Shoulder proprioception – lessons we learned from idiopathic frozen shoulder

Abstract

BackgroundOf all the most frequent soft tissue disorders of the shoulder, idiopathic frozen shoulder (IFS) offers the greatest potential for studying proprioception. Studies concerning the presence of proprioception dysfunctions have failed to determine the potential for spontaneous healing of passive shoulder stabilizers (anterior and posterior capsule, middle and inferior gleno-humeral ligaments), its relationship with passive (PJPS) and active (AJPS) shoulder proprioception for internal and external rotation (IR, ER), as well as the isokinetic muscle performance of the internal and external rotators. This study investigates these dependencies in the case of arthroscopic release of IFS.MethodsThe study group comprised 23 patients (average aged 54.2) who underwent arthroscopic release due to IFS and 20 healthy volunteers. The average follow-up time was 29.2 months. The Biodex system was used for proprioception measurement in a modified neutral arm position and isokinetic evaluation. The results were analysed using the T-test, Wilcoxon and interclass correlation coefficient. P-values lower than 0.05 were considered significant.ResultsStatistically significant differences were found between involved (I) and uninvolved (U) shoulders only in the cases of PJPS and AJPS, peak torque, time to peak torque and acceleration time for ER (p < 0.05). No statistically significant difference was noted between PJPS IR and PJPS ER or between AJPS IR and AJPS ER (p > 0.05) for the U shoulders.ConclusionsThe anatomical structure of anterior (capsule, middle and anterior band of inferior gleno-humeral ligament) and posterior (capsule and posterior band of inferior gleno-humeral ligament) passive shoulder restraints has no impact on the difference in PJPS values between ER and IR in a modified neutral shoulder position. The potential for spontaneous healing of the anterior and posterior passive shoulder restraints influences PJPS recovery after arthroscopic release of IFS. ER peak torque deficits negatively affect AJPS values. PJPS and AJPS of ER and IR can be measured with a high level of reproducibility using an isokinetic dynamometer with the arm in a modified neutral shoulder position. Differences greater than 15 % for PJPS and >24 % for AJPS for ER and IR can be helpful for future studies as baseline data for identification of particular passive and active shoulder stabilizers at risk.

The effects of rotator cuff tear on shoulder proprioception

“…Many studies investigated the changes in shoulder proprioception in patients with idiopathic frozen shoulder [23], suprascapular nerve neuropathy [38], anterior shoulder instability [21,22], glenohumeral arthritis needing shoulder [39,40], and after rotator cuff tear repair [41,42]: impaired shoulder proprioception, at different level of severity, was found by all these authors. Focusing on the subacromial space pathology, both Anderson et al [43] and Maenhout et al [44] investigated patients with rotator cuff pathology, founding a significant decrease in joint proprioception.…”

“…Little information regarding impaired proprioception in shoulder injuries is known; the only studies are limited to shoulder instability [21,22], idiopathic frozen shoulder [23], and subacromial impingement syndrome [24].…”

Relationship between Joint Position Sense, Force Sense, and Muscle Strength and the Impact of Gymnastic Training on Proprioception

“…JPS was then evaluated using the Biodex System 4 isokinetic dynamometer. The reliability of this device in JPS assessment of the elbow and other joints was previously shown [ 27 , 28 ]. Prior to testing, participants were familiarized with the test using different random target angles.…”

Shoulder Pain and Disability Among Post Mastectomy Patients

“…Patients with shoulder pain experienced difficulty in dressing, personal hygiene and overhead activities [10]. Decrease range of motion worse the condition and in most cases they are dependent on others for simple activities of daily living [11][12][13]. It is pertinent to mention that majority of these pain can be prevented if proper preventative strategies such as physical therapy exercises etc.…”