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

Impaired shoulder function and range of motion are important consequences of functional instability of the shoulder joint in overhead athletes. Therefore, the purpose of this study was to investigate the effect of a period of neuromuscular training on range of motion and shoulder function in athletes with functional instability of the shoulder joint.The present study was performed quasi-experimentally with pre-test and post-test design. The statistical sample consisted of 30 girls aged 22 to 35 years who were selected purposefully and available based on inclusion and exclusion criteria and finally were randomly divided into two groups of control and training. All subjects participated in the research voluntarily after completing the consent form. In the pre-test stage, shoulder joint function was assessed by YBT–UQ test and also shoulder joint range of motion was assessed by goniometer. After the pre-test, the subjects in the exercise group performed a neuromuscular training program for 8 weeks and 3 sessions per week. At the end of 8 weeks of training, all the measurements that were performed in the pre-test stage were performed again in the post-test stage. Two-way analysis of variance with repeated measures was used to analyze the obtained data.Findings showed that neuromuscular exercises of the shoulder joint significantly increase the score of the upper limb function test of the subjects of the exercise group in all three directions, as well as significantly increase the range of motion of the shoulder joint in flexion, abduction, internal rotation and external rotation (p≤0.05). However, no significant difference was observed in the above variables between pre-test and post-test in the control group (p≥0.05). Also, the results showed that in the post-test, there is a significant difference between all the investigated variables between the two groups (p≤0.05).Neuromuscular training develops muscle coordination and strength due to its multifaceted approach. Improving the efficiency of the neuromuscular system increases the function and range of motion of the shoulder joint. Therefore, this training method can be used as a suitable option in the rehabilitation of athletes with functional shoulder instability.

Shoulder and scapular abnormalities are the most common shoulder girdle disorders. The relationship between central stability and upper and lower body muscles strength and endurance has always been emphasized. Therefore, it is important to choose a better training method to prevent and treat shoulder girdle disorders. The purpose of this study was to compare the effect of functional corrective exercises and central stability on the shoulder girdle status of adolescent girls.

In this quasi-experimental study, 52 adolescent girls with forward-form shoulders with an age range of 14 to 16 years were purposefully selected and randomly allocated into 4 equal groups of 13 people, including functional corrective exercises, central stability, combination, and control. The amount of forwarding part of shoulder and scapular index was measured by double squares model (EM 420) and a tape meter, respectively before and after the interventions. Data were statistically analyzed using covariance and Bonferroni test in SPSS25 software.

The results of this study showed that exercise intervention had a significant effect on the forwarded shoulder (p=0/001), and scapular index (p=0/001). The results of the Bonferroni test showed that among the exercises performed, combined group exercises, functional correction group exercises, and central stabilization group exercises had the greatest effect on forwarding shoulder deformity and girls' shoulder index, respectively.

Based on the results, it can be concluded that performing a course of functional corrective exercises combined with central stabilization exercises can improve shoulder anomalies and scapular index in girls.

The purpose of the present research was to compare the effect and follow up of eight-week corrective exercises with and without the myofascial release forward head and forward shoulder deformity in young adults.

A total of 45 male students suffering from abnormal forward head more than 46° and forward shoulder more than 52° deformity with the Mean±SD age of 22.12±2.88 years, height of 175.44±6.80 cm, and weight of 71.21±7.31 kg were selected and randomly distributed in three groups: corrective exercises, combinational exercises (corrective and myofascial release), and control. These groups performed the exercises for eight weeks under the direct observation of the researcher. Prior to starting the exercises, after the end of eighth week, and four weeks after the end of the exercises, the angles of the forward head and forward shoulder of the participants were measured using a photography method. Then, the collected data was analyzed using the variance analysis tests with repeated measurements and ANCOVA.

The results showed that the degree of forward head and forward shoulder after eight weeks of exercises in both training groups in post-test and follow-up test was significantly lower than those of the pretest. The ANCOVA test results also demonstrated that the forward shoulder degree in corrective exercises group with myofascial release in post-test and follow-up test was significantly lower than that of the corrective exercises (P≤0.05). However, the forward head degree did not show a significant difference between the intervention groups in post-test and follow-up tests (P≥0.05).

