جستجوی مقالات مرتبط با کلیدواژه « سندرم گیرافتادگی شانه » در نشریات گروه « پزشکی »

 Shoulder impingement syndrome is one of the most common shoulder disorders. The kinematic alterations observed in shoulder impingement syndrome comprise a visible change in the position of the scapula and its movement on the chest. The lack of corrective exercises for shoulder impingement syndrome and its frequent problems are important challenges. Since shoulder pain is relatively common and impingement syndrome is one of its most common causes, and according to previous studies that stated that the lack of muscle balance is the source of functional impingement syndrome, it is essential to provide appropriate solutions to correct this injury. This study aimed to investigate the effects of an 8–week corrective exercise program based on the National Academy of Sports Medicine (NASM) principles on physical condition, pain, and proprioception in male swimmers with shoulder impingement syndrome.

 Considering the intervention (NASM corrective exercises), the targeted selection of the subjects, and the inclusion and exclusion criteria, the current research was quasi–experimental. The statistical population, excluding the effect of gender, included all elite male swimmers aged 20 to 35 living in Kohgiluyeh and Boyer–Ahmad Province, Iran. In this research, among the qualified volunteers based on the study inclusion criteria, 30 people entered the research using the available method. Then, they were randomly divided into two groups of 15 people each: corrective exercises and control. The inclusion criteria for participants included a kyphosis angle greater than 42 degrees and the presence of at least two symptoms of shoulder impingement syndrome, as determined by a series of diagnostic tests, including pain in the subacromial region, the presence of a painful arch up to 120 degrees, a positive Jobs test, a positive Neer test, a positive Hawkins test, and shoulder isometric resistance abduction pain. The exclusion criteria were having related pathological symptoms such as a history of fracture and surgery and or joint diseases of the spine and the presence of hyperlordosis abnormality (degree of lumbar lordosis above 50 degrees). The corrective exercise group performed NASM exercises for 8 weeks, and pre– and post–intervention measurements were taken of back arch angle, pain, and proprioceptive accuracy. The information obtained from measuring the research variables was analyzed using descriptive and inferential statistics (including analysis of covariance, paired t test, and independent t test) In SPSS version 23 software. The level of significance was set at p< 0.05.

 The results of the paired t test showed a significant decrease in the average amount of back arch angle (p=0.003) and shoulder pain (p=0.003) and a significant increase in the accuracy average of shoulder proprioception (p<0.001) in the corrective exercise group from pretest to posttest. However, these variables did not change in the control group (p>0.05). The results of covariance analysis showed a significant decrease in the amount of back arch angle (p<0.001) and pain (p<0.001), as well as a significant increase in shoulder proprioceptive accuracy in the corrective exercise group (p<0.001). The analysis of covariance showed back arch angle with an effect size of 0.58, pain with an effect size of 0.44, and target reconstruction error angle with an effect size of 0.37 in the posttest in the exercise group after controlling the effect of the pretest.

 This study found that NASM exercises can effectively reduce back arch angle and pain and improve proprioception in male swimmers with shoulder impingement syndrome. The study suggests that the NASM–based corrective exercise program is a viable treatment option for shoulder impingement syndrome in male swimmers.

Shoulder pain is a common musculoskeletal disorder in the general public. Shoulder impingment syndrome is one of the most common shoulder disorders. Due to the lack of a similar questionnaire in Iran and the need to use standard tools in the field of clinical evaluation, localization and validity and reliability of the Persian version of this questionnaire was considered as the purpose of this study.

This study included 20 women with shoulder involvement syndrome in the age range (20-50) years who were evaluated by a physiotherapist.Using the translation-re-translation method, the necessary corrections were made and the final form of the questionnaire was prepared. In order to determine the content validity of CVI and CVR methods, to determine the degree of reliability, internal consistency test (Cronbach's alpha) was used and to evaluate the reliability, test-retest.

The results of CVI showed that all questions with CVI score higher than 0.79, patient ward (0.85 on communication scale, resolution 1, simplicity 0.92, ambiguity 0.92) and physician ward (on communication scale 1, resolution 1, Simplicity 1, Ambiguity 0.88). average content validity index of the patient ward was 0.92 and the physician ward was 0.97. Statistical analysis showed that the internal consistency of the Cronbach's alpha questionnaire questions is equal to 0.74. ICC values showed that the intra-group correlation of the patient ward (% 95 CI: 96-89) and the physician ward (95% CI: 95 -88) were calculated.

CMS "gold standard tool" for assessing shoulder occlusion syndrome.

