A muscular co-operation change was observed at exercising intent on improvement of a scapula dynamic stability. In the study there were ten individuals participating in a specific resistance exercise for a period of seven to nine weeks. The cooperation of scapular muscles was evaluated in stand - by (tilt test) and investigation the stereotype of arm abduction, visually and by the help of a surface polyelectromyography. A distinct improvement of a scapula dynamic stability occurred at three observed objects. Powered by TCPDF (www.tcpdf.org)

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-07-23T18:20:19Z No. of bitstreams: 1 Diogo Henrique Magalhães Gonçalves.pdf: 1521507 bytes, checksum: 0d42f8a3b94345ef905deb7a85a90628 (MD5) / Made available in DSpace on 2018-07-23T18:20:19Z (GMT). No. of bitstreams: 1 Diogo Henrique Magalhães Gonçalves.pdf: 1521507 bytes, checksum: 0d42f8a3b94345ef905deb7a85a90628 (MD5) Previous issue date: 2016-12-07 / The reproducibility of scapular kinematics has already been tested intra- and inter-sessions and intra- and inter-days, however, these evaluations were only performed by experienced evaluators and the majority of studies included only one evaluator. Thus, the comparison between evaluators with different levels of experience has not yet been explored, leaving doubts as to the accuracy of the evaluation results when performed by different evaluators. The objective of the present study was to evaluate the reproducibility inter and intra-rater, experienced and inexperienced, during flexion and abduction movements of the arm for the scapula, humerus, and trunk segments. Kinematic data were captured during flexion and abduction movements of the arm using a system of 8 cameras and a sampling frequency of 120 Hz. In total, twenty healthy volunteers were evaluated (10 men and 10 women), with an average age of 25.1 (1.1) years, who underwent 6 sessions of movement analysis. Each evaluator carried out three sessions, two sessions on the first day, with a three-hour interval between them, and the third session on the second day, twenty-four hours after the first day. For each session, 5 repetitions of each movement, unilateral abduction and flexion of the arm, were performed. Statistical analysis was performed by an independent evaluator and the Shapiro-Wilk test was used for data distribution. The reproducibility of the range of motion and angular values at angles of 30º, 60º, 90º, and 120º was verified through the intraclass correlation coefficient (ICC) and standard measurement error (SEM). The values obtained for the angles 30°, 60°, 90°, and 120° intra-day ranged from 0.67-0.98 and (0.58° to 5.64°) for the inexperienced evaluator and from 0.67° to 0.98° and (0.64° to 6.17°) for the experienced evaluator in the flexion movement. During the abduction movement the values obtained at angles of 30°, 60°, 90°, and 120° intra-day ranged from 0.75° to 0.96° and (0.51° to 4.93°) for the inexperienced evaluator and from 0.62° to 0.97° and (0.66° to 6.58°) for the experienced evaluator. The model presented good to excellent intra-day reproducibility for both evaluators in the flexion and abduction movements of the arm. Inter-day values in flexion varied from 0.41° to 0.88° and (0.64° to 6.17°) for the inexperienced evaluator and 0.72° to 0.95° and (0.67° to 4.31°) for the experienced evaluator. In the inter-day abduction movement, values ranged from 0.33° to 0.91° and (0.74° to 6.60°) for the inexperienced evaluator and 0.72° to 0.98° and (0.73° to 5.01°) for the experienced evaluator. The reproducibility of the inexperienced evaluator presented from weak to excellent in the arm flexion movement and poor to excellent in abduction of the arm. The reproducibility for the experienced evaluator was good to excellent for flexion and abduction of the arm between the scapula, humerus, and trunk segments in healthy