TY - JOUR
T1 - In Vivo Evaluation of Subacromial and Internal Impingement Risk in Asymptomatic Individuals
AU - Coats-Thomas, Margaret S.
AU - Massimini, Daniel F.
AU - Warner, Jon J.P.
AU - Seitz, Amee L.
N1 - Funding Information:
ALS is supported in part by a Fellowship (New Investigator Fellowship In Training Initiative) from the Foundation for Physical Therapy. The funding agencies had no role in support of this study including study design, collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding sources.
Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc. All rights reserved.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Objective The study aim was to evaluate subacromial and internal impingement risk between shoulders (dominant/nondominant) during dynamic motion using subject-specific anatomy and precise in vivo kinematics. Design In a prospective cross-sectional study, nine subjects underwent bilateral magnetic resonance (N = 18 shoulders) and fluoroscopic imaging during elevation and external rotation at 90 degrees of abduction. Subject-specific bone models were created and distances from footprint to (a) acromion and (b) glenoid were measured to evaluate risk. Results Throughout elevation, subacromial impingement risk was greater in the dominant shoulder (P = 0.0178). Regardless of side, high subacromial impingement risk occurred at 30% (78 degrees), 50% (101 degrees), and 70% (57 degrees) of the elevation cycle (P < 0.0001). High subacromial impingement risk also occurred at 30% (94 degrees), 50% (120 degrees), and 70% (63 degrees) of the external rotation motion cycle (P < 0.0001). Throughout both motions, internal impingement risk was not observed; however, the footprint and glenoid were closest at 50% of the elevation (101 degrees) and external rotation (120 degrees) cycles (P < 0.0001). Conclusions During elevation, subacromial impingement risk is greatest at lower arm positions (30% cycle, 78 degrees) and is greater in the dominant shoulder. High subacromial impingement risk also occurs with external rotation (63-120 degrees). Internal impingement risk does not occur with maximal elevation (101 degrees) or external rotation at 90-degree abduction but is more closely approached with elevation.
AB - Objective The study aim was to evaluate subacromial and internal impingement risk between shoulders (dominant/nondominant) during dynamic motion using subject-specific anatomy and precise in vivo kinematics. Design In a prospective cross-sectional study, nine subjects underwent bilateral magnetic resonance (N = 18 shoulders) and fluoroscopic imaging during elevation and external rotation at 90 degrees of abduction. Subject-specific bone models were created and distances from footprint to (a) acromion and (b) glenoid were measured to evaluate risk. Results Throughout elevation, subacromial impingement risk was greater in the dominant shoulder (P = 0.0178). Regardless of side, high subacromial impingement risk occurred at 30% (78 degrees), 50% (101 degrees), and 70% (57 degrees) of the elevation cycle (P < 0.0001). High subacromial impingement risk also occurred at 30% (94 degrees), 50% (120 degrees), and 70% (63 degrees) of the external rotation motion cycle (P < 0.0001). Throughout both motions, internal impingement risk was not observed; however, the footprint and glenoid were closest at 50% of the elevation (101 degrees) and external rotation (120 degrees) cycles (P < 0.0001). Conclusions During elevation, subacromial impingement risk is greatest at lower arm positions (30% cycle, 78 degrees) and is greater in the dominant shoulder. High subacromial impingement risk also occurs with external rotation (63-120 degrees). Internal impingement risk does not occur with maximal elevation (101 degrees) or external rotation at 90-degree abduction but is more closely approached with elevation.
KW - Kinematics
KW - Rotator Cuff
KW - Shoulder
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U2 - 10.1097/PHM.0000000000000940
DO - 10.1097/PHM.0000000000000940
M3 - Article
C2 - 29613881
AN - SCOPUS:85051803731
VL - 97
SP - 659
EP - 665
JO - American Journal of Physical Medicine
JF - American Journal of Physical Medicine
SN - 0894-9115
IS - 9
ER -