Title: Effect of the range of the shoulder joint rotation in volleyball players on the development of functional changes. Objectives: The aim of this thesis is to confirm the presence of the glenohumeral internal rotation deficit in beach volleyball players and to determine whether it affects the development of functional changes of the shoulder joint located in the dominant upper limb. Methods: The thesis was a quantitative study with the character of an experiment. There were 60 active volleyball players aged 18-30 years who were deliberately selected for the purposes of the study. The essence was to ascertain whether GIRD affects the pain in the shoulder joint of volleyball players and whether it was deemed positive for all participants of the study. In order to examine the range of motion, the goniometer in the external and internal rotation according to Janda and Pavla, Janda and Sachse was used, as well as hypermobility tests and a shoulder joint pain questionnaire. The statistical data processing was performed by Microsoft Excel 2010. The sum and average functions were used. Subsequently, graphs and tables were created from the results Results: The established hypotheses were confirmed in two cases. GIRD is determined positive for beach volleyball players. From the results of hypermobility...

Author: Bc. Jan Vocásek Thesis title: Analysis of the shoulder girdle injury and therapy of overhead athletes in Czech republic Cíl: The aim of the thesis was to create a literal research for the shoulder girdle injuries of overhead athletes, theoretically to write the anatomical and kinesiological characteristics of the shoulder girdle, to analyze the biomechanics, injury mechanisms in individual overhead sports, rehabilitation treatment and to find out how frequent the injuries of athletes in the Czech Republic follow-up treatment varies from abroad. Methods: For the purpose of this research was established a non-standardized questionnaire, based on literature studied and research questions, and then was distributed to 6 selected physicians dealing with this issue in the Czech Republic, who anonymously filled out questions regarding the shoulder joint injury based on their own clinical experiences. Results: Four of the six hypotheses were confirmed from the data obtained. The number of patients with shoulder girdle injuries in overhead sports in the Czech Republic has risen year- on-year and the most common injury is SLAP lesion. It has also been confirmed that the most common injury is caused by ball overhead sports and on the dominant upper limb. Key words: shoulder girdle, overhead sports,...

Made available in DSpace on 2016-06-02T20:18:20Z (GMT). No. of bitstreams: 1 5258.pdf: 7048287 bytes, checksum: a29ea2c867092740240721084371d1d4 (MD5) Previous issue date: 2013-05-10 / Universidade Federal de Minas Gerais / Athlete´s shoulder most frequent lesions are anterior shoulder instability and superior labrum anterior and posterior lesion ( SLAP), altering structures and functions of the shoulder joint, leading to impairments in sports activity. The aim of this thesis was to evaluate functional and supraspinatus morphological adaptations of shoulder in athletes with anterior instability and SLAP lesion. Three studies were developed. The first study investigated functional differences regarding clinical complaints and the scoring systems of American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) and the Athletic Shoulder Outcome Rating Scale (ASORS) in 249 athletes (153 with instability and 96 with SLAP lesion). The groups presented functional differences related mainly to sports activitiy and, even with more complaints of shoulder pain, SLAP lesion athlete´s tolerate more training hours compared to instability athletes. The second study evaluated isokinetic strenght and muscular control of shoulder rotators in four groups: instability group (n=10), instability control group (n=10), SLAP group (n=10) and SLAP control group (n=10). The torque steadiness and rotator cuff strength in 90 and 180°/s were evaluated. Athlete´s with anterior stability presented shoulder rotation weakness, while athletes with SLAP lesion showed higher torque fluctuation of shoulder internal rotation. The third study characterized the different fiber types of supraspinatus and shoulder function in those lesions. This study performed muscles biopsies in 10 athletes undergoing to arthroscopy repair of shoulder anterior instability and SLAP lesion. The volunteers were functionally evaluated with ASES and ASORS, and muscle samples were processed with histochemical reaction for myosin adenosine triphosphatase (mATPase). Muscles fibers were then