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Shoulder proprioception - lessons we learned from idiopathic frozen shoulder
Jaroslaw Fabis1, Remigiusz Rzepka2, Anna Fabis2
1Department of Arthroscopy Minimally Invasive Surgery and Sport Traumatology, Medical University of Lodz and FMC Medical Centre Lodz, Lodz, Poland. fabis@onet.eu.
BMC Musculoskeletal Disorders
|March 13, 2016
Summary
Idiopathic frozen shoulder (IFS) release impacts shoulder proprioception and muscle performance. Recovery of passive joint position sense (PJPS) depends on healing of shoulder restraints, while external rotation (ER) deficits affect active joint position sense (AJPS).
Area of Science:
- Orthopedics
- Sports Medicine
- Rehabilitation
Background:
- Idiopathic frozen shoulder (IFS) is a common shoulder disorder.
- Proprioception deficits are characteristic of IFS, but spontaneous healing potential and its relation to shoulder stabilizers and muscle performance remain unclear.
- Arthroscopic release is a treatment option for IFS, necessitating investigation into its effects on shoulder function.
Purpose of the Study:
- To investigate the relationship between passive shoulder stabilizers, passive (PJPS) and active (AJPS) shoulder proprioception, and isokinetic muscle performance in patients undergoing arthroscopic release for IFS.
- To determine the influence of anatomical structures and spontaneous healing on PJPS recovery.
- To assess the impact of peak torque deficits on AJPS.
Main Methods:
- A study group of 23 patients with IFS who underwent arthroscopic release and 20 healthy volunteers were evaluated.
- Proprioception (PJPS and AJPS) and isokinetic muscle performance for internal and external rotation (IR, ER) were measured using a Biodex system in a modified neutral arm position.
- Statistical analysis included T-test, Wilcoxon, and interclass correlation coefficient, with significance set at p < 0.05.
Main Results:
- Significant differences were observed between involved and uninvolved shoulders in PJPS, AJPS, peak torque, time to peak torque, and acceleration time for ER (p < 0.05).
- No significant differences were found in PJPS or AJPS between IR and ER for the uninvolved shoulders.
- The anatomical structure of passive restraints did not affect PJPS differences between ER and IR in the neutral position.
Conclusions:
- Spontaneous healing of passive shoulder restraints influences PJPS recovery after arthroscopic IFS release.
- External rotation peak torque deficits negatively impact AJPS.
- PJPS and AJPS for ER and IR can be reliably measured with an isokinetic dynamometer, providing baseline data for identifying at-risk shoulder stabilizers.
