by Charles Yuk-Po Lo. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1990. / Bibliography: leaves 179-188. / Abstract --- p.1 / Chapter I. --- INTRODUCTION --- p.4 / Chapter 1.1 --- The shoulder complex --- p.4 / Chapter 1.2 --- Reactions of overuse --- p.6 / Chapter 1.3 --- Controversies --- p.9 / Chapter 1.4 --- The Cybex II isokinetic dynamometer --- p.11 / Chapter 1.5 --- Objectives --- p.12 / Chapter 1.6 --- Methodology --- p.16 / Chapter 1.7 --- Scope --- p.18 / Chapter 1.8 --- Definition of terms --- p.22 / Chapter II. --- LITERATURE REVIEW --- p.24 / Chapter 2.1 --- Functional anatomy of the shoulder complex --- p.24 / Chapter 2.2 --- Shoulder impingement syndrome --- p.34 / Chapter 2.3 --- Forces upon the supraspinatus tendon --- p.39 / Chapter III. --- METHODOLOGY --- p.43 / Chapter 3.1 --- Epidemiological survey --- p.43 / Chapter 3.2 --- Standardization of assessment --- p.47 / Chapter 3.3 --- Isokinetic evaluation --- p.60 / Chapter 3.4 --- Biomechanical study of stress upon supraspinatus tendon --- p.77 / Chapter 3.5 --- Data analysis --- p.88 / Chapter IV. --- RESULTS --- p.90 / Chapter 4.1 --- Epidemiological survey --- p.92 / Chapter 4.2 --- Standardization of assessment --- p.105 / Chapter 4.3 --- Isokinetic evaluation --- p.106 / Chapter 4.4 --- Biomechanical study --- p.111 / Chapter 4.5 --- Correlation between angle of maximal stress with isokinetic finding --- p.117 / Chapter V. --- DISCUSSION --- p.124 / Chapter 5.1 --- Epidemiological survey --- p.124 / Chapter 5.2 --- Standardization of assessment --- p.129 / Chapter 5.3 --- Isokinetic evaluation --- p.130 / Chapter 5.4 --- Biomechanical study --- p.133 / Chapter VI. --- CONCUSION --- p.139 / Chapter VII. --- APPENDICES --- p.142 / Chapter 3.1 --- Questionnaire --- p.142 / Chapter 3.2 --- Stage score --- p.145 / Chapter 3.3 --- Pain score --- p.146 / Chapter 3.4 --- Activity score --- p.147 / Chapter 3.5 --- Assessment form --- p.148 / Chapter 3.6 --- Defining dominant side --- p.152 / Chapter 3.7 --- Pattern of load during calibration --- p.153 / Chapter 3.8 --- Calibration of load cell --- p.154 / Chapter 4.1 --- Format for input of isokinetic data --- p.156 / Chapter 4.2 --- Log command for analysing isokinetic data --- p.157 / Chapter 4.3 --- Isokinetic performance of impingement subjects --- p.160 / Chapter 4.4 --- Isokinetic performance of control subjects --- p.161 / Chapter 4.5 --- Log command for the comparison between impingement and control groups --- p.162 / Chapter 4.6 --- Comparison of isokinetic performance between impingement & control subjects --- p.164 / Chapter 4.7 --- Format for input of body weight ratio data --- p.165 / Chapter 4.8 --- Log command for analysing body weight ratio data --- p.166 / Chapter 4.9 --- Format for input of biomechanical study data --- p.167 / Chapter 4.10 --- Raw data of biomechanical study --- p.168 / Chapter 4.11 --- Analysis of maximal stress at 100° shoulder flexion/abduction --- p.169 / Chapter 4.12 --- Analysis of stress in biomechanical study --- p.170 / Chapter 4.13 --- Significance of trough during 100° shoulder movement --- p.178 / Chapter VIII. --- REFERENCES --- p.179

