Multidirectional Instability: Natural History and Evaluation

Navlet, Miguel García; Asenjo-Gismero, Cristina Victoria

doi:10.2174/1874325001711010861

Cited by 10 publications

(9 citation statements)

References 36 publications

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“…When SD is not the primary cause, it could be associated with impingement syndrome, GH instability, clavicular fracture, RC disease, superior labral injury and AC joint pathology, which, in turn, could be related to local tumors, ST crepitus and multidirectional instability [17,[69][70][71][72]. Impingement syndrome reduces the scapular ER, and increases upper trapezius muscle activity.…”

Section: Causes and Effects Of Sdmentioning

confidence: 99%

Scapular Dyskinesis: From Basic Science to Ultimate Treatment

Longo

Ambrogioni

Berton

et al. 2020

IJERPH

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Background: This study intends to summarize the causes, clinical examination, and treatments of scapular dyskinesis (SD) and to briefly investigate whether alteration can be managed by a precision rehabilitation protocol planned on the basis of features derived from clinical tests. Methods: We performed a comprehensive search of PubMed, Cochrane, CINAHL and EMBASE databases using various combinations of the keywords “Rotator cuff”, “Scapula”, “Scapular Dyskinesis”, “Shoulder”, “Biomechanics” and “Arthroscopy”. Results: SD incidence is growing in patients with shoulder pathologies, even if it is not a specific injury or directly related to a particular injury. SD can be caused by multiple factors or can be the trigger of shoulder-degenerative pathologies. In both cases, SD results in a protracted scapula with the arm at rest or in motion. Conclusions: A clinical evaluation of altered shoulder kinematics is still complicated. Limitations in observing scapular motion are mainly related to the anatomical position and function of the scapula itself and the absence of a tool for quantitative SD clinical assessment. High-quality clinical trials are needed to establish whether there is a possible correlation between SD patterns and the specific findings of shoulder pathologies with altered scapular kinematics.

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Section: Causes and Effects Of Sdmentioning

confidence: 99%

Scapular Dyskinesis: From Basic Science to Ultimate Treatment

Longo

Ambrogioni

Berton

et al. 2020

IJERPH

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“…7,18,23 In these studies, scapular dyskinesis was evaluated with regard to rotator cuff tears and impingement syndrome. Few studies have evaluated the role of scapular dyskinesis in shoulder instability, 17,28 and we found no study that evaluated the presence of scapular dyskinesis after ABR.…”

Section: Discussionmentioning

confidence: 89%

Scapular Dyskinesis, Shoulder Joint Position Sense, and Functional Level After Arthroscopic Bankart Repair

Sayaca

Unal

Çalık

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Scapular kinesia is an important component of glenohumeral rhythm and shoulder stability. No studies have evaluated scapular dyskinesis and its relationship to shoulder proprioception in patients who have undergone arthroscopic Bankart repair (ABR). Purpose: To investigate scapular dyskinesis, proprioception, and functional level after ABR. Study Design: Cohort study; Level of evidence, 3. Methods: This study included 13 male patients who underwent ABR (ABR group; mean age, 30 years; range, 24-36 years) and 13 sex- and age-matched healthy individuals (control group). The age, height, weight, and dominant side of all participants were collected. Scapular dyskinesis was evaluated using the lateral scapular slide test and the scapular dyskinesis test; proprioception was measured by the active angle reproduction test using a smartphone goniometer application, and functional level was assessed using the upper-quarter Y-balance test for dynamic stability as well as the Rowe score and Walch-Duplay score for quality of life and return to activities of daily living. Results: The presence of static scapular dyskinesis in the neutral position, at 45° of abduction, and at 90° of abduction as well as the presence of dynamic scapular dyskinesis was higher in the ABR group compared with the control group ( P ≤ .04 for all). Shoulder joint position sense (absolute error) at 40° and 100° of shoulder elevation and shoulder functional level according to the Rowe score were worse in the ABR patients compared with the healthy controls ( P ≤ .02 for all). Dynamic scapular dyskinesis was negatively related to shoulder joint position sense at 40° of shoulder elevation ( r = –0.64; P = .01). Static scapular movement as measured on the lateral scapular slide test was moderately related to the Rowe score ( r = 0.58; P = .03). Conclusion: Scapular kinematics and proprioception should be evaluated after ABR. Treatment approaches to improve scapular control and proprioceptive sense should be included in the rehabilitation program for patients after ABR.

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“…The higher rates of collagen turnover in people with MDI [ 12 , 13 , 17 ] also reduce the tensile strength of the tissue [ 18 ]. Capsular laxity may be congenital [ 13 , 19 ], and some authors have suggested it may be acquired due to repetitive microtrauma such as swimming or throwing [ 13 , 19 , 20 ], although this theory has yet to be empirically tested. It is important to distinguish laxity from instability.…”

Section: Aetiologymentioning

confidence: 99%

“…Often, patients who have a background of shoulder laxity that was previously asymptomatic and well controlled, start to experience symptoms in the inferior and anterior and/or posterior directions when motor control is lost in association with micro-trauma and pain [ 22 , 32 ]. These acquired MDI types are more likely to have instability in two directions [ 20 ]. This group has a larger variation in their associated factors; however, they have an increased incidence of acquired structural lesions due to the repetitive microtrauma imposed on their shoulder [ 32 , 48 ].…”

Section: Classificationmentioning

confidence: 99%

Advances in the Non-Operative Management of Multidirectional Instability of the Glenohumeral Joint

Watson¹,

Pizzari

Balster³

et al. 2022

JCM

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Multidirectional instability (MDI) of the glenohumeral joint refers to symptomatic subluxations or dislocations in more than one direction. The aetiology of MDI is multifactorial, which makes the classification of this condition challenging. A shoulder rehabilitation program is the initial recommended treatment for MDI, however available rehabilitation programs have varying levels of evidence to support their effectiveness. In 2016, we published the details of an evidence-based program for MDI that has been evaluated for efficacy in two single-group studies and a randomised controlled trial. In 2017, we published a clinical commentary on the aetiology, classification, and treatment of this condition. The aim of this paper is to provide an update on the components of these publications with a particular focus on new advances in the non-operative management of this condition.

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Multidirectional Instability: Natural History and Evaluation

Cited by 10 publications

References 36 publications

Scapular Dyskinesis: From Basic Science to Ultimate Treatment

Scapular Dyskinesis: From Basic Science to Ultimate Treatment

Scapular Dyskinesis, Shoulder Joint Position Sense, and Functional Level After Arthroscopic Bankart Repair

Advances in the Non-Operative Management of Multidirectional Instability of the Glenohumeral Joint

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