characterized in type I, IIa, IIb and hybrid, and percentual and lesser diameter of each fiber type were calculated. In this study, volunteers presented evident functional limitations in sports activity and hypertrophy of all typees of muscles fibers. Most of the sample also presented a great number of type IIa and IIb in the supraspinatus muscle. In conjuction, those studies proves different functional and supraspinatus morphologic adaptations in athletes with anterior shoulder instability and SLAP lesion, justifying the need of different rehabilitations approaches. / As lesões mais frequentes presentes no ombro do atleta são a instabilidade anterior do ombro e a lesão do lábio glenoidal superior, anterior e posterior (Superior Labrum Anterior and Posterior- SLAP), que levam a alterações nas estruturas e funções do ombro, prejudicando a atividade esportiva. O objetivo desta tese foi avaliar as adaptações funcionais do ombro e morfológicas do músculo supraespinal em atletas com instabilidade anterior ou lesão SLAP. Para isso foram desenvolvidos três estudos. O primeiro estudo investigou as diferenças funcionais entre essas lesões por meio das queixas clínicas e os questionários do American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) e a Escala de Resultados do Ombro do Esportista (EROE), em 249 atletas (153 com instabilidade e 96 com lesão SLAP). Os grupos apresentaram diferenças funcionais relacionadas especialmente às atividades esportivas, de forma que mesmo apresentando mais queixas de dor, os atletas com lesão SLAP toleraram mais horas de treinamento comparado aos atletas com instabilidade. O segundo estudo avaliou o torque isocinético e o controle muscular dos rotadores do ombro de quatro grupos: grupo instabilidade (n=10), grupo controle da instabilidade (n=10), grupo SLAP (n=10) e grupo controle do SLAP (n=10). Foram avaliados o controle da flutuação do torque isométrico submáximo e o torque de rotadores em 90 e 180°/s. Os atletas com instabilidade anterior apresentaram fraqueza na rotação do ombro, enquanto atletas com lesão SLAP demonstraram alterações no controle da força de rotação medial. O terceiro estudo permitiu caracterizar os diferentes tipos de fibras musculares do músculo supraespinal, assim como as atividades funcionais do ombro em atleta com essas lesões. Para tanto, foram realizadas biópsias do músculo supraespinal em 10 atletas submetidos ao reparo artroscópico da instabilidade anterior ou lesão SLAP. Os voluntários foram avaliados funcionalmente por meio da escalas ASES e EROE e fragmentos do músculo foram processados pela reação histoenzimológicas para Adenosina Trifosfatase Miofibrilar (mATPase). As fibras musculares foram então classificadas em tipo I, IIa, IIb e híbridas, e a porcentagem e o diâmetro menor de cada tipo de fibra foram calculadas. Os resultados mostraram que os voluntários apresentaram limitações funcionais mais evidentes nas atividades esportivas e uma hipertrofia de todos os tipos de fibras musculares. Além disso, na maioria da amostra, houve um maior número de fibras do tipo IIa e IIb no músculo supraespinal. Em conjunto, esses estudos comprovam a existência de diferentes adaptações funcionais e morfológicas do músculo supraespinal em atletas com instabilidade anterior e lesão SLAP, o que justifica a necessidade de diferentes enfoques na reabilitação dessas lesões.

The thesis describes the anatomical study, which has been taken place at Orthopedic Clinic of the 1st Faculty of Medicine, Motol University Hospital and at Institute of Anatomy 1st Faculty of Medicine, Charles University in Prague from 2002 till 2009. The study was focused on the area of the upper part of the humerus in order to measure spatial relationships among anatomical structures, especially attachments of rotator cuff muscles to optimize implantation arthroplasty of shoulder joint. Clinico-anatomical study, which results were published in 2010, was also based at measuring angular relations of structures proximal humerus. The proximal humerus was marked by 29 points on the cortical bone, which defined the position of the medial margin of the greater tubercle, the lateral margin of the lesser tubercle, bicipital groove, the crest of greater tubercle and to define position of the proximal humeral metaphyseal axis and anatomical neck. Measurements were carried out in the transversal planes and the measurement method was developed on the reconstruction and the spatial definition of basic axes (axis of humeral head and axis of proximal humeral shaft) with the optimized number of reference points of anatomical neck and cortical bone of proximal humeral shaft. Angles between the axis of the head...

