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Motion sickness caused by rotations about Earth-horizontal and Earth-vertical axes.

Rotation at constant angular velocity about the head's Z-axis, with the rotational axis horizontal (barbecue-spit rotation), causes motion sickness and illusory perceptions of bodily movement. To determine whether such rotations about the head's X- and Y-axes cause similar effects, and to test the validity of the mismatch theory of motion sickness, more than 200 tests (using vertical axes as well as horizontal axes) were administered to 14 subjects. Three different visual conditions were also investigated: normal external vision, vision of only the inside walls of the rotating capsule, and eyes closed in the dark. In Earth-horizontal rotation, the X- and Y-axis stimuli were found to be equally as effective in provoking sickness as was the original Z-axis stimulus, and a comparable loss of perception of gravity occurred for all three stimuli. The horizontal axis stimuli were found to be very effective in producing sickness in all the three visual conditions, but the external vision condition was significantly less effective than the other two conditions. The findings were generally inconsistent with the mismatch theory.

Adult↗

Visuospatial memory computations during whole-body rotations in roll.

We used a memory-saccade task to test whether the location of a target, briefly presented before a whole-body rotation in roll, is stored in egocentric or in allocentric coordinates. To make this distinction, we exploited the fact that subjects, when tilted sideways in darkness, make systematic errors when indicating the direction of gravity (an allocentric task) even though they have a veridical percept of their self-orientation in space. We hypothesized that if spatial memory is coded allocentrically, these distortions affect the coding of remembered targets and their readout after a body rotation. Alternatively, if coding is egocentric, updating for body rotation becomes essential and errors in performance should be related to the amount of intervening rotation. Subjects (n = 6) were tested making saccades to remembered world-fixed targets after passive body tilts. Initial and final tilt angle ranged between -120 degrees CCW and 120 degrees CW. The results showed that subjects made large systematic directional errors in their saccades (up to 90 degrees ). These errors did not occur in the absence of intervening body rotation, ruling out a memory degradation effect. Regression analysis showed that the errors were closely related to the amount of subjective allocentric distortion at both the initial and final tilt angle, rather than to the amount of intervening rotation. We conclude that the brain uses an allocentric reference frame, possibly gravity-based, to code visuospatial memories during whole-body tilts. This supports the notion that the brain can define information in multiple frames of reference, depending on sensory inputs and task demands.

Adult↗

Responses of primate caudal parabrachial nucleus and Kölliker-fuse nucleus neurons to whole body rotation.

The caudal aspect of the parabrachial (PBN) and Kölliker-Fuse (KF) nuclei receive vestibular nuclear and visceral afferent information and are connected reciprocally with the spinal cord, hypothalamus, amygdala, and limbic cortex. Hence, they may be important sites of vestibulo-visceral integration, particularly for the development of affective responses to gravitoinertial challenges. Extracellular recordings were made from caudal PBN cells in three alert, adult female Macaca nemestrina through an implanted chamber. Sinusoidal and position trapezoid angular whole body rotation was delivered in yaw, roll, pitch, and vertical semicircular canal planes. Sites were confirmed histologically. Units that responded during rotation were located in lateral and medial PBN and KF caudal to the trochlear nerve at sites that were confirmed anatomically to receive superior vestibular nucleus afferents. Responses to whole-body angular rotation were modeled as a sum of three signals: angular velocity, a leaky integration of angular velocity, and vertical position. All neurons displayed angular velocity and integrated angular velocity sensitivity, but only 60% of the neurons were position-sensitive. These responses to vertical rotation could display symmetric, asymmetric, or fully rectified cosinusoidal spatial tuning about a best orientation in different cells. The spatial properties of velocity and integrated velocity and position responses were independent for all position-sensitive neurons; the angular velocity and integrated angular velocity signals showed independent spatial tuning in the position-insensitive neurons. Individual units showed one of three different orientations of their excitatory axis of velocity rotation sensitivity: vertical-plane-only responses, positive elevation responses (vertical plane plus ipsilateral yaw), and negative elevation axis responses (vertical plane plus negative yaw). The interactions between the velocity and integrated velocity components also produced variations in the temporal pattern of responses as a function of rotation direction. These findings are consistent with the hypothesis that a vestibulorecipient region of the PBN and KF integrates signals from the vestibular nuclei and relay information about changes in whole-body orientation to pathways that produce homeostatic and affective responses.