adults. The results showed that there is no difference between evaluators in the intra-day evaluations; however, on an inter-day basis the experienced evaluator obtained better reproducibility results, demonstrating that a difference in levels of experience between evaluators is of fundamental importance to obtain reproducible results on different days. However, we emphasize the importance of performing further studies, with different movements and patients, performed by two or more evaluators. / A reprodutibilidade da cinemática escapular já foi testada intra e inter-sessões e intra e inter-dias, porém essas avaliações foram realizadas apenas por avaliadores experientes e a maioria dos estudos com apenas um avaliador. A comparação entre avaliadores com diferentes níveis de experiência ainda não foi explorada, deixando dúvidas quanto a precisão dos resultados da avaliação se realizadas por diferentes avaliadores. O objetivo do presente estudo foi avaliar a reprodutibilidade inter e intra-avaliadores, com diferentes níveis de experiência, nos movimentos de flexão e abdução do braço para os segmentos da escápula, úmero e tronco. As capturas dos dados de cinemática foram realizadas utilizando um sistema de 8 câmeras e frequência de amostragem de 120Hz durante os movimentos de flexão e abdução do braço. Foram avaliados 20 voluntários saudáveis (10 homens e 10 mulheres) com idade média de 25.1 (±1.1) anos, que foram submetidos à 6 sessões de análise do movimento. Cada avaliador realizou três sessões, duas sessões realizadas no primeiro dia com intervalo de três horas entre elas e a terceira sessão foi realizada no segundo dia, 48 horas após o primeiro dia. Para cada sessão foram realizadas 5 repetições de cada movimento, abdução e flexão unilateral do braço. A análise estatística foi realizada por um avaliador independente, para distribuição dos dados, foi utilizado o teste de Shapiro-Wilk, A reprodutibilidade da amplitude de movimento e dos valores angulares nos ângulos de 30º, 60º, 90º e 120º do braço foi verificada pelo coeficiente de correlação intraclasse (ICC) assim como o erro de medida padrão (SEM). Os valores obtidos nos ângulos de 30°, 60°, 90° e 120° intra-dia variaram de 0,67-0,98 e (0,58° à 5,64°) para o avaliador inexperiente e variaram de 0,67-0,98 e (0,64° à 6,17°) para o avaliador experiente, no movimento de flexão. Durante o movimento de abdução os valores obtidos nos ângulos de 30°, 60°, 90° e 120° intra-dia variaram de 0,75-0,96 e (0,51° à 4,93°) para o avaliador inexperiente e variaram de 0,62-0,97 e (0,66° à 6,58°) para o avaliador experiente. O modelo apresentou de boa a excelente reprodutibilidade, intra-dia para ambos os avaliadores nos movimentos de flexão e abdução do braço. Os valores obtidos inter-dias na flexão variaram de 0,41 a 0,88 e (0,64° a 6,17) para o avaliador inexperiente e de 0,72 a 0,95 e (0,67° a 4,31°) para o avaliador experiente. No movimento de abdução inter-dias os valores variaram de 0,33 a 0,91 e (0,74° a 6,60°) para o avaliador inexperiente e de 0,72 a 0,98 e (0,73° a 5,01°) para o avaliador experiente. Apresentando a reprodutibilidade do avaliador inexperiente de fraca a excelente no movimento de flexão do braço e pobre a excelente na abdução do braço. A reprodutibilidade para o avaliador experiente foi de boa a excelente para a flexão e abdução do braço entre os segmentos da escápula, úmero e tronco em adultos saudáveis. Mostrando que não há diferença entre avaliadores nas avaliações intra-dia, porém inter-dias o avaliador experiente obteve melhores resultados de reprodutibilidade, mostrando que a diferença de níveis de experiência entre os avaliadores é de fundamental importância para se ter resultados reprodutíveis em diferentes dias. Entretanto devemos ressaltar a importância de mais estudos serem realizados, com diferentes movimentos e pacientes, realizados por dois ou mais avaliadores.

