노벨 스트레칭과 관절가동술이 어깨 후방 뻣뻣함으로 인한 어깨관절 안쪽돌림 결핍 환자의 관절가동범위와 봉우리-위팔뼈 거리에 미치는 영향
The Effect of Novel Stretching on the Range of Motion and Acromio-Humeral Distance in Patients with Glenohumeral Internal Rotation Deficits with Posterior Shoulder Tightness
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: The cross-body and the sleeper stretches have been used to improve posterior shoulder tightness (PST). However, such stretching techniques may not always help achieve scapular stability and may even aggravate patient’s symptoms. Therefore, a new stretching technique (passive glenohumeral internal rotation with bridging) was developed as a more effective method that may allow for greater scapular stability without aggravating the symptoms. Thus, this study aimed to examine and compare this novel stretching technique to determine its effect on the range of motion (ROM) and acromio-humeral distance (AHD) in patients with glenohumeral internal rotation deficits (GIRD) with posterior shoulder tightness. Methods: A total of 30 symptomatic patients with asymmetrical GIRD were randomly assigned to two groups: the novel stretching group (n=15) and the joint mobilization group (n=15). The intervention was conducted twice a week for a total of four weeks. The ROM of shoulder internal rotation was measured by a goniometer and the AHD was evaluated by an X-ray before and after the intervention. Results: Both the treatments improved ROM and AHD in patients with GIRD (p<.05). However, the improvements in internal rotation ROM and AHD in the novel stretching group were significantly greater than that of the subjects in the mobilization group. There was a significant difference between the two groups (p<.05). Conclusion: These results show that both novel stretching and joint mobilization improved ROM and AHD in patients with GIRD with PST. However, novel stretching was more effective than joint mobilization.
Abstract
Background: The cross-body and the sleeper stretches have been used to improve posterior shoulder tightness (PST). However, such stretching techniques may not always help achieve scapular stability and may even aggravate patient’s symptoms. Therefore, a new stretching technique (passive glenohumeral internal rotation with bridging) was developed as a more effective method that may allow for greater scapular stability without aggravating the symptoms. Thus, this study aimed to examine and compare this novel stretching technique to determine its effect on the range of motion (ROM) and acromio-humeral distance (AHD) in patients with glenohumeral internal rotation deficits (GIRD) with posterior shoulder tightness. Methods: A total of 30 symptomatic patients with asymmetrical GIRD were randomly assigned to two groups: the novel stretching group (n=15) and the joint mobilization group (n=15). The intervention was conducted twice a week for a total of four weeks. The ROM of shoulder internal rotation was measured by a goniometer and the AHD was evaluated by an X-ray before and after the intervention. Results: Both the treatments improved ROM and AHD in patients with GIRD (p<.05). However, the improvements in internal rotation ROM and AHD in the novel stretching group were significantly greater than that of the subjects in the mobilization group. There was a significant difference between the two groups (p<.05). Conclusion: These results show that both novel stretching and joint mobilization improved ROM and AHD in patients with GIRD with PST. However, novel stretching was more effective than joint mobilization.
참고문헌 (23)
- Bach HG, "Posterior capsular contracture of the shoulder", J Am Acad Orthop Surg, 14(5), pp.265~277 (2006)[DOI]
- Borstad JD, "Quantifying strain on posterior shoulder tissues during 5 simulated clinical tests : A cadaver study", J Orthop Sports Phys Ther, 41(2), pp.90~99 (2011)[DOI]
- Borstad JD, "Clinical measurement of posterior shoulder flexibility", Man Ther, 12(4), pp.386~389 (2007)[DOI]
- Gharisia O, "Effect of a novel stretching technique on shoulder range of motion in overhead athletes with glenohumeral internal rotation deficits : A randomized controlled trial", BMC Musculoskelet Disord, 22(1), pp.402~ (2021)[DOI]
- Goutallier D, "Acromio humeral distance less than six millimeter : its meaning in full-thickness rotator cufftear", Orthop Traumatol Surg Res, 97(3), pp.246~251 (2011)[DOI]
- Gruber G, "Measurement of the acromiohumeral interval on standardized anteroposterior radiographs : A prospective study of observer variability", J Shoulder Elbow Surg, 19(1), pp.10~13 (2010)[DOI]
- Harryman DT 2nd, "Translation of the humeral head on the glenoid with passive glenohumeral motion", J Bone Joint Surg Am, 72(9), pp.1334~1343 (1990)
- Izumi T, "Stretching positions for the posterior capsule of the glenohumeral joint : Strain measurement using cadaver specimens", Am J Sports Med, 36(10), pp.2014~2022 (2008)[DOI]
- Johnson JE, "Glenohumeral Internal Rotation Deficit and Injuries : A Systematic Review and Metaanalysis", Orthop J Sports Med, 6(5), pp.2325967118773322~ (2018)[DOI]
- Kaltenborn FM, "Manual Mobilization of Joints: The Kaltenborn Method of Joint examination and treatment :The spine" (2003), Norli
- Kim SY, "Effect of the scapula-setting exercise on acromio-humeral distance and scapula muscle activity in patients with subacromial impingement syndrome", Phys Ther Sport, 37, pp.99~104 (2019)[DOI]
- Laudner KG, "The acute effects of sleeper stretches on shoulder range of motion", J Athl Train, 43(4), pp.359~363 (2008)[DOI]
- Lundberg A, "Role of joint afferents in motor control exemplified by effects on reflex pathꠓways from Ib afferents", J Physiol, 284, pp.327~343 (1978)[DOI]
- Maitland GD, "Maitland's Vertebral Manipulation", pp.472~ (2005), Butterworth Heinemann. Ltd
- Manske RC, "A randomized controlled single-blinded comparison of stretching versus stretching and joint mobilization for posterior shoulder tightness measured by internal rotation motion loss", Sports Health, 2(2), pp.94~100 (2010)[DOI]
- McClure P, "A randomized controlled comparison of stretching procedures for posterior shoulder tightness", J Orthop Sports Phys Ther, 37(3), pp.108~114 (2007)[DOI]
- 문귀도, "관절가동술과 스트레칭이 어깨후방뻣뻣함을 가진 충돌증후군의 어깨관절 근활성도와 안쪽돌림에 미치는 영향", 한국전문물리치료학회지, 27(1), pp.38~44 (2020), 한국전문물리치료학회[DOI]
- Muraki T, "Effect of posteroinferior capsule tightness on contact pressure and area beneath the coracoacromial arch during pitching motion", Am J Sports Med, 38(3), pp.600~607 (2010)[DOI]
- Razmjou H, "Diagnostic value of acromiohumeral distance in rotator cuffpathology : Implications for advanced-practice physiotherapists", Physiother Can, 72(1), pp.52~62 (2020)[DOI]
- Riddle DL, "Goniometric reliability in a clinical setting. Shoulder measurements", Phys Ther, 67(5), pp.668~673 (1987)[DOI]
- Steuri R, "Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement : A systematic review and meta-analysis of RCTs", Br J Sports Med, 51(18), pp.1340~1347 (2017)[DOI]
- Werner CM, "Intermethod agreement and interobserver correlation of radiologic acromiohumeral distance measurements", J Shoulder Elbow Surg, 17(2), pp.237~240 (2008)[DOI]
- Wilk KE, "The modified sleeper stretch and modified cross-body stretch to increase shoulder internal rotation range of motion in the overhead throwing athlete", J Orthop Sports Phys Ther, 43(12), pp.891~894 (2013)[DOI]