Afferent Pathways↗

Time course and magnitude of illusory translation perception during off-vertical axis rotation.

Human spatial orientation relies on vision, somatosensory cues, and signals from the semicircular canals and the otoliths. The canals measure rotation, whereas the otoliths are linear accelerometers, sensitive to tilt and translation. To disambiguate the otolith signal, two main hypotheses have been proposed: frequency segregation and canal-otolith interaction. So far these models were based mainly on oculomotor behavior. In this study we investigated their applicability to human self-motion perception. Six subjects were rotated in yaw about an off-vertical axis (OVAR) at various speeds and tilt angles, in darkness. During the rotation, subjects indicated at regular intervals whether a briefly presented dot moved faster or slower than their perceived self-motion. Based on such responses, we determined the time course of the self-motion percept and characterized its steady state by a psychometric function. The psychophysical results were consistent with anecdotal reports. All subjects initially sensed rotation, but then gradually developed a percept of being translated along a cone. The rotation percept could be described by a decaying exponential with a time constant of about 20 s. Translation percept magnitude typically followed a delayed increasing exponential with delays up to 50 s and a time constant of about 15 s. The asymptotic magnitude of perceived translation increased with rotation speed and tilt angle, but never exceeded 14 cm/s. These results were most consistent with predictions of the canal-otolith-interaction model, but required parameter values that differed from the original proposal. We conclude that canal-otolith interaction is an important governing principle for self-motion perception that can be deployed flexibly, dependent on stimulus conditions.

Adaptation, Physiological↗

Ratio of shear to load ground-reaction force may underlie the directional tuning of the automatic postural response to rotation and translation.

This study sought to identify the sensory signals that encode perturbation direction rapidly enough to shape the directional tuning of the automatic postural response. We compared reactions to 16 directions of pitch and roll rotation and 16 directions of linear translation in the horizontal plane in freely standing cats. Rotations and translations that displaced the center of mass in the same direction relative to the feet evoked similar patterns of muscle activity and active ground-reaction force, suggesting the presence of a single, robust postural strategy for stabilizing the center of mass in both rotation and translation. Therefore we postulated there should be a common sensory input that encodes the direction of the perturbation and leads to the directional tuning of the early electromyographic burst in the postural response. We compared the mechanical changes induced by rotations and translations prior to the active, postural response. The only consistent feature common to the full range of rotation and translation directions was the initial change in ground-reaction force angle. Other variables including joint angles, ground-reaction force magnitudes, center of pressure, and center of mass in space showed opposite or nonsignificant changes for rotation and translation. Change in force angle at the paw reflects the ratio of loading force to slip force, analogous to slips during finger grip tasks. We propose that cutaneous sensors in the foot soles detect change in ground-reaction force angle and provide the critical input underlying the directional tuning of the automatic postural response for balance.

Animals↗

Effect of eye rotation on visual-field map onto superior colliculus and visual cortex.

We used multiunit recording to assess the effect of rotating one eye approximately 90 degrees at about the time of normal eye opening. Rotation of the eye did not alter the topography of the retinal maps onto visual cortex or superior colliculus. The intorted eye drove cells at most recording points in the contralateral visual cortex and superior colliculus. In its ipsilateral colliculus the intorted eye drove cells at about 10% of the recording points; that is, the temporal retina of this eye was quite ineffective in driving collicular cells. In its ipsilateral cortex the intorted eye drove cells at about 30% of the recording sites. The unoperated eye drove cells at all locations in both colliculus and cortex on both sides of the brain. The effects of extorsion were studied only in the superior colliculus. Extorsion and intorsion produced similar results except that extorsion produced a less severe deficit in the ability of the temporal retina to drive cells in its ipsilateral colliculus. Cutting all the extraocular muscles without eye rotation was studied only in the colliculus and produced results similar to those produced by intorsion and extorsion. However, the temporal retina of the operated eye was more effective after muscle cut alone than after intorsion or extorsion. Forcing the animal to use the rotated right eye alone on alternate days during the first 3 mo of life did not decrease the deficits. Almost all recording sites in the right colliculus were driven only by the unoperated left eye. If the left eye was sutured when the right eye was rotated, only the right eye drove cells in the left colliculus, but the two eyes were about equally effective in the right colliculus; however, rather few sites in the right colliculus were binocularly driven. We conclude that both extraocular muscle section and eye rotation reduce the effectiveness of the uncrossed input from the operated eye to the superior colliculus and visual cortex. The effects on the superior colliculus are, however, greater.

