Document Detail


Scapular and humeral movement patterns of people with stroke during range-of-motion exercises.
MedLine Citation:
PMID:  21475080     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: In people with stroke, range-of-motion (ROM) exercises may contribute to hemiparetic shoulder pain, but the underlying mechanisms are unknown. This study examined scapular and humeral movement patterns in people with poststroke hemiparesis as they performed commonly prescribed ROM exercises.
METHODS: Using kinematic techniques, we studied 13 people with hemiparesis, both with and without pain, as they performed 3 commonly prescribed ROM exercises: person-assisted ROM, self-assisted ROM, and cane-assisted ROM. Their data were compared with those of a group of 12 matched control subjects performing scapular plane shoulder elevation, using mixed-model ANOVAs. Correlation analyses were used to examine the relationship between participants' ratings of pain and kinematic data.
RESULTS: The hemiparetic group had mild pain at rest that increased during the performance of the exercises. During shoulder elevation, humeral external rotation in the hemiparetic group was decreased in all 3 ROM exercises compared with that in the control group. Scapular upward rotation in the hemiparetic group was decreased for the person-assisted ROM exercise only. No differences in scapular tilt were found between groups. The extent of movement abnormalities was not related to pain severity.
DISCUSSION AND CONCLUSIONS: People with hemiparesis had altered scapular and humeral movement patterns and increased shoulder pain when performing the ROM exercises. These data can assist clinicians in making decisions regarding which exercises to prescribe to preserve shoulder motion and prevent contractures in this population.
Authors:
Dustin D Hardwick; Catherine E Lang
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neurologic physical therapy : JNPT     Volume:  35     ISSN:  1557-0584     ISO Abbreviation:  J Neurol Phys Ther     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-04-08     Completed Date:  2011-08-18     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  101193365     Medline TA:  J Neurol Phys Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  18-25     Citation Subset:  IM    
Affiliation:
Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Biomechanics
Case-Control Studies
Exercise Therapy / methods
Female
Humans
Humerus / physiopathology
Male
Middle Aged
Movement*
Paresis / etiology,  physiopathology*,  rehabilitation
Range of Motion, Articular*
Scapula / physiopathology
Shoulder Pain / etiology*
Stroke / complications,  physiopathology,  rehabilitation*
Grant Support
ID/Acronym/Agency:
HD007434/HD/NICHD NIH HHS; HD047669/HD/NICHD NIH HHS; K01 HD047669-03/HD/NICHD NIH HHS; K01 HD047669-04/HD/NICHD NIH HHS; K01 HD047669-05/HD/NICHD NIH HHS
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