Reverse Total shoulder arthroplasty (RTSA) is an effective treatment and a surgical alternative approach to conventional total shoulder arthroplasty for patients with severe rotator cuff tears and glenoid erosion. To help optimize RTSA design, it is necessary to gain insight into the geometry of glenoid erosions and consider their unique morphology across the entire bone. One of the most powerful tools to systematically quantify and visualize the variation of bone geometry throughout a population is Statistical Shape Modeling (SSM); this method can assess the variation in the full shape of a bone, rather than of discrete anatomical features, which is very useful in identifying abnormalities, planning surgeries, and improving implant designs. Recently, many scapula SSMs have been presented in the literature; however, each has been created using normal and healthy bones. Therefore, creation of a scapula SSM derived exclusively from patients exhibiting complex glenoid bone erosions is critical and significantly challenging. In addition, several studies have quantified scapular bone properties in patients with complex glenoid erosion. However, because of their discrete nature these analyses cannot be used as the basis for Finite Element Modeling (FEM). Thus, a need exists to systematically quantify the variation of bone properties in a glenoid erosion patient population using a method that captures variation across the entire bone. This can be achieved using Statistical Intensity Modeling (SIM), which can then generate scapula FEMs with realistic bone properties for evaluation of orthopaedic implants. Using an SIM enables researchers to generate models with bone properties that represent a specific, known portion of the population variation, which makes the findings more generalizable. Accordingly, the main purpose of this research is to develop an SSM and SIM to mathematically quantifying the variation of bone geometries in a systematic manner for the complex geometry of scapulae with severe glenoid erosion and to determine the main modes of variation in bone property distribution, which could be used for future FEM studies, respectively. To draw meaningful statistical conclusions from the dataset, we need to compare and relate corresponding parts of the scapula. To achieve this correspondence, 3D triangulated mesh models of 61 scapulae were created from pre-operative CT scans from patients who were treated with RTSA and then a Non-Rigid (NR) registration method was used to morph one Atlas point cloud to the shapes of all other bones. However, the more complex the shape, the more difficult it is to maintain good correspondence. To overcome this challenge, we have adapted and optimized a NR-Iterative Closest Point (ICP) method and applied that on 61 eroded scapulae which results in each bone shape having identical mesh structure (i.e., same number and anatomical location of points). To assess the quality of our proposed algorithm, the resulting correspondence error was evaluated by comparing the positions of ground truth points and the corresponding point locations produced by the algorithm. The average correspondence error of all anatomical landmarks across the two observers was 2.74 mm with inter and intra-observer reliability of ±0.31 and ±0.06 mm. Moreover, the Root-Mean-Square (RMS) and Hausdorff errors of geometric registration between the original and the deformed models were calculated 0.25±0.04 mm and 0.76±0.14 mm, respectively. After registration, Principal Component Analysis (PCA) is applied to the deformed models as a group to describe independent modes of variation in the dataset. The robustness of the SSM is also evaluated using three standard metrics: compactness, generality, and specificity. Regarding compactness, the first 9 principal modes of variations accounted for 95% variability, while the model’s generality error and the calculated specificity over 10,000 instances were found to be 2.6 mm and 2.99 mm, respectively. The SIM results showed that the first mode of variation accounts for overall changes in intensity across the entire bone, while the second mode represented localized changes in the glenoid vault bone quality. The third mode showed changes in intensity at the posterior and inferior glenoid rim associated with posteroinferior glenoid rim erosion which suggests avoiding fixation in this region and preferentially placing screws in the anterosuperior region of the glenoid to improve implant fixation. / Graduate

Name: The Effect of Facilitating Kinesio Taping of lower scapula fixators on pain threshold of trigger points in the m. trapezius pars descendens Objectives: This study is a pilot study. The goal of this study is to determine effects of Facilitating Kinesio Taping of lower scapula fixators on painfulness of trigger points in the m. trapezius pars descendens. Methods: The study took place in a private medical office with thirteen patients. All of these patients were physically examined using standard tests of physiotherapy. Patients were measured using a pressure algometer to assess trigger points as painful. They reported the intensity of pain on VAS. The places of measurement were trigger points one and two in the muscle according Travell and Simons. Data were analyzed using the statistical program SPSS 15.0 and Microsoft Office Excel. Results: This study had three hypotheses. In the case of the first hypothesis, I concluded that KT has an effect on the pain threshold and its application will reduce the pain threshold in m.trapezius pars descendens. Statistical significance was the value of p = 0.03 and p = 0.011, the value of material significance (101.31 kPa and 106.7 kPa) confirmed my theory that after KT will increase the pressure of 100 kPa in the TrP1 and TrP2. In the second hypothesis, it...