According to the results, it can be stated that the corrective exercises program with myofascial release is more effective than the corrective exercises in correcting the forward shoulder deformity.

Shoulder dystocia is one of the obstetric emergencies which is associated with significant fetal and maternal complications. This study was performed with aim to evaluate the frequency of shoulder dystocia and its relationship with maternal factors and fetal parameters.

This descriptive cross-sectional study was performed on 7148 files of pregnant mothers referring to the maternity ward of Ali Ibn-e Abitaleb Hospital of Zahedan in 2015-2019. Necessary information such as maternal age, gestational age, sex of the newborn, birth weight and height, and having or not having of shoulder dystocia were extracted from the files of women in the hospital archive and were analyzed using SPSS software (version 22).

In this study, the files of 7148 pregnant women who had normal vaginal delivery (NVD) in Ali Ibn-e Abitaleb Hospital during 2015-2019 were evaluated. Among the, 64 newborns had shoulder dystocia and the frequency of shoulder dystocia was 0.89%. Moreover, 44 (66%) of women were over 30 years old and 39 (59%) of newborns were male. Also, 56 (87.5%) of infants weighed more than 4000 g and 15 (23%) of mothers had diabetes.

The frequency of shoulder dystocia was 0.89% and maternal age, fetal weight and gender are risk factors for shoulder dystocia. Considering these risk factors, timely cesarean section can prevent maternal and neonatal complications due to dystocia.

Painful entrapment of subacromial structures versus the choraco-acromial arch is defined as subacromial impingement syndrome (SAIS). Many studies have been done on the use of low-level laser in the treatment of musculoskeletal disorders. However, as the results of the studies are controversial, this study reviewed the results of studies on the effect of low-level laser on the pain and function of patients with subacromial impingement syndrome.Materials and Methods: PubMed, Scopus, Elsevier, Science Direct, ProQuest, and Medline databases were searched to retrieve clinical trials in English language that were published during the years 2000-2019. The keywords were as shoulder, subacromial impingement syndrome, and low-level laser.

Using the keywords, initially 200 articles were obtained, out of which, 7 clinical trials in English language that met the inclusion criteria were evaluated.

Studies showed that low-level laser was an effective modality for reducing pain and improving the function in subjects with subacromial impingement syndrome.

Shoulder dyskinesia is common among athletes with overhead throws and can make athletes susceptible to shoulder injuries. The purpose of this study was to compare the isometric strength and functional stability of shoulder girdle muscles in volleyball women Players with and without scapular dyskinesia.

In this descriptive-comparative study, 12 women volleyball players with scapular dyskinesia and 12 women volleyball players without scapular dyskinesia between 18 and 30 years were purposefully selected and compared. Kibler shoulder lateral slip test was used to assess shoulder movement disorder. A manual dynamometer was used to measure the maximal isometric strength of the shoulder muscles and the Y balance board was used to measure the functional stability of the upper extremity. Data were analyzed by SPSS 21 software.

There was a significant difference between the maximum isometric strength of infraspinatus
(P = 0.001), sub-scapula (P = 0.004), upper trapezoid (P = 0.001), lower trapezoid (P = 0.001) and serratus anterior (P=0.003) was present in individuals with and without dyskinesia. Also, the results of upper extremity functional stability test showed that in the superior-lateral (P = 0.04), middle (P = 0.009) and composite (P = 0.01) areas between athletes 'superior hand performance with scapular dyskinesia with athletes' superior hand performance.

In volleyball players with scapular dyskinesia, scapular stabilizers, including the dentate muscles and the inferior trapezius, were weaker than others. Also, functional stability in the shoulder of volleyball players with scapular dyskinesia was lower than in healthy subjects. Considering the association between decreased strength of shoulder girdle movements with dyskinesia, strengthening of shoulder girdle muscles, especially anterior and lower trapezius muscles, is recommended in in with scapular dyskinesia.

