3D Shoulder Kinematics During Throwing-related Movement Patterns Tasks in Upper Extremity Low-to-moderate/Moderate-to-high Loading Conditions

Universidade do Porto

Status: Unknown

Conditions: Shoulder Pain

Treatments: Behavioral: PNF D2 for extension; low-to-moderate loading condition; Behavioral: PNF D2 for flexion; low-to-moderate loading condition; Behavioral: PNF D2 for extension; moderate-to-high loading condition; Behavioral: PNF D2 for flexion; moderate-to-high loading condition

Study type: Observational

Funder types: Other

Identifiers

NCT02852785

FADEUP_PhDPT_NunoMorais_std#3

Details and patient eligibility

About

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.

Full 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.

Enrollment: 150 estimated patients

Sex: All

Ages: 18 to 40 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• subjects who can perform at least 150 degrees of arm elevation

Exclusion criteria

• 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).

Trial design

150 participants in 5 patient groups

Asymptomatic volleyball attackers

Description:

Asymptomatic volleyball attackers involved in competitive events ≥ 2 years and no signs of postural and movement impairments of the upper body quadrant

Treatment:

Behavioral: PNF D2 for flexion; low-to-moderate loading condition

Behavioral: PNF D2 for extension; moderate-to-high loading condition

Behavioral: PNF D2 for extension; low-to-moderate loading condition

Behavioral: PNF D2 for flexion; moderate-to-high loading condition

Asymptomatic bilateral overhead athletes

Description:

Asymptomatic swimmers involved in competitive events ≥ 2 years and no signs of postural and movement impairments of the upper body quadrant

Treatment:

Behavioral: PNF D2 for flexion; low-to-moderate loading condition

Behavioral: PNF D2 for extension; moderate-to-high loading condition

Behavioral: PNF D2 for extension; low-to-moderate loading condition

Behavioral: PNF D2 for flexion; moderate-to-high loading condition

Asymptomatic non-athletes

Description:

Asymptomatic persons not regularly involved in sports activities or occupational overhead tasks (e.g. construction workers),

Treatment:

Behavioral: PNF D2 for flexion; low-to-moderate loading condition

Behavioral: PNF D2 for extension; moderate-to-high loading condition

Behavioral: PNF D2 for extension; low-to-moderate loading condition

Behavioral: PNF D2 for flexion; moderate-to-high loading condition

Asympt. athletes / scapula dyskinesis

Description:

Asymptomatic volleyball attackers involved in competitive events ≥ 2 years and with clinical evidence of scapula dyskinesis

Treatment:

Behavioral: PNF D2 for flexion; low-to-moderate loading condition

Behavioral: PNF D2 for extension; moderate-to-high loading condition

Behavioral: PNF D2 for extension; low-to-moderate loading condition

Behavioral: PNF D2 for flexion; moderate-to-high loading condition

Symptom. athletes / scapula dyskinesis

Description:

Volleyball attackers involved in competitive events ≥ 2 years and with clinical evidence of scapula dyskinesis and complaints of shoulder pain and disability

Treatment:

Behavioral: PNF D2 for flexion; low-to-moderate loading condition

Behavioral: PNF D2 for extension; moderate-to-high loading condition

Behavioral: PNF D2 for extension; low-to-moderate loading condition

Behavioral: PNF D2 for flexion; moderate-to-high loading condition