The comparison of acromiohumeral distance and scapular dyskinesis prevalence in females with and without rounded shoulder posture.

Background: Altered scapular kinematics in individuals with rounded shoulder posture (RSP) may affect acromiohumeral distance (AHD). The purpose of this study was to compare AHD and scapular dyskinesis prevalence in individuals with and without RSP. Methods: A total of 44 women (RSP, n=21; control, n=23) participated in the study. RSP was assessed by measuring acromion to table distance (ATD) in supine position and forward shoulder angle (FSA) using a camera and the AutoCAD software from the lateral side. According to these measurements, ATD more than 2.6 cm and FSA equal or more than 52° were considered as RSP. AHD was measured via ultrasonography with the arm at rest and 90 º of active elevation in scapular plane (scaption). Also, scapular dyskinesis was assessed by Uhl yes/no rating system. Independent and paired t tests were used to compare AHD between and within groups' comparisons, respectively. Chi-square test was used to compare the scapular dyskinesis prevalence in individuals with or without RSP. The data were analyzed using the SPSS statistical software version 17. Significance level was set at 0.05 Results: There were no statistically significant differences in participants' AHD in rest position (dominant side, p=0.187, nondominant side, p=0.144) and 90° scaption (dominant side, p=0.144, nondominant side, p=0.182) in each side between the 2 groups. Also, the results of chi-square test showed that there were not any significant differences in the prevalence of scapular dyskinesis during shoulder flexion (dominant side, p=0.653, nondominant side, p=0.541) and shoulder abduction (dominant side, p=0.141, nondominant side, p=0.277) in individuals with and without rounded shoulder postures. Conclusion: According to our results, RSD cannot lead to reduced AHD and higher prevalence of scapular dyskinesis.

Exercise therapy may affect scapular position and motion in individuals with scapular dyskinesis: a systematic review of clinical trials.

BACKGROUND: Therapeutic exercise for scapular muscles is suggested to be effective in reducing shoulder pain in patients with rotator cuff disorders, whereas its effectiveness on scapular position and motion has remained unclear. Therefore, the aim of this systematic review was to investigate whether exercise therapy improves scapular position and motion in individuals with scapular dyskinesis. METHODS: This study is a wide systematic review including any type of clinical trial in which the effect of any type of therapeutic exercise, including scapular muscle strengthening, stretching, and scapular stabilization exercise, is investigated in adult participants. RESULTS: Twenty studies were included in this systematic review. Studies were categorized on the basis of the techniques they used to measure scapular position and motion and the included participants. Methodologic quality of the studies was assessed by the Cochrane tool of assessing the risk of bias. Eight studies used 3-dimensional techniques for measuring scapular motions. Among them, 5 studies showed significant effects of exercise on scapular motion, of which 3 studies investigated individuals with subacromial impingement syndrome (SIS). The other 12 studies used 2-dimensional measurement techniques, of which 8 studies reported significant effects of exercise on scapular position and motion both in SIS patients and in asymptomatic individuals. However, their methodologic quality was debatable. Therefore, there was conflicting evidence for the effect of exercise on scapular dyskinesis. CONCLUSION: There is a lack of evidence for beneficial effects of exercise in improving scapular position and motion in individuals with scapular dyskinesis. However, exercise is beneficial in reducing pain and disability in individuals with SIS.

The Effectiveness of Exercise Therapy on Scapular Position and Motion in Individuals With Scapular Dyskinesis: Systematic Review Protocol.

