THE IMMEDIATE EFFECTS OF POSTERIOR CAPSULE STRETCHING EXERCISE ON INDIVIDUALS WITH GLENOHUMERAL INTERNAL ROTATION DEFICIT
Öz
Purpose: To examine the immediate effect on joint position
sense and range of motion of posterior capsule stretching exercise, which is
recommended after glenohumeral internal rotation deficit (GIRD) that can be
seen in healthy individuals.
Methods:
The study included 28 healthy individuals who met the
inclusion criteria and were diagnosed with GIRD via goniometric measurements.
In order to measure the joint position sense, the angle repetition test was
performed using a laser pointer, and the range of motion (ROM) of the shoulder
joints was measured via goniometer. After the measurements in both of the
shoulders were completed, the posterior capsule stretching exercise was
demonstrated for the extremity where the deficit was detected. After the
exercise was completed, the measurements were repeated for both of the
shoulders.
The study included 28 healthy individuals who met the
inclusion criteria and were diagnosed with GIRD via goniometric measurements.
In order to measure the joint position sense, the angle repetition test was
performed using a laser pointer, and the range of motion (ROM) of the shoulder
joints was measured via goniometer. After the measurements in both of the
shoulders were completed, the posterior capsule stretching exercise was
demonstrated for the extremity where the deficit was detected. After the
exercise was completed, the measurements were repeated for both of the
shoulders.
Results: At the end of the study, while no significant
immediate change was found in joint position sense in the study group (p=0.28),
significant immediate changes were determined in internal rotation (p=0.00),
external rotation (p=0.021) and horizontal adduction ranges (p=0.003).
Conclusion: GIRD
is a condition that can be observed in healthy individuals. Posterior capsule
stretching exercise immediately decreases the GIRD, but does not affect the
joint position sense. The long-term effects can be examined in further studies.
Anahtar Kelimeler
Kaynakça
- Referans1 Warner JJ, Allen AA, Marks PH, Wong P. Ar¬throscopic release of postoperative capsular contracture of the shoulder. The Journal of bone and joint surgery. American volume. 1997;79:1151-1158.
- Referans2 Aydin T, Yildiz Y, Yanmis İ, Yildiz C, Kalyon T. Shoulder proprioception: a comparison between the shoulder joint in healthy and surgically repaired shoulders. Archives of orthopaedic and trauma surgery. 2001;121(7),422-425.
- Referans3 Myers JB, Laudner KG, Pasquale MR, Bradley JP, Lephart SM. Glenohumeral range of motion deficits and posterior shoulder tightness in throwers with pathologic internal impingement. The American Journal of Sports Medicine. 2006;34(3):385-391. doi: 10.1177/0363546505281804
- Referans4 Thomas SJ, Swanik KA, Swanik CB, Kelly JD. Internal Rotation and Scapular Position Differences: A Comparison of Collegiate and High School Baseball Players. Journal of Athletic Training. 2010;45(1):44-50.
- Referans5 Wilk KE, Macrina LC, Fleisig GS, Porterfield R, Simpson CD 2nd, Harker P, Paparesta N, Andrews JR. Correlation of glenohumeral internal rotation deficit and total rotational motion to shoulder injuries in professional baseball pitchers. The American Journal of Sports Medicine. 2011;Feb;39 (2):329-35. doi: 10.1177/0363546510384223
- Referans6 Kibler WB, Sciascia A, Thomas SJ. Glenohumeral internal rotation deficit: pathogenesis and response to acute throwing. Sports medicine and arthroscopy review. 2012;20(1):34-8. doi: 10.1097/JSA.0b013e318244853e
- Referans7 Warner JJ, Micheli LJ, Arslanian LE, Kennedy J, Kennedy R. Patterns of flexibility, laxity, and strength in normal shoulders and shoulders with instability and impingement. The American Journal of Sports Medicine. 1990;18:366-375.
- Referans8 McClure P, Balaicuis J, Heiland D, Broersma ME, Thorndike CK, Wood A. A Randomized Controlled Comparison of Stretching Procedures for Posterior Shoulder Tightness. Journal of Orthopaedic & Sports Physical Therapy. 2007;37(3):108-114. doi: 10.2519/jospt.2007.2337
- Referans9 Manske RC, Meschke M, Porter A, Smith B, Reiman M. A randomized controlled single-blinded comparison of stretching versus stretching and joint mobilization for posterior shoulder tightness measured by internal rotation motion loss. Sports Health. 2010;2(2):94-100. doi: 10.1177/1941738109347775
- Referans10 Revel M, Andre-Deshays C, Minguet M. Cervicocephalic kinesthetic sensibility in patients with cervical pain. Archives of physical medicine and rehabilitation. 1991;72:288-291.
