Motor control retraining exercises for shoulder impingement: effects on function, muscle activation, and biomechanics in young adults
Worsley, Peter, Warner, Martin, Mottram, Sarah, Gadola, Stephan D., Veeger, H.E.J, Hermens, H, Morrissey, D, Little, Paul, Cooper, C., Carr, A and Stokes, M. (2013) Motor control retraining exercises for shoulder impingement: effects on function, muscle activation, and biomechanics in young adults. Journal of Shoulder and Elbow Surgery, 22, (4), 11-19. (doi:10.1016/j.jse.2012.06.010).
Objective: Evidence for effective management of shoulder impingement is limited. The present study aimed to quantify the clinical, neurophysiological, and biomechanical effects of a scapular motor control retraining for young individuals with shoulder impingement signs.
Method: Sixteen adults with shoulder impingement signs (mean age 22 � 1.6 years) underwent the intervention and 16 healthy participants (24.8 � 3.1years) provided reference data. Shoulder function and pain were assessed using the Shoulder Pain and Disability Index (SPADI) and other questionnaires. Electromyography (EMG) and 3 dimensional motion analysis was used to record muscle activation and kinematic data during arm elevation to 90� and lowering in 3 planes. Patients were assessed pre and post a 10-week motor control based intervention, utilizing scapular orientation retraining.
Results: Pre-intervention, patients reported pain and reduced function compared to the healthy participants (SPADI in patients 20 � 9.2; healthy 0 � 0). Post intervention, the SPADI scores reduced significantly (P < .001) by a mean of 10 points (�4). EMG showed delayed onset and early termination of serratus anterior and lower trapezius muscle activity pre-intervention, which improved significantly post-intervention (P < .05). Pre intervention, patients exhibited on average 4.6-7.4� less posterior tilt, which was significantly lower in 2 arm elevation planes (P < .05) than healthy participants. Postintervention, upward rotation and posterior tilt increased significantly (P <.05) during 2 arm movements, approaching the healthy values.
Conclusion: A 10-week motor control intervention for shoulder impingement increased function and reduced pain. Recovery mechanisms were indicated by changes in muscle recruitment andscapular kinematics. The efficacy of the intervention requires further examined in a randomized
|Digital Object Identifier (DOI):||doi:10.1016/j.jse.2012.06.010|
|Keywords:||shoulder impingement, rehabilitation, biomechanics, electromyography, motor control, function|
|Subjects:||Q Science > QM Human anatomy
Q Science > QP Physiology
R Medicine > RD Surgery
|Divisions:||Faculty of Health Sciences
|Date Deposited:||10 Sep 2012 13:26|
|Last Modified:||07 Jul 2014 10:21|
|RDF:||RDF+N-Triples, RDF+N3, RDF+XML, Browse.|
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