MODİFİYE POSTERİOR OMUZ GERME EGZERSİZLERİNİN POSTERİOR OMUZ GERGİNLİĞİ VE GLENOHUMERAL İNTERNAL ROTASYON DEFİSİTİNDEKİ ETKİNLİĞİ: BİR SİSTEMATİK DERLEME

Year 2023, Volume: 34 Issue: 2, 256 - 272, 31.08.2023

Halime Ezgi Türksan Sevgi Sevi Yesılyaprak

https://doi.org/10.21653/tjpr.1009683

Abstract

Amaç: Glenohumeral internal rotasyon defisiti (GİRD) ve posterior omuz gerginliği (POG), omuz biyomekaniğini etkileyebilir ve omuz fonksiyonuna zarar verebilir. GİRD ve POG tedavisinde posterior omuz germe egzersizleri (POGE) sıklıkla geleneksel pozisyonlarda uygulanmaktadır. Ancak bu geleneksel pozisyonlar skapulanın ve glenohumeral rotasyonun yetersiz kontrolüne neden olabilmektedir. GİRD ve POG’un etkin tedavisi için güncel yaklaşımlar olarak skapular stabilizasyon ile gerçekleştirilen modifiye POGE tercih edilmektedir. Ancak hangi modifiye germe egzersizinin GİRD ve POG’un iyileşmesinde daha etkili olduğuna dair bir fikir birliği bulunmamaktadır. Bu nedenle, klinisyenlere semptomatik ve asemptomatik popülasyonlar için karar vermede yardımcı olmak için modifiye POGE’nin bu popülasyonlarda POG ve GİRD üzerindeki etkinliğini tanımlamayı amaçladık.
Yöntem: Sistematik bir literatür taraması gerçekleştirdik. İlgili çalışmalar dahil edilmek üzere değerlendirildi ve seçilen çalışmalar uygun elektronik veri tabanlarından (CINAHL, Cochrane Review, Pubmed (MEDLINE), Web of Science ve Google Scholar©) araştırıldı.
Sonuçlar: Sistematik literatür araştırması 127 ilgili makale ile sonuçlandı ve final incelemeye 17 makale dahil edildi. Sonuç ölçümü olarak GİRD dahil edilen tüm çalışmalarda değerlendirilirken, POG 10 çalışmada değerlendirildi.
Tartışma: Bu sistematik literatür derlemesine göre, hem modifiye cross-body germe hem de modifiye sleeper germe GİRD ve POG’u iyileştirmede etkilidir. Gelecekteki araştırmalar POGE’nin GİRD ve POG üzerindeki etkinliğini belirlemek için diğer spesifik omuz hastalıklarına da odaklanmalı ve ayrıca spesifik katılımcıları çalışmalara almalıdır.

Keywords

Yaralanmalar, Mobilite, Fizik Tedavi

EFFECTIVENESS OF MODIFIED POSTERIOR SHOULDER STRETCHING EXERCISES IN POSTERIOR SHOULDER TIGHTNESS AND GLENOHUMERAL INTERNAL ROTATION DEFICIT: A SYSTEMATIC REVIEW

Abstract

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 Review, Pubmed (MEDLINE), Web of Science as well as Google Scholar©), and selected the eligible studies for inclusion.
Results: The present systematic literature search generated 127 relevant citations and 17 articles were included in the final review. As an outcome measure GIRD was assessed in all included studies, whereas PST was assessed in 10 studies.There was high evidence related to the positive effects of both modified cross-body and sleeper stretch to improve GIRD and PST.
Conclusion: According to this systematic literature review, both modified cross-body and sleeper stretch are effective in the improvement of GIRD and PST. Future research should focus on other specific shoulder diseases and should also recruit specific participants to address the effectiveness of modified PSSEs on GIRD and PST.