This research report is presented to the University of the Witwatersrand in partial fulfilment of the requirements for the degree of Master of Science in Physiotherapy Johannesburg, 2017 / BACKGROUND: The game of cricket requires the repetitive use of the upper limbs in batting, bowling and fielding. Shoulder injuries are prevalent in cricket players with the most common activities causing injury being fielding and bowling. There is no research on pectoralis minor muscle length in cricketers or the role that the throwing arc range of movement (ROM) plays in shoulder injuries, in a male only cricket population older than 18 years of age. OBJECTIVE: The objective of this study was to determine if there is an association between shoulder rotation ROM, throwing arc ROM, pectoralis minor muscle length, and incidence of shoulder injury, as monitored in the first three months of a cricket season METHOD: This was a prospective, observational cohort study. Thirty six male, provincial and club cricket players, with and without shoulder pain, were recruited. Shoulder internal rotation ROM, external rotation ROM and pectoralis minor muscle length test distance were measured at the beginning of a cricket season and during the first three weeks of the in-season. Glenohumeral internal rotation deficit (GIRD), external rotation gain (ERG) and throwing arc ROM were calculated from these measurements. The incidence of injury was monitored for three months. Comparisons were made between the injured and uninjured groups. Parametric data were analysed using independent t-tests and paired t-tests. Non-parametric data were analysed with the Mann-Whitney U tests, chi-squared tests and Sign tests. A logistic regression model was used to determine the relationship between variables. RESULTS: Thirty six participants were recruited and underwent the baseline testing procedure, although only thirty two participants’ data were analysed. During the study, four participants were not exposed to the typical cricket training and match workloads and were therefore excluded from the study. The mean age of participants was 23.56 (SD ± 4.27) years. Nine participants (28%) sustained dominant shoulder injuries and twenty-three (72%) remained uninjured. The presence of initial shoulder pain at rest, during or after training (p = 0.007) at the beginning of the season occurred in six participants who sustained shoulder injuries during the season. There were no statistically significant differences between the injured and uninjured group in any of the other variables. All pre-season measurements in the entire group were significantly different between the dominant and non-dominant upper limb. The external rotation ROM (p = 0.0037) was increased on the dominant side and the internal rotation ROM (p < 0.0001), throwing arc ROM (p = 0.016) and pectoralis minor muscle length (p = 0.0001) (decreased pectoralis minor length test distance) was increased on the non-dominant side. In the injured group, there was no significant difference between dominant and non-dominant measurements. The uninjured group had a smaller dominant internal rotation ROM (p = 0.0001), throwing arc ROM (p = 0.005) and pectoralis minor muscle length (p = 0.0002) (larger pectoralis minor length test distance) which was statistically significantly different to the non-dominant shoulder. A logistic regression analysis found no association between the variables and injury. CONCLUSION: Shoulder pain at the beginning of the season may be a precursor to shoulder injuries in cricket players. The presence of pain should be questioned during the pre-season screening, so that preventative programmes may be put into place to prevent shoulder injuries which result in time out of play. Asymmetries were found in the uninjured group with internal rotation ROM, throwing arc ROM and pectoralis minor muscle length although, no asymmetries existed in the injured group. These asymmetries may have a protective role in injury prevention whereas, non-asymmetries (as seen in the injured participants) may precipitate dominant shoulder injuries. / MT2017

