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

IF 1.6 Q3 SPORT SCIENCES
International Journal of Sports Physical Therapy Pub Date : 2024-04-01 eCollection Date: 2024-01-01 DOI:10.26603/001c.95040
Brian T Swanson, Marissa Hagenbruch, Bernardine Lapaan, Kirill Skipalskiy
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引用次数: 0

Abstract

Background/purpose: Interventions including posterior glenohumeral mobilizations (PGM), sleeper stretches, and thoracic manipulation are commonly used to address posterior shoulder tightness. The purpose of this study was to assess the effects of adding thoracic manipulation to PGM and sleeper stretches on passive range of motion (PROM), joint mobility, and infraspinatus electromyographic (EMG) activity in shoulders with decreased internal rotation (IR) PROM.

Design: Randomized Sequential Intervention Laboratory Study.

Methods: Forty individuals with clinically significant IR loss attended two study sessions. Participants were randomized to receive five 30 seconds bouts of either grade III PGM or sleeper stretching. Following a seven-day washout period, all participants attended a second session and received a prescriptive supine HVLA manipulation targeting the T3-4 segment, followed by the previously randomized intervention. Outcome measures included internal rotation PROM, horizontal adduction PROM, posterior glenohumeral joint translation assessed via ultrasound imaging, and EMG activity of the infraspinatus during a PGM. All outcome measures were assessed pre- and immediately post-intervention and compared statistically.

Results: There were significant within-group, but not between-group, differences for IR and horizontal adduction PROM following a single session of PGM or sleeper stretch. When combined with thoracic manipulation, significantly smaller within session changes of IR PROM were observed for both PGM (mean difference 4.4, p=0.017) and sleeper stretches (mean difference 6.4, p=0.0005). There were no significant between group differences for horizontal adduction PROM, humeral head translation, or EMG activity across all time points.

Discussion: Both GH posterior mobilizations and sleeper stretches improved IR and horizontal adduction PROM in a single session. The addition of thoracic manipulation prior to local shoulder interventions resulted in smaller gains of both IR and horizontal adduction ROM.

Level of evidence: Level 2.

盂肱关节活动、拉伸和胸椎手法对肩关节内旋活动范围的综合影响。
背景/目的:包括后盂肱肌活动(PGM)、卧位拉伸和胸廓手法在内的干预措施通常用于解决肩部后部紧绷问题。本研究的目的是评估在PGM和卧位拉伸的基础上增加胸廓手法对内旋(IR)PROM减少的肩部被动活动范围(PROM)、关节活动度和冈下肌电(EMG)活动的影响:随机序列干预实验室研究:方法: 40 名临床上有明显 IR 损失的人参加了两次研究。参与者被随机分配接受五次 30 秒的三级 PGM 或卧位拉伸。经过七天的冲洗期后,所有参与者都参加了第二个疗程,并接受了针对 T3-4 节段的规定性仰卧 HVLA 操作,随后接受了之前随机分配的干预。结果测量包括内旋PROM、水平内收PROM、通过超声波成像评估的盂肱关节后移,以及在PGM过程中冈下肌的EMG活动。所有结果均在干预前和干预后进行评估,并进行统计比较:结果:在进行单次 PGM 或卧位拉伸后,IR 和水平内收 PROM 存在明显的组内差异,但无组间差异。当与胸廓手法相结合时,PGM(平均差异为 4.4,P=0.017)和卧位拉伸(平均差异为 6.4,P=0.0005)的 IR PROM 在疗程内的变化明显较小。在所有时间点上,水平内收PROM、肱骨头平移或肌电图活动均无明显组间差异:讨论:GH后方活动和卧床拉伸都能在单次治疗中改善IR和水平内收PROM。讨论:GH后方活动和卧位拉伸均可在单次治疗中改善IR和水平外展PROM,而在局部肩关节干预前增加胸廓手法治疗,则IR和水平外展ROM的改善幅度较小:证据等级:2级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.50
自引率
5.90%
发文量
124
审稿时长
16 weeks
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