Abstract
Alterations of shoulder motion have been suggested to be associated with shoulder disorders. The objective of this study was to perform a 3D motion analysis (kinematic and electromyographical) of skeletal elements and muscles of shoulder joint in patients with multidirectional instability. Fifteen patients with multidirectional instability and 15 normal controls were investigated during continuous elevation in the scapular plane. The spatial coordinates of 16 anatomical points of the shoulder to determine kinematical parameters were quantified by an ultrasound-based motion analyzer. The activities of 12 muscles were measured by surface electromyography. Kinematic characteristics of motion were identified by scapulothoracic, glenohumeral, and humeral elevation angles; range of angles; scapulothoracic and glenohumeral rhythm; scapulothoracis, glenohumeral, and scapuloglenoid ratios; and the relative displacement between the rotation centers of the humerus and the scapula. The electromyographical characteristics of motion were modeled by the on–off pattern of muscle activity. Significant alterations in kinematical parameters were observed between patients and asymptomatic volunteers. The anterior, posterior, and inferior dislocations of shoulders with multidirectional instability could be properly modeled by the relative displacement between the rotation centers of the scapula and humerus. The shorter activity by m. pectoralis maior and all three parts of m. deltoideus and longer activity by m. supraspinatus, m. biceps brachii, and m. infraspinatus assure the centralization of the glenuhumeral head of a shoulder with multidirectional instability.
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References
An YH, Friedman RJ (2000) Multidirectional instability of the glenohumeral joint. Orthop Clin North Am 31:275–285
Arendt EA (1988) Multidirectional instability. Orthopedics 11:113–120
Baeyens JP, Roy PV, DeSchepper A, Declercq G, Clarijs JP (2001) Glenohumeral joint kinematics related to minor anterior instability of the shoulder at the end of the late preparatory phase of throwing. Clin. Biomech 16:752–757
Basmajian JV, DeLuca C. (1985) Muscles alive: their functions revealed by electromyography, 5th edn. Williams and Wilkins, Baltimore
Beasley L, Faryniarz DA, Hannafin JA (2000) Multidirectional instability of the shoulder in the female athlete. Clin Sports Med 19:331–349
Bechtol CO (1975) Normal human gait. In: Bowker JH, Hall CB, (eds) Atlas of orthoticis. American Academy of Orthopeadic Surgeon. pp 133–143
Brown GA, Tan JL, Kirkley A (2000) The lax shoulder in females: issues, answers but many more questions. Clin Orthop 372:110–122
Cholnoky T (1968) Mechanics (in Hungarian). Tankönyvkiadó, Budapest
Constant CR, Murley AHG (1987) A clinical method of functional assessment of the shoulder. Clin Orthop 214:160–164
Constant CR (1997) Assessment of the shoulder function. In: Gazielly DF, Gleyze P, Thomas P (eds) The cuff. Elsevier, Paris, pp 39–44
De Leest O, Van der Helm FCT, Rozendal LA, Rozing PM (1996) The influence of glenohumeral prothesis geometry and placement on shoulder muscle forces. Clin Orthop 331:222–233
Emery RJ, Mullaji AB(1991) Glenohumeral joint instability in normal adolescents: Incidence and significance. J Bone Joint Surg 73B:406–408
Glousman R, Jobe F, Tibone J, Moynes D, Antonelli D, Perry J (1988) Dynamic electomyographic analysis of the throwing shoulder with glenohumeral instability. J Bone Joint Surg 70A:220–226
Graichen H, Hinterwimmer S, von Eisenhart-Rothe R, Vogl T, Englmeier KH, Eckstein F (2005) Effect of abducting and adducting muscle activity on glenohumeral translation, scapular kinematics and subacromial space width in vivo. J Biomech 38(4):755–760
Hermes HJ, Freriks B, Merletti R, Stegemann D, Blok J, Rau G, Disselhorst-Klug C, Hagg G (1999). European recommendations for surface electromyography. Results of the SENIAM project Roessingh Research and Development b.v. Enschede, The Netherlands