- Referans11 Balke M, Liem D, Dedy N, Thorwesten L, Balke M, Poetzl W, Marquardt B. The laser-pointer assisted angle reproduction test for evaluation of proprioceptive shoulder function in patients with instability. Archives of orthopaedic and trauma surgery. 2011;131:1077-1084. doi: 10.1007/s00402-011-1285-6
- Referans12 Duzgun I, Simsek IE, Yakut Y, Baltaci G, Uygur F. Assessing shoulder position sense using angle reproduction test in healthy individuals: a pilot study. Turkish Journal of Physiotherapy and Rehabilitation. 2011;22(3):240-244.
- Referans13 Vafadar AK, Côté JN, Archambault PS. Interrater and Intrarater Reliability and Validity of 3 Measurement Methods for Shoulder-Position Sense. Journal of Sport Rehabilitation. 2016;Feb 2; Technical Report 19: 2014-0309. doi: 10.1123/jsr.2014-0309
- Referans14 Balke M, Liem D, Dedy N, Thorwesten L, Poetzl W, Marquardt B. The laser-pointer assisted angle reproduction test for evaluation of proprioceptive shoulder function in patients with instability. Arch Orthop Trauma Surg. 2011;131:1077-1084. doi: 10.1007/s00402-011-1285-6
- Referans15 Baltaci G, 2015 Rehabilitation in Shoulder Injuries, 1st edn. Ankara, Pelikan.
- Referans16 Vafadar AK, Côté JN, Archambault PS. Sex differences in the shoulder joint position sense acuity: a cross-sectional study. BMC Musculoskeletal Disorders Sep. 2015;30;16:273. doi: 10.1186/s12891-015-0731-y
POSTERİOR KAPSÜL GERME EGZERSİZİNİN TOTAL ARK HAREKET DEFİSİTİ OLAN BİREYLERDE ANLIK ETKİLERİ
Öz
Amaç: Bu çalışma, sağlıklı bireylerde de görülebilecek glenohumeral internal
rotasyon defisiti (GİRD) sonrası verilen posterior kapsül germe egzersizinin
eklem pozisyon hissine ve hareket açıklıklarına olan anlık etkisini incelemek
amacı ile yapılmıştır.
Yöntem: Çalışmaya gonyometrik ölçümler sonucunda GİRD belirlenen, dahil edilme
kriterlerine uyan ve gönüllü olan 28 sağlıklı birey dahil edilmiştir.
Bireylerin GİRD tespit edilen omuz eklemi çalışma grubu, defisitin olmadığı
omuz eklemi ise kontrol grubu olarak belirlenmiştir. Eklem pozisyon hissinin
ölçümü için lazer pointer kullanılarak açı tekrarlama testi yapılmış ve omuz
ekleminin hareket açıklıkları gonyometre ile ölçülmüştür. Her iki omuz
ekleminde de ölçümler yapıldıktan sonra defisit belirlenen ekstremite için
posterior kapsül germe egzersizi gösterilmiştir. Egzersiz tamamlandıktan sonra
ölçümler her iki omuz ekleminde de tekrarlanmıştır.
Sonuçlar: Çalışmamızın sonucunda; çalışma grubunda eklem pozisyon hissinde anlık
olarak anlamlı değişiklik bulunmazken (P=0.28),
internal rotasyon (P=0.00), eksternal
rotasyon (P=0.021) ve horizontal
addüksiyon (P=0.003) hareket
açıklıklarında anlık olarak anlamlı değişiklik gözlenmiştir.
Tartışma: Glenohumeral
internal rotasyon defisiti sağlıklı bireylerde de görülebilen bir durumdur.
Posterior kapsül germe egzersizi anlık olarak glenohumeral internal rotasyon
defisitini azaltmakta ancak eklem pozisyon hissine etki etmemektedir. Gelecek
çalışmalarda, uzun dönem etkilerine de bakılabilir.
Anahtar Kelimeler
Kaynakça
- Referans1 Warner JJ, Allen AA, Marks PH, Wong P. Ar¬throscopic release of postoperative capsular contracture of the shoulder. The Journal of bone and joint surgery. American volume. 1997;79:1151-1158.
