Tansy (Physical Therapy Book 2)

Although the SEM values were relatively small compared with both the pixel size and previous reports, they were relatively high compared with the differences found before and after RTC fatigue. Therefore, future researchers should consider using a DFV system with greater resolution. Additionally, future investigators should establish interrater reliability using the described measurement technique and should establish reliability values associated with the postfatigue state. Although we did not find a main effect for condition arm elevation angle or an interaction effect Figure 4 , Table 3 , we recommend that future researchers continue to address the interaction between RTC fatigue and arm angle during shoulder abduction in patients with shoulder lesions.

The influence of greater superior migration through a longer arc of motion, and hence a longer time, may be an important factor in patients with shoulder disorders. More study is needed. The use of DFV to describe underlying arthrokinematics is potentially helpful in describing aberrant motion in patients with shoulder disorders. It could be used to assess changes in velocity and acceleration associated with RTC fatigue and shoulder disorders.

Additionally, the ability to assess dynamic arthrokinematics with DFV at either 30 Hz or 60 Hz provides a tool for future researchers to compare measurements obtained with skin markers and motion analysis capture systems. Although our research revealed a significant difference in the amount of superior humeral head migration between prefatigue and postfatigue conditions, our study had limitations that need to be addressed with future investigation.

We analyzed GH arthrokinematics using a 2-dimensional imaging technique that assumes that a superior translation should lead to a decrease in the subacromial space. Authors 7 — , 10 have used this technique, but they have not shown a correlation between GH positioning and acromiohumeral distance. Three-dimensional imaging eg, biplanar fluoroscopy would provide a tool to assess the effect of the position of the scapula eg, scapular tilting ; the shape of the acromion; the humeral position in the anterior-posterior direction; and superior migration, which we addressed in our study.

In addition, we analyzed only dynamic concentric contraction during arm elevation. Eccentric conditions may display a different direction of humeral head migration because different arthrokinematics rolling and gliding are required. Another limitation was that only young, healthy men participated in our study.

Generalizing our results to other age groups, women, or those with shoulder disorders is difficult. Differences in GH migration based on sex have not been analyzed. However, Graichen et al 43 reported that the subacromial space was dependent on sex and was smaller in women. Future researchers using DFV should assess GH arthrokinematics between the sexes and in participants with shoulder disorders.

Additionally, researchers should analyze GH migration while measuring electromyography of shoulder muscle activation to better understand the relationship between RTC fatigue and GH migration. We demonstrated that DFV measurement of humeral head migration has good to excellent reliability, making it a viable technique for assessing GH arthrokinematics. Dynamic assessment of GH migration in participants without shoulder disorders demonstrated a more superiorly positioned humeral head relative to the glenoid fossa during arm elevation under conditions of fatigue of the suprapsinatus, infraspinatus, and teres minor muscles.

Teyhen, PhD, PT, OCS, contributed to conception and design; acquisition and analysis and interpretation of the data; and drafting, critical revision, and final approval of the article. Miller, MPT, PT, contributed to acquisition and analysis and interpretation of the data and drafting, critical revision, and final approval of the article. Kane, PhD, PT, ECS, ATC, contributed to conception and design; acquisition and analysis and interpretation of the data; and drafting, critical revision, and final approval of the article.

The opinions or assertions expressed herein are those of the authors. They should not be interpreted as the official position and do not necessarily reflect the views of the Departments of the Army, Navy, or Defense. National Center for Biotechnology Information , U. Journal List J Athl Train v. Author information Copyright and License information Disclaimer. Address e-mail to lim. This article has been cited by other articles in PMC. Patients or Other Participants: Main Outcome Measure s: Superior migration of the humeral head increased during dynamic arm elevation after the supraspinatus, infraspinatus, and teres minor muscles of the rotator cuff were fatigued.