Breast cancer is the most common cancer in women. Surgery is the main treatment, and patients may experience some complications after surgery, including pain and shoulder function limitation. The severity of these complications is greater in modified radical mastectomy. In various studies, Kinesio Tape (KT) has been introduced as a supporting and complementary method in rehabilitation after surgeries. The aim of the present study was to compare the effects of a rehabilitation program with or without KT on shoulder pain and function after mastectomy in women with breast cancer. This study was a double-blind randomized clinical trial (RCT). In this study, 20 participants were randomly assigned to 2 groups. The intervention started the first day after surgery. One of the groups (n = 10) received therapeutic exercise program, and the other group (n = 10) received therapeutic exercise program as well as lymphatic correction with fan-shaped KT over a four-week period. KT was attached to the upper limb of the surgical side, the effects of the interventions were examined from two aspects of shoulder pain and function (based on the SPADI questionnaire). The findings of the study indicated that both groups had significant improvements in pain and function after the four-week period of intervention. The improvement in shoulder function was significantly greater in the exercise + KT group (p < 0.05), although there was no significant difference between the two groups in shoulder pain (p > 0.05). The use of fan-shaped KT with therapeutic exercises is recommended for improving the shoulder function after a modified radical mastectomy.

This is a report on simultaneous dislocation of the left shoulder and elbow resulting in a 16 years old boy. Bipolar dislocation of Luxatio Erecta and posterior dislocation of the elbow is extremely rare. After clinical examinations (attention to pain, swelling, and deformity of the shoulder and elbow joints and neurovascular examinations), the necessary radiography was performed for the patient at the level of his tolerance: AP of the shoulder and side imaging of the elbow. Closed reduction was carried out with emergency maneuvers, followed by physiotherapy. Good result was obtained in the 6 weeks follow-up the examination of the adjacent joints of a dislocated limb is an important issue and must be emphasized.

Alteration of scapular position and motion is called scapular dyskinesis. Scapular dyskinesis is a common clinical problem. Strength of shoulder girdle muscles is important in shoulder motions and stability, so their weakness may lead to scapular dyskinesis. The aim of this study was to compare the maximum voluntary isometric force of shoulder girdle movements in subjects with and without scapular dyskinesis
A case-control study was designed where the participants were selected by nonprobability sampling; 30 subjects with scapular dyskinesis and an average age of 22.95±2.62 years and 30 subjects without scapular dyskinesis and an average age of 22.43±2.50 years. The subjects were instructed to stand with their arms resting on each side of the body. The examiner stood behind them at a distance of 1.5 meter and asked them to elevate their arms to the highest level possible. Scapular dyskinesis test was used to visually examine alteration in scapulohumeral rhythm during arm elevation in sagittal and frontal planes. The shoulder flexion and abduction were repeated for 5 times. At the same time, the examiner rated the scapular movement as normal or observable dyskinesis. The maximal voluntary isometric force of shoulder internal and external rotation on both sides, such as “scaption with external rotation”, “scapular abduction and upward rotation”, “scapular adduction and downward rotation”, “scapular adduction” and “adduction and depression of scapula” were measured with manual Dynamometer. For determining the maximal shoulder isometric rotational force, subjects were positioned prone on tables, arm brought into 90º abduction in frontal plane with 90° elbow flexion and resistance given to distal forearm into shoulder external and internal rotations. The maximal isometric force of scaption (supraspinatus strength) was measured in seated position; shoulder elevated 70º into scapular plane abduction (scaption) with external rotation. The maximal isometric force of scapular abduction and upward rotation was determined in supine position while the arm was elevated to 90º flexion with elbow extension and resistance given against forward pushing. For determining the maximal isometric force of rhomboids and middle trapezius muscles, resistance was given against scapular adduction and downward rotation, and scapular adduction, respectively. The maximal isometric force of lower trapezius was determined in prone position while the arm was elevated to 135º shoulder elevation with elbow extension. Independent t-test was performed to compare the maximal voluntary isometric force of shoulder girdle motions in individuals with and without scapular dyskinesis.
The mean±SD of age, weight and height of the participants without and with scapular dyskinesis were 22.43±2.50 years/ 22.95±2.62 years, 64.39±13.38 kg/ 65.67(±12.2) kg and 171.35(±11.29) cm/ 173.43(±8.66) cm, respectively. No statistically significant differences were found between the participants of the two groups with regard to the age, weight and height. Our result showed that the isometric force of “scaption with external rotation”, “scapular abduction and external rotation”, “adduction and depression of scapula”, “scapular adduction and downward rotation” and “scapular adduction” were significantly different between the two groups (P Scapular dyskinesia or altered kinematics of the scapula (downward rotation, anterior tilt and internal rotation) contributes to impingement syndrome by decreasing the subacromial space. The tissues that occupy the subacromial space are the supraspinatus tendon, subacromial bursa and long head of the biceps brachii tendon. The supraspinatus is the major rotator cuff muscle that is susceptible to tendinopathy in subacromial space. The inflammatory processes or tension overload during shoulder activities, which may result from altered kinematics of the scapula and decrease in the subacromial space, may lead to supraspinatus weakness. It has been shown that scapular stabilizers, such as serratus anterior, rhomboids and middle and lower trapezius muscles are more prone to weakness than the other shoulder muscles. So, the weakness in these muscles may relate to scapular dyskinesis. Scapular muscle exercises are executed in the rehabilitation of patients with subacromial impingement syndrome and scapular dyskinesis, as the muscular system is one of the major contributors to scapular positioning, both at rest and during movements. It seems that improving the strength of shoulder girdle muscles especially supraspinatus, serratus anterior, rhomboids, and middle and lower trapezius muscles would be necessary in individual with scapular dyskinesis.