Shoulder pain in elite swimmers is common and its cause is unknown. One hypothesis is that repetitive swimming leads to shoulder laxity, which in turn leads to impingement and shoulder pain. An observational cross-sectional study was designed to test this hypothesis. Eighty elite swimmers (13-25 years of age) completed questionnaires on their swimming training, pain and shoulder function. They were given a standardized clinical shoulder examination, and tested for inferior glenohumeral joint laxity using a noninvasive electronic laxometer designed for this study. Fifty-two swimmers also attended for a shoulder MRI. The laxometer had good-excellent reliability for inter-observer (Intra-class correlation coefficient, ICC = 0.74) and intra-observer (ICC = 0.76) assessments of joint laxity. The reliability of MRI-determined supraspinatus tendinosis was excellent with a single experienced musculoskeletal radiologist (intra-observer ICC = 0.85) and fair for an inter-observer assessment including less experienced radiologists (ICC = 0.55). MRIdetermined supraspinatus tendinosis was present in 36/52 (69%) swimmers, including four international-level athletes. A positive impingement sign correlated with supraspinatus tendinosis (r = 0.49, p = 0.0002). The impingement sign had 100% sensitivity and 65% specificity for diagnosing supraspinatus tendinopathy. Shoulder laxity correlated modestly with impingement (r = 0.23, p &lt 0.05). There was no association between shoulder laxity and supraspinatus tendinosis (r = 0.24, p = 0.08). The number of hours swum/week (r = 0.36, p = 0.01) and the weekly mileage (r = 0.34, p = 0.02) both correlated significantly with supraspinatus tendinopathy whereas swimming stroke preference did not. Multiple logistic regression analysis performed with supraspinatus tendinopathy as the dependent variable showed the combination of hours swum/week and weekly mileage correctly predicted tendinopathy in 85% of elite swimmers. These data indicate that: (1) supraspinatus tendinopathy is a major cause of shoulder pain in elite swimmers; and (2) this supraspinatus tendinopathy is induced by the volume/dose of swimming; and (3) shoulder laxity per se has only a minimal association with shoulder impingement in elite swimmers. These finding in humans are consistent with animal and tissue culture findings which support the hypothesis that tendinopathy is related to the dose and duration of load to tendon cells.

A thorough understanding of typical shoulder motion is desirable for both clinicians and shoulder researchers. With this knowledge, comparisons between normal and special populations (e.g. athletic, working, elderly, injured) are enabled and injury mechanisms for heightened or diminished performance may be identified. The purpose of this study was to generate a robust quantification of typical shoulder kinematic profiles during dynamic humeral elevation in six vertical movement planes, and to determine the influence of humeral movement plane, movement phase, gender, and humeral elevation angle on typical scapulothoracic (ST), glenohumeral (GH), acromioclavicular (AC), and sternoclavicular (SC) kinematics. Upper limb kinematic data were collected on 15 males and 14 females as they elevated and lowered their right humerus in six vertical movement planes with elbows fully extended. A total of 60 shoulder kinematic profiles were generated for both raising and lowering motion phases. Trial-to-trial repeatability of the measured rotations, as indicated by intra-class correlation coefficient was found to be moderate (0.658) to high (0.999). Overall, as the humerus was elevated, scapulothoracic (ST) upward rotation, ST posterior tilt, sternoclavicular (SC) elevation, SC retraction, acromioclavicular (AC) elevation and glenohumeral (GH) elevation all increased. However, ST protraction/retraction, GH internal/external rotation, GH anterior/posterior plane of elevation, and AC protraction/retraction responses were less consistent. There was a main effect of humeral movement plane and elevation angle (p < 0.001) identified for all measured joint rotations. A significant phase main effect was not found for right glenohumeral +anterior/-posterior plane of elevation (GAP), glenohumeral +medial/-lateral elevation (GLE), and acromioclavicular protraction/retraction (APR). At least one significant interaction of the main effects, including that of gender, was present for all rotations. The typical shoulder kinematic profiles provided in this investigation is the largest to date of its kind obtained using skin-mounted shoulder tracking techniques. Clinical scientists will find the profiles useful because they provide motion trends that can be compared to profiles from other segments of the population, including patients with specific shoulder injuries. This work supports the more ambitious future clinical goal of being able to identify people who are at risk for developing shoulder pathologies in clinical settings in a non-invasive manner.

Thesis (M. Tech.(Chiropractic))--Technikon Witwatersrand, 2004. / Supervisor: Malany Moodley ; Co-supervisor: Neil De Villiers. Includes abstract. Includes bibliographical references (leaves 107-114). Also available via World Wide Web.

The purpose of this Master's project was to investigate the effects of a l2-week Pilates training program on neck-shoulder posture and motion, core strength and neck-shoulder kinematics and muscles activity associated with a shoulder flexion task performed under six different conditions. After the training, scapula anterior tilt and upper and lower thoracic extension were reduced and there was increased activity of the rectus abdominis, serratus anterior and rhomboid muscles during the shoulder flexion task; passive shoulder range of motion increased in flexion and internal rotation; static thoracic kyphosis was smaller and abdominal strength was greater. Theses results suggest that Pilates is effective in improving core strength, thoracic static and dynamic posture, and shoulder flexibility as well as in stabilizing core posture as limb movements are performed. Our results support the use of the Pilates method in the rehabilitation, and possibly in the prevention, of neck-shoulder disorders.