Animals↗

Kinematic principles of primate rotational vestibulo-ocular reflex. II. Gravity-dependent modulation of primary eye position.

The kinematic constraints of three-dimensional eye positions were investigated in rhesus monkeys during passive head and body rotations relative to gravity. We studied fast and slow phase components of the vestibulo-ocular reflex (VOR) elicited by constant-velocity yaw rotations and sinusoidal oscillations about an earth-horizontal axis. We found that the spatial orientation of both fast and slow phase eye positions could be described locally by a planar surface with torsional variation of <2.0 +/- 0.4 degrees (displacement planes) that systematically rotated and/or shifted relative to Listing's plane. In supine/prone positions, displacement planes pitched forward/backward; in left/right ear-down positions, displacement planes were parallel shifted along the positive/negative torsional axis. Dynamically changing primary eye positions were computed from displacement planes. Torsional and vertical components of primary eye position modulated as a sinusoidal function of head orientation in space. The torsional component was maximal in ear-down positions and approximately zero in supine/prone orientations. The opposite was observed for the vertical component. Modulation of the horizontal component of primary eye position exhibited a more complex dependence. In contrast to the torsional component, which was relatively independent of rotational speed, modulation of the vertical and horizontal components of primary position depended strongly on the speed of head rotation (i.e., on the frequency of oscillation of the gravity vector component): the faster the head rotated relative to gravity, the larger was the modulation. Corresponding results were obtained when a model based on a sinusoidal dependence of instantaneous displacement planes (and primary eye position) on head orientation relative to gravity was fitted to VOR fast phase positions. When VOR fast phase positions were expressed relative to primary eye position estimated from the model fits, they were confined approximately to a single plane with a small torsional standard deviation ( approximately 1.4-2.6 degrees). This reduced torsional variation was in contrast to the large torsional spread (well >10-15 degrees ) of fast phase positions when expressed relative to Listing's plane. We conclude that primary eye position depends dynamically on head orientation relative to space rather than being fixed to the head. It defines a gravity-dependent coordinate system relative to which the torsional variability of eye positions is minimized even when the head is moved passively and vestibulo-ocular reflexes are evoked. In this general sense, Listing's law is preserved with respect to an otolith-controlled reference system that is defined dynamically by gravity.

Animals↗

Responses of neurons in the nucleus of the basal optic root to translational and rotational flowfields.

The nucleus of the basal optic root (nBOR) receives direct input from the contralateral retina and is the first step in a pathway dedicated to the analysis of optic flowfields resulting from self-motion. Previous studies have shown that most nBOR neurons exhibit direction selectivity in response to large-field stimuli moving in the contralateral hemifield, but a subpopulation of nBOR neurons has binocular receptive fields. In this study, the activity of binocular nBOR neurons was recorded in anesthetized pigeons in response to panoramic translational and rotational optic flow. Translational optic flow was produced by the "translator" projector described in the companion paper, and rotational optic flow was produced by a "planetarium projector" described by Wylie and Frost. The axis of rotation or translation could be positioned to any orientation in three-dimensional space. We recorded from 37 cells, most of which exhibited a strong contralateral dominance. Most of these cells were located in the caudal and dorsal aspects of the nBOR complex and many were localized to the subnucleus nBOR dorsalis. Other units were located outside the boundaries of the nBOR complex in the adjacent area ventralis of Tsai or mesencephalic reticular formation. Six cells responded best to rotational flowfields, whereas 31 responded best to translational flowfields. Of the rotation cells, three preferred rotation about the vertical axis and three preferred horizontal axes. Of the translation cells, 3 responded best to a flowfield simulating downward translation of the bird along a vertical axis, whereas the remaining 28 responded best to flowfields resulting from translation along axes in the horizontal plane. Seventeen of these cells preferred a flowfield resulting from the animal translating backward along an axis oriented approximately 45 degrees to the midline, but the best axes of the remaining eleven cells were distributed throughout the horizontal plane with no definitive clustering. These data are compared with the responses of vestibulocerebellar Purkinje cells.

Animals↗

Neural processing of gravito-inertial cues in humans. II. Influence of the semicircular canals during eccentric rotation.