Made available in DSpace on 2016-06-02T20:19:21Z (GMT). No. of bitstreams: 1 5121.pdf: 13124971 bytes, checksum: 6e287fe7f29cdce25264d37ed5bc3045 (MD5) Previous issue date: 2013-02-21 / Financiadora de Estudos e Projetos / Background: There is a lack of studies that evaluated within day and between day reliabilities of 3-D scapular kinematics during elevation and lowering of the arm in different shoulder conditions, as well as studies about low-amplitude and high-velocity thoracic spine manipulation (TSM) effects on scapular kinematics in subjects with shoulder dysfunctions. Objective: To establish within day and between day reliability of scapular motion during elevation and lowering of the arm and at rest position and to evaluate the immediate effects of a TSM on pain and scapular kinematics during elevation and lowering of the arm, both in subjects with and without shoulder impingement syndrome (SIS). Methods: Kinematic data were collected using Flock of Birds® electromagnetic device. Subjects were divided in 2 groups: control and impingement. For reliability kinematic data were collected during elevation and lowering of the arm and at rest position on 2 different occasions separated by 3 to 5 days. Forty-nine subjects were tested for within day reliability. Forty-three subjects were reassessed for between day reliability. For kinematic evaluation pre- and ppost-manipulation, scapular kinematics was collected during elevation and lowering of the arm before and immediately after the intervention. Numeric pain rating scale was used to assess shoulder pain during arm movement at pre- and post- intervention. Fifty subjects (31.76 ± 10.91 years) with SIS and 47 subjects (25.76 ± 5.01 years) asymptomatic for shoulder dysfunctions were randomly assigned to one of the groups: manipulation or sham. Results: There was very good within day reliability for assessing scapular internal and upward rotations and tilt from both groups during elevation and lowering of the arm (ICC=0.92-0.99). In general, there was good between day reliability for assessing scapular motion during elevation and lowering of the arm from both groups (ICC=0.54-0.88). There was also good and very good between day reliability for assessing scapular rest position in both groups (ICC=0.66-0.95). Study 2: Subjects with SIS experienced reduced shoulder pain (from 3.29 to 2.45, p<0.01) during arm movement immediately after TSM. Subjects with and without SIS who received TSM and asymptomatic subjects who received sham intervention showed significant increase in scapular upward rotation at post-intervention. Increase in scapular anterior tilt at postmanipulation was also observed in asymptomatic subjects who received TSM. Conclusion: Flock of Birds® electromagnetic tracking system is a reliable device for measuring 3-D scapular motion during elevation and lowering of the arm and at rest position in subjects with and without impingement symptoms over time. TSM is associated with improved shoulder pain and scapular upward rotation in subjects with SIS. Although with questionable clinical relevance, TSM may not be immediately favorable to scapular tilt in asymptomatic subjects. / Além da escassez de evidências a respeito da confiabilidade entre repetições e dias da avaliação cinemática 3-D da escápula durante a elevação e descida do braço em diferentes condições do ombro, estudos sobre os efeitos da manipulação torácica de alta velocidade e baixa amplitude (MT) na cinemática escapular em sujeitos assintomáticos e portadores de disfunções no ombro também são bastante escassos. Objetivo: Determinar a confiabilidade entre repetições e entre dias das medidas do movimento 3-D da escápula durante a elevação e descida do braço e na posição de repouso e avaliar os efeitos imediatos de uma MT na dor e na cinemática da escápula durante