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Research paper thumbnail of Shoulder abduction strength is correlated with acromiohumeral distance in patients with acute subacromial impingement syndrome symptoms but not with supraspinatus tendon thickness regardless of disease stage

Kinesiology, 2022

We aimed to investigate the relationships of isometric and eccentric shoulder abduction strength ... more We aimed to investigate the relationships of isometric and eccentric shoulder abduction strength with acromiohumeral distance and supraspinatus tendon thickness based on the disease stage in patients with subacromial impingement syndrome. Eighty-two patients with subacromial impingement syndrome were assessed. Acromiohumeral distance and supraspinatus tendon thickness were measured using ultrasonography. Isometric and eccentric shoulder abduction strength were measured with a hand-held dynamometer. Spearman's correlation coefficients were calculated. Isometric (rho = 0.428, p=.021) and eccentric (rho = 0.487, p=.007) shoulder abduction strength showed moderate correlations with acromiohumeral distance in patients with acute symptoms (n = 29). There was no relationship between acromiohumeral distance and abduction strength in patients with chronic symptoms (n = 53) (p>.050). Supraspinatus tendon thickness showed no significant correlation with abduction strength (p>.050). These findings suggest that the relationship between acromiohumeral distance and abduction strength differs according to disease stage. However, supraspinatus tendon thickness was not correlated with abduction strength regardless of disease stage. In patients with acute subacromial impingement syndrome symptoms increasing shoulder abduction strength may be a potential strategy to improve acromiohumeral distance.

Research paper thumbnail of Modi̇fi̇ye Posteri̇or Omuz Germe Egzersi̇zleri̇ni̇n Posteri̇or Omuz Gergi̇nli̇ği̇ Ve Glenohumeral İnternal Rotasyon Defi̇si̇ti̇ndeki̇ Etki̇nli̇ği̇: Bi̇r Si̇stemati̇k Derleme

Türk Fizyoterapi ve Rehabilitasyon Dergisi

Purpose: Posterior shoulder tightness (PST) and Glenohumeral internal rotation deficit (GIRD) can... more Purpose: Posterior shoulder tightness (PST) and Glenohumeral internal rotation deficit (GIRD) can impact shoulder biomechanics and damage shoulder function. Posterior shoulder stretching exercises (PSSEs) are often performed in traditional positions to improve posterior shoulder inflexibility. However, these traditional positions can cause inadequate control of the scapula and glenohumeral rotation. The modified PSSEs through scapular stabilization are preferred as current trends to effective management of the GIRD and PST. However, there is a lack of consensus regarding which type of modified PSSE is more effective on PST and GIRD improvement. Therefore, we aimed to describe the efficacy of modified PSSEs on PST and GIRD in symptomatic and asymptomatic populations to aid clinicians when making decisions for these populations. Methods:A literature search was conducted for a systematic review. Relevant studies were searched from appropriate electronic databases (CINAHL, Cochrane Revi...

Research paper thumbnail of Novel Posterior Shoulder Stretching With Rapid Eccentric Contraction and Static Stretching in Patients With Subacromial Pain Syndrome: A Randomized Trial

Sports Health: A Multidisciplinary Approach

Background: In subacromial pain syndrome (SPS), it is unknown whether posterior shoulder stretchi... more Background: In subacromial pain syndrome (SPS), it is unknown whether posterior shoulder stretching exercises (PSSE) with rapid eccentric contraction, a muscle energy technique, improve clinical and ultrasonographic outcomes more than no stretching or static PSSE. Hypothesis: PSSE with rapid eccentric contraction is superior to no stretching and static PSSE in improving clinical and ultrasonographic outcomes in SPS. Study Design: Randomized controlled trial. Level of Evidence: Level 1. Methods: Seventy patients with SPS and glenohumeral internal rotation deficit were randomized into the modified cross-body stretching with rapid eccentric contraction group (EMCBS; n = 24), static MCBS group (SMCBS; n = 23), or control group (CG; n = 23). In addition to 4-week physical therapy, EMCBS received PSSE with rapid eccentric contraction, SMCBS static PSSE, and CG no PSSE. The primary outcome was internal rotation range of motion (ROM). Secondary outcomes were posterior shoulder tightness, ex...