This study aimed to evaluate the effects of scapular-focused treatment with (SFTF) and without (SFT) feedback on pain, function, and scapular kinematics in patients with Shoulder Impingement Syndrome (SIS).

36 males and females with SIS (age of 37 ± 6.3 years) were randomly assigned into SFTF (n=12), SFT (n=12) and control (n=12) groups. The primary outcome was pain, assessed by Visual Analog Scale (VAS). The secondary outcomes were function and scapular kinematics, assessed by DASH Questionnaire and a 3-D motion capture, respectively. All outcomes were measured at the baseline and after the 8-week interventions.

A post-hoc analysis performed to show significant differences between groups after the 8-week interventions. For pain, there were significant differences between SFTF vs. SFT (ES (95%CI) = -0.3(-0.4 to -0.1); P= 0.04), SFTF vs. control (ES (95%CI) = 1.3(0.7 to 1.9); P= 0.01). For DASH, also, there were significant differences between SFTF vs. SFT (ES (95%CI) = 1.8(1.1 to 2.4); P= 0.03), SFTF vs. control (ES (95%CI) = 4.4(3.3 to 5.4); P= 0.01), and SFT vs. control (ES (95%CI) = 2.6(1.8 to 3.4); P= 0.01). For scapular internal rotation (the sagittal or scapular planes), scapular upward rotation, and the scapular tilt, however, there weren’t differences between SFTF vs. SFT.

Based on the study results, a rehabilitation program integrated with verbal feedbacks is effective to relieve pain, and improve function and scapular kinematics in patients with SIS. Adding feedback to an exercise therapy could clinically enhance outcomes in patients with SIS.

Shoulder obstruction syndrome is a common disease of the shoulder joint that causes shoulder pain, especially in adults. In the present study, we aimed to evaluate and compare the effect of a combination of conventional therapies with kinesiotaping on shoulder pain and activity in patients with shoulder obstruction syndrome.

This was a randomized controlled clinical trial study performed on 20 patients with shoulder entrapment syndrome. Patients were assigned to control and intervention treatment groups. For patients in both control (medication and exercise) and intervention (medication, exercise, and kinesiotaping) groups, the same medication was prescribed by a physical therapist, and the same exercise was provided by the physical therapist. Patients 'pain was measured, and patients' shoulder function were compared.</em>

The mean pain score decreased significantly in both groups after treatment (P = 0.003). The mean pain score in the intervention group was significantly lower than the control group (P < 0.001). The mean shoulder function score improved significantly in both groups after treatment (P = 0.007). The mean shoulder performance score in the intervention group was significantly better than the control group (P = 0.003).

The use of kinesiotaping along with exercise and painkillers had significant effects on improving patients' performance and reducing pain.

Impingement syndrome is the most common injury and cause of pain and limitation of movement in the shoulder area. The purpose of the present study was to compare the electromyographic activity of selected shoulder muscles and scapulohumeral rhythm in elite male swimmers with and without shoulder impingement syndrome.         

In the present study, 30 elite 18-25 year-old male swimmers, including 15 patients with shoulder impingement syndrome and 15 healthy individuals (age 22.15±1.23 years; height 179.40±5.59 cm; weight 78.35±7.37 kg) were selected as the statistical sample. To collect data, a goniometer to assess the scapulohumeral rhythm in the 90 ° abduction in frontal plans and American noraxon wireless surface EMG device to assess the electromyographic activity of muscles in the 90 ° abduction and recovery in sagittal, frontal, and scapular plans and the dominant sides were used. For data normalization, Shapiro–Wilk test and for data analysis independent t-test were used (P> 0.05).

The results indicated that with regard to mean scapular rotation start (P<0/001), scapular rotation (P = 0.001) and scapulohumeral rhythm ratio (P = 0.001), there were significant differences between the patient and healthy groups. Also, there was a significant difference between the mean onset and offset of Serratus anterior and lower trapezius muscles in all three plans and upper trapezius muscles in the sagittal and scapular plans of the patient group compared with healthy group (P> 0.05), and the swimmers with impingement syndrome had a lower onset (delayed activation) and higher offset (early termination of activity) compared with the healthy group. Moreover, the sequence of muscle recruitment to be active and inactive had undergone a change in the patient group.  

Therefore, swimmers with impingement syndrome have higher scapular rotation start, lower scapular rotation, and higher scapulohumeral rhythm ratio compared with the healthy groups, and the regular coordination of scapulohumeral rhythm in the shoulder compartment has been disrupted in the patient group. Swimmers also exhibit abnormal activity and increased latency in the muscles, meaning lower onset (delayed activation), and higher offset (early termination of activity. Therefore, the theory that the shoulder impingement may be related to changes in the level of activity and recruitment of the scapulothoracic muscles is generally acknowledged as a sign of the change in neurovascular control.

