1. QUANTITATIVE ANALYSIS OF TRACTION IN THE GLENOHUMERAL JOINT. IN VIVO ROENTGENOGRAPHIC MEASUREMENTS
- Author
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DeClerck, S, Matthijs, O, Gokeler, A, van Paridon-Edauw, GH, and Winkel, D
- Subjects
Joints -- Range of motion ,Shoulder joint -- Care and treatment - Abstract
PURPOSE: Joint mobilization by means of fraction is a technique frequently applied by physical therapists treating shoulder patients in daily practice. According to the literature the effects are based on separating the humeral head from the glenoid cavity, thus stretching of the collagenous tissues. No studies have been done in vivo to determine if separation indeed occurs. Based on a preliminary study we hypothesized that fraction does not result in an increase of the glenohumeral joint (GHJ) space more than 1 mm in healthy subjects. SUBJECTS: Six healthy subjects (3 male and 3 female) with an average age of 40.5 years, volunteered to participate in this study. MATERIALS AND METHODS: All subjects were placed with the right shoulder in a modified shoulder brace (Otto Bock Armabduktions-Orthese in Modular Bauweise[R]) that held the shoulder in 45 [degrees] abduction in the plane of the scapula with neutral rotation, corresponding to the maximally loose packed position (MLPP). The scapula was additionally fixated with a Soft Belt[R]. A 14 kilogram force of fraction was applied by a therapist for 40 seconds to the GHJ before a roentgenographic film was taken. The same procedure was repeated with the shoulder placed in the closed packed position (CPP) of 90 [degrees] abduction and 90 [degrees] external rotation. Measurements were made by a radiologist blinded to the variable pull force or no pull force applied. ANALYSES AND RESULTS: Mean GHJ space in the MLPP increased from 4.33 mm without traction to 4.58 mm with traction, while in the CPP it increased from 4.83 mm to 5.08 mm with traction. The Wilcoxon Signed-Ranks test was used to determine statistical significance of the results. No statistically significant changes in joint space were found in the MLPP (p=0.02) and in the CPP (p=0.18). CONCLUSIONS: Application of a 14 kilogram force perpendicular to the glenoid fossa does not result in a significant separation of the humeral head from the glenoid fossa in subjects with no known shoulder pathologies. Joint play testing of the GHJ in healthy subjects by means of traction to test GHJ mobility, appears not to be useful since no significant separation of the GHJ occurs. Further studies are needed to determine if GHJ traction may result in GHJ separation in subjects with shoulder pathologies., DeClerck S, Matthijs O, Gokeler A, van Paridon-Edauw GH and Winkel D; BVBA Medische Beeldvorming, Schofen, [...]
- Published
- 2000