Research paper thumbnail of AB1405-HPR The comparison of posterior shoulder tightness in patients having chronic neck pain and in healthy subjects

Saturday, 16 JUNE 2018, 2018

Background Chronic neck pain (CNP) causes the disruption of the thoracic region and the shoulder ... more Background Chronic neck pain (CNP) causes the disruption of the thoracic region and the shoulder girdle biomechanics besides the cervical region.The shoulder capsule is often thickened in shoulder problems, which causes shoulder tightness. In the literature, the effect of CNP on shoulder tightness was not investigated. Objectives The purpose of this study is to investigate the posterior shoulder tightness (PST) in patients having CNP and to interpret the effect of patients functional level and posture. Methods Non-specific CNP patients (n=16, female) and healthy subjects (n=16, female) were included and no shoulder problem was identified. The severity of the pain with Visual Analogue Scale (VAS); PST with bubble inclinometer; functional disability level with Neck Disability Index (NDI); influence of posture with New York Postural Rating Scale (NYPRS), upper limb muscle strength evaluated with handgrip. The Mann-Whitney U test Pearson correlation analysis was used to determine the relationship between PST and functional disability levels. Results Age and BMI values of healthy subjects and patients with CNP were similar (p>0.05). The mean duration of disease in patients with CNP was 60.63±35.37 months. Patients with CNP had lower PST values than healthy subjects, namely shoulder tightness is more than healthy subjects (p<0.001). The functional disability level score was higher in patients with CNP than in healthy subjects (p<0.001). NYPRS scores were lower in patients with CNP than in healthy subjects, namely the posture was more adversely affected in these patients (p<0.001). Handgrip values were lower and he pain severity at rest and activity was significantly higher in patients with CNP than in healthy subjects (p<0.001, Table 1). PST correlated well with the NYPS value (r=−0.56, p=0.03) and functional disability level (r=−0.63, p<0.001) in patients with CNP.Abstract AB1405HPR – Table 1 The comparison of clinical parameters in patients having chronic neck pain and healthy subjects Healthy Subjects mean±SD Patients with CNP mean±SD p Age(years) 40.63±11.86 45.06±11.04 0.20 BMI(kg/m2) 26.25±6.57 25.81±4.06 0.76 Painrest (VAS, cm) 0.13±0.52 2.77±2.51 <0.001 Painactivity (VAS, cm) 0.31±0.60 6,00±2.08 <0.001 PST (°) 66.89±13.15 43.6±9.27 <0.001 NDI 0.94±1.23 19,94±6.29 <0.001 NYPRS 60.38±4.60 43.13±8.34 <0.001 Handgrip Strenght (kg) 28.48±4.08 23.00±5.65 0.003 SD: Standard Deviation, BMI: Body Mass Index, CNP: Chronic Neck Pain, PST: Posterior Shoulder Tightness, NYPRS: New York Postural Rating Scale, NDI: Neck Disability Index. Conclusions Pain and upper limb muscle strength loss due to problem in patients with CNP, adversely affect patients‘ posture and reduce their functional levels. For these reasons, it is suggested that the shoulder girdle should be evaluated besides the neck area in the treatment of patients having CNP and treatment should be included with appropriate physiotherapy and exercise program from the early period. Reference [1] Kolber MJ, et al. The reliability, minimal detectable change and construct validity of a clinical measurement for identifying posterior shoulder tightness. N Am J Sports Phys Ther, 2010;5: 208–19. Disclosure of Interest None declared

Research paper thumbnail of The Effects of Isolytic and Static Posterior Shoulder Stretching in Individuals with Subacromial Impingement Syndrome

Medicine & Science in Sports & Exercise, 2020

RESULTS: Overall, 48 of 330 participants (14.6%) reported generalized joint hypermobility (GJH) b... more RESULTS: Overall, 48 of 330 participants (14.6%) reported generalized joint hypermobility (GJH) based on a Beighton score ≥ 5. Sixty-three participants reported hypermobility in at least one elbow; there was no difference in prevalence of hypermobility between elbows (Right: r = .483, p < .001; Left: r = .465, p < .001). Hypermobility in one elbow was strongly correlated with hypermobility in both elbows (r =.828; p < .001). We found moderate correlations between UCL thickness and joint gapping for left and right elbows (r=.422,r=.324,p < .001) We found no difference in UCL thickness or joint width between participants with hypermobile elbows and those without (e.g., right elbow joint width under valgus stress: Normal = .231799, Hypermobile = .228415; t(251) = .301, p=.763) Left elbow joint width under valgus stress was weakly correlated (r =.167, p=.006) with GJH overall but not specifically with left elbow hypermobility. CONCLUSION: There was no relationship between Beighton score and UCL anterior bundle thickness or joint width under gravity induced valgus stress. There was no statistically significant difference in UCL thickness or joint width in participants with elbow hypermobility and those without.