Shoulder impingement syndrome is one of the important causes of shoulder pain, which affects the shoulder joint proprioception. Closed kinetic chain exercises are more useful and safer than opened kinetic chain exercises. The purpose of this study was to determine the effect of total body resistance exercise (TRX) on the shoulder joint proprioception of athletes with overhead movements with impingement syndrome. This research is a randomized clinical trial. 22 athletes with overhead movements with shoulder impingement syndrome in Kerman (2017) were selected and randomly assigned to two groups: TRX and control. The exercises were performed for 8 weeks, three days a week and 60 minutes each session. Proprioception sense was evaluated by Leighton’s flexometer in four movements of external rotation, internal rotation, abduction, and flexion of the arm. Independent t-test was used to analyze the data. The results showed that there was no significant difference between the control and TRX groups in the pre-test of external rotation, internal rotation, abduction, and flexion angles (p<0.05) but in post-test, there was a significant difference in all target angles of external rotation (p<0.001), internal rotation (p<0.001), abduction (p<0.001), and flexion (p=0.015). According to the results, 8 weeks of TRX exercises had an effect on the condition of shoulder joint in athletes with overhead movements with shoulder impingement syndrome. It seems that it can be used as an appropriate training method in athletes with shoulder impingement syndrome.

The previous studies have reported controversial results on the shoulder muscles’ activity of individuals with shoulder impingement. The aim of the present study was to quantify the shoulder muscles’ activity during the cocking and acceleration phases of handball throwing with slow and fast speeds. A total of 12 controls (age: 23±3; weight: 64±12) and 12 patients with shoulder impingement (age: 27±4; weight: 60±13) were studied. The electrical activity of shoulder muscles in the right sides, including upper trapezius, anterior, middle, posterior deltoid, latissimus dorsi, pectoralis major, supraspinatus, and triceps muscles, were measured in both shoulders using an EMG system with surface electrodes. A mixed 2×2 analysis of variance was used at a significant level of p < 0.05. In cocking phase of the slow and fast throwing, in patients, higher activities of upper trapezius, supraspinatus, and latissimus dorsi muscles were observed, as compared with control group and in cocking phase of fast throwing, middle deltoid activity was lower in patient group (p<0.02). In the acceleration phase of the slow throwing, the activity of upper trapezius muscle was higher in patients compared with control group. However, in the acceleration phase of the fast throwing, in patients, lower activity in middle deltoid and higher activities in latissimus dorsi and trapezius muscles were observed (p<0.05). Shoulder pain syndrome results in altered shoulder muscle activity. These alterations are greater in fast throwing activity. The current study does not determine whether these changes are because of adaptation to the pain, or are caused by the injury. However, it appears that with pain present, fast throwing movements will put the shoulder in greater risk of injury. It is suggested that isometric or slow movements be used in the shoulder rehabilitation at the early stage of the treatment. Correct muscle enhancement is also recommended to prevent the shoulder pain syndrome.

Altered scapular kinematics are common disabilities among patients with shoulder impingement syndrome and/or rotator cuff tear. The scapular assistance test (SAT) might be a helpful diagnosis tool to identify clinical type of scapular dyskinesia. The SAT may correct scapular upward rotation and posterior tilt. The aim of this pilot study was to identify the SAT application as a diagnostic tool for type of scapular dyskinesia and among patients with shoulder impingement syndrome and rotator cuff tear. Moreover, another aim was to determine the effect of SAT on the shoulder pain and shoulder range of abduction.
Seven patients with shoulder impingement syndrome and seven patients with rotator cuff tear met the inclusion criteria and included in the study population. An experienced therapist palpated patient's scapula as starting position for the SAT. In the next stage, patient was asked to perform shoulder abduction and reported any pain or inconvenience during the examination. Meanwhile, the therapist kept upward rotation and posterior tilt of the scapula.
The pain level in shoulder (by VAS, Visual Analogue Scale), shoulder range of abduction, flexion and scapular plane elevation (by electrogoniometer) and also, shoulder disability (by DASH, Disability of Shoulder and Hand Questionnaire) had been measured during shoulder abduction and also the SAT performance. The statistical analysis was performed using independent and paired t-test after normal distribution approval.
Duration of disease (p=0.02), night pain (p Current study depicts that the SAT might be a useful test to diagnose the type of scapular dyskinesia in patients with shoulder impingement syndrome. However, the SAT may not be a valuable diagnostic test for patients with rotator cuff tear.

