Bioelectric activity of selected muscle groups in people with impingement syndrome.

The aim of this study was to assess the changes of the bioelectric activity of the selected muscles and their impact on the functioning of the shoulder joint in people with impingement syndrome. The study covered 58 subjects aged between 24 and 85, who were treated for impingement syndrome in the years 2004-2006. The average duration of the disease was 40 months. The following muscles were tested for bioelectric activity using surface myography: deltoid, supraspinatus, infraspinatus, latissimus dorsi, greater pectoral and biceps brachii on the healthy and the diseased sides. A significant drop in activity of the deltoid and the infraspinatus muscles on the diseased side was observed. The following muscles showed comparable activity on both sides: the supraspinatus, latissimus dorsi and the greater pectoral muscle. The activity of the biceps brachii muscles grew during resisted movements. The drop in the activity of the deltoid and the infraspinatus muscles on the affected side is an important factor responsible for changes of the active mobility of the shoulder and for the development of instability of the shoulder joint. A similar activity of the latissimus dorsi, greater pectoral and biceps brachii muscles on both sides indicates a development of the compensatory mechanisms and the role of those muscles in the dynamic stabilisation of the shoulder joint.

Principles of physiotherapeutic management of shoulder impingement syndrome.

BACKGROUND: The study aimed to assess changes in shoulder joint mobility and symmetry as well as changes in the bioelectrical activity of selected muscles important for the functioning of the shoulder complex in order to determine optimal physiotherapeutic management in patients with shoulder impingement syndrome. MATERIAL AND METHOD: The study involved 58 persons aged 24-85 years treated for shoulder impingement syndrome from 2004 to 2006. Symptoms had been present for 40 months on average. The examination of patients included in each case measurement of active mobility ranges using the SFTR method, photogrammetry-based assessment of shoulder symmetry and an examination of the bioelectrical activity of muscles using surface electromyography. RESULTS: The results demonstrated that the degree of limitation of external rotation, which considerably affects the other motion ranges, is the most important index of shoulder joint dysfunction. The decrease in the bioelectrical activity of the deltoid muscle is caused by pain avoidance, with high activity of the pectoralis major and latissimus dorsi muscles indicating the development of compensatory mechanisms. A spatial displacement of the scapula referred to as a wing-like position impairs the scapulobrachial rhythm. CONCLUSIONS: Therapeutic management should firstly aim to eliminate pain, then to restore shoulder joint stability by instructing the patient on how to properly centre the humeral head, and, subsequently, to restore normal movement patterns and the scapulobrachial rhythm, and finally to gradually increase the range of active mobility, in particular of external rotation.

Analysis of three-dimensional motion of the glenohumeral joint in impingement syndrome.

INTRODUCTION: Impingement syndrome (IS) is one of the most common causes of progressive dysfunctions of the shoulder joint. The aim of the study was to evaluate the changes in the joint's mobility in patients with IS and to find correlations between the angular values of particular motion ranges. MATERIAL AND METHOD: The study involved 58 people aged 24-85 years, treated for IS from 2004 to 2006. The average duration of the disease was 40 months. A comparative examination of active mobility on the healthy and affected side was carried out according to the SFTR method. RESULTS: A comparison of mean values of the motion ranges indicated significant limitations of active mobility in the affected shoulder. The greatest mobility deficit was found in the external rotation range. Moreover, there was a statistically significant correlation between the angular values of internal rotation and the values of the remaining motion ranges. CONCLUSIONS: Impingement syndrome.

Posture in people with shoulder impingement syndrome.

BACKGROUND: The posture of people with shoulder impingement syndrome (SIS) is a result of adaptive defensive posturing to decrease the intensity of pain in the affected joint. The aim of this work is to characterise trunk and shoulder girdle positioning in patients with SIS. MATERIAL AND METHOD: The study involved 58 patients treated for SIS in the years 2004-2006. Symptoms had been present for 40 months on average. A photogrammetric study was performed with the use of a MORA 4G system. It consisted in measuring lordosis and kyphosis, as well as the symmetry of some selected anthropometric points in the frontal plane. RESULTS: Changes in posture presenting as an increased angle of trunk inclination in the sagittal plane and in the frontal plane were observed in all patients. There was asymmetry of bony points as regards the position of the scapula and the waist triangles. CONCLUSIONS: The impingement syndrome is associated with displacement of all bony points analysed. Changes in posture are a result of adaptive mechanisms. Trunk asymmetry is secondary to changes in the spatial position of the scapula.

Assessment of postural stability disorders in older adults treated at a health resort.

Background. Falls are a common and often devastating occurrence for the elderly in both home and institutional settings. The main purpose of our study was to assess disorders of postural stability in elderly patients undergoing health resort treatment, recruited at the sanatorium in Swieradów Zdrój, Poland. Material and methods. Thirty two older adults between the ages of 67 and 84 years were enrolled. All subjects completed a questionnaire pertaining to their fall history, subjective feeling of unsteadiness, activity level, medical status and use of assistive devices and/or medications. The Berg Balance Test (BBT), consisting of 14 functional subtests, was used to measure balance abilities and identify individuals with a higher risk of falling. Results. The mean score on the BBT for all these older adults was 42. The lowest number of points was obtained by those persons who showed all the risk factors for falls: postural instability, previous falls, and no physical activity (26 +/- 15.5). The highest number of points was obtained by persons who had only one risk factor (45.3 +/- 4.5) or no risk factors (49.5 +/- 5.8). 41% of our study group had a higher risk of falling (score 40), while in 19% of the patients the risk of incurring a fall was 100% (score 36). Conclusions. Among health resort patients over the age of 65, there is a decline in balance abilities and more propensity to fall. Testing of balance and fall prevention programs should become a standard part of the treatment program at health resorts for the elderly.