a elevação e descida do braço, ambos em sujeitos assintomáticos e portadores da síndrome do impacto (SI). Métodos: Para a avaliação cinemática foi utilizado o dispositivo eletromagnético Flock of Birds®. Os sujeitos foram divididos em 2 grupos (controle e impacto). Os dados cinemáticos para a confiabilidade foram coletados durante a elevação e descida do braço e na posição de repouso em duas ocasiões diferentes separadas por 3 a 5 dias. Quarenta e nove sujeitos foram avaliados para a confiabilidade entre repetições e quarenta e três sujeitos foram avaliados para a confiabilidade entre dias. Para a avaliação pré e pós-manipulação os dados cinemáticos foram coletados durante a elevação e descida do braço antes e imediatamente após a intervenção. A escala numérica de dor mediu a dor durante o movimento do braço antes e após a intervenção. Cinquenta sujeitos (31,76 ± 10,91 anos) com SI e 47 sujeitos (25,76 ± 5,01 anos) assintomáticos para disfunções no ombro foram aleatoriamente designados a um dos seguintes grupos : manipulação ou sham. Resultados: A confiabilidade das medidas entre as repetições foi excelente para as rotações medial e superior e para a inclinação da escápula em ambos os grupos durante a elevação e a descida do braço (CCI=0,92-0,99). No geral, confiabilidade entre dias para avaliar os movimentos escapulares durante a elevação e a descida do braço para ambos os grupos foi boa (CCI=0,54-0,88). A confiabilidade entre dias também foi boa e excelente para as rotações escapulares durante a posição de repouso em ambos os grupos (ICC=0,66-0,95). Houve melhora significativa da dor nos sujeitos com SI (de 3,29 para 2,45, p<0,01) durante o movimento do braço imediatamente após a MT. Os sujeitos com e sem SI que receberam a MT e os sujeitos assintomáticos que receberam a intervenção sham apresentaram significativo aumento na rotação superior da escápula após a intervenção. O aumento na inclinação anterior após a manipulação também foi observado nos sujeitos assintomáticos que receberam a MT. Conclusão: O Flock of Birds® é um dispositivo eletromagnético confiável para medir ao longo do tempo o movimento 3-D da escápula durante a elevação e descida do braço e na posição de repouso em sujeitos assintomáticos e portadores de SI ao longo do tempo. A MT está associada com a melhora da dor e da rotação superior da escápula nos sujeitos com SI. E, apesar da questionável relevância clínica, a MT pode não ser imediatamente favorável para a inclinação escapular nos sujeitos assintomáticos.

Title: Corrected arm hang as a compensatory element in physioterapy Objective: The main objective of this master thesis is to measure and compare the level of engagement of muscles stabilizing the scapula during arm hang and supported exercise. Methods: Our study included nine probands whose measurement results were evaluated quantitatively. The age of probands at the time of measurement was from 18 to 25 years. A condition for inclusion in the investigated group was absence of subjective symptoms, functional impairment, traumatic injury, orthopedic defects or diseases of the upper limb. All probands were active athletes. Biomonitor ME 6000 manufacturer Mega Electronics Ltd. was used for recording the electrical activity of the muscles. The obtained data were processed by the Megawin software. All measurements for the purposes of the study took place in the laboratory of biomechanics FTVS UK. The resulting data were compared intraindividual and interindividual. Results: The results demonstrated that middle and lower portions of m. Trapezius is more active in the corrected arm hang. In contrast, the supported exercise leads to greater activity of m. Serratus anterior and lower activity of upper portion of m. Trapezius. Keywords: arm hang, supported exercise, surface electromyography, stabilization...