Shoulder impingement syndrome is one of the causes of shoulder pain and improve of range of motion in muscles of scapula and rotator cuff have great importante in the treatment of this syndrome. Therefore the purpose of this study was to investigate the effect of 8 weeks selected exercise training on range of motion of the shoulder impingement syndrome. In this study, 24 non-athletes aged 35 to 55 years voluntarily participated and randomly divided into two experimental and control 12 person.
The experimental group participated in eight weeks training program (three sessions per week). While the control group did their daily activities. Descriptive statistics were used to calculate the mean and standard deviation. For determining the extent of changes within the group and between groups, was used dependent and independent t-test (P The results of study showed that selected exercises in the experimental group significantly increased range of motion in the shoulder and the pain was reduced compared to the control group.
The results indicate that the use of the exercise therapy can be an effective way for improve range of motion and decrease of pain in patients with shoulder impingement syndrome.

This study evaluated the effect of theraband training on Position sense of internal and external rotator muscles in male athletes with shoulder impingement syndrome. In this semi-experimental interventional study 30 cases of men with Shoulder syndrome with age range of 20 to 30 years participated. They were divided in test and control groups, each group including 15 people through non-random and purposeful method Biodex System 3 Made in America was used to measure position sense of internal and external rotator muscles. For data analysis independent 7 paired t-test was used in SPSS software (version 21). The experimental group showed significant improvement after six weeks of theraband training in the internal and external rotator muscles in three 90,45,0 degree angle at a significance level of 0.05 (P=0.05). The results of this study showed that of theraband training resulted in improved position sense of internal and external rotator muscles in male athletes with impingement syndrome thus, the benefits of these exercises can be used widely in team sports and also for easy and quick rehabilitation of patients.

Subacromial impingement is one of the most common complaints of shoulder. Treatments include avoiding of painful activities, oral anti-pain drugs, physical therapy modalities, corticosteroid injection and exercise therapy. Some studies have shown that platelet- rich plasma(PRP) is effective on tendinitis and tearing of tendons, ligaments and muscles, but evidence that has proved PRP as a conservative treatment in shoulder pathologies is very limited. This study aims to investigate the effect of PRP injection on relieving pain and improving daily function of patients with shoulder impingement syndrome. In this clinical trial study, patients older than 40 with pain more than three months were included. If they had three of four positive diagnostic clinical tests of shoulder impingement that were confirmed by shoulder MRI, could be injected PRP twice. The time between injections was 1 month. Pain was measured by visual analog scale (VAS) and function was measured by two questionnaires named disabilities of the arm, shoulder and hand (DASH) and western Ontario rotator cuff index (WORC). Range of motion (ROM) of shoulder was measured in five directions by goniometry. All of these parameters were evaluated before intervention and in 1, 3, 6 months later. with due attention to a six-month folloe-up, PRR injection was effective in pain reduction and improvement of patient's function (p<0.05). Shoulder Rom increased in all directions except external rotation and the power of shoulder muscles was evidently improved statistically in flexion, abduction and internal toration. PRP injection could effectively reduce pain and improve daily activities in patients with shoulder impingement syndrome.

Among all shoulder injuries, shoulder impingement syndrome (SIS) is more common and is the most common cause for pain and stiffness in the shoulder area. The study purpose was to investigate the effect of six weeks resistance exercises with elastic-band on joint pain and range of motion (ROM) in athlete men with shoulder impingement syndrome.

This was a semi experimental research. The statistical population was athlete 20 to 30 year’s old men with SIS, referred to a counseling and health center.، Twenty students were selected as statistical samples and divided into two experimental (n = 10) and control (n = 10) groups. Then, one group had shoulder band workout for six weeks, and every week 3 sessions, and the control group only performed their daily activities. We used electro goniometer for measuring pre and posttest ROM and Visual Analog Scale (VAS) for pain assessment. The data was analyzed using independent samples t-test (p ≤ 0. 05).

In this study, a significant improvement was found in joint pain relief in the experimental group compared to pre-test and the control group. In addition, the experimental group compared with the control group showed a significant difference in ROM of the shoulder joint after six weeks of shoulder band workout in abduction, internal rotation and external rotation movements.