- Referans2 Aydin T, Yildiz Y, Yanmis İ, Yildiz C, Kalyon T. Shoulder proprioception: a comparison between the shoulder joint in healthy and surgically repaired shoulders. Archives of orthopaedic and trauma surgery. 2001;121(7),422-425.
- Referans3 Myers JB, Laudner KG, Pasquale MR, Bradley JP, Lephart SM. Glenohumeral range of motion deficits and posterior shoulder tightness in throwers with pathologic internal impingement. The American Journal of Sports Medicine. 2006;34(3):385-391. doi: 10.1177/0363546505281804
- Referans4 Thomas SJ, Swanik KA, Swanik CB, Kelly JD. Internal Rotation and Scapular Position Differences: A Comparison of Collegiate and High School Baseball Players. Journal of Athletic Training. 2010;45(1):44-50.
- Referans5 Wilk KE, Macrina LC, Fleisig GS, Porterfield R, Simpson CD 2nd, Harker P, Paparesta N, Andrews JR. Correlation of glenohumeral internal rotation deficit and total rotational motion to shoulder injuries in professional baseball pitchers. The American Journal of Sports Medicine. 2011;Feb;39 (2):329-35. doi: 10.1177/0363546510384223
- Referans6 Kibler WB, Sciascia A, Thomas SJ. Glenohumeral internal rotation deficit: pathogenesis and response to acute throwing. Sports medicine and arthroscopy review. 2012;20(1):34-8. doi: 10.1097/JSA.0b013e318244853e
- Referans7 Warner JJ, Micheli LJ, Arslanian LE, Kennedy J, Kennedy R. Patterns of flexibility, laxity, and strength in normal shoulders and shoulders with instability and impingement. The American Journal of Sports Medicine. 1990;18:366-375.
- Referans8 McClure P, Balaicuis J, Heiland D, Broersma ME, Thorndike CK, Wood A. A Randomized Controlled Comparison of Stretching Procedures for Posterior Shoulder Tightness. Journal of Orthopaedic & Sports Physical Therapy. 2007;37(3):108-114. doi: 10.2519/jospt.2007.2337
- Referans9 Manske RC, Meschke M, Porter A, Smith B, Reiman M. A randomized controlled single-blinded comparison of stretching versus stretching and joint mobilization for posterior shoulder tightness measured by internal rotation motion loss. Sports Health. 2010;2(2):94-100. doi: 10.1177/1941738109347775
- Referans10 Revel M, Andre-Deshays C, Minguet M. Cervicocephalic kinesthetic sensibility in patients with cervical pain. Archives of physical medicine and rehabilitation. 1991;72:288-291.
- Referans11 Balke M, Liem D, Dedy N, Thorwesten L, Balke M, Poetzl W, Marquardt B. The laser-pointer assisted angle reproduction test for evaluation of proprioceptive shoulder function in patients with instability. Archives of orthopaedic and trauma surgery. 2011;131:1077-1084. doi: 10.1007/s00402-011-1285-6
- Referans12 Duzgun I, Simsek IE, Yakut Y, Baltaci G, Uygur F. Assessing shoulder position sense using angle reproduction test in healthy individuals: a pilot study. Turkish Journal of Physiotherapy and Rehabilitation. 2011;22(3):240-244.
- Referans13 Vafadar AK, Côté JN, Archambault PS. Interrater and Intrarater Reliability and Validity of 3 Measurement Methods for Shoulder-Position Sense. Journal of Sport Rehabilitation. 2016;Feb 2; Technical Report 19: 2014-0309. doi: 10.1123/jsr.2014-0309
- Referans14 Balke M, Liem D, Dedy N, Thorwesten L, Poetzl W, Marquardt B. The laser-pointer assisted angle reproduction test for evaluation of proprioceptive shoulder function in patients with instability. Arch Orthop Trauma Surg. 2011;131:1077-1084. doi: 10.1007/s00402-011-1285-6
- Referans15 Baltaci G, 2015 Rehabilitation in Shoulder Injuries, 1st edn. Ankara, Pelikan.
- Referans16 Vafadar AK, Côté JN, Archambault PS. Sex differences in the shoulder joint position sense acuity: a cross-sectional study. BMC Musculoskeletal Disorders Sep. 2015;30;16:273. doi: 10.1186/s12891-015-0731-y