3D Shoulder Kinematics During Throwing-related Movement Patterns Tasks in Upper Extremity Low-to-moderate/Moderate-to-high Loading Conditions
- Conditions
- Shoulder Pain
- Interventions
- Behavioral: PNF D2 for flexion; low-to-moderate loading conditionBehavioral: PNF D2 for flexion; moderate-to-high loading conditionBehavioral: PNF D2 for extension; low-to-moderate loading conditionBehavioral: PNF D2 for extension; moderate-to-high loading condition
- Registration Number
- NCT02852785
- Lead Sponsor
- Universidade do Porto
- Brief Summary
The main purpose of this study is to characterize and compare the 3D shoulder kinematics bilaterally while performing functional movement patterns tests that hypothetically replicate the 5 main phases of the throwing cycle. The tests are based on diagonal D2 for flexion (early and late cocking of the arm) and D2 for extension (acceleration, deceleration and follow-through of the arm) of the upper extremity of proprioceptive neuromuscular facilitation techniques.
- Detailed Description
The 3D shoulder kinematics (thorax, scapula and humerus) will be collected in different groups of subjects with specific characteristics. To load the upper extremity during PNF D2 for flexion and extension directions, elastic tubing (Thera-Band) will be used as resistance. Selection of the two resistances will be according to a self-perceived ability of the subjects to consistently move a maximal amount of resistance (color) during PNF D2 flexion and extension tests for 15s and 30s, respectively. Each subject will be permitted to sample various resistances in order to assist in selecting the most appropriate load, with no more than three practice repetitions permitted per each resistance sampled.
To perform the tests, subjects will be sited in a standard chair without armrests, with their feet and lower legs placed on another standard chair, positioned just in front of their chair and the non-testing arm placed across the thoracic wall, to minimize the participation of the legs and trunk to upper extremity performance during testing. Elastic tubing will be anchored to a stable base to perform the diagonals (Thera-Band door anchor accessory or the opposite foot). Five repetitions of each test on both sides will be performed, in two different moments (5-10 minutes apart). A rate of 2 seconds per repetition will be employed during recordings using a metronome. A rest period will be given between trials to avoid fatigue. To perform the tests, subjects will begin/end with their hand on the contralateral hip and end/begin at head height and shoulder width. A marker will be placed in the latter position to standardize the start and end of hand position. The order of the tests (PNF D2 flexion and extension) and side (symptomatic/dominant and asymptomatic/non-dominant) will be randomized.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 150
- subjects who can perform at least 150 degrees of arm elevation
- subjects rating pain ≥8/10
- score 5 on any of the items of the Disabilities of Arm, Shoulder and Hand (DASH)
- pain elicited by provocation maneuvers of the neighboring regions (e.g., cervical spine).
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Asymptomatic volleyball attackers PNF D2 for extension; moderate-to-high loading condition Asymptomatic volleyball attackers involved in competitive events ≥ 2 years and no signs of postural and movement impairments of the upper body quadrant Asymptomatic bilateral overhead athletes PNF D2 for flexion; moderate-to-high loading condition Asymptomatic swimmers involved in competitive events ≥ 2 years and no signs of postural and movement impairments of the upper body quadrant Asymptomatic non-athletes PNF D2 for extension; moderate-to-high loading condition Asymptomatic persons not regularly involved in sports activities or occupational overhead tasks (e.g. construction workers), Asymptomatic bilateral overhead athletes PNF D2 for flexion; low-to-moderate loading condition Asymptomatic swimmers involved in competitive events ≥ 2 years and no signs of postural and movement impairments of the upper body quadrant Asymptomatic bilateral overhead athletes PNF D2 for extension; moderate-to-high loading condition Asymptomatic swimmers involved in competitive events ≥ 2 years and no signs of postural and movement impairments of the upper body quadrant Asymptomatic non-athletes PNF D2 for flexion; low-to-moderate loading condition Asymptomatic persons not regularly involved in sports activities or occupational overhead tasks (e.g. construction workers), Asympt. athletes / scapula dyskinesis PNF D2 for flexion; low-to-moderate loading condition Asymptomatic volleyball attackers involved in competitive events ≥ 2 years and with clinical evidence of scapula dyskinesis Asymptomatic volleyball attackers PNF D2 for flexion; low-to-moderate loading condition Asymptomatic volleyball attackers involved in competitive events ≥ 2 years and no signs of postural and movement impairments of the upper body quadrant Asymptomatic volleyball