Reverse shoulder arthroplasty is a relatively new procedure that is used to treat shoulders with massive rotator cuff tears combined with arthritis, a condition that is not well managed using conventional shoulder arthroplasty. By reversing the ‘ball-and-socket’ anatomy of the shoulder, the constraint of the joint can be increased. Despite the success of this prosthesis in improving pain and function, complication rates remain high and instability is often reported as the most commonly occurring complication. The mechanism of dislocation as well as factors that can be modified to decrease the risk of dislocation are not well understood for reverse shoulder arthroplasty. Therefore, the purpose of this study was to create a platform for examining the stability of reverse shoulder arthroplasty and use this to investigate factors affecting stability, including shoulder orientation (abduction and abduction plane angles), loading direction, glenosphere eccentricity and diameter, and humeral socket constraint. An anatomical shoulder simulator was developed using a synthetic bone model and pneumatically actuated cables to represent the three heads of the deltoid. A displacing force was applied to the humeral head by a material testing machine in an anterior, posterior, superior, or inferior direction. The force required to dislocate the joint was used as a measure of stability and the identified factors and the interactions between factors were examined using a half-fraction factorial design experiment. Increases in glenohumeral abduction or inferior-offset of the glenosphere were found to improve the stability of the prosthesis. Additionally, increased humeral socket depth resulted in greater stability for all loading directions, with the exception of inferior loading. Abduction plane angle and glenosphere diameter had no effect on the stability of reverse shoulder arthroplasty. / Thesis (Master, Mechanical and Materials Engineering) -- Queen's University, 2011-12-23 11:42:21.592

No description available.

A thorough understanding of typical shoulder motion is desirable for both clinicians and shoulder researchers. With this knowledge, comparisons between normal and special populations (e.g. athletic, working, elderly, injured) are enabled and injury mechanisms for heightened or diminished performance may be identified. The purpose of this study was to generate a robust quantification of typical shoulder kinematic profiles during dynamic humeral elevation in six vertical movement planes, and to determine the influence of humeral movement plane, movement phase, gender, and humeral elevation angle on typical scapulothoracic (ST), glenohumeral (GH), acromioclavicular (AC), and sternoclavicular (SC) kinematics. Upper limb kinematic data were collected on 15 males and 14 females as they elevated and lowered their right humerus in six vertical movement planes with elbows fully extended. A total of 60 shoulder kinematic profiles were generated for both raising and lowering motion phases. Trial-to-trial repeatability of the measured rotations, as indicated by intra-class correlation coefficient was found to be moderate (0.658) to high (0.999). Overall, as the humerus was elevated, scapulothoracic (ST) upward rotation, ST posterior tilt, sternoclavicular (SC) elevation, SC retraction, acromioclavicular (AC) elevation and glenohumeral (GH) elevation all increased. However, ST protraction/retraction, GH internal/external rotation, GH anterior/posterior plane of elevation, and AC protraction/retraction responses were less consistent. There was a main effect of humeral movement plane and elevation angle (p < 0.001) identified for all measured joint rotations. A significant phase main effect was not found for right glenohumeral +anterior/-posterior plane of elevation (GAP), glenohumeral +medial/-lateral elevation (GLE), and acromioclavicular protraction/retraction (APR). At least one significant interaction of the main effects, including that of gender, was present for all rotations. The typical shoulder kinematic profiles provided in this investigation is the largest to date of its kind obtained using skin-mounted shoulder tracking techniques. Clinical scientists will find the profiles useful because they provide motion trends that can be compared to profiles from other segments of the population, including patients with specific shoulder injuries. This work supports the more ambitious future clinical goal of being able to identify people who are at risk for developing shoulder pathologies in clinical settings in a non-invasive manner.

Thesis (MAppSc in Physiotherapy) -- University of South Australia, 1994