Research paper thumbnail of Effects of a Progressive Rehabilitation Program on Shoulder Internal Rotation Range of Motion, Acromiohumeral Distance, and Pain in an Adolescent Female Swimmer with Subacromial Pain (Impingement) Syndrome

International journal of disabilities sports & health sciences, Mar 25, 2022

Research paper thumbnail of Shoulder abduction strength is correlated with acromiohumeral distance in patients with acute subacromial impingement syndrome symptoms but not with supraspinatus tendon thickness regardless of disease stage

Kinesiology, 2022

We aimed to investigate the relationships of isometric and eccentric shoulder abduction strength ... more We aimed to investigate the relationships of isometric and eccentric shoulder abduction strength with acromiohumeral distance and supraspinatus tendon thickness based on the disease stage in patients with subacromial impingement syndrome. Eighty-two patients with subacromial impingement syndrome were assessed. Acromiohumeral distance and supraspinatus tendon thickness were measured using ultrasonography. Isometric and eccentric shoulder abduction strength were measured with a hand-held dynamometer. Spearman's correlation coefficients were calculated. Isometric (rho = 0.428, p=.021) and eccentric (rho = 0.487, p=.007) shoulder abduction strength showed moderate correlations with acromiohumeral distance in patients with acute symptoms (n = 29). There was no relationship between acromiohumeral distance and abduction strength in patients with chronic symptoms (n = 53) (p>.050). Supraspinatus tendon thickness showed no significant correlation with abduction strength (p>.050). These findings suggest that the relationship between acromiohumeral distance and abduction strength differs according to disease stage. However, supraspinatus tendon thickness was not correlated with abduction strength regardless of disease stage. In patients with acute subacromial impingement syndrome symptoms increasing shoulder abduction strength may be a potential strategy to improve acromiohumeral distance.

Research paper thumbnail of Modi̇fi̇ye Posteri̇or Omuz Germe Egzersi̇zleri̇ni̇n Posteri̇or Omuz Gergi̇nli̇ği̇ Ve Glenohumeral İnternal Rotasyon Defi̇si̇ti̇ndeki̇ Etki̇nli̇ği̇: Bi̇r Si̇stemati̇k Derleme

Türk Fizyoterapi ve Rehabilitasyon Dergisi

Purpose: Posterior shoulder tightness (PST) and Glenohumeral internal rotation deficit (GIRD) can... more Purpose: Posterior shoulder tightness (PST) and Glenohumeral internal rotation deficit (GIRD) can impact shoulder biomechanics and damage shoulder function. Posterior shoulder stretching exercises (PSSEs) are often performed in traditional positions to improve posterior shoulder inflexibility. However, these traditional positions can cause inadequate control of the scapula and glenohumeral rotation. The modified PSSEs through scapular stabilization are preferred as current trends to effective management of the GIRD and PST. However, there is a lack of consensus regarding which type of modified PSSE is more effective on PST and GIRD improvement. Therefore, we aimed to describe the efficacy of modified PSSEs on PST and GIRD in symptomatic and asymptomatic populations to aid clinicians when making decisions for these populations. Methods:A literature search was conducted for a systematic review. Relevant studies were searched from appropriate electronic databases (CINAHL, Cochrane Revi...

Research paper thumbnail of Novel Posterior Shoulder Stretching With Rapid Eccentric Contraction and Static Stretching in Patients With Subacromial Pain Syndrome: A Randomized Trial

Sports Health: A Multidisciplinary Approach

Background: In subacromial pain syndrome (SPS), it is unknown whether posterior shoulder stretchi... more Background: In subacromial pain syndrome (SPS), it is unknown whether posterior shoulder stretching exercises (PSSE) with rapid eccentric contraction, a muscle energy technique, improve clinical and ultrasonographic outcomes more than no stretching or static PSSE. Hypothesis: PSSE with rapid eccentric contraction is superior to no stretching and static PSSE in improving clinical and ultrasonographic outcomes in SPS. Study Design: Randomized controlled trial. Level of Evidence: Level 1. Methods: Seventy patients with SPS and glenohumeral internal rotation deficit were randomized into the modified cross-body stretching with rapid eccentric contraction group (EMCBS; n = 24), static MCBS group (SMCBS; n = 23), or control group (CG; n = 23). In addition to 4-week physical therapy, EMCBS received PSSE with rapid eccentric contraction, SMCBS static PSSE, and CG no PSSE. The primary outcome was internal rotation range of motion (ROM). Secondary outcomes were posterior shoulder tightness, ex...