Pacientes lesados medulares frequentemente mencionam dores nos ombros, devido à elevada demanda dos membros superiores. Estes pacientes se submetem a diferentes tipos de reabilitação, no entanto é importante avaliar os métodos utilizados em tais programas para evitar possíveis prejuízos. O objetivo deste trabalho é avaliar o esforço e a atividade muscular dos ombros em pacientes paraplégicos caminhando com Estimulação Elétrica Neuro Muscular (EENM) e um andador em seções de reabilitação e comparar com duas atividades diárias executadas por estes indivíduos: propulsão da cadeira de rodas e elevação para alívio da pressão. Quinze homens adultos com paraplegia foram avaliados. Os movimentos em 3 dimensões foram obtidos com um sistema de 6 câmeras de infravermelho, e a atividade mioelétrica de 6 músculos dos ombros foi obtida bilateralmente por eletrodos de superfície ativos. Um andador instrumentalizado capturou a força durante a marcha, e a força nas outras duas atividades foi obtida por dinâmica inversa utilizando os dados cinemáticos e antropométricos. Os dados cinéticos e da atividade muscular foram avaliados estatisticamente utilizando análise de variância (ANOVA) e o teste das diferenças menos significativas de Tukey com nível de significância p<0,05. Foram obtidos picos de força quatro vezes maiores durante a marcha comparando-se à propulsão da cadeira de rodas. O esforço do ombro durante a marcha e a elevação foi equivalente, porém o lado direito durante a marcha apresentou maiores valores. O músculo mais ativo durante a marcha foi o tríceps, seguido pelo peitoral maior, deltóide anterior e trapézio inferior. A ação geral dos músculos durante a marcha também foi maior comparada aos outros exercícios executados. A marcha com EENM e andador, realizada por lesados medulares durante as seções de reabilitação, requer esforços significativos dos membros superiores, podendo gerar complicações nas articulações do ombro. Lesados medulares submetidos a seções de reabilitação que executam esforços significativos devem ser frequentemente monitorados, por métodos de ultra-som ou ressonância magnética, para evitar o comprometimento dos membros superiores e a consequente perda das funções de independência remanescentes / Spinal Cord Injured subjects often refer pain in their shoulders, due to the increased demand of the upper limbs. These subjects usually go through different rehabilitation strategies. Therefore, it becomes rather important to assess those methods in order to avoid further injuries to the patients. The goal of this work was to evaluate the shoulder effort and muscular activity in paraplegic subjects during gait with Neuromuscular Electrical Stimulation (NMES) with the aid of a walker and to compare it with two daily activities: wheelchair start up and weight relief raise. Fifteen adult male paraplegics were part of this study. The three-dimensional motions were acquired with six infrared cameras, and surface-active electrodes recorded the electromyography activity of 6 shoulder muscles, bilaterally. The vertical reaction force during walking was measured with a strain gauge instrumented walker, and the horizontal (wheelchair start-up) and vertical (weight relief raise) forces were obtained by inverse dynamics from kinematics and anthropometric data. The statistics of kinetic and electromyography data were done by analysis of variance (ANOVA) and the Tukey least significant differences post hoc test with significance level of p<0,05. Results have shown NMES gait force peaks being about four times higher than the values obtained for wheelchair start-up. The shoulder effort (force and torque) during walking and weight relief was similar, although the right side during NMES gait presented greater values. The triceps was the most active muscle during NMES walking, followed by pectoralis major, anterior deltoid and lower trapezius. The overall muscular activity during NMES walking was again higher than the other tasks executed. The NMES walking, when performed by spinal cord injured subjects can lead to injuries to the shoulder girdle. Due to the results obtained, continuous supervision of paraplegic upper limb effort should therefore be part of any rehabilitation center and for that ultrasound or magnetic resonance imaging may be recommended

