ArticlesMeasuring shoulder internal rotation range of motion: A comparison of 3 techniques☆,☆☆,★,★★,♢,♢♢
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Participants
Three hundred forty junior-high and high-school athletes attending the annual preparticipation physical examination program at our institution were given the opportunity to participate in the study. Of these, 56 athletes (32 men, 24 women; age range, 13–18y) volunteered for the current study. Inclusion criteria included (1) no history of neurologic disease, arthritis, connective tissue disorder, or shoulder/neck injury or surgery and (2) informed consent (parental consent was obtained if the
Results
Ninety-three percent of the 56 unimpaired individuals (30/32 men, 22/24 women) participating in this study were right-hand dominant. The ANOVA did not reveal any significant interaction between arm dominance and measurement technique (NSS vs SS vs VI). Therefore, the data in tables 1 through 4 are presented in terms of right and left arms, irrespective of arm dominance.
The mean values for shoulder IR and ER using the 3 measurement techniques are presented in table 2. Shoulder rotation
Discussion
The current study represents an extension of our previous investigation showing the reliability of shoulder IR ROM measurements using the scapular stabilization technique.13 As previously discussed, manual scapular stabilization minimizes or prevents accessory scapulothoracic motion while the examiner measures glenohumeral IR.12, 13 Therefore, the IR-SS technique is thought to represent a more valid measure of glenohumeral IR.12, 13 The challenge of the IR-SS technique is that it typically
Conclusion
Shoulder ER and IR motions as measured with the techniques used in the current study exhibit acceptable reliability for clinical use. Shoulder IR ROM measured with either the scapular stabilized (IR-SS) or visual inspection (IR-VI) techniques results in significantly less IR when compared with the standard technique (IR-NSS), in which accessory scapulothoracic motion may occur. Therefore, the IR-SS and IR-VI may represent more valid measures of glenohumeral internal rotation. The IR-VI
Acknowledgements
We thank Dirk Larson, MS, and Terry M. Therneau, PhD, of the Department of Biostatistics, Mayo Clinic, for their statistical contribution to this study, and Jeff Brault, DO, PT, Dave Schroeder, PT, Katie Altman, MD, and Nicole Detman, MS, from the Mayo Clinic Sports Medicine Center, for their technical assistance.
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No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
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Reprint requests to Jay Smith, MD, Dept of Physical Medicine and Rehabilitation, Mayo Clinic, 200 First St SW, Rochester, MN 55905, e-mail [email protected].
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