Research paper thumbnail of AB1405-HPR The comparison of posterior shoulder tightness in patients having chronic neck pain and in healthy subjects

Saturday, 16 JUNE 2018, 2018

Background Chronic neck pain (CNP) causes the disruption of the thoracic region and the shoulder ... more Background Chronic neck pain (CNP) causes the disruption of the thoracic region and the shoulder girdle biomechanics besides the cervical region.The shoulder capsule is often thickened in shoulder problems, which causes shoulder tightness. In the literature, the effect of CNP on shoulder tightness was not investigated. Objectives The purpose of this study is to investigate the posterior shoulder tightness (PST) in patients having CNP and to interpret the effect of patients functional level and posture. Methods Non-specific CNP patients (n=16, female) and healthy subjects (n=16, female) were included and no shoulder problem was identified. The severity of the pain with Visual Analogue Scale (VAS); PST with bubble inclinometer; functional disability level with Neck Disability Index (NDI); influence of posture with New York Postural Rating Scale (NYPRS), upper limb muscle strength evaluated with handgrip. The Mann-Whitney U test Pearson correlation analysis was used to determine the relationship between PST and functional disability levels. Results Age and BMI values of healthy subjects and patients with CNP were similar (p>0.05). The mean duration of disease in patients with CNP was 60.63±35.37 months. Patients with CNP had lower PST values than healthy subjects, namely shoulder tightness is more than healthy subjects (p<0.001). The functional disability level score was higher in patients with CNP than in healthy subjects (p<0.001). NYPRS scores were lower in patients with CNP than in healthy subjects, namely the posture was more adversely affected in these patients (p<0.001). Handgrip values were lower and he pain severity at rest and activity was significantly higher in patients with CNP than in healthy subjects (p<0.001, Table 1). PST correlated well with the NYPS value (r=−0.56, p=0.03) and functional disability level (r=−0.63, p<0.001) in patients with CNP.Abstract AB1405HPR – Table 1 The comparison of clinical parameters in patients having chronic neck pain and healthy subjects Healthy Subjects mean±SD Patients with CNP mean±SD p Age(years) 40.63±11.86 45.06±11.04 0.20 BMI(kg/m2) 26.25±6.57 25.81±4.06 0.76 Painrest (VAS, cm) 0.13±0.52 2.77±2.51 <0.001 Painactivity (VAS, cm) 0.31±0.60 6,00±2.08 <0.001 PST (°) 66.89±13.15 43.6±9.27 <0.001 NDI 0.94±1.23 19,94±6.29 <0.001 NYPRS 60.38±4.60 43.13±8.34 <0.001 Handgrip Strenght (kg) 28.48±4.08 23.00±5.65 0.003 SD: Standard Deviation, BMI: Body Mass Index, CNP: Chronic Neck Pain, PST: Posterior Shoulder Tightness, NYPRS: New York Postural Rating Scale, NDI: Neck Disability Index. Conclusions Pain and upper limb muscle strength loss due to problem in patients with CNP, adversely affect patients‘ posture and reduce their functional levels. For these reasons, it is suggested that the shoulder girdle should be evaluated besides the neck area in the treatment of patients having CNP and treatment should be included with appropriate physiotherapy and exercise program from the early period. Reference [1] Kolber MJ, et al. The reliability, minimal detectable change and construct validity of a clinical measurement for identifying posterior shoulder tightness. N Am J Sports Phys Ther, 2010;5: 208–19. Disclosure of Interest None declared

Research paper thumbnail of The Effects of Isolytic and Static Posterior Shoulder Stretching in Individuals with Subacromial Impingement Syndrome

Medicine & Science in Sports & Exercise, 2020

RESULTS: Overall, 48 of 330 participants (14.6%) reported generalized joint hypermobility (GJH) b... more RESULTS: Overall, 48 of 330 participants (14.6%) reported generalized joint hypermobility (GJH) based on a Beighton score ≥ 5. Sixty-three participants reported hypermobility in at least one elbow; there was no difference in prevalence of hypermobility between elbows (Right: r = .483, p < .001; Left: r = .465, p < .001). Hypermobility in one elbow was strongly correlated with hypermobility in both elbows (r =.828; p < .001). We found moderate correlations between UCL thickness and joint gapping for left and right elbows (r=.422,r=.324,p < .001) We found no difference in UCL thickness or joint width between participants with hypermobile elbows and those without (e.g., right elbow joint width under valgus stress: Normal = .231799, Hypermobile = .228415; t(251) = .301, p=.763) Left elbow joint width under valgus stress was weakly correlated (r =.167, p=.006) with GJH overall but not specifically with left elbow hypermobility. CONCLUSION: There was no relationship between Beighton score and UCL anterior bundle thickness or joint width under gravity induced valgus stress. There was no statistically significant difference in UCL thickness or joint width in participants with elbow hypermobility and those without.

Research paper thumbnail of Effects of a Progressive Rehabilitation Program on Shoulder Internal Rotation Range of Motion, Acromiohumeral Distance, and Pain in an Adolescent Female Swimmer with Subacromial Pain (Impingement) Syndrome

International journal of disabilities sports & health sciences, Mar 25, 2022