Made available in DSpace on 2014-07-29T15:29:19Z (GMT). No. of bitstreams: 1 RENATA.pdf: 841954 bytes, checksum: 22a19d48bb00070603bf3c14a16b8ab8 (MD5) Previous issue date: 2009-11-25 / OBJECTIVES: To compare the prevalence of shoulder-arm morbidity, quality of life (QOL) and satisfaction with surgical treatment in women submitted to quadrantectomy with those submitted to modified radical mastectomy (MRM) with immediate breast reconstruction (IBR). METHODS: A cross-sectional study was performed on women with breast cancer who had been submitted to quadrantectomy or to MRM+IBR with a transverse rectus abdominis myocutaneous (TRAM) flap, who had completed treatment at least six months previously. A total of 44 women submitted to quadrantectomy and 26 submitted to MRM+IBR were included in the study. RESULTS: Prevalence of lymphedema was 12% in the MRM+IBR group and 18% in the quadrantectomy group (OR: 0.51; 95%CI: 0.02-10.1; p=0.66). There was a greater prevalence of restricted inner shoulder rotation in the women submitted to quadrantectomy (OR: 7.23; 95%CI: 1.28-17.1; p=0.03). There was no difference in QOL scores or satisfaction with surgery. When the participants were questioned whether they would have opted for a different surgical technique, 25% of women in the MRM+IBR group and 12% in the quadrantectomy group reported that they would have made a different choice (adjusted analysis, OR: 7.4; 95%CI: 0.7- 73.3; p=0.09). CONCLUSIONS: The present findings suggest that the type of surgery does not affect the occurrence of lymphedema. Quadrantectomy increased the likelihood of restricted shoulder movement. In addition, the two surgical techniques evaluated were found to exert a similar effect on QOL and on the woman s satisfaction with surgery. / OBJETIVOS: Comparar a prevalência da morbidade no complexo ombro-braço, satisfação com o tratamento cirúrgico e a qualidade de vida (QV) de mulheres submetidas à quadrantectomia às daquelas submetidas à mastectomia radical modificada (MRM) com reconstrução imediata (RI) da mama. MÉTODOS: Conduziu-se um estudo de corte transversal incluindo mulheres com câncer de mama, que haviam se submetido à quadrantectomia ou à MRM+RI com retalho miocutâneo transverso do músculo reto abdominal, que apresentavam pelo menos seis meses de término do tratamento. Foram incluídas 44 mulheres submetidas à quadrantectomia e 26 à MRM+RI. RESULTADOS: A prevalência de linfedema foi de 12% no grupo de MRM+RI e 18% na quadrantectomia (OR: 0,51; IC 95%: 0,02-10,1; p=0,66). As mulheres submetidas à quadrantectomia apresentaram maior prevalência de restrição do movimento de rotação interna do ombro (OR: 7,23; IC 95%; 1,28-17,1; p=0,03). Não houve diferença nos escores de QV e da satisfação com a cirurgia. Quando as participantes foram questionadas se optariam por outra técnica cirúrgica, 25% no grupo de MRM+RI e 12% no grupo de quadrantectomia referiram que fariam uma escolha diferente (análise ajustada, OR: 7,4; IC 95%: 0,7-73,3; p=0,09). CONCLUSÕES: Nossos dados sugerem que o tipo de cirurgia não influenciou a ocorrência de linfedema. A quadrantectomia aumentou a chance de restrição do movimento do ombro. Observou-se ainda que a técnica cirúrgica apresentou impacto semelhante na QV e na satisfação da mulher com a cirurgia.

The focus of this report is to discuss graphical password systems and how they can contribute to handle security problems that threaten authentication processes. One such threat is shoulder-surfing attacks, which are also reviewed in this report. Three already existing systems that are claimed to be shoulder-surfing resilient are described and a new proposed system is presented and evaluated through a user study. Moreover, the system is compared to the mentioned existing systems to further evaluate the usability, memorability and the time it takes to authenticate. The user study shows that test subjects are able to remember their chosen password one week after having registered and signed in once. It is also shown that the average time to sign in to the system after five minutes of practice is within a range of 3.30 to 5.70 seconds. The participants in the experiments gave the system an average score above 68 on the System Usability Scale, which is the score of an average system.

