Thoracic spine mobility, an essential link in upper limb kinetic chains in athletes: A systematic review

Abstract

Knowledge of the contribution of the thoracic spine movement, a requisite for UL functional movement, offers the potential for novel directions for research and management in rehabilitation. This systematic reviewed synthesized evidence of thoracic spine mobility during UL movement in athletes. Using three reviewers at each stage, key databases (MEDLINE, CINAHL, Web of Science) were searched up to 30/6/18. Eligibility criteria: adults age 18‐40 (reflecting athletic population) and studies assessing thoracic spine and UL movement. Quality assessment was evaluated using AXIS tool and GRADE for overall quality of evidence. Seven studies were included (n = 168, mean age 26.4 years, 33% males) with n = 20 in an athlete population. Main findings were: Unilateral and bilateral UL flexion resulted in 6.7‐8.0 and 12.0‐12.8° thoracic extension, respectively. Unilateral and bilateral UL abduction resulted in 3.0‐4.0 and 9.0‐15.0 and degrees, respectively. Other thoracic spine movement (lower and upper, rotation and lateral flexion) was variable across movement planes. Overall there was unequivocal evidence of thoracic spine movement, mainly extension during UL movement and notably at the end of elevation across all planes. Findings support further targeted high‐quality research and examination of thoracic mobility, an essential link in the kinetic chain, in practice.

A feasibility study on home-based kyphosis-specific exercises on reducing thoracic hyperkyphosis in older adults

“…For dimension 3, the training targets increasing upper extremity muscles and shoulder mobility to contribute to scapular alignment, which is associated with spinal alignment [ 35 , 36 ]. The exercises increase spine mobility, and muscle flexibility can reduce the obstacles of spine extension and thoracic extension [ 62 ], which will further benefit obtaining alignment posture and enhance cardiopulmonary function [ 63 ]. Further study may need to reveal the mechanism of posture alignment progress.…”

Responses of Tai Chi in Upper Limb Sports Injuries Rehabilitation on Young People

“…There was no significant difference in depression and anxiety scores of patients with sports injuries before exercise. 9 After exercise, the bad mood of the patients with sports injuries has been improved. However, the scores of depressions (52.18±3.26) and anxiety (50.36±3.15) in the control group were still higher than those in the experimental group (P<0.05).…”

Injury surveillance in elite Paralympic athletes with limb deficiency: a retrospective analysis of upper quadrant injuries

“…It is documented in the literature that there is an association between altered scapula kinematics and upper quadrant pathology [25,28] which could have contributed to the high levels of injuries reported within the shoulder complex. Whilst relatively under researched the relationship between the thoracic spine and upper quadrant has recently gained some momentum, with evidence of a kinematic relationship between mobility in the thoracic spine and shoulder [29] and neck [30]. With a recent review synthesising evidence of thoracic spine exercises for mobility, motor control, work capacity and strength, there now exists a clinical reasoning framework to support personalised exercise prescription and rehabilitation for athletes with impairments [31].…”