Keywords

Injuries, Mobility, Physical Therapy

References

• 1. Salamh PA, Liu X, Hanney WJ, Sprague PA, Kolber MJ. The efficacy and fidelity of clinical interventions used to reduce posterior shoulder tightness: a systematic review with meta-analysis. J Shoulder Elbow Surg. 2019; 28.6; 1204-1213.
• 2. Kirsch JM, Bakshi NK, Ayeni OR, Khan M, Bedi A. Clinical Outcomes and Quality of Literature Addressing Glenohumeral Internal Rotation Deficit: A Systematic Review. HSS J, 2020;16.3; 233-241.
• 3. Harshbarger ND, Eppelheimer BL, Valovich McLeod TC, Welch MC. The effectiveness of shoulder stretching and joint mobilizations on posterior shoulder tightness. J Sport Rehabil. 2013; 22(4); 313-319.
• 4. Mine K, Nakayama T, Milanese S, Grimmer K. Effectiveness of Stretching on Posterior Shoulder Tightness and Glenohumeral Internal-Rotation Deficit: A Systematic Review of Randomized Controlled Trials. J Sport Rehabil. 2017; 26(4); 294-305.
• 5. Muraki T, Yamamoto N, Zhao KD, Sperling JW, Steinmann SP, Cofield RH, et al. Effect of posteroinferior capsule tightness on contact pressure and area beneath the coracoacromial arch during pitching motion. Am J Sports Med. 2010; 38(3); 600-7.
• 6. Hall K, Borstad JD. Posterior Shoulder Tightness: To Treat or Not to Treat? J Orthop Sports Phys Ther. 2018; 48(3); 133-136.
• 7. Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology part I: pathoanatomy and biomechanics. Arthrosc. 2003; 19(4); 404-420.
• 8. Tyler TF, Nicholas SJ, Lee SJ, Mullaney Ml, McHugh MP. Correction of posterior shoulder tightness is associated with symptom resolution in patients with internal impingement. Am J Sports Med. 2010; 38; 114-119.
• 9. Ellenbecker TS, Cools A. Rehabilitation of shoulder impingement syndrome and rotator cuff injuries: an evidence-based review. Br J Sports Med. 2010; 44(5); 319-327.
• 10. Lewis J. Rotator cuff related shoulder pain: assessment, management and uncertainties. Man Ther. 2016; 23; 57-68.
• 11. Tyler TF, Nicholas SJ, Roy T, Gleim GW. Quantification of posterior capsule tightness and motion loss in patients with shoulder impingement. Am J Sports Med. 2000; 28(5); 668-673.
• 12. Cools A, Johansson FR, Cagnie B, Cambier DC, Witvrouw EE. Stretching the posterior shoulder structures in subjects with internal rotation deficit: comparison of two stretching techniques. Shoulder & Elbow. 2012; 4(1); 56-63.
• 13. McClure P, Balaicuis J, Heiland D, Broersma ME, Thorndike CK, Wood A. A randomized controlled comparison of stretching procedures for posterior shoulder tightness. J Orthop Sports Phys Ther. 2007; 37(3); 108-114.
• 14. Wilk KE, Hooks TR, Macrina LC. The modified sleeper stretch and modified cross-body stretch to increase shoulder internal rotation range of motion in the overhead throwing athlete. J Orthop Sports Phys Ther. 2013; 43(12); 891-4.
• 15. Johansen RL, Callis M, Potts J, Shall LM. A modified internal rotation stretching technique for overhand and throwing athletes. J Orthop Sports Phys Ther. 1995; 21(4); 216-9.
• 16. Mine K. Immediate effects of two types of stretching techniques on glenohumeral internal rotation deficit and posterior shoulder tightness; a crossover randomised controlled trial. Phys Ther Sports Med. 2017; 1(1); 19-24.
• 17. Brown A, Alfieri V, Fazulak D, Ozcan EA. The Immediate Effects of Two Different Stretching Interventions on Passive Shoulder Internal Rotation in Collegiate Baseball Players. J StudentPhys Ther Res. 2015; 8(5); 129-40.