The most frequent sequelae following an obstetric brachial plexus lesion without complete functional recovery concern the impaired shoulder rotation movements and the associated structural changes of the growing glenohumeral joint. <p>This pathology is often unrecognized and may lead to a limitation in active movements, a pathologic and less efficient motion pattern in the affected limb, and the development of a severely incongruent and dysplastic glenohumeral joint prone to further arthrosis.<p><p>Hypothesis<p><p>Glenohumeral dysplasia after obstetric brachial plexus lesion has multiple etiologies: A hypothetic obstetric trauma may precede the motor imbalance, due to the initial palsy and prevalent recovery of the medial rotators of the shoulder.<p>The correction of the muscular imbalance, by neurotization of the lateral rotators (supra- and infraspinatus muscle) using a local nerve transfer or by a later muscle transfer surgery, improves function, seems to prevent the development of joint dysplasia and limits the articular deformities once they are present. <p>The early (peripartal) glenohumeral subluxation must be recognized and treated immediately to prevent the development of a severe joint contracture and dysplasia.<p> <p>Material and methods<p><p>Two retrospective and one prospective study evaluate how surgery may correct the muscular imbalance.<p>In a first series of 65 children, we analyse the recovery of the supra- and infraspinatus muscle after a nerve transfer onto the suprascapular nerve.<p>In a second retrospective analysis on 114 children, we study the outcome after secondary surgery (anterior joint release, modified Hoffer muscle transfer) dedicated to improve active and passive lateral rotation of the shoulder.<p>A prospective study of 50 magnetic resonance (MRI) scans of the glenohumeral joint describes the articular deformities.<p>Finally, 10 children presenting a very early glenohumeral subluxation have undergone a closed orthopaedic reposition and plaster immobilisation and were followed for a minimum of 2 years.<p><p>Results<p><p>In the first group, neurotization of the suprascapular nerve has been performed either by a dorsal or a ventral approach at a mean age of 14 months. The mean follow up is of 3 years and the improvement in aLR(ABD) is 68°and only 25°in aLR(ADD). None of these children with improved active lateral rotation of the shoulder developed clinical signs of a glenohumeral dysplasia within the follow up period.<p><p>Among the 114 children operated between 6 months and 44 years with a shoulder release, 74 had an isolated release procedure, 40 an associated tendon transfer or a suprascapular neurotization. The mean improvement in passive lateral rotation with the arm adducted (pLR (ADD)) was 60°. Active lateral rotation was possible in 63 % of children who underwent an isolated joint release.<p>The Hoffer muscle transfer was performed in 29 children and improved the aLR (ABD) by 60° (mean postoperative follow-up of 30 months). No signs of severe glenohumeral dysplasia developed in these children later on.<p><p>The prospective study of 50 consecutive MRI scans in children presenting at the consultation with a rotatory imbalance of their shoulder, as a sequel from obstetric brachial plexus palsy (Bahm et al. 2007) shows 37 congruent joints, 10 dorsal subluxations, 2 dorsal luxations and one complete dislocation associated with the formation of an independent neoglenoid. The humeral head was deformed in 12 cases; the glenoid in 34 children (flat in 23, biconcave 7 times, convex 3 times).<p><p>The follow up of 2 years in 10 children who underwent an immediate closed reposition shows evidence of joint congruence with a limited (30°) pLR (ADD), definitely lower than after a surgical release.<p><p>Conclusion<p><p>Some osteo-articular deformities secondary to neuromuscular diseases are well described ;those following an obstetric brachial plexus lesion are insufficiently recognized. Their etiology is unclear.<p>At the level of the shoulder joint, these sequels might be very important.<p>Our neuroorthopaedic hypothesis concerning a multifactorial etiology and treatment strategy raises the need of an early and precise screening of the deforming forces to render normal biomechanics and function.<p>The surgical strategy includes the reconstruction of the responsible motor nerve and the improvement of the passive and active range of motion of the shoulder in lateral rotation<p>It seems to be efficient to limit the progression to severe glenohumeral dysplasia and further arthrosis.<p> / Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished

During discussions in collocated work it is necessary to vote for results or to rate them to reach an agreement and continue working. To ensure impartiality and to avoid social embarrassment, the assessment should then be performed anonymously in so far as other groups members should not see directly how a person votes or rates. With a growing number of digital devices in collaboration, this requirement also concerns such kinds of equipment. Our approach of ensuring anonymity of individual votes and ratings submitted on personal mobile phones is to avoid shoulder surfing activities. For this purpose, we designed four device-based interactions that aim at being easy to use and eyes-free to perform to stay in touch with the environment and potential shoulder surfers. We conducted a user study to investigate these interaction techniques and observed seven groups with four participants each while testing the interactions. Participants evaluated usability and User Experience (UX) aspects as well as unobtrusiveness of the four device-based interactions. Furthermore, participants gave valuable user feedback and stated that our proposed interactions help to avoid shoulder surfing.

