In vivo measurements of humeral movement during posterior glenohumeral mobilizations

Abstract

Objectives: The purpose of this study was to quantify in vivo posterior translational movements occurring in the glenohumeral joint during posterior mobilizations and to determine the intratester reliability of those posterior translational movements. Methods: Twenty-eight individuals (17 females, 11 males) participated in this study. One physical therapist utilized a Kaltenborn approach to apply three grades of posterior humeral mobilization. A hand held dynamometer was used to quantify the force used during each grade of mobilization. Ultrasound imaging was used to visualize and measure posterior humeral movement. Statistical analysis included descriptive statistics for force and posterior movement, intraclass correlation coefficient (ICC) for intrarater reliability of force and posterior movement during each grade of mobilization and paired t-tests to compare movement and force between grades of mobilization. Results: Mean posterior movement (mm) measurements were 3.0, 8.2 and 10.7 for grade I, grade II and grade III mobilizations, respectively. Mean force (Newtons) measurements used during mobilization were 41.7, 121.5 and 209.4 for grade I, grade II and grade III mobilizations, respectively. The ICCs ranged from 0.849 to 0.905 for movement and from 0.717 to 0.889 for force. Force and measurement values were significantly different between grades of mobilization and between dominant and non-dominant arms. Gender was found to be significantly associated with force. Discussion: Mean movements and mean forces occurring during posterior mobilization increased with increasing grades. Intratester reliability was high for all grades of manual mobilization supporting the use of subjective feedback to determine appropriate force application. Quantification of forces and movements helps to clarify parameters that can serve as a reference for clinical practice.

Effect of Scapular Fixation on Lateral Movement and Scapular Rotation during Glenohumeral Lateral Distraction Mobilisation

“…In the study by López-de-Celis et al [22] the force intensity in low and medium force was lower than those in the present study, with values of 16.2 N ± 5.1 for grade I and 46.7 N ± 12.4 for grade II, whereas in the present study the applied force values were 22.4 N ± 3.8 and 68.0 N ± 9.6, respectively. However, for high force, a higher force was applied in the present study, with a difference of 57.8 N. We cannot compare this with the applied force in the study by Guerra-Rodríguez et al [32], who, with practically equal coracohumeral distraction distances, did not evaluate the applied force.…”

Combined Effects of Glenohumeral Mobilization, Stretching, and Thoracic Manipulation on Shoulder Internal Rotation Range of Motion

“…US imaging has been shown to be a reliable measure of posterior translation of the humeral head during mobilization. 46 The transducer was oriented horizontally over the anterior shoulder visualizing the coracoid process, the lesser tuberosity, and the biceps tendon in the display. ( Figure 1 ) With the arm held in the GH resting position, a resting image was taken.…”

Glenohumeral joint capsular tissue tension loading correlates moderately with shear wave elastography: a cadaveric investigation

“…Several authors [17][18][19] reported that GHJ mobilization using loads of 20-80 N increased capsule extensibility or elongation and improved patient symptoms [20,21]. The proposed mechanical and neurophysiological changes responsible for increased joint ROM following joint mobilizations are not well understood and require further investigation [22]. Shear wave elastography (SWE) measurements are a reproducible method of evaluating muscle and tendon [23][24][25][26], with good repeatability, as demonstrated by intraclass coefficients (ICCs) of 0.81-0.91.…”