Aims: Spinal cord injury is an acute and devastating event that causes significant and permanent changes in veterans’ life and leads to functional impairments. Exercise can reduce the incapacity or improve individuals’ functions. The aim of this study was to investigate the effect of shoulder centralized exercises and Pushrim-Activated Power-Assisted Wheelchair (PAPAW) on pain and shoulder function in veterans with paraplegic spinal cord injury.
In this semi-experimental study with pre-test and post-test design, 20 wheelchair-user veterans with spinal cord injury and shoulder pain referring to Kosar orthosis and prosthesis center were selected by purposive sampling in 2015. They were randomly assigned into experimental (n=10) and control (n=10) groups. Data were collected by Wheelchair User's Shoulder Pain Index (WUSPI) and Shoulder Rating Questionaire (SRQ). The exercises were performed for 8 weeks and 3 days each week in the experimental group with using Pushrim-Activated Power-Assisted Wheelchair (PAPAW) at home and the control group did not receive any interventions. Data were analyzed by dependent t-test and Analysis of Covariance (ANCOVA).
Findings: In the experimental group, the pain level significantly decreased and the shoulder function significantly increased in the post-test compared to the pre-test. There was a significant difference between experimental and control groups (p Shoulder centralized exercises and Pushrim-Activated Power-Assisted Wheelchair (PAPAW) is effective on decreasing the pain and increasing shoulder function in veterans with paraplegic spinal cord injury.

This study aimed to evaluate the symmetry of the isometric strength of the shoulder and scapulothoracic muscles in volleyball and futsal athletes.
In this case-control study, the strength of the scapulothoracic muscles and rotation of the shoulders in 20 adult volleyball athletes and 20 futsal adult athletes, who were randomly selected from sports clubs around Tehran, were measured using a manual dynamometer. The obtained data between the different groups and within the individual groups were compared by Independent and paired t tests, respectively.
The isometric strength of the external rotator muscles, internal rotator muscles, upper trapezius and serratus anterior of the dominant side of volleyball and futsal athletes were different (P In volleyball athletes, disturbances in the strength ratio of the agonist and antagonist muscles of the scapula, and weaknesses in these muscles, impair the dynamic stability of the scapula and shoulder joints and disturbances in the rhythm of the scapulohumeral muscles. It is recommended that during training, assessment and treatment of these athletes strengthening these muscles be considered.

One of the most common musculoskeletal injuries in modern societies is neck and shoulder pains which often lead to postural disorders and soft tissue shortenings. This study was done to compare the length of shoulder girdle’s muscles in healthy subjects and patients with shoulder and neck pain.
This case-control study was done on16 patients with chronic neck- shoulder pain as cases and 15 healthy subjects as control group. Length of upper trapezius, pectoralis major and minor muscles was evaluated with functional tests. Also, the range of shoulder abduction and external rotation and cervical flexion and lateral flexion were measured by goniometer.
Significant differences between patient and control groups were found in pectoralis major and minor muscles length in involved side (P This study confirmed a significant reduction in range of motion in the neck and shoulder and also a remarkably shortening in the muscles of in the involved side.