Pertinence. Compléter des tests d’endurance cardiorespiratoire maximaux basés sur la performance chez les utilisateurs de fauteuils roulants manuels est très pertinent pour développer des programmes d'entraînement cardiorespiratoire personnalisés et pour évaluer leurs impacts au fil du temps. Cependant, ces tests augmentent potentiellement l’exposition au risque de développement de troubles musculosquelettiques secondaires aux membres supérieurs, particulièrement aux épaules. Par conséquent, il est fondamental de trouver un équilibre entre la nécessité de mesurer la capacité aérobie et le risque accru de développer des troubles musculosquelettiques secondaires lors de la réalisation d'un test basé sur les performances. Objectif. Caractériser les effets de la performance d’un test de propulsion progressif par paliers sur tapis roulant sur l'intégrité des tendons de la longue portion du biceps et du supra-épineux en utilisant des biomarqueurs obtenus via l'imagerie musculosquelettique par ultrasonographie. Méthode. Quinze utilisateurs de fauteuils roulants manuels vivant avec une lésion chronique de la moelle épinière ont complété le test de propulsion progressif par paliers sur tapis roulant. Des images des tendons de la longue portion du biceps et du supra- épineux ont été enregistrées avec un appareil d’imagerie musculosquelettique par ultrasonographie dans les plans transversal et longitudinal avant, immédiatement après et 48 heures après la fin du test en suivant un protocole standardisé. Des biomarqueurs ultrasonographiques liés à la géométrie, à la luminosité et à la texture d’une région d’intérêt ont permis de caractériser l'intégrité des tendons. Résultats. Les participants ont propulsé en moyenne pendant 10,2 ± 2,9 minutes alors que la majorité d’entre eux (N = 13/15) a atteint au moins le huitième stade du test (vitesse = 0,8 m / s; pente = 3,6 ̊). Aucun des biomarqueurs géométriques, de luminosité et de texture caractérisant l'intégrité des deux tendons, mesurés dans les plans longitudinal et transverse, n’a changé de façon significative (p = 0,063 à 1 000) entre les trois temps de mesure. Conclusion. La performance du test de propulsion progressif par paliers sur tapis roulant motorisé pour évaluer la capacité aérobie n'amène aucun changement délétère observable immédiatement après et 48 heures après la réalisation du test. / Relevance. The completion of performance-based maximal cardiorespiratory fitness tests among manual wheelchair user is highly relevant to develop personalized cardiorespiratory fitness training programs and to assess their impacts over time. However, these tests could potentially increase risk exposure for the development of upper limb secondary musculoskeletal impairments specifically to the shoulder. Hence, finding an equilibrium between the need to measure aerobic fitness and the increased risk of developing secondary musculoskeletal impairments when completing performance-based test is fundamental. Objective. To characterize the effect of the completion of a recently- developed treadmill-based progressive workload incremental test on the integrity of the long head of the biceps and supraspinatus tendons using musculoskeletal ultrasound imaging biomarkers. Method. Fifteen manual wheelchair users living with a spinal cord injury completed the treadmill-based progressive workload incremental test. Ultrasound images of the long head of the biceps and supraspinatus tendons were recorded with a musculoskeletal ultrasound imaging device in the transversal and longitudinal planes before, immediately after, and 48 hours after the completion of the test using a standardized protocol. Geometric, luminosity, and texture-related ultrasound biomarkers of a region of interest have characterized tendon integrity. Results. The participants propelled an average of 10.2 ± 2.9 minutes with the majority (N = 13/15) reached at least the eighth stage of the test (speed = 0.8 m/s; slope = 3.6 ̊). None of the geometric, luminosity and texture biomarkers characterizing the integrity of the two tendons, measured in the longitudinal and transversal planes, changed significantly (p=0.063 to 1.000) between the three measurement times. Conclusion. The performance of the treadmill-based progressive workload propulsion test to assess aerobic capacity does not result in any observable deleterious change immediately after and 48 hrs after the performance of the test.