Muscle activity and scapular kinematics in individuals with multidirectional shoulder instability: A systematic review

Spanhove, Valentien; Daele, Matthias Van; Abeele, Aäron Van den; Rombaut, Lies; Castelein, Birgit; Malfait, Fransiska; Cools, Ann; Wandele, Inge De

doi:10.1016/j.rehab.2020.10.008

Cited by 16 publications

(12 citation statements)

References 55 publications

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“…Perhaps its most significant limitation is that it does not include the joints that patients most commonly describe as unstable such as the shoulder, foot/ankle, and patellofemoral joints. 41 , 42 While the 5-part Hypermobility Questionnaire has very good sensitivity and specificity for identifying GJH, it has been validated only in adults and does not provide clinicians with information about individual joints. The more recently developed and validated Lower Limb Assessment Score 34 , 35 and the ULHAT 33 have the potential to provide clinicians with richer insight into joint range and integrity to inform further functional assessments and interventions.…”

Section: Strengths and Limitations Of Current Joint Hypermobility Ass...mentioning

confidence: 99%

“… 54 , 55 These factors include muscle weakness, 56 reduced mobility, insufficient musculotendinous length, muscle hypertonicity in proximity to a hypermobile joint, obesity, 57 and altered movement patterns. 42 If hypermobility is present in combination with pain, recurrent (sub)luxations, and musculoskeletal overload injuries, 58 it can be categorized as “symptomatic joint hypermobility” (Fig. 1 , left side of symptomatic hypermobility iceberg).…”

Section: Phenotypic Presentations Of Joint Hypermobilitymentioning

confidence: 99%

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International Perspectives on Joint Hypermobility

et al. 2022

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There is exponential clinical and research interest in joint hypermobility due to recognition of the complexity of identification, assessment, and its appropriate referral pathways, ultimately impacting management. This state-of-the-science review provides an international, multidisciplinary perspective on the presentation, etiology, and assessment of joint hypermobility, as it presents in those with and without a systemic condition. We synthesize the literature, propose standardizing the use of terminology and outcome measures, and suggest potential management directions. The major topics covered are (i) historical perspectives; (ii) current definitions of hypermobility, laxity, and instability; (iii) inheritance and acquisition of hypermobility; (iv) traditional and novel assessments; (v) strengths and limitations of current assessment tools; (vi) age, sex, and racial considerations; (vii) phenotypic presentations; (viii) generalized hypermobility spectrum disorder and hypermobility Ehlers-Danlos syndrome; and (ix) clinical implications and research directions. A thorough understanding of these topics will equip the reader seeking to manage individuals presenting with joint hypermobility, while mindful of its etiology. Management of generalized joint hypermobility in the context of a complex, multisystem condition will differ from that of acquired hypermobility commonly seen in performing artists, specific athletic populations, posttrauma, and so on. In addition, people with symptomatic hypermobility present predominantly with musculoskeletal symptoms and sometimes systemic symptoms including fatigue, orthostatic intolerance, and gastrointestinal or genitourinary issues. Some also display skeletal deformities, tissue and skin fragility, and structural vascular or cardiac differences, and these warrant further medical follow-up. This comprehensive review on the full spectrum of joint hypermobility will assist clinicians, coaches/ sports trainers, educators, and/or researchers in this area.

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Section: Strengths and Limitations Of Current Joint Hypermobility Ass...mentioning

confidence: 99%

Section: Phenotypic Presentations Of Joint Hypermobilitymentioning

confidence: 99%

International Perspectives on Joint Hypermobility

et al. 2022

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“…Patients with MDI typically display a downward rotation of their scapulae at rest and a lack of upward rotation through arm elevation [ 8 , 28 , 29 , 30 ]. This reduces the relative contact area of the humeral head on the glenoid, which contributes to the quintessential sulcus sign (inferior instability) seen at rest in MDI, and pathological humeral head translations through range [ 31 , 32 , 33 , 34 ].…”

Section: Aetiologymentioning

confidence: 99%

“…Electromyography (EMG) studies have shown patients with MDI have altered scapulo-thoracic, rotator cuff and deltoid function compared to people with stable shoulders [ 8 , 30 , 37 ], although the altered motor patterns are not consistent between studies [ 28 ]. The inconsistencies are likely due to the varied presentations of the pathology and the different movement strategies patients use to stabilize their shoulders.…”

Section: Aetiologymentioning

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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“…The deltoid is a very important agonist of shoulder elevation. Its anterior and middle parts progressively contribute to shoulder anterior elevation and abduction in conjunction with the supraspinatus [34,35]. On the other hand, the upper trapezius helps maintain, along with other scapular stabilisers such as the serratus anterior, the scapula in stable position in order to give a stable base for the rotator cuff muscles to act on and reduce risk of injury of subacromial structures.…”

Section: Muscular Activitymentioning

confidence: 99%

The use of a three-dimensional dynamic arm support prevents the development of muscle fatigue during repetitive manual tasks in healthy individuals

et al. 2022

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Work-related upper extremity disorders are costly to society due to resulting medical costs, presenteeism and absenteeism. Although their aetiology is likely multifactorial, physical workplace factors are known to play an important role in their development. Promising options for preventing work-related upper extremity disorders include assistive technologies such as dynamic arm supports designed to follow the movement of the arm while compensating for its weight. The objective of this study was to assess the effects of a dynamic arm support on perceived exertion, muscle activity and movement patterns of the upper limb during repetitive manual tasks in healthy individuals. Thirty healthy right-handed individuals were allocated either a static or a dynamic task to perform with and without a dynamic arm support. During the task, surface electromyographic activity (anterior and middle deltoid, upper trapezius) and upper limb kinematics (elbow, shoulder, sternoclavicular) were measured using surface EMG and inertial sensors. Results showed that the dynamic arm support significantly reduced perceived exertion during the tasks and limited the development of muscular fatigue of the anterior and middle deltoid as demonstrated by EMG signal mean epoch amplitudes and median frequency of the EMG power spectrum. The dynamic arm support also prevented a decrease in shoulder elevation and an increase in total shoulder joint excursion during static and dynamic task, respectively. These results denote the potential benefits of dynamic arm supports in work environments. Further studies should focus on their efficacy, acceptability and implementability in work settings.

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Muscle activity and scapular kinematics in individuals with multidirectional shoulder instability: A systematic review

Cited by 16 publications

References 55 publications

International Perspectives on Joint Hypermobility

International Perspectives on Joint Hypermobility

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

The use of a three-dimensional dynamic arm support prevents the development of muscle fatigue during repetitive manual tasks in healthy individuals

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