All linear accelerometers, including the otolith organs, respond equivalently to gravity and linear acceleration. To investigate how the nervous system resolves this ambiguity, we measured perceived roll tilt and reflexive eye movements in humans in the dark using two different centrifugation motion paradigms (fixed radius and variable radius) combined with two different subject orientations (facing-motion and back-to-motion). In the fixed radius trials, the radius at which the subject was seated was held constant while the rotation speed was changed to yield changes in the centrifugal force. In variable radius trials, the rotation speed was held constant while the radius was varied to yield a centrifugal force that nearly duplicated that measured during the fixed radius condition. The total gravito-inertial force (GIF) measured by the otolith organs was nearly identical in the two paradigms; the primary difference was the presence (fixed radius) or absence (variable radius) of yaw rotational cues. We found that the yaw rotational cues had a large statistically significant effect on the time course of perceived tilt, demonstrating that yaw rotational cues contribute substantially to the neural processing of roll tilt. We also found that the orientation of the subject relative to the centripetal acceleration had a dramatic influence on the eye movements measured during fixed radius centrifugation. Specifically, the horizontal vestibuloocular reflex (VOR) measured in our human subjects was always greater when the subject faced the direction of motion than when the subjects had their backs toward the motion during fixed radius rotation. This difference was consistent with the presence of a horizontal translational VOR response induced by the centripetal acceleration. Most importantly, by comparing the perceptual tilt responses to the eye movement responses, we found that the translational VOR component decayed as the subjective tilt indication aligned with the tilt of the GIF. This was true for both the fixed radius and variable radius conditions even though the time course of the responses was significantly different for these two conditions. These findings are consistent with the hypothesis that the nervous system resolves the ambiguous measurements of GIF into neural estimates of gravity and linear acceleration. More generally, these findings are consistent with the hypothesis that the nervous system uses internal models to process and interpret sensory motor cues.

Acceleration↗

Ocular responses to head rotations during mirror viewing.

The gain of the human vestibuloocular reflex (VOR) is influenced by the proximity of the object of regard. In six human subjects, we measured the eye rotations induced by passive, sinusoidal, horizontal head rotations at 2.0 Hz during binocular fixation of a stationary far target at 7 m; a stationary target close to the subject's near point of fixation (<15 cm); and the bridge of the subject's own nose, viewed through a mirror positioned so that, for each subject, the angle of vergence was similar to that during viewing of the near target. The median gain of compensatory eye movements for the group of subjects during far viewing was 0.99 (range 0.80-1.04), during near viewing was 1.21 (range 0.88-1.47), and during mirror viewing was 0.85 (range 0.71-1.01). The gain during near and mirror viewing was significantly different for each subject (P < 0.001) even though the vergence angles were similar. The lower gain values during mirror viewing can be attributed to the geometric relationship between the head rotation, the position of the eyes in the head, and the movement of the subject's virtual image in the mirror. To determine whether visually mediated eye movements were responsible for the observed gain values, we conducted a control experiment in which subjects were rotated using a sum-of-sines stimulus that minimized the effects of predictive visual tracking; differences of gain values between near- and mirror-viewing conditions were similar to those during rotation at 2 Hz. We conclude that, in these experiments, target proximity and vergence angle were not the key determinants of gain of the visuo-vestibular response during head rotation while viewing a near target but that contextual cues from motion vision were more important in generating the appropriate response.

Adult↗

Development of rotation of mandibular premolar tooth germs in the dog.

The development of premolar tooth germs in dogs, particularly their rotation and crowding, was examined on radiographs, dissected specimens of tooth germs, serial sections stained by Masson-Goldner's technique and reconstructed models. The materials used were the mandibles of 32 puppies from birth to 6 months, and the species was a highly pedigreed Shiba Inu which has no crowding of the premolars in the mature stage. The results obtained are as follows. (1) Rotations and crowdings of premolars, similar to those in brachygnathus dogs and wolves raised in captivity, were observed during ontogenesis of dolichocephalic dogs, whose adult state exhibits no crowding of teeth. (2) The type of rotation was B (the mesial portion is rotated buccally) for the second and third premolars and L (the mesial portion lingually) for the fourth premolar. (3) The rotations of the premolars did not coincide with those of their deciduous predecessors. (4) These rotations appeared in the bud and cap stages of premolars, before the formation of roots of deciduous molars. The premolars developed crowding at 5 months when they increased in dimension.

