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Impact of Physiotherapeutic Procedures on the Treatment of Damaged Rotator Cuff Muscules of the Shoulder Girdle

100%
Bolach B., Walowska J., Bolach E.
Central European Journal of Sport Sciences and Medicine
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2019
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vol. 27
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issue 3
17-23
EN
Damage to the rotator cuffs within the shoulder girdle is one of the many causes of the painful shoulder syndrome. The main symptom is the accompanying pain limiting partial or complete mobility in the shoulder joint. Weakness and atrophy of the deltoid and supraspinous muscles of the shoulder are secondary symptoms caused by immobilization of the upper limb. The aim of the study was to evaluate the effects of the use of physical therapy in women with damaged rotator cuff muscles of the shoulder girdle. The study involved 30 women aged 45–70, who were divided into two groups: professionally active (n = 15) and professionally inactive (n = 15). The muscle strength of the shoulder joint rim, strength of the hand grip and pain assessment according to the VAS scale were analyzed. The assessment of upper limb fitness was assessed before and after 20 physiotherapy procedures. Professionally active women returned to physical fitness faster, gaining greater strength of the shoulder girdle, strength of the hand grip and reduction of perceptible pain.
2
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Electric Muscle Activity During Manual Muscle Testing of the Shoulder

72%
Mikołajczyk K., Wiszomirska I.
Advances in Rehabilitation
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2013
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vol. 27
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issue 1
25-32
EN
Introduction: This is a research study, supported by a literature review, which gave the principles of anatomy, biomechanics, physiological and patological conditions of shoulder functioning. Correct muscle activity is essential for proper functioning of the shoulder. Electromyography is a method which enables to record and analize the signs of muscle activity. This tool is useful for veryfing the manual muscle tests, typically used for clinical examination of the shoulder. The aim of this study was to investigate electric activation of 8 shoulder muscles while manual testing the resistive external rotation in scapulohumeral joint. Material and methods: Fourteen healthy subjects (n=14) were manually tested for isometric resistance. Three tests were used, each with different level of abduction, respectively: the m. infraspinatus test (1): 0 degrees, non-specific biceps brachii tendon test (2): 45 degrees, resistive test for external rotation in the position of maximal internal rotation (3): 90 degrees. The superficial electromyography device used in the study was Noraxon: TeleMyo System 2400T, with MyoResearch XP software. It collected data about the muscle electric activity during all the tests. Statistic data mining was made using Statistica programme. Peak amplitude values were collected and comparison of three tests was made. Results: High supraspinatus activation could be observed together with high coactivation of other shoulder muscles. Also, inter-individual dispersion of muscle activation values was high. Conclusions: Surface electromyography alone appeared to be insufficient method for assesing manual muscle tests, although it may give suggestions for testing and therapeutic exercises. Results of electromyography need to be confirmed by conducting large group studies, and large scatter of muscle activation values has to be taken account.
3
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Anatomia diagnostyczna i diagnostyka patologii strefy entezy pierścienia rotatorów

72%
Czyrny Z.
Journal of Ultrasonography
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2012
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vol. 12
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issue 49
178-187
EN
Detailed anatomy, crucial in modern high-definition diagnostics imaging, is a base for understanding diagnostic images and the nature of the diagnosed disease. The aim of this paper is presentation of a new anatomical model of the rotator cuff, which includes definition of tendinous and capsule-ligamentous layers as equally important to rotator cuff function understanding. Schematic and diagnostic (ultrasonography, magnetic resonance imaging) anatomy of the rotator cuff based on the core tendon concept is presented. Appropriate tissue layers of the cuff are discussed in detail. In the diagnostics part some enthesal pathologies of the rotator cuff are presented. Material and methods: New anatomical data was analyzed in the context of rotator cuff layers – their presence, thickness and structure observed on magnetic resonance imaging and ultrasonographic images. Conclusions: Rotator cuff should be regarded as a multilayer structure consisting of fused fibers of tendons and capsuloligamentous complex. The thickness of these layers is comparable therefore it is important to realize that capsular pathologies may become a serious obstacle to normal shoulder joint function. Understanding of anatomical rotator cuff layers explains the formation of calcific cavities within the rotator cuff. In fact between layers of the cuff. Calcific cavities are a sequelae of chronic enthesopathy/enthesal tear with hydroxyapatite filling and probably delaminating the tendinous layer from the capsuloligamentous one.
PL
Anatomia szczegółowa, jakiej wymaga nowoczesna diagnostyka obrazowa, jest podstawą zrozumienia obrazów diagnostycznych oraz natury diagnozowanej choroby. Celem pracy jest przedstawienie nowego modelu anatomicznego struktur mięśniowo-ścięgnistych i torebkowo-więzadłowych o kompleksowej nazwie pierścień rotatorów, na podstawie schematów anatomicznych i anatomii diagnostycznej (ultrasonografia i rezonans magnetyczny) pierścienia z zastosowaniem koncepcji rdzeni ścięgnistych. Omawiane są odpowiednie warstwy tkankowe pierścienia rotatorów. W części diagnostycznej przedstawiono niektóre patologie entezy ramiennej pierścienia rotatorów. Materiał i metoda: Przeanalizowano najnowsze dane z badań anatomicznych struktury warstw pierścienia rotatorów – ich lokalizację, wymiary i strukturę w badaniach ultrasonograficznym i rezonansu magnetycznego. Wnioski: Pierścień rotatorów powinien być rozpatrywany jako wielowarstwowa struktura składająca się z przeplatających się i zespalających ze sobą włókien ścięgien i kompleksu torebkowo-więzadłowego spełniających różne funkcje statyczno- dynamiczne. Grubość tych warstw jest porównywalna, stąd duże znaczenie ma świadomość, że patologie kompleksu torebkowo-więzadłowego mogą stać się poważną przeszkodą w prawidłowym funkcjonowaniu stawu ramiennego, mając istotny wpływ na zachowanie się całego pierścienia rotatorów. Zrozumienie anatomii i funkcji warstw pierścienia rotatorów wyjaśnia część zagadki tworzenia się hydroksyapatytowych jam wapiennych pomiędzy warstwami ścięgien/kompleksu. Jamy te są konsekwencją uszkodzeń entezy pierścienia rotatorów na granicy przyczepu warstwy ścięgnistej i torebkowo- więzadłowej. Takie uszkodzenie entezy otwiera drogę do wypełniania już istniejących rozwarstwień ścięgna-kompleksu oraz aktywnego ich rozlaminowywania poprzez ciągłe wypełnianie materiałem wapiennym.
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