Introduction: Shoulder pain cases represents about 7% to 50% in the population and its prevalence in athletes between 15 and 19 years old is about 43.5%. Additionally, another pathology in the upper limb is scapular dyskinesia, caused by the scapular´s movements and position alteration. Objective: To determine association between scapula-vertebral distance and shoulder pain in athletes from a private university in Lima. Materials and Methods: Cross-sectional analytical study - preliminary. The study population were athletes from a private university in Lima. The shoulder pain variables were measured by four orthopedic tests Jobe, Patte, Gerber, and Hawkins Kennedy, where shoulder pain (YES) is considered when at least one of the tests is positive and no shoulder pain (NO) when all tests are negative. And the scapular-vertebral distance variables were evaluated in three positions, by the lateral scapular sliding test (LSST); measured in (cm). Results: 51 athletes from climbing, rugby, volleyball, and basketball sports were evaluated in this study. The age ranged was 19 to 21 years. The scapula-vertebral distance of the right side was mayor than the left. 17.65% had shoulder pain. The frequency of training and sex associated with shoulder pain (p<0.05). The scapula-vertebral distance from athletes who had shoulder pain was higher than those without it (p<0.05). Conclusion: Was found association between scapula-vertebral and shoulder pain in athletes from a private university in Lima. Its recommended doing more researches with a considerable sample to reach an adequate statistical power. / Introducción: El dolor de hombro representa casos de 7% al 50% en la población, su prevalencia en deportistas entre 15 y 19 años es de 43,5%. Adicionalmente, otra patología en la extremidad superior es la disquinesia escapular, generada por la alteración de la posición y el movimiento de la escápula. Objetivo: Determinar si existe asociación entre la distancia escápulo-vertebral y el dolor de hombro en deportistas de una universidad privada de Lima. Materiales y métodos: Estudio transversal analítico - preliminar. La población fueron deportistas de una universidad privada de Lima. Las variables fueron, dolor de hombro medido por cuatro test ortopédicos Jobe, Patte, Gerber y Hawkins Kennedy, donde se considera dolor de hombro (SI) cuando al menos de unos de los test da positivo y no dolor de hombro (NO) cuando todos los tests dan negativo, respecto a la variable distancia escápulo-vertebral evaluada en tres posiciones, por la prueba de deslizamiento escapular lateral (LSST) medido en (cm). Resultado: Se evaluaron 51 deportistas de escalada, rugby, vóley y básquetbol. La edad tuvo un rango de 19 a 21 años. La distancia escápulo-vertebral del lado derecho fue mayor que el izquierdo. El 17.65% de la población si tuvo dolor de hombro. La frecuencia de entrenamiento y el sexo estuvieron asociados con el dolor de hombro (p<0.05). La distancia escápulo-vertebral de los que tenían dolor de hombro era mayor que en los que no tenían dolor (p<0.05). Conclusiones: Si se encontró asociación entre la distancia escápulo vertebral y el dolor de hombro en los deportistas de una universidad privada de Lima. Se recomienda realizar estudios con mayor tamaño de muestra para alcanzar un adecuado poder estadístico. / Tesis

本論文の目的は，体表から無侵襲に肩甲骨運動を推定する方法を確立すること，肩甲骨運動を拡大する運動介入としての肩甲骨エクササイズを明らかにすること，そのエクササイズが投球動作中の肩甲骨運動に与える即時的な効果を検討することとした．その結果，本研究で考案した推定方法によって肩甲骨姿勢の推定精度は向上した．また体幹運動をともなった肩甲骨エクササイズによって投球動作中の肩甲骨後傾運動が増加した． / 博士(スポーツ健康科学) / Doctor of Philosophy in Health and Sports Science / 同志社大学 / Doshisha University

No description available.

Winged scapula is a condition characterized by lateral or medial protrusion of the scapula caused by nerve damage leading to muscular paralysis. The purpose of this systematic review of literature is to evaluate the current research literature related to the effectiveness of therapy options for winged scapula. Eleven peer reviewed English language research articles published from 1998 to present were included for evaluation. Study results revealed positive therapeutic outcomes for physical therapy and scapular bracing. Results also showed positive outcomes for the use of transcutaneous electrical nerve stimulation and acupuncture for the treatment of nerve related conditions similar to winged scapula. Additional research is needed to evaluate the effectiveness of transcutaneous electrical nerve stimulation and acupuncture for winged scapula patients specifically.