• 18. Salamh PA, Kolber MJ, Hegedus EJ, Cook CE. The efficacy of stretching exercises to reduce posterior shoulder tightness acutely in the postoperative population: a single blinded randomized controlled trial. Physiother Theory Pract. 2018; 34(2); 111-120.
• 19. Salamh PA, Kolber MJ, Hanney WJ. Effect of scapular stabilization during horizontal adduction stretching on passive internal rotation and posterior shoulder tightness in young women volleyball athletes: a randomized controlled trial. Arch Phys Med Rehabil. 2015; 96(2); 349-56.
• 20. Joung HN, Yi CH, Jeon HS, Hwang UJ, Kwon OY. Effects of 4-week self-cross body stretching with scapular stabilization on shoulder motions and horizontal adductor strength in subjects with limited shoulder horizontal adduction: cross body stretching with stabilization. J Sports Med Phys Fitness. 2019; 59(3):456-461.
• 21. Rao MS, Tejitha S. Comparison of 3 stretching protocols for posterior shoulder tightness in throwers. Int J Physiother Res. 2016; 4(2); 1429-35.
• 22. Oyama S, Goerger C, Goerger BM, Lephart SM, Myers JB. Effects of non-assisted posterior shoulder stretches on shoulder range of motion among collegiate baseball pitchers. J Athl Train Sports Health Care. 2010; 2(4); 163-170.
• 23. Bailey LB, Thigpen CA, Hawkins RJ, Beattie PF, Shanley E. Effectiveness of Manual Therapy and Stretching for Baseball Players With Shoulder Range of Motion Deficits. Sports Health. 2017 May/Jun;9(3):230-237.
• 24. Gharisia O, Lohman E, Daher N, Eldridge A, Shallan A, Jaber H. Effect of a novel stretching technique on shoulder range of motion in overhead athletes with glenohumeral internal rotation deficits: a randomized controlled trial. BMC Musculoskelet Disord. 2021;30; 22(1); 402.
• 25. Yamauchi T, HasegawaS, Nakamura M, Nishishita S, Yanase K, Fujita K, et al. Effects of two stretching methods on shoulder range of motion and muscle stiffness in baseball players with posterior shoulder tightness: a randomized controlled trial. J Shoulder Elbow Surg. 2016; 25(9);1395-403.
• 26. Hammons D, McChesney JW, Curtin M, Pfeiffer R, Thiede K. Randomized and Blinded Study for the Treatment of Glenohumeral Internal Rotation of Motion Restriction: The Prone-Passive Stretching Technique. Sports Med Allied Health Sci.2015; 1(2); 1-9.
• 27. Tahran Ö, Yeşilyaprak SS. Effects of Modified Posterior Shoulder Stretching Exercises on Shoulder Mobility, Pain, and Dysfunction in Patients With Subacromial Impingement Syndrome. Sports Health. 2020; 12(2); 139-148.
• 28. Guney H, Karabicak GO, Pekyavas NO, Teker B, Günaydın OE, Balci P, et al. Which stretching technique is effective in decreasing glenohumeral internal rotation deficit? Medicina Dello Sport. 2015; 68; 291-302.
• 29. Lo CL, Hsueh YH, Wang CH, Chang HY. Comparison of the Acute Effects of Kinesio Taping and Sleeper Stretching on the Shoulder Rotation Range of Motion, Manual Muscle Strength, and Sub-Acromial Space in Pitchers with Glenohumeral Internal Rotation Deficit. Medicina (Kaunas). 2021; 23; 57(2);102.
• 30. Pandya D, Raithatha K. Comparison of modified sleeper stretch with and without taping on glenohumeral internal rotation deficit in overhead throwers-A randomized clinical trial. Int J Advance Research Ideas Innovations Technology. 2018; 4(4); 2454-132X
• 31. John Shaji MS, Chachra R. Comparative analysis of stretching vs mobilization on posterior shoulder tightness in cricketers. Indian J Physiother Occup Ther. 2010; 4(1); 75-79.
• 32. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;29:372:n71.
• 33. Cohen J. A power primer. Psychological bulletin. 1992; 112(1); 155.