Effect of a 12-Week Rehabilitation Exercise Program on Shoulder Proprioception, Instability and Pain in Baseball Players with Shoulder Instability
Background: The shoulder joint has a wide range of motion, but is vulnerable to sport-related injuries. We aimed to evaluate the differences in the proprioception of the shoulder should instability, and shoulder pain in high school baseball players with shoulder instability following a 12-week rehabilitation exercise program.
Methods: We enrolled 13 baseball players with shoulder instability who visited the Orthopedics Department at Konkook University Hospital in Seoul, South Korea and 12 controls without shoulder instability. We examined the dominant shoulder and the non-dominant shoulder for both groups. We restricted participation to individuals who had no other orthomechanical disease in the past six months, except for instability of the shoulder, and no physical limitation to participate in the exercise. We measured the proprioception of the shoulder and shoulder instability, and we also evaluated pain with the Visual Analog Scale before and after the rehabilitation program. To verify the differences between groups, we used a two-way analysis of variance, and a two-way analysis of covariance was used when a significant difference was found at the pretest (baseline between groups).
Results: Proprioception was associated with shoulder instability. The Visual Analog Scale rating improved in the dominant shoulder with instability; and a positive change was found in the dominant shoulder without instability after the rehabilitation program (P < 0.05).
Conclusion: The 12-week rehabilitation exercise program might improve the proprioception and pain of patients with shoulder instability. However, further studies with more participants and a rehabilitation exercise program should be undertaken.
2. Terry GC, Chopp TM (2000). Functional Anatomy of the Shoulder. J Athl Train, 35(3):248-255.
3. Hess SA (2000). Functional stability of the glenohumeral joint. Man Ther, 5(2):63-71.
4. Powell JW, Barber-Foss KD (1999). Injury Patterns in Selected High School Sports: A Review of the 1995-1997 Seasons. J Athl Train, 34(3):277-284.
5. Steinbrück K (1999). Epidemiology of sports injuries-25-year-analysis of sports orthopedic-traumatologic ambulatory care. Sportverletz Sportschaden, 13(2):38-52.
6. Lephart SM, Pincivero DM, Giraldo JL, et al (1997). The role of proprioception in the management and rehabilitation of athletic injuries. Am J Sports Med, 25(1):130-137.
7. Sherrington CS (1907). On the proprio-ceptive system, especially in its reflex as-pect. Brain, 29(4):467-482.
8. Menz HB, Morris ME, Lord SR (2005). Foot and ankle characteristics associated with impaired balance and functional abil-ity in older people. J Gerontol A Biol Sci Med Sci, 60(12):1546-1552.
9. Myers JB, Lephart SM (2000). The role of the sensorimotor system in the athletic shoulder. J Athl Train, 35:351-363.
10. Voight ML, Hardin JA, Blackburn TA (1996). The effects of muscle fatigue on and the relationship of arm dominance to shoulder proprioception. J Orthop Sports Phys Ther, 23:348-352.
11. Allegrucci M, Whitney SL, Lephart SM, et al (1995). Shoulder kinesthesia in healthy unilateral athletes participating in upper extremity sports. J Orthop Sports Phys Ther, 21:220-226.
12. Dover GC, Kaminski TW, Meister K, et al (2003). Assessment of shoulder proprio-ception in the female softball athlete. Am J Sports Med, 31(3):431-437.
13. McMahon SB, Malcangio M (2009). Current challenges in glia-pain biology. Neuron, 64(1):46-54.
14. Watkins LR, Maier SF (1999). Implications of immune-to-brain communication for sickness and pain. Proc Natl Acad Sci USA. 96(14):7710-7713.
15. Hsieh LF, Hongm CZ, Chern SH, et al (2010). Efficacy and side effects of diclo-fenac patch in treatment of patients with myofascial pain syndrome of the upper trapezius. J Pain Symptom Manage, 39(6):7-8.