Shoulder injuries are common among athletes in sports that involve overhead throwing of the ball such as handball. The objectives of this study were to evaluate the timing and activation intensity of shoulder muscles during handball penalty throwing in individuals with shoulder pain and in control subjects.
Using BTS FREE EMG 300 system with bipolar surface electrodes, the timing (onset) and intensity of the activation of the shoulder muscles were measured including upper trapezius, anterior, middle and posterior deltoid, latissimus dorsi, pectoralis major, supraspinatus and triceps during penalty throwing. Multivariate analysis of variance (ANOVA) was used for between group comparisons with the significance level P The activation intensity of upper trapezius and latissimus dorsi muscles in the healthy individuals were about 50.74% and 43.42% higher than in patients. Middle deltoid in healthy individuals was about 38.05% smaller than that in patients. In control group, supraspinatus muscle started earlier (23.5 ms) than the shoulder motion initiation. Triceps muscle was activated about 18.5 ms later than shoulder motion initiation. In patients, supraspinatus muscle started sooner (11 ms) and triceps brachialis muscle started later than the other muscles (22.16 ms).
The coordination of shoulder muscles i.e. the onset and intensity of muscle activity is disturbed in the patient group during throwing. Hence, strength and stretching programs are recommended for athletes to reduce the risk of shoulder pain syndrome. The rehabilitation program can be focused on modifying the pattern of activity in upper trapezius, supraspinatus, latissimus dorsi and deltoid muscles in addition to pain control in the rehabilitation centers.

One of the most common postural abnormalities which is seen in 60 percent of patients with neck and shoulder disorders is Forward head posture. The purpose of current study was the comparison of contribution ratio in scapular rotator muscles over dominant and non-dominant arm abduction on loading in women with and without Forward Head Posture.
In this case-control study 18 women with Forward Head Posture and 14 healthy women were studied. The subjects were matched based on weight, height, age, dominance of upper extremity and voluntarily participated. The contribution ratio of Serratus Anterior, Upper and Lower Trapezius muscles were recorded by surface electrodes during arm abduction with loading.
The independent t-test results revealed that the upper trapezius muscle activity ratio of dominant arm in subjects with forward head posture is significantly greater than healthy ones (P= .011), whereas the significant difference was not revealed in non-dominant arm. There were also no significant differences in Serratus Anterior muscle (p>.05) and Lower Trapezius muscle (p>.05) ratio between the groups.
Because of the changes in contribution ratio of Upper Trapezius, a simple assessment of head posture through the shoulder muscles can provide useful information for the examiner to decide on prescription of corrective exercises for patient.

The aim of this study was the comparison of the functional stability of dominant and non-dominant shoulder in female volleyball players with and without anterior shoulder instability, using YBT-UQ.
In this descriptive study, 28 female university volleyball players (age=20 to 25 years) were categorized into healthy (n=14) and anterior shoulder instability (n=14) group. Upper quarter y balance test (YBT-UQ) was used for measuring functional stability of both dominant and non-dominant shoulder. After checking the normal distribution of the results with 1-s Kolmogorov-Smirnov, paired sample t-test and independent sample t-test were used for comparing the dominant and non-dominant shoulder’s functional stability and for comparing the results between groups, respectively.
Higher YBT-UQ composite score was observed in non-dominant shoulder and dominant shoulder of the healthy group and the non-dominant shoulder and dominant (injured) shoulder of shoulder instability group, respectively. No significant difference was observed between functional stability of both shoulders of the healthy group (p=0.144), while the functional stability of the non-dominant shoulders of the instability group was significantly higher than the dominant unstable shoulders (p=0.001). The results of functional stability of the unstable shoulders of the injured group were significantly lower than the results of the dominant shoulders of the healthy group, while in non-dominant side, all directions but the Superolateral direction showed significant difference.
Based on the results of this study, functional stability of the unstable shoulder of female university volleyball players is lower than the functional stability of their non-dominant side or the functional stability of the healthy subjects therefore, we suggest that the upper extremity stabilization exercises, specially the closed kinetic chain exercises should be added to the shoulder rehabilitation programs.