BACKGROUND: Scapular dyskinesis is an alteration in normal scapular position and motion. Some researchers believe that altered kinematics of the scapula subsequent to dysfunction or weakness of scapular stabilizing muscles contributes to impingement syndrome. Scapular muscle exercises are included in the rehabilitation of patients with subacromial impingement syndrome and scapular dyskinesis because the muscular system is one of the major contributors of scapular positioning both at rest and during shoulder movement, but there is considerable uncertainty relating to the relative effectiveness of such approaches on changing scapular position and motion. OBJECTIVE: The aim of this systematic review protocol is to evaluate the effectiveness of exercise therapy on scapular position and motion in individuals with scapular dyskinesis. METHODS: A systematic review will be conducted using PubMed, Scopus, Web of Science, Elsevier, Ovid, ProQuest, Physiotherapy Evidence Database, and Cochrane Library. The reference lists of articles, other reviews, gray literature, and key journals will be searched for relevant articles. Clinical trials reporting the effect of therapeutic exercises (scapular strengthening exercise, scapular stabilization exercise, scapular muscle stretching) with the aims of changing scapular position and motion in individuals with scapular dyskinesis will be included. Two independent reviewers will select studies, extract data, and assess the quality of primary studies. Any disagreement during the selection of studies will be discussed and decided by the whole team. RESULTS: This systematic review began in December 2016 and is currently in progress. The findings will be synthesized to determine the effectiveness of recommended therapeutic exercise on scapular position and motion in individuals with scapular dyskinesis. CONCLUSIONS: This is the first systematic review protocol aiming to assess the effectiveness of exercise therapy in individuals with scapular dyskinesis. The systematic review doesn't require ethics approval because all data used will be provided from published documents. The results of this study will be published in a peer-reviewed journal. TRIAL REGISTRATION: PROSPERO CRD42017053923; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=53923 (Archived by WebCite at http://www.webcitation.org/6uzq32T02).

The duration effects of lumbar extensor muscle fatigue on postural control in soccer players.

Background: The ability to maintain body position in space is called postural control. Muscular fatigue created after doing voluntary repeated contractions impairs postural control. Thus, the present study was conducted to compare the effects of fatigue of the lumbar extensor muscles and duration of these effects on postural sway between soccer player and non-athlete participants. Methods: A total of 15 male soccer players and 15 male non-athletes participated in this cross- sectional study. Lumbar extensor fatigue is produced by a dynamometer and maintains 60% of the maximum voluntary isometric contraction in standing position. The mean velocity and the total area of the participants were evaluated using force plate at baseline, immediately, 3, 6, and 9 minutes after fatigue and compared between the 2 groups. Descriptive statistics, repeated measurement ANOVA, and independent t test were used for data analysis. Results: The results demonstrated that fatigue of the waist extensor muscles affects the postural sway (p= 0.001). Also, the total area level was recovered earlier than the mean velocity after fatigue. The results revealed that total area and velocity with eyes closed decreased in the soccer player group compared with the non-athlete group. Conclusion: Lumbar extensors fatigue significantly changed the mean velocity and the total area in soccer players and non-athletes. Lumbar fatigue had more effects on the total area than the mean velocity in the two groups.

Falls and postural control in older adults with cataracts.

BACKGROUND: There is increasing evidence that visual impairment contribute to falling. The aim of this study was to determine the influence of vision impairment of old adult patients with cataract on the occurrence of falls and postural control. METHODS: According to the results of screening ophthalmic examination, 48 cataract patients (mean±SD aged 68.5 ± 6.08 yrs.) and 50 individuals without any obvious eye disorders (mean age ± SD 70.7 ± 5.97 yrs.) were enrolled in this study. The postural control was determined using the clinical test of Sensory Interaction and Balance (CTSIB) and Timed up and Go (TUG) test. RESULTS: The results of this study revealed that 18% (n = 9) of the normal individuals and 22.9% (n =11) of the cataract patients had at least two falls in the past 12 months. However, the result of chisquare test did not show any differences between the two groups (p= 0.36). The mean ± SD TUG times in cataract and control groups in our study were15.17 ± 3.58 and13.77 ± 4.90, respectively. However, no significant differences were found between the two groups (p= 0.12).The results of CTSIB test showed no significant differences between the two groups on standing on the floor with eyes open and eyes closed (p= 0.61, p= 0.89) and on standing on the foam with eyes open and eyes closed (p= 0.32, p= 0.74 ). CONCLUSION: According to the results of CTSIB and TUG tests, vision impairment of old adult patients with cataract is not associated with falls and balance disorders. Further work including assessment of postural control with advanced devices and considering other falls risk factors are also required to identify predictors of falls in cataract patients.

The comparison of spinal curves and hip and ankle range of motions between old and young persons.