Aging↗

Rotation of the myocardial wall of the outflow tract is implicated in the normal positioning of the great arteries.

Congenital heart defects frequently involve a failure of outflow tract (OFT) formation during development. We analyzed the remodeling of the OFT, using the y96-Myf5-nlacZ-16 transgene, which marks a subpopulation of myocardial cells of the pulmonary trunk. Expression analyses of reporter transcript and protein suggest that the myocardial wall of the OFT rotates before and during the formation of the great arteries. Rotational movement was confirmed by Di-I injection experiments with cultured embryos. We subsequently examined the expression of the transgene in mouse models for OFT defects. In hearts with persistent truncus arteriosus (PTA), double outlet right ventricle (DORV), or transposition of the great arteries, rotation of the myocardial wall of the OFT is arrested or fails to initiate. This is observed in Splotch (Pax3) mutants with PTA or DORV and may be a result of defects in neural crest migration, known to affect OFT septation. However, in Pitx2deltac mutant embryos, where cardiac neural crest cells are present in the heart, PTA and DORV are again associated with a rotation defect. This is also seen in Pitx2deltac mutants, which have transposition of the great arteries. Because Pitx2c is involved in left-right signaling, these results suggest that embryonic laterality affects rotation of the myocardial wall during OFT maturation. We propose that failure of normal rotation of OFT myocardium may underlie major forms of congenital heart disease.

Animals↗

Ocular rotation axes during dynamic Bielschowsky head-tilt testing in unilateral trochlear nerve palsy.

PURPOSE: To explain the positive Bielschowsky head-tilt (BHT) sign in unilateral trochlear nerve palsy (uTNP) by the kinematics of three-dimensional eye rotations. METHODS: Twelve patients with uTNP monocularly fixed on targets on a Hess screen were oscillated (+/- 35 degrees, 0.3 Hz) about the roll axis on a motorized turntable (dynamic BHT). Three-dimensional eye movements were recorded with dual search coils. Normal data were collected from 11 healthy subjects. RESULTS: The rotation axis of the viewing paretic or unaffected eye was nearly parallel to the line of sight. The rotation axis of the covered fellow eye, however, was tilted inward relative to the other axis. This convergence of axes increased with gaze toward the unaffected side. Over entire cycles of head roll, the rotation axis of either eye remained relatively stable in both the viewing and covered conditions. CONCLUSIONS: In patients with uTNP, circular gaze trajectories of the covered paretic or unaffected eye during dynamic BHT are a direct consequence of the nasal deviation of the rotation axis from the line of sight. This, in turn, is a geometrical result of decreased force by the superior oblique muscle (SO) of the covered paretic eye or, according to Hering's law, increased force parallel to the paretic SO in the covered unaffected eye. The horizontal incomitance of rotation axes along horizontal eye positions can be explained by the same mechanism.

Adolescent↗

Posturography following rotation: a model of posture control during vestibular dysfunction.

Postural stability is influenced by multiple sensory inputs, including visual, somatosensory, and vestibular cues. Adaptive changes in how these sensory inputs influence posture may occur in the presence of vestibular dysfunction. In this study, we simulated vestibular dysfunction in normal subjects in order to study immediate and adaptive modifications in postural control under reproducible and reversible experimental conditions. Twenty subjects (ages 20 to 35 years) were tested on a force-detecting platform; the support surface or visual surround was modulated (anterior-posterior) proportionally to body sway. Vestibular dysfunction was simulated by rotating subjects with their eyes closed at 180 degrees/second for 30 seconds, then rapidly halting rotation. Posturographic measures were obtained during the subsequent 20 seconds. Ten identical rotation trials for each subject were performed, alternating the direction of rotation, and with either the support surface or the visual surround modulated with sway in different subjects. Thus, only one sensory modality could provide Earth-stable sensory cues. Control groups were tested to assess effects of repeated alternating rotations alone, and effects of repeated posturographic trials alone. Sway was quantified by measuring peak-to-peak excursions of the center of mass. Results showed that subjects were more stable after rotation when they were provided with a stable support surface than with a stable visual surround. No subject could maintain stance without at least one Earth-stable sensory input. Improvement of mean sway scores in either group was not significant, although isolated cases did exhibit adaptive changes with improved stability over repeated trials.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Greater tuberosity notch: an important indicator of articular-side partial rotator cuff tears in the shoulders of throwing athletes.