The result of this study showed that the resistance exercises with elastic-band are effective to joint pain relief and ROM improvement in athlete men SIS,

There is impairment in the level of muscle activity of scapular and rotator cuff muscles in patients with shoulder impingement syndrome. Exercise therapy is one of the important methods of treatment in these patients. In addition، the application of tape has been suggested in the rehabilitation of patients with shoulder impingement syndrome. The purpose of this study was to study effects of therapeutic exercise associated with facilitative taping of selected shoulder girdle muscles on the activity level of these muscles in patients with shoulder impingement syndrome. Subjects and This study was performed on two groups of 12 subjects from patients with shoulder impingement syndrome، by non-probability convenient sampling method. Electromyography recorded from selected muscles in both groups during movements of flexion and abduction. Electromyography was recorded after a period of exercise therapy associated with tape for one group and without tape for the other group. Comparison of level of electromyography activity of middle and lower trapezius and infraspinatus muscles during flexion and abduction tasks in tape group، before and after treatment shows increase to 17. 54% (p=0. 41) and in non tape group before and after treatment increases to 2. 94 % (p=0. 38). The results of our investigation revealed that there is no significant influence of tape application on level of electrical activity of muscles studied during flexion and abduction tasks in patients with shoulder impingement syndrome.

The purpose of this study is to compare muscle activation pattern between patients with shoulder impingement syndrome and healthy subjects during selected functional task. In this comparative and case-control study, fifteen patients with shoulder impingement syndrome as case group were selected simply and conveniently from Avesta orthopedic clinic and fifteen healthy subjects as control group were selected on the basis ofAWT IMAGE matching with patients. In each group selected exercises including open kinetic chain with and without external load and closed kinetic chain with axial load was done and during each exercises surface electromyography (EMG) from selected muscle including Superior Trapezius, Infraspinatus and Anterior, Middle and Posterior Deltoid recorded. Independent T-test used for data analysis. Generally two groups showed different muscle activity during kinetic chain exercises. There were significant differences in relative muscle latency times between two groups in superior Trapezius, Infraspinatus and three regions of Deltoid muscle (P<0.05). Changes in muscle recruitment pattern are task dependent that this may be due to direction of movement and axial compression loading in subacromial space. Among all selected exercises in D2E (Diagonal 2 Extension) minimum changes and in tripod maximum changes (in time domain) were seen.

Therapeutic exercise is one of the methods to reduce pain and to strengthen muscles in patients with shoulder impingement syndrome. There are many exercise protocol for shoulder rehabilitation. The aim of this study was to compare the effect of two exercise regimen (traditional vs functional) on pain and maximal voluntary contraction (MVIC) of shoulder muscles.Subjects and Measures: 24 men and women (mean age: 18-50) with shoulder impingement syndrome were randomly assigned to one of two exercise groups. MVIC of shoulder muscles (pectoralis major, upper trapezius, middle trapezius, infraspinatus, anterior, middle and posterior deltoid) by surface electromyography and pain assessed during before and after four week treatment. In both groups resting pain was reduced after treatment (P<.000). There was no significant difference between two groups (P<.007). MVIC force of all shoulder muscles increased after treatment in both groups (P<.05). There was no significant difference between two groups except for pectoralis major muscle that had more MVIC force in functional group(P<.006).Pain reduction after therapeutic exercise was associated with an improved MVIC force in both groups but there was more reduction in pain and increase in MVIC in the kinetic chain group than the traditional.

Epidemiologic Investigations have revealed a high prevalence (16% - 44%) of shoulder complaints consistent with "impingement" in certain occupations. Multiple theories exist in respect to the primary etiology of shoulder "impingement" such as anatomic abnormalities of the coracoacrominal arch or humeral head weakness or degeneration of the rotator cuff tendons shoulder kinematic postural abnormalities and improper scapular muscles control. comparison of kinematic parameters of shoulder complex in healthy and impingement persons. 17 patients with shoulder Impingement syndrome that were selected conveniently (age = 43.82) and 17 healthy persons that were matched with patients (age=44.5) participated in this case – control study. A three - dimentional electromechanical digitizer was used to measure scapular position and orientation. Measurments were taken while the arm placed at the side of the body and elevated 45˚, 90˚, 120˚ along with full range of motien in the scapular plane. Orientation was described by upward rotation angle, posterior tilting angle and internal rotation angle. Position was described by medio – lateral position and superio – inferior position. Comparing to non impaired subjects, those with impingement, demonstrated a significantly lower upward rotation angle (90˚, 120˚) and posterior tilt angle of the scapla in respective scapular plane. (P<0/05) These results suggest that altered scapular kinematic maybe an Important aspect of the "impingement syndrome". Scapular upward Rotation and posterior tipping are important to consider in the rehabilitation of pateints with symptoms of shoulder Impingement.