BACKGROUND: Falls have been strongly associated with decreased physical activity and impaired mobility. Reduced range of motion, as a consequence of muscle stiffness, has been indicated to assume a positive relationship to fall incidence. Also clinical observations suggest that maintaining the normal spinal curves is associated with the prevention of spinal, knee and hip disorders. Thus, the aim of this study was to compare hip and ankle range of motions and thoracic and lumbar curves between young and old persons Methods: Using a nonprobability sampling 30 elderly persons at average of 68.14 ±4.03 years of age and 30 young people (age 23.37 ± 2.31 years) through a case - control design participated in the study. Maximal hip extension and ankle dorsiflexion range of motions were measured by a standard goniometer. Thoracic and lumbar curvatures were measured by a flexible ruler in both groups. Independent t test were used to statistically analyze differences between groups. RESULTS: Compared with the young group, the elderly group had decreased hip extension and ankle dorsiflexion motions (p<0.01). The result of independent t test showed that the mean of lumbar curve was higher in young group (31.29± 6.37) than elderly subjects (27.93±8.11) ,however, no significant difference was found between two groups (p=0.08). The result also showed increasing thoracic curvature with aging (young group=34.43±13.27, old group= 36.19±8.97), however, no significant difference was found between two groups CONCLUSION: Findings suggest decreased ankle and hip joint range of motions should be considered in rehabilitation of elderly people.

The comparison of cross-education effect in young and elderly females from unilateral training of the elbow flexors.

BACKGROUND: Many studies have reported the increase in strength of the untrained contralateral limb after unilateral training. The aim of this study was to compare the cross education effect in the young and elderly persons. METHODS: In this quasi-experimental and pre-post study, 12 young people aged 28.25 ±3.11 years and 12 elderly persons (aged 73.08 ± 5.3 years) participated. The subjects had no history of strength training and upper limb movement impairments. Maximal isometric flexion strength in the dominant limb and the contralateral side before and after training were measured by tensiometer. Subjects performed elbow flexion exercises in the dominant side, using 3 sets of 10 repetition of the 60-70% maximal force for two weeks. Independent and paired t test were used to analyze between and within groups differences. RESULTS: The results showed that short-term isometric resistive exercise led to a significant increase of strength in trained and untrained limbs in both groups (p<0.05). There was not a significant difference between the two groups in the rate of strength increase, both in the upper limb that was exercised and also in the opposite side (p> 0.05). CONCLUSION: The increased muscle strength observed during training indicates positive effect of training in old adult. The increased muscle strength in untrained limb suggests the capacity of neuromuscular adaptation among old adults, suitable to be used in cases of limb immobility or unilateral impairment.

A Comparative Study on Shoulder Rotational Strength, Range of Motion and Proprioception between the Throwing Athletes and Non-athletic Persons.

PURPOSE: The repetitive micro traumatic stresses placed on the athletes shoulder joint complex during the throwing motion challenge the surrounding tissues. The purpose of this study was to compare shoulder rotational strength, range of motion and proprioception between the throwing athletes and non-athletic persons. METHODS: Fifteen throwing athletes and 15 non-athletes participated in a nonrandom case - control study. Strength of shoulder rotational movements was tested with a hand held dynamometer. The ranges of internal and external rotation of shoulder were measured by a standard goniometer. The ability of subjects to replicate the target position and kinesthetic sense was examined on the subjects' right shoulder by using a continuous passive motion device. Independent and paired t tests were used to statistically analyze between and within group differences. RESULTS: No significant difference was detected on the range of internal rotation between throwing athletes and non-athletic candidates (P=0.3). The range of external rotation was significantly more in athletic subjects (P=0.03). The results also showed that throwing athletes demonstrated a significantly higher isometric strength of shoulder external and internal rotation than the non-athletic group (P<0.05). However, the comparison of the internal and external rotation strength of dominant side in each group showed that throwing athletes showed a significant lower isometric strength of shoulder external rotation than internal rotation (P<0.001). It was also demonstrated higher joint position acuity in the throwing athletes than non athlete subjects (P=0.01). CONCLUSION: The repetitive nature of overhead throwing and the high forces that it causes result in adaptive changes of the dominant extremity. Throwing can lead to mobility, strength and neural adaptation.