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2014 ; 44
(9
): 636-45, A1-8
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Comparison of 3-dimensional shoulder complex kinematics in individuals with and
without shoulder pain, part 1: sternoclavicular, acromioclavicular, and
scapulothoracic joints
#MMPMID25103135
Lawrence RL
; Braman JP
; Laprade RF
; Ludewig PM
J Orthop Sports Phys Ther
2014[Sep]; 44
(9
): 636-45, A1-8
PMID25103135
show ga
STUDY DESIGN: Cross-sectional. OBJECTIVES: To compare sternoclavicular,
acromioclavicular, and scapulothoracic joint motion between symptomatic and
asymptomatic individuals during shoulder motion performed in 3 planes of
humerothoracic elevation. BACKGROUND: Differences in scapulothoracic kinematics
are associated with shoulder pain. Several studies have measured these
differences using surface sensors, but the results of this technique may be
affected by skin-motion artifact. Furthermore, previous studies have not included
the simultaneous measurement of sternoclavicular and acromioclavicular joint
motion. METHODS: Transcortical bone pins were inserted into the clavicle,
scapula, and humerus of 12 asymptomatic and 10 symptomatic individuals for
direct, bone-fixed tracking using electromagnetic sensors. Angular positions for
the sternoclavicular, acromioclavicular, and scapulothoracic joints were measured
during shoulder flexion, abduction, and scapular plane abduction. RESULTS:
Differences between groups were found for sternoclavicular and scapulothoracic
joint positions. Symptomatic individuals consistently demonstrated less
sternoclavicular posterior rotation, regardless of angle, phase, or plane of
shoulder motion. Symptomatic individuals also demonstrated less scapulothoracic
upward rotation at 30° and 60° of humerothoracic elevation during shoulder
abduction and scapular plane abduction. CONCLUSION: The results of this study
show that differences in shoulder complex kinematics exist between symptomatic
and asymptomatic individuals. However, the magnitude of these differences was
small, and the resulting clinical implications are not yet fully understood. The
biomechanical coupling of the sternoclavicular and acromioclavicular joints
requires further research to better understand scapulothoracic movement
deviations and to improve manual therapy and exercise-based physical therapy
interventions.