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Characteristics of functional shoulder instability.

Philipp Moroder1, Victor Danzinger1, Nina Maziak1

  • 1Department for Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Campus Virchow, Charité-Universitaetsmedizin Berlin, Berlin, Germany.

Journal of Shoulder and Elbow Surgery
|August 6, 2019
PubMed
Summary
This summary is machine-generated.

Functional shoulder instability (FSI) is characterized by muscle activation patterns causing shoulder instability. This study classified FSI into four subtypes, revealing distinct functional impairments and a prevalence of posterior instability.

Keywords:
Shoulder instabilityanterior shoulder instabilityfunctional shoulder instabilitymultidirectional shoulder instabilitynoncontrollable shoulder instabilitypositional shoulder instabilityposterior shoulder instabilityvoluntary shoulder instability

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Biomechanics

Background:

  • Pathologic muscle activation patterns can lead to shoulder instability, termed functional shoulder instability (FSI).
  • Understanding the characteristics of FSI is crucial for effective diagnosis and treatment.
  • This study provides a detailed description of FSI characteristics.

Purpose of the Study:

  • To prospectively investigate and describe the characteristics of functional shoulder instability (FSI).
  • To classify subtypes of FSI based on pathomechanism and volitional control.
  • To analyze the functional impairment associated with different FSI subtypes.

Main Methods:

  • Prospective collection of 36 consecutive FSI cases.
  • Diagnostic investigations included questionnaires, clinical scores, physical examination, psychological evaluation, video/fluoroscopy, and MRI.
  • Cases were evaluated to determine and compare different FSI subtypes based on observed patterns.

Main Results:

  • FSI was classified into positional (78%) and nonpositional (22%) subtypes.
  • Subtypes included controllable/noncontrollable positional and nonpositional FSI, with significant differences in clinical scores and functional impairment.
  • The majority of patients (78%) presented with posterior instability; few had structural defects.

Conclusions:

  • Functional shoulder instability (FSI) can be categorized into four subtypes based on pathomechanism and volitional control.
  • The degree of functional impairment varies significantly among FSI subtypes.
  • Unidirectional posterior FSI is the most common presentation.