RESUMEN
ABSTRACT BACKGROUND AND OBJECTIVES: The subacromial impingement syndrome is a dysfunction of the glenohumeral joint which can cause pain, functional disability, dependence, and low quality of life. The aim of this study was to compare the muscle strength between painful and non-painful shoulders and to verify the relationship between shoulder pain and disability and isometric muscle strength of the upper limb and kinesiophobia level in individuals with symptoms of subacromial impingement syndrome. METHODS: Twenty volunteers with symptoms of subacromial impingement syndrome participated in the study. The evaluation was carried out by means of an evaluation form, the Shoulder Pain and Disability Index questionnaire (SPADI - BRAZIL) to assess disability and shoulder pain and the TAMPA questionnaire to analyze the level of kinesiophobia. The evaluation of shoulder isometric muscle strength was performed using the Manual Hand-Held Dynamometer stabilized by a rigid band in the movements of flexion, extension, abduction and internal and external rotation of the shoulder. RESULTS: In the comparison of muscle strength between symptomatic and asymptomatic side, evidence of significant difference (p<0.05) was verified for all movements evaluated. There was a significant negative relationship between shoulder pain and disability index and isometric muscle strength of flexion and internal rotation, and a significant positive relationship with the level of kinesiophobia. CONCLUSION: Individuals with symptoms of subacromial impingement syndrome showed a significant reduction in muscle strength of the symptomatic shoulder. The shoulder pain and disability index is related to the isometric muscle strength of the shoulder and to the level of kinesiophobia.
RESUMO JUSTIFICATIVA E OBJETIVOS: A síndrome do impacto subacromial é uma disfunção da articulação glenoumeral, podendo gerar dor, incapacidade funcional, dependência e baixa qualidade de vida. O objetivo deste estudo foi comparar a força muscular isométrica entre ombro doloroso e não doloroso e verificar a relação entre dor e incapacidade no ombro e força muscular isométrica do ombro e nível de cinesiofobia em indivíduos com sintomas de síndrome do impacto subacromial. MÉTODOS: Participaram do estudo 20 voluntários com sintomas de síndrome do impacto subacromial. A avaliação foi realizada por meio de ficha de avaliação, questionário Shoulder Pain and Disability Index (SPADI - BRASIL) para avaliação da incapacidade e dor no ombro e questionário TAMPA para analisar o nível de cinesiofobia. A avaliação da força muscular isométrica do ombro foi realizada utilizando o instrumento Manual Hand-Held Dynamometer estabilizado por faixa rígida nos movimentos de flexão, extensão, abdução, rotação interna e externa do ombro. RESULTADOS: Na comparação de força muscular isométrica entre lado sintomático e assintomático foi verificada evidência de diferença significativa (p<0,05) para todos os movimentos avaliados. Houve relação negativa significativa entre índice de dor e incapacidade no ombro e força muscular isométrica no movimento de flexão e rotação interna, além de relação positiva significativa com nível de cinesiofobia. CONCLUSÃO: Indivíduos com sintomas de síndrome do impacto subacromial apresentaram redução significativa da força muscular isométrica do ombro sintomático. O índice de dor e incapacidade no ombro está relacionado com força muscular isométrica do ombro e com nível de cinesiofobia.
RESUMEN
Abstract Aims: To investigate the factors associated with shoulder rotational range of motion and its correlation with the self-reported function scale and functional assessment of the shoulder (closed kinetic chain upper extremity stability, peak torque of shoulder rotators, glenohumeral internal rotation deficit - GIRD, and pectoralis minor length index) in competitive water polo players. Methods: Thirty-four competitive water polo players (age: 15 +/- 1.6 years) participated in this study. The shoulder rotational range of motion, closed kinetic chain upper extremity stability, pectoralis minor length index, isokinetic torque of shoulder internal and external rotations, and self-reported upper limb function were assessed. The Pearson correlation coefficient was used to test the linear correlation before the multiple linear regressions, that were used to predict the variables associated with the external rotation and internal rotation range of motion ratio (ER/IR ratio) of the throwing limb. Results: A significant association was identified between the throwing limb ER/IR ratio and GIRD, and this observation allows us to infer that GIRD was responsible for 18.4% (p=0.01) of the variation. No associations between ER/IR ratio and the variables closed kinetic chain upper extremity stability, peak torque of shoulder internal rotation, and pectoralis minor length index were identified. Conclusion: Anatomical GIRD was the only factor associated with the ER/IR ratio in asymptomatic competitive water polo players from high school, indicating the beginning of the typical adaptations to increase performance without significantly altering the self-perception and functionality of their upper limbs.