Muscle fatigue is considered to be one cause of shoulder pain, and subjects with generalized joint hypermobility (GJH) are affected more by shoulder pain. The purpose of this study was to examine the effects of muscle fatigue on acromiohumeral distance (AHD) and scapular dyskinesis in women with GJH. Thirty-six asymptomatic participants were assigned to either a GJH (n = 20) or control group (n = 16) using the Beighton scale. Before and after elevation fatigue trials, AHD was measured with ultrasonography at rest and when the arm was in 90° active elevation. A scapular dyskinesis test was used to visually observe alterations in scapular movement. Our results showed that in both groups, the fatigue reduced AHD in the 90° elevation position and increased the presence of scapular dyskinesis; however, no differences were found between the two groups. Although GJH has been identified as a factor for developing musculoskeletal disorders, generalized joint hypermobility did not result in changes to scapular dyskinesis or AHD, even after an elevation fatigue task. More studies are needed to evaluate the effects of muscle fatigue in subjects with GJH and a history of shoulder instability.
Razie J. Alibazi, Afsun Nodehi Moghadam, Ann M. Cools, Enayatollah Bakhshi, and Alireza Aziz Ahari
Alya H. Bdaiwi, Tanya Anne Mackenzie, Lee Herrington, Ian Horlsey, and Ann Cools
Compromise to the acromiohumeral distance (AHD) has been reported in subjects with subacromial impingement syndrome when compared with healthy subjects. In clinical practice, patients are taped with the intention of altering scapular position and influencing the AHD. However, research to determine the effects of taping on AHD is exiguous.
To evaluate the effect of ridged taping techniques to increase posterior scapular tilt and upward scapular rotation on the AHD.
1-group pretest/posttest repeated-measures design.
Human performance laboratory.
20 asymptomatic participants (10 male and 10 female) age 27 y (SD 8.0 y).
Ridged tapping of the scapula into posterior tilt and upward scapular rotation.
Main Outcome Measure:
Ultrasound measurement of the AHD.
AHD increased significantly after rigid tape application to the scapula (P < .003) in healthy shoulders in 60° of passive arm abduction.
Taping techniques applied to the scapula had an immediate effect of increasing the AHD in healthy shoulders in 60° of passive arm abduction. Results suggest that taping for increasing posterior scapular tilt and increasing scapular upward rotation can influence the AHD and is a useful adjunct to rehabilitation in patients with subacromial impingement syndrome.
Amanda L. Ager, Dorien Borms, Magali Bernaert, Vicky Brusselle, Mazarine Claessens, Jean-Sébastien Roy, and Ann Cools
Context: Proprioception deficits contribute to persistent and recurring physical disability, particularly with shoulder disorders. Proprioceptive training is thus prescribed in clinical practice. It is unclear whether nonsurgical rehabilitation can optimize shoulder proprioception. Objectives: To summarize the available evidence of conservative rehabilitation (ie, nonsurgical) on proprioception among individuals with shoulder disorders. Evidence Acquisition: PubMed, Web of Science, and EBSCO were systematically searched, from inception until November 24, 2019. Selected articles were systematically assessed, and the methodological quality was established using the Dutch Cochrane Risk of Bias Tool and the Newcastle-Ottawa Quality Assessment Scale. The Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were utilized for this review. The conservative treatments were categorized as follows: (1) conventional therapy, (2) proprioceptive training, (3) elastic kinesiology tape, and (4) other passive therapies. Evidence Synthesis: Twelve articles were included, yielding 58 healthy control shoulders and 362 shoulders affected by impingement syndrome, glenohumeral dislocations, nonspecific shoulder pain, rotator cuff dysfunction, or subluxation poststroke. The level of agreement between the evaluators was excellent (84.9%), and the studies were evaluated to be of fair to excellent quality (risk of bias: 28.5%–100%). This review suggests, with moderate evidence, that proprioceptive training (upper-body wobble board or flexible foil training) can improve proprioception in the midterm. No decisive evidence exists to suggest that conventional therapy is of added value to enhance shoulder proprioception. Conflicting evidence was found for the improvement of proprioception with the application of elastic kinesiology tape, while moderate evidence suggests that passive modalities, such as microcurrent electrical stimulation and bracing, are not effective for proprioceptive rehabilitation of the shoulder. Conclusions: Proprioceptive training demonstrates the strongest evidence for the effective rehabilitation of individuals with a shoulder proprioceptive deficit. Elastic kinesiology tape does not appear to affect the sense of shoulder proprioception. This review suggests a possible specificity of training effect with shoulder proprioception.