder joint capsule (hydroplasty) has potential to provide rapid relief of pain and immediate improvement of shoulder function for patients with adhesive capsulitis. We performed 21 hydroplasty procedures on 16 patients over a 4-year period. Ninety-four percent (17/18) of the procedures improved patient's measured mobility immediately after the procedure. Fifty-three percent (10/19) of the procedures produced immediate, short term, and sustained improvement in comfort and function. No significant complications of the procedure were detected. Our series suggests that the hydroplasty procedure should be further evalutated.

Adult↗
PubMed1994

[Biomechanics of the shoulder and its surgical consequences: personal experience operating on 250 shoulders].

Functional anatomy induces functional surgery. According to the anatomy of the locomotor apparatus, biomechanics opens the way to a more logical surgery. Two main concepts rule the study of the shoulder: the articular complex; the muscular chain. The articular complex: the scapulo- humeral joint is the main of the motion. The 50% remaining are due to the movements of the scapula around the thorax. The muscular chain: sixteen muscles are concerned in shoulder motion. They are classified in two principal groups: long muscles, fixing the scapula upon the thorax short muscles are disposed in two plans: superficial (deltoïd) deep, called the rotator cuff (subs scapularis; supraspinatus; infra-spinatus; teres minor). They only produce motion of the humerus on the scapula. The lateral elevation of the arm relies on the harmonious contraction of all these muscles. The mechanical environment of the cuff, particularly of the supra spinatus is not a favorable one: poorly vascularised, overworking, it goes through a narrow osteo fibrous tunnel. This produces irritation or rupture of the muscle. The surgery is indicated only in case of medical treatment failure. It has two alternative purposes, either to suppress the anterior conflict between the acromial vault and the cuff, or to repair a rupture of the supra spinatus. The acromioplasty is a benign operation that gives excellent results: 65% recover a normal shoulder. We notice 10 to 15% failures (105 cases. Follow up one to ten years). The surgery of reinsertion of the supra spinatus is a little more difficult and the results are less convincing: 36% good and excellent results; 43% fair; 21% failures (82 cases. Follow up one to fifteen years).

Biomechanical Phenomena↗
PubMed1978

Myology of the shoulder of Pontoporia blainvillei, including a review of the literature on shoulder morphology in the cetacea.

The purpose of this paper is to describe in detail the shoulder myology of the La Plata River Dolphin, Pontoporia blainvillei, and to review the literature on cetacean shoulder myology. Three fetal and one adult animal were used for the collection of morphological information. Pontoporia is less specialized in its shoulder anatomy that most delphinid cetaceans, and shares several characteristics with some mysticetes. The omohyoid and anterior serratus anterior muscles are found in both Pontoporia and the mysticete Balaenoptera, but are absent in most delphinids. The pectoralis abdominalis and three rhomboideus divisions are found in Pontoporia and Kogia, but in only a few delphinid species described in the literature. It is suggested that these characteristics are associated with a generalized use of the forelimb in Pontoporia.

Animals↗
PubMed1987

On the biomechanics of human shoulder complex--I. Kinematics for determination of the shoulder complex sinus.

Effectiveness of the multi-segmented total-human-body models to predict realistically live human response depends heavily on the proper biomechanical description and simulation of the major articulating joints of the body. In these models, the most difficult and the least successful modelling of a joint has been the shoulder complex because of the lack of appropriate biomechanical data as well as the anatomical complexity of the region. This paper in Part I presents various aspects of a research program to collect three-dimensional kinematic data for the shoulder complex. A sonic digitizing technique which utilizes an overdeterminate number of sonic emitters on the moving body segment was used for the kinematics analysis. The numerical results are presented for three male subjects for their voluntary shoulder complex sinuses. The results are given in a locally-defined joint axis system as well as in the torso-fixed coordinate system in the form of globographic representation.

Biomechanical Phenomena↗
PubMed1987

On the biomechanics of human shoulder complex--II. Passive resistive properties beyond the shoulder complex sinus.

In multi-segmented total-human-body models the most difficult and the least successful modeling of a major articulating joint has been the shoulder complex because of the lack of appropriate biomechanical data as well as the anatomical complexity of the region. In this paper, quantitative results on the three-dimensional passive resistive properties beyond the voluntary shoulder complex sinus are presented by applying the methodology developed in part I. Constant-restoring-force(moment) contours are established for the shoulder complex and the numerical results are presented for the three subjects tested. In addition, functional expansions are presented for the voluntary and restoring force(moment) contours using spherical coordinates.

Biomechanical Phenomena↗
PubMed1991

Biomechanical model of the human shoulder joint--II. The shoulder rhythm.

A method to investigate the rhythm of the human shoulder, i.e. the interplay between the motion of constituent parts of the shoulder, has been devised and tested. The method is based upon numerical evaluation of low dose roentgenstereophotogrammetric motion pictures of subjects equipped with radiation dense implantations in the bones. Evaluation of the method shows that it may be used in determining motion patterns and that the employed interpolation techniques can be used to simulate motions not actually performed in the laboratory. The shoulder rhythm has been previously poorly investigated and quantified results published pertain to one plane only. Our results on motion patterns correlate with previous investigations. With this method, we show that the absolute position of the bones varies significantly between individuals while the relative displacement of the bones during motion exhibit similarities. In particular the results show that, under normal conditions, the individual rhythm is very stable and insensitive to small hand-loads.