We examined the location of rotator cuff tears, associated labral injuries, and notches on the greater tuberosity of the humeral head in shoulders of throwing athletes. Arthroscopic findings (rotator cuff tear, labral condition, and greater tuberosity notch) as well as other factors (duration of playing baseball, range of motion, and joint laxity) of 61 baseball players were retrospectively studied. The presence of a greater tuberosity notch was also evaluated for by plain radiographs. Forty patients had articular-side partial rotator cuff tears, most of which occurred in the interval between the supraspinatus and infraspinatus tendons. The existence of a rotator cuff tear was not related to the range of motion, joint laxity, the detachment of the superior glenoid labrum, or posterosuperior labral injury. Greater tuberosity notches were recognized in 38 shoulders by arthroscopy and most were detected on plain radiographs. The presence of a notch was significantly related to the existence of a rotator cuff tear, while the size of the notch was significantly related to the depth and width of the tear. The greater tuberosity notch seems to be one of the most important diagnostic indicators for a rotator cuff tear in throwing athletes.

Adolescent↗

Peak torque and rotational stiffness developed at the shoe-surface interface: the effect of shoe type and playing surface.

BACKGROUND: Shoe-surface interactions have been implicated in the high number of noncontact knee injuries suffered by athletes at all levels. PURPOSE: To examine shoe-surface interactions on newer field designs and compare these with more traditional shoe-surface combinations. The peak torque and rotational stiffness (the rate at which torque is developed under rotation) were determined. STUDY DESIGN: Controlled laboratory study. METHODS: A device was constructed to measure the torque versus applied rotation developed between different shoe-surface combinations. Data were collected on 5 different playing surfaces (natural grass, Astroturf, 2 types of Astroplay, and FieldTurf), using 2 types of shoes (grass and turf), under a compressive load of 333 N. RESULTS: The highest peak torques were developed by the grass shoe-FieldTurf tray and the turf shoe-Astroturf field combinations. The lowest peak torques were developed on the grass field. The turf shoe-Astroturf combination exhibited a rotational stiffness nearly double that of any other shoe-surface combinations. CONCLUSION: The differences in the rotational stiffness across all 10 shoe-surface combinations were greater than those of the peak torques. It is possible that rotational stiffness may provide a new criterion for the evaluation of shoe-surface interface. CLINICAL RELEVANCE: An improved understanding of shoe-surface interactions remains a critical need to improve the design of shoe-surface combinations with the goal of meeting player needs while minimizing injury potential.

Equipment Design↗

Upper extremity range of motion and isokinetic strength of the internal and external shoulder rotators in major league baseball players.

Forty-one professional baseball players volunteered for upper extremity range of motion measurements and isokinetic testing for internal and external shoulder rotation. Pitchers demonstrated 9 degrees more external shoulder rotation with the arm abducted, 5 degrees more forearm pronation, and 9 degrees less shoulder extension on the dominant side compared with the dominant side of position players. Pitchers also demonstrated 9 degrees more external rotation in abduction, 5 degrees less shoulder flexion, 11 degrees less horizontal extension, 15 degrees less internal rotation in abduction, 6 degrees less elbow extension, 4 degrees less elbow flexion, and 5 degrees less forearm supination on the dominant side compared with their nondominant side. Position players demonstrated 8 degrees more external rotation in abduction, 14 degrees less horizontal extension, and 8 degrees less elbow extension on the dominant side compared with their nondominant side. Greater torque was produced by pitchers compared with position players for the dominant and nondominant arm at all test speeds for both mean peak and mean average torque. Greater torque was produced by the dominant arm compared with the nondominant arm also at all test speeds for both of these measurements. No difference was found between the rotation ratios for either arm, for either group, for all speeds.

Adaptation, Physiological↗

Contribution of axial arm rotation to humeral head translation.

The contribution of axial arm rotation to translation of the humeral head with the arm in the hanging position was examined using nine fresh-frozen cadaveric shoulders. Three standard clinical tests were simulated: anterior and posterior translation and sulcus tests. In both the anterior translation and sulcus tests, anterior and inferior displacements were significantly restricted in internal rotation but not in neutral and external rotation. In the posterior translation test, no significant differences in displacement could be observed in internal, neutral, or external rotation. Since anterior and inferior translations of the humeral head were significantly affected by the rotation of the arm, we recommend that the anterior translation and sulcus tests be performed in various rotations.

Adult↗