No abstract

A comparison of electromyographic (EMG) activity of muscles between and within subjects, and during separate occasions of testing, requires normalization. The most common way for generating the reference level used for normalizing shoulder EMG data is with a maximum isometric voluntary contraction (MVIC). The purpose of this study was to develop a parsimonious set of standardized tests that generate an MVIC in all the major muscle groups of the shoulder. Twelve muscles of the dominant shoulder of 15 subjects were examined using a combination of surface and intramuscular electrodes during 15 tests. The results indicated that many tests maximally activated more than one muscle simultaneously. Four tests were identified as being sufficient for generating an MVIC in the 12 muscles examined and are recommended as the standard set for normalizing shoulder muscle EMG: abduction 908 with internal rotation (''empty can''), internal rotation in 908 abduction (''internal rotation 908''), flexion at 1258 with scapula resistance (''flexion 1258''), and horizontal adduction at 908 flexion (''palm press''). The use of these shoulder normalization tests will make comparisons between shoulder EMG studies more reliable. ß

No abstract

based in part on a specific approach to shoulder symptom modification procedures (SSMPs) outlined herein. Emerging research implicating the potential for central sensitization and cortical involvement is also discussed. Central Sensitization and Cortical ChangesThe cause of local pain in tendinopathy remains elusive, and frequently the level of pain experienced varies substantially

These results suggest that the physical therapy approach used in this study is effective in improving shoulder function in subjects experiencing pain of mechanical origin. The results also provide little evidence of spontaneous recovery over a 1-month period.

No abstract

48Purpose: Shoulder pain is a common disorder. Despite growing evidence of the importance of 49 physiotherapy, in particular active exercise therapy, little data is available to guide treatment. 50The aim of this project was to contribute to the development of an internationally accepted 51 assessment and treatment algorithm for patients with shoulder pain.

The optimal form of rehabilitation after rotator cuff repair has yet to be determined. A randomised clinical trial was undertaken to compare outcomes for two forms of rehabilitation for this condition: individualised supervised physiotherapy treatment, and a standardised unsupervised home exercise regime. Fifty-eight volunteers with all sizes of operatively repaired rotator cuff tears were allocated randomly to one of the two treatment groups. All subjects received a standardised home exercise regime. Subjects who were randomised to the physiotherapy group received additional individualised treatment. Independent, blinded assessments of range of motion, muscle force and functional outcome measures were performed pre-operatively, and at six, 12 and 24 weeks postoperation. At six, 12 and 24 weeks post-operation, comparable outcomes were demonstrated for both rehabilitation groups. By 24 weeks post-operation, most subjects demonstrated outcomes that were consistent with a favourable recovery, regardless of rehabilitation mode. On the basis of these results, outcomes for subjects allocated to individualised physiotherapy treatment after rotator cuff repair are no better than for subjects allocated to a standardised home exercise regime.