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Motor control retraining exercises for shoulder impingement: effects on function, muscle activation, and biomechanics in young adults

Motor control retraining exercises for shoulder impingement: effects on function, muscle activation, and biomechanics in young adults
Motor control retraining exercises for shoulder impingement: effects on function, muscle activation, and biomechanics in young adults
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
control trial.
shoulder impingement, rehabilitation, biomechanics, electromyography, motor control, function
1058-2746
11-19
Worsley, Peter
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Warner, Martin
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Mottram, Sarah
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Gadola, Stephan D.
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Veeger, H.E.J
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Hermens, H
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Morrissey, D
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Little, Paul
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Cooper, C.
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Carr, A
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Stokes, M.
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Worsley, Peter
6d33aee3-ef43-468d-aef6-86d190de6756
Warner, Martin
f4dce73d-fb87-4f71-a3f0-078123aa040c
Mottram, Sarah
1d5657d1-cb55-4fc8-9d11-986f551d4ef6
Gadola, Stephan D.
ef2fa6cf-2ccc-4fea-a7a5-cc03a9d13ab1
Veeger, H.E.J
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Hermens, H
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Morrissey, D
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Little, Paul
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Cooper, C.
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Carr, A
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Stokes, M.
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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).

Record type: Article

Abstract

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
control trial.

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Published date: 1 April 2013
Keywords: shoulder impingement, rehabilitation, biomechanics, electromyography, motor control, function
Organisations: Faculty of Health Sciences

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Local EPrints ID: 342622
URI: http://eprints.soton.ac.uk/id/eprint/342622
ISSN: 1058-2746
PURE UUID: c819e39f-8540-4bf1-8604-c950b7404cc9
ORCID for Peter Worsley: ORCID iD orcid.org/0000-0003-0145-5042
ORCID for Martin Warner: ORCID iD orcid.org/0000-0002-1483-0561
ORCID for Paul Little: ORCID iD orcid.org/0000-0003-3664-1873
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for M. Stokes: ORCID iD orcid.org/0000-0002-4204-0890

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Date deposited: 10 Sep 2012 13:26
Last modified: 12 Jul 2024 01:46

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Contributors

Author: Peter Worsley ORCID iD
Author: Martin Warner ORCID iD
Author: Sarah Mottram
Author: Stephan D. Gadola
Author: H.E.J Veeger
Author: H Hermens
Author: D Morrissey
Author: Paul Little ORCID iD
Author: C. Cooper ORCID iD
Author: A Carr
Author: M. Stokes ORCID iD

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