Acromion↗
PubMedDate not supplied

Gentle thawing of the frozen shoulder: a prospective study of supervised neglect versus intensive physical therapy in seventy-seven patients with frozen shoulder syndrome followed up for two years.

Seventy-seven patients with idiopathic frozen shoulder syndrome were included in a prospective study to compare the effect of intensive physical rehabilitation treatment, including passive stretching and manual mobilization (stretching group) versus supportive therapy and exercises within the pain limits (supervised neglect group). There were no significant differences in age, sex, time elapsed since onset, and disease severity at inclusion. All patients were followed up for 24 months after the start of treatment. In the patients treated with supervised neglect, 89% had normal or near-normal painless shoulder function (Constant score > or =80) at the end of the observation period. This end result was reached by 64% within 12 months. In contrast, of the group receiving intensive physical therapy treatment, only 63% reached a Constant score of 80 or higher after 24 months. Both the level of the Constant score at the end of the study and the moment a Constant score of 80 or higher was reached confirm that supervised neglect yields better outcomes than intensive physical therapy and passive stretching in patients with frozen shoulder.

Adult↗
PubMed1998

Bipolar shoulder arthroplasty for painful conditions of the shoulder.

Between April 1991 and March 1997, 182 bipolar shoulder replacements were implanted in 174 patients (8 bilateral) for painful conditions of the shoulder. The study group comprises 108 patients who were followed for an average of 2.9 years (range, 2-6 years). Diagnoses included osteoarthritis (51), rotator cuff arthropathy (27), avascular necrosis (3), revisions (8), rheumatoid arthritis (2), and fractures--both old and recent (17). A satisfactory rating (University of California at Los Angeles shoulder rating score greater than or equal to 28 points of 35) was achieved by 72% of the patients (including rotator cuff arthropathy patients). Patients with osteoarthritis obtained 90.2% of satisfactory results (46 of 51). The overall pain score after surgery was 8.8 points (of 10), meaning that none or occasional pain was present. Five patients required prosthetic revision, and 102 (94.4%) were satisfied with the surgical procedure.

Adult↗
PubMedDate not supplied

The effects of age, sex, and shoulder dominance on range of motion of the shoulder.

To determine the effects of age, sex, and arm dominance on shoulder range of motion, we measured active and passive forward elevation, abduction, internal and external rotation at 90 degrees of abduction, external rotation with the arm adducted, and extension bilaterally in 280 subjects ranging in age from 4 to 70 years. Linear regression analyses were performed for all motions except forward elevation. This motion, which showed a nonlinear pattern of decline with age, was evaluated with 3-way analysis of variance. Shoulder range of motion decreased with age for all measured motions with the exception of internal rotation, which increased with age. Female subjects had a significantly greater range of motion than male subjects for all motions measured. Dominant arms displayed significantly greater external rotation than nondominant, regardless of whether the arm was abducted or adducted at the time of measurement. However, nondominant shoulders demonstrated significantly greater internal rotation and extension than dominant. No significant differences were found between dominant and nondominant sides for forward elevation or abduction.

Adolescent↗
PubMed2005

A population study on differences in the determinants of a specific shoulder disorder versus nonspecific shoulder pain without clinical findings.

Musculoskeletal pain frequently occurs without particular clinical findings. Pain per se may be determined by factors other than those indicating a clinical disorder. The authors examined the prevalence and determinants of clinically diagnosed chronic rotator cuff tendinitis and self-reported nonspecific shoulder pain. The Health 2000 survey, carried out in 2000-2001 in Finland, included a nationally representative sample of 8,028 persons aged 30 years or more. In the present study, analyses were restricted to subjects aged 30-64 years who had held a job during the preceding 12 months. The prevalences of chronic rotator cuff tendinitis and nonspecific shoulder pain were 2.0% (78 of 3,909 subjects) and 12% (410 of 3,525 subjects), respectively. Nonspecific pain was related to burnout (adjusted odds ratio (OR) = 1.7, 95% confidence interval (CI): 1.4, 2.2), depression (among women, the adjusted OR was 1.8 (95% CI: 1.1, 2.9) for mild depression and 3.0 (95% CI: 1.6, 5.6) for severe depression), and inability to express one's feelings (alexithymia) (adjusted OR = 1.6, 95% CI: 1.1, 2.5). However, these factors were not associated with chronic rotator cuff tendinitis, determinants of which were work-related cumulative loading on the shoulder, age, and insulin-dependent diabetes mellitus (adjusted OR = 8.8, 95% CI: 1.9, 40.3). The determinants of specific musculoskeletal disorders differ from those of subjective complaints without clinical findings. Such complaints may be indicators of adverse psychological and psychosocial factors rather than the presence of an underlying pathologic condition.

Adult↗