Dynamic stability in shoulder is an important element in life and any disorder in muscular function which helps maintain this stability leads to shoulder pathology. One of these disturbing factors is fatigue. According to the research team information until now there has not been a study investigated systematically the effect of fatigue on shoulder girdle biomechanics. So the purpose of this systematic review is to determine the effect of muscle fatigue on normal shoulder girdle biomechanics.

This study is a systematic review based on search in PubMed, Scopus, Elsevier, Ovid, CINAHL, Science Direct, ProQuest, Thompson, EMBASE and Medline databases for the period of 1995- 2012. The keywords used were Shoulder, Muscle Fatigue, Proprioception and Kinematics. Two levels of reevaluation were used on 350 citations.

The search strategy resulted in 350 results out of which 22 papers met the criteria for this study. Variation among studies in terms of sample size, fatigue protocol and method of measurement were investigated.

Evidences demonstrated muscle fatigue leads to change in activation pattern of muscles shoulder girdle and consequently kinematics as well as reduction in proprioception during different positions and movements in both scapulothoracic and glenohumeral joints. Generally the results indicated that there are sufficient evidences based on the effect of fatigue on the muscular fatigue has disturbance effects on shoulder girdle kinematics and could alter the normal biomechanics.

Introduction & The glenohumeral joint becomes dislocated more than any other major joint because it involves a wide range of motion، and its stability is inherently weak. The most common complication following acute initial shoulder dislocation is recurrent dislocation or chronic instability. The imbalance of strength and range of motion in individuals with anterior dislocation can be a contributing factor in recurrent shoulder dislocation. This case-control study consisted of 24 individuals with a mean age of 24. 29±4. 33 years، and a mean dislocation rate of 5. 37±3. 62 times. Isometric cuff strength was measured by using a handheld dynamometer، and for range of motion، the Leighton flexometer was used for the internal and external rotational motions of both upper extremities SPSS 18 and Independent t-test was used for data analysis. The internal and external range of motion of the injured glenohumeral joint was less than the uninjured joint (P

Neck pain is an important public health care problem in modern societies, and proper and effective training programs are required for its prevention and treatment. The purpose of this study was to determine the effect of shoulder-abduction resistance trainings on isometric strength of the neck extensor muscles. In this study, a total of 28 healthy women (20-25 years of age), were randomly divided into two groups of shoulder-abduction resistance exercises (n=14) and control (n=14), who performed active range of motion exercises (AROM). Both groups performed exercises 3 days/week for 10 weeks. In both groups, isometric strength of neck muscles was measured before and after the intervention period using an isometric neck muscle strength measurement device. Data were analyzed by independent and paired t-tests. The strength of the neck extensor muscles in the case group was 72.69±15.82, which was significantly higher in comparison with the control group, 52.68±14.20 (p<0.001). The results of this study showed that shoulder-abduction resistance exercises are effective in increasing isometric strength of the neck extensor muscles.

Rotator cuff tear is one of the major causes of shoulder pain and disability especially in over 60 year old age people. The problems with arthroscopic repair and also failure to repair with strong and valuable sutures in massive tears have increased the trend towards open surgery. This study was done to assess repair of rotator cuff tear by open surgery. In this cross-sectional study, 14 candidates (8 female, 6 male) for rotator cuff surgery, were assessed for shoulder function by the use of ASES and SST scoring systems, before and after surgery, by the same observing orthopaedic surgeon. Mean age of patients was 57.94±14.04 years old. The mean SST score before surgery and 6 and 9 months after surgery were 10.17, 10.67 and 10.81, respetively; with a significant post-operative improvement (p=.026). The mean ASES score before surgery, 6 and 9 months post surgery were 42.82, 47.95 and 57.43, respectively; showing significant improvement after surgery (p=.025). The open surgical repair of rotator cuff tear is effective and shoulder function improves and pain decreases significantly. This is with the technique of constructing a surface, rather than making a trough, and also using of interoseous suture rather than anchor suture.