16. Bergh I, Sjöström B, Odén A, et al (2000). An application of pain rating scales in geriatric patients. Aging (Milano), 12(5):380-387.
17. Bala SV, Forslind K, Månsson ME (2010). Self-reported outcomes during treatment with tumour necrosis factor alpha inhibi-tors in patients with rheumatoid arthritis. Musculoskeletal Care, 8(1):27-35.
18. Furuta K, Ishihara S, Sato S, et al (2009). Development and verification of the Izumo Scale, new questionnaire for quality of life assessment of patients with gastro-intestinal symptoms. Nippon Shokakibyo Gakkai Zasshi, 106(10):1478-1487.
19. Lee KJ, Min BW, Bae KC, et al (2009). Effi-cacy of multimodal pain control protocol in the setting of total hip arthroplasty. Clin Orthop Surg, 1(3):155-160.
20. Veeger HE, Helm FC (2007). Shoulder func-tion: the perfect compromise between mobility and stability. J Biomech, 40(10):2119-2129.
21. Callanan M, Tzannes A, Hayes K, et al (2001). Shoulder instability. Diagnosis and management. Aust Fam Physician, 30(7):655-661.
22. Myers JB, Wassinger CA, Lephart SM (2006). Sensorimotor contribution to shoulder stability: effect of injury and re-habilitation. Man Ther, 11(3):197-201.
23. Jensen MP, Chen C, Brugger AM (2003). Interpretation of visual analog scale rat-ings and change scores: a reanalysis of two clinical trials of postoperative pain. J Pain, 4(7):407-414.
24. Wilk KE, Meister K, Andrews JR (2002). Current concepts in the rehabilitation of the overhead throwing athlete. Am J Sports Med, 30(1):136-151.
25. Hardin JA (1998). The effects of muscle fa-tigue on shoulder joint position sense. Am J Sports Med, 26(2):262-265.
26. Grigg P (1994). Peripheral neural mechanism in proprioception. J Sport Rehab, 3:2-17.
27. Bresch JP, Nuber G (1995). Mechanorecep-tors of the middle and inferior gleno-humeral ligaments: histologic study of human cadaver shoulders. J Shoulder El-bow Surg, 4(1):S63-S64.
28. Rokito AS, Birdzell MG, Cuomo F, et al (2010). Recovery of shoulder strength and proprioception after open surgery for recurrent anterior instability: a com-parison of two surgical techniques. J Shoulder Elbow Surg, 19(4):564-569.
29. Sullivan JA, Hoffman MA, Harter RA (2008). Shoulder joint position sense after thermal, open, and arthroscopic capsu-lorrhaphy for recurrent anterior instabil-ity. J Shoulder Elbow Surg, 17(3):389-394.
30. Blasier RB, Carpenter JE, Huston LJ (1994). Shoulder proprioception. Effect of joint laxity, joint position, and direction of mo-tion. Orthop Rev, 23(1):45-50.
31. Jonsson P, Alfredson H, Sunding K, et al (2008). New regimen for eccentric calf-muscle training in patients with chronic insertional Achilles tendinopathy: results of a pilot study. Br J Sports Med, 42(9):746-749.
32. Wang C, Schmid CH, Hibberd PL, et al (2009). Tai Chi is effective in treating knee osteoarthritis: A randomized controlled trial. Arthritis Rheum, 61(11):1545-1553.
33. Hübscher M, Vogt L, Bernhörster M, et al (2008). Effects of acupuncture on symp-toms and muscle function in delayed-onset muscle soreness. J Altern Complement Med, 14(8):1011-1016.
34. Mori H, Ohsawa H, Tanaka TH, et al (2004). Effect of massage on blood flow and muscle fatigue following isometric lumbar exercise. Med Sci Monit, 10(5):CR173-CR178.
35. Hazard RG, Haugh LD, Reid S (1996). Early prediction of chronic disability after oc-cupational low back injury. Spine, 21:945-951.
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