attackers PNF D2 for flexion; moderate-to-high loading condition Asymptomatic volleyball attackers involved in competitive events ≥ 2 years and no signs of postural and movement impairments of the upper body quadrant Asymptomatic volleyball attackers PNF D2 for extension; low-to-moderate loading condition Asymptomatic volleyball attackers involved in competitive events ≥ 2 years and no signs of postural and movement impairments of the upper body quadrant Asymptomatic non-athletes PNF D2 for extension; low-to-moderate loading condition Asymptomatic persons not regularly involved in sports activities or occupational overhead tasks (e.g. construction workers), Asympt. athletes / scapula dyskinesis PNF D2 for extension; moderate-to-high loading condition Asymptomatic volleyball attackers involved in competitive events ≥ 2 years and with clinical evidence of scapula dyskinesis Asympt. athletes / scapula dyskinesis PNF D2 for extension; low-to-moderate loading condition Asymptomatic volleyball attackers involved in competitive events ≥ 2 years and with clinical evidence of scapula dyskinesis Symptom. athletes / scapula dyskinesis PNF D2 for extension; moderate-to-high loading condition Volleyball attackers involved in competitive events ≥ 2 years and with clinical evidence of scapula dyskinesis and complaints of shoulder pain and disability Asymptomatic bilateral overhead athletes PNF D2 for extension; low-to-moderate loading condition Asymptomatic swimmers involved in competitive events ≥ 2 years and no signs of postural and movement impairments of the upper body quadrant Asymptomatic non-athletes PNF D2 for flexion; moderate-to-high loading condition Asymptomatic persons not regularly involved in sports activities or occupational overhead tasks (e.g. construction workers), Asympt. athletes / scapula dyskinesis PNF D2 for flexion; moderate-to-high loading condition Asymptomatic volleyball attackers involved in competitive events ≥ 2 years and with clinical evidence of scapula dyskinesis Symptom. athletes / scapula dyskinesis PNF D2 for extension; low-to-moderate loading condition Volleyball attackers involved in competitive events ≥ 2 years and with clinical evidence of scapula dyskinesis and complaints of shoulder pain and disability Symptom. athletes / scapula dyskinesis PNF D2 for flexion; low-to-moderate loading condition Volleyball attackers involved in competitive events ≥ 2 years and with clinical evidence of scapula dyskinesis and complaints of shoulder pain and disability Symptom. athletes / scapula dyskinesis PNF D2 for flexion; moderate-to-high loading condition Volleyball attackers involved in competitive events ≥ 2 years and with clinical evidence of scapula dyskinesis and complaints of shoulder pain and disability
- Primary Outcome Measures
Name Time Method Side-to-side differences in 3-dimensional scapular angular displacement (in degrees) Through study completion, an average of 1 year The angular position and displacement of the scapula in the 3 planes of \[lateral/medial (upward/downward) rotation, protraction/retraction (internal/external rotation), anterior/posterior tilting\] at 4 key events of the simulated throwing motion during the two loading conditions (1, initiation of humeral motion; 2, maximum humeral horizontal abduction relative to the trunk; 3, maximum humeral external rotation; 4, maximum humeral internal rotation)
Side-to-side differences in 3-dimensional humerus angular displacement (in degrees) Through study completion, an average of 1 year The angular position and displacement of the humerus in the 3 planes of (plane of elevation, elevation/depression, axial rotation) at 4 key events of the simulated throwing motion during the two loading conditions (1, initiation of humeral motion; 2, maximum humeral horizontal abduction relative to the trunk; 3, maximum humeral external rotation; 4, maximum humeral internal rotation)
Side-to-side differences in 3-dimensional thoracic angular displacement (in degrees) Through study completion, an average of 1 year The angular position and displacement of the thorax in the 3 planes of \[flexion/extension, lateral rotation (inclination), axial rotation\] at 4 key events of the simulated throwing motion during the two loading conditions (1, initiation of humeral motion; 2, maximum humeral horizontal abduction relative to the trunk; 3, maximum humeral external rotation; 4, maximum humeral internal rotation)
- Secondary Outcome Measures
Name Time Method Borg's Rate of Perceived Exertion scale Through study completion, an average of 1 year Rate of Perceived Exertion (RPE) scale varies from 6 (no exertion) to 20 (very, very hard)
Visual Numeric Rating Scale score (0-10) Through study completion, an average of 1 year A 11-point scale to rate pain intensity
Trial Locations
- Locations (3)
Escola Superior de Saúde, Instituto Politécnico de Leiria
🇵🇹Leiria, Portugal
Faculdade de Desporto, Universidade do Porto
🇵🇹Porto, Portugal
Faculdade de Motricidade Humana, Universidade de Lisboa
🇵🇹Oeiras, Cruz-Quebrada, Portugal