When used to analyze humeral head migration relative to the glenoid fossa, digital fluoroscopic video had good to excellent intrarater reliability. Research is required to determine the influence of rotator cuff fatigue on glenohumeral migration in individuals with underlying shoulder disorders. Methods Participants We recruited 20 healthy male participants with an average age of Table 1 Exclusion Criteria Open in a separate window. The height of the C-arm was adjusted to ensure that the glenohumeral joint and the proximal humeral shaft were visible during the entire range of motion.

Foot, scapular, and hand markings were used to ensure similar positioning between trials. Radiographic Analysis The method of determining GH migration and humeral angle was based on protocols by Poppen and Walker 8 and Chen et al, 9 who used digital point placement techniques. Example of the data extraction technique from a single frame from the digital fluoroscopic video.

BC1 depicts the best-fit circle representing the humeral head. BL1 depicts a best-fit line, the ends of which represent the superior and inferior borders of the glenoid fossa. Humeral head migration was defined as the distance between the center of the glenoid line BL1 and the perpendicular projection of the center of the BC1 to BL1. AF1 is the humeral angle.

It was determined as the angle between vertical L1 and a line drawn on the medial border of the humeral shaft L2. Radiographic measurement of humeral head migration was adapted based on a technique described by Deutsch et al. This value was expressed as positive if the center of the humeral head was superior to the center of the glenoid or negative if it was inferior to the center of the glenoid. In this figure, the center of the humeral head was inferior to the center of the glenoid line. Discussion Superior humeral head migration increased by an average of 0. Mean superior migration of the humeral head with elevation during prefatigue and postfatigue conditions.

Conclusions We demonstrated that DFV measurement of humeral head migration has good to excellent reliability, making it a viable technique for assessing GH arthrokinematics. Contributed by The opinions or assertions expressed herein are those of the authors. Joint Structure and Function: Lippincott Williams and Wilkins; p. J Bone Joint Surg Am.

The shoulder impingement view: Articular geometry of the glenohumeral joint. Clin Orthop Relat Res. Quantitation of in situ contact areas at the glenohumeral joint: Yamaguchi K, Sher J. Glenohumeral motion in patients with rotator cuff tears: J Shoulder Elbow Surg.

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Normal and abnormal motion of the shoulder. Radiographic evaluation of glenohumeral kinematics: Deutsch A, Altchek D. W, Schwartz E, Otis J. Radiologic measurement of superior displacement of the humeral head in the impingement syndrome. The anterior tilt of the acromion: Grieving and wounded, Annie retreats to her old family home in Switchback, Vermont, a maple farm generations old. There, surrounded by her free-spirited brother, their divorced mother, and four young nieces and nephews, Annie slowly emerges into a world she left behind years ago: And with the discovery of a cookbook her grandmother wrote in the distant past, Annie unearths an age-old mystery that might prove the salvation of the family farm..

It took 32 seconds to end his career, But it only took 1 to change his life. That's how long it took for Delon Sanchez's life to end. One minute he was the best bronc rider in the Panhandle and the next he was nothing. Knee shattered, future in question, all he can do is pull together the pieces Tori's finally come home, intent on escaping the public eye. It's just her luck that Delon limps into her physical therapy office, desperate for help. All hard-packed muscle and dark-eyed temptation, he's never been anything but a bad idea.

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Promising to come back after she finished school. Beck stayed behind to save the family business, dreaming of the day when Tansy would return. Instead, his trust and his heart were broken when she inexplicably married another man and bore his child. Five years later, Tansy comes home, a sadder and wiser woman.

Rotator Cuff Fatigue and Glenohumeral Kinematics in Participants Without Shoulder Dysfunction

Despite his anger, Beck finds it hard to avoid her and her adorable little daughter,? But after her brother's death, Jenni Beth returns home to help mend her parents' hearts as well as restore their beautiful but crumbling antebellum mansion. New dreams take shape as Jenni Beth sets to work replacing floors and fixing pipes to convert the family homestead into the perfect wedding destination. However, some folks in their small Southern town are determined to see her fail. Cole Bryson was once the love of Jenni Beth's life, but the charming architectural salvager has plans of his own for the Beaumont family home.

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