Howell SM, Galinat BJ, Renzi AJ (1988) Normal and abnormal mechanics of the glenohumeral joint in the horizontal plane. J Bone Joint Surg 70A:227–232
Illyés Á, Kiss RM (2005a) Method for determining the spatial position of the shoulder with ultrasound-based motion analyzer. J Electromyogr Kinesiol (under publication)
Illyés Á, Kiss RM (2005b) Kinematics parameters for modeling of shoulder joint motion. In: Abstract book of 9th international conference orthopeadics, biomechanics, sport rehabilitation, Assissi, Italy, pp 139–146
Illyés Á, Kiss RM (2005c) Contraction of muscles of the shoulder joint with multidirectional instability during elementary arm motion and throwing. In: Abstract book of 9th international conference orthopeadics, biomechanics, sport rehabilitation, Assissi, Italy, pp 255–260
Jurák M, Kocsis L (2002) New package for calculation of gait parameters using instrumented treadmill. In: Proceedings of the third conference on mechanical engineering. Budapest, Hungary, pp 500–504
Kocsis L (2002) More precise measurement method for gait analysis. In: Proceedings of the third conference on mechanical engineering. Budapest, Hungary 843–847
Kocsis L, Béda G (2001) Closed formulae to determine the angular velocity of a body segment based on 3D measurements. Acta Physiol Hung 88:1–13
Kronberg M, Broström LA, Nemeth G (1991) Differences in shoulder muscle activity between patients with generalized joint laxity and normal controls. Clin Orthop Rel Res 269:181–192
Lebar RD, Alexander H (1992) Multidirectional shoulder instability. Clinical results of inferior capsular shift in an active-duty population. Am J Sports Med. 20:193–198
Mallon WJ, Speer KP (1995) Multidirectional instability: current concepts. J Shoulder Elbow Surg 4:54–64
Matsen FA III (1994) Stability. In: Matsen FA III, Lippit SB, Sidles JA, Harrymann DT (eds) Practical evaluation and management of the shoulder. W.B. Sauders, Philadelphia pp 59–109
Morris AD, Kemp GJ, Frostick SP (2004) Shoulder electromyography in multidirectional instability. J Shoulder Elbow Surg 13:24–29
Myers JB, Ju JJ, Hwang JH, McMahon PJ, Rodosky MW, Lephart SM (2004) Reflexive muscle activation alterations in shoulder with anterior glenohumeral instability. Am J Sports Med 32:1013–1021
Neer CS, Foster CR (1980) Inferior capsular shift for involuntary inferior and multidirectional instability of shoulder. J Bone Joint Surg 62A:897–908
Nyland JA, Caborn DNM, Johnson DL (1998) The human glenohumeral joint: a proprioceptive and stability alliance. Knee Surg Sports Traumatol Arthrosc 6:50–61
Pagnani MJ, Warren RF (1994) Stabilizers of the glenohumeral joint. J Shoulder Elbow Surg 3:173–190
Poppen NK, Walker PS (1976) Normal and abnormal motion at the shoulder. J Bone Joint Surg 58A:195–201
Sciascia AD, Uhl TL, Mattacola CG, McCrory JL, Nity AJ, Mair SD (2004) Muscle activity comparison of four common shoulder exercises in unstable and stable shoulders. J Shoulder Elbow Surg 13:E1–E2
Sidles JA, Harryman DT II, Harris SL (1991) In vivo quantification of glenohumeral stability. Trans Orthop Res Soc 16:646
Vaughan CL, Davis BL, O’Connor JC (1999) Dynamics of human gait. Kiboho Publisher, Cape Town
Acknowledgements
The research was supported by Scientific Research Fund thematic proposal T034150 and T 049471 as well as by HAS-BUTE Research Group of Structures and the Semmelweis Foundation. We are indebted to Professor Kocsis for providing us access to the Biomechanical Laboratory at the Budapest University of Technology and Economics and his assistance in experiments.
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Illyés, Á., Kiss, R.M. Kinematic and muscle activity characteristics of multidirectional shoulder joint instability during elevation. Knee Surg Sports Traumatol Arthr 14, 673–685 (2006). https://doi.org/10.1007/s00167-005-0012-7
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DOI: https://doi.org/10.1007/s00167-005-0012-7