H. Sarig Bahat1, M. Linkovski1
1University of Haifa, Physical Therapy, Haifa, Israel
Background: Patients with Rotator-cuff-related shoulder pain (RCRSP) suffer from pain, functional disability, and weakness. The shoulder has few functional tests, and therefore we need functional tests to measure strength without aggravating pain.
Seated Medicine Ball Throw (SMBT) and Unilateral Shot Put (ULSP) are throwing tests that use a weighted ball in a seated position. They measure throwing distance (m) and were mainly investigated in athletes.
These could become clinical functional tests that measure shoulder strength and power quantitatively.
Seated Medicine Ball Throw (SMBT) and Unilateral Shot Put (ULSP) are throwing tests that use a weighted ball in a seated position. They measure throwing distance (m) and were mainly investigated in athletes.
These could become clinical functional tests that measure shoulder strength and power quantitatively.
Purpose: To evaluate the SMBT and ULSP for their clinical value in assessment of individuals with RCRSP.
Methods: A cross-sectional study included individuals with RCRSP, and controls. Exclusion criteria included systemic/neurological disorders, acute shoulder pathology or shoulder pain>=9/10. Self-report measures included shoulder pain 100mmVAS: during past week; pre- and post-physical assessment. Participants completed the Disability of arm shoulder and hand questionnaire (QuickDASH), and the Fear-avoidance belief questionnaire (FABQ). The SMBT and the ULSP were performed in sitting on the floor, back against the wall. Participants threw a 2kg weighted ball forwards, in a bilateral chest throw (SMBT), and unilateral shoulder throw (ULSP). Throwing distance was calculated as the average of three trials in meters. We collected shoulder active range of motion, and isometric grip strength using JAMAR dynamometer.
Bilateral outcome measures (SMBT, quickDASH, FABQ) were analyzed by 2 groups (RCRSP, control), and unilateral measures (ULSP, ROM, grip strength, VAS) that were analyzed by 3 groups (Painful shoulder, non-painful shoulder, control). A two-way mixed-model repeated-measures analysis of variance (ANOVA) was run to examine the group effect. Post-hoc mean analysis was used when relevant. Spearman/Pearson correlations were used to explore associations amongst the outcome measures.
Bilateral outcome measures (SMBT, quickDASH, FABQ) were analyzed by 2 groups (RCRSP, control), and unilateral measures (ULSP, ROM, grip strength, VAS) that were analyzed by 3 groups (Painful shoulder, non-painful shoulder, control). A two-way mixed-model repeated-measures analysis of variance (ANOVA) was run to examine the group effect. Post-hoc mean analysis was used when relevant. Spearman/Pearson correlations were used to explore associations amongst the outcome measures.
Results: This cohort study recruited 64 volunteers: 34 controls and 30 with RCRSP. The age and gender of both groups were similar (P>0.05). The RCRSP group presented with chronic moderate shoulder pain (mean duration=6.33±5.7, VAS=5.03±1.99, quickDASH=22.9±4.4).
Pre- and post-throwing test pain were not significantly different (VASpost-pre=0.35±2.43), supporting the feasibility of these tests.
In the ULSP participants with RCRSP demonstrated shorter throwing distance in both symptomatic (2.03±0.81m) and asymptomatic shoulders (2.04±0.8m) compared tB controls (2.51±0.93m, P<0.01). The SMBT demonstrated only a trend between groups (p=0.05), although controls threw about 0.5m farther than patients. Participants with RCRSP showed reduced ROM (166.2±10° vs 175.1±8.2°), but similar grip strength as compared with controls. ULSP was highly correlated with SMBT (r=.92-.94,P<0.05), and both throwing tests correlated with grip strength (r=.61-81,P<0.05), disability, pain, and fear avoidance (r=.26-.48,P<0.05).
Pre- and post-throwing test pain were not significantly different (VASpost-pre=0.35±2.43), supporting the feasibility of these tests.
In the ULSP participants with RCRSP demonstrated shorter throwing distance in both symptomatic (2.03±0.81m) and asymptomatic shoulders (2.04±0.8m) compared tB controls (2.51±0.93m, P<0.01). The SMBT demonstrated only a trend between groups (p=0.05), although controls threw about 0.5m farther than patients. Participants with RCRSP showed reduced ROM (166.2±10° vs 175.1±8.2°), but similar grip strength as compared with controls. ULSP was highly correlated with SMBT (r=.92-.94,P<0.05), and both throwing tests correlated with grip strength (r=.61-81,P<0.05), disability, pain, and fear avoidance (r=.26-.48,P<0.05).
Conclusions: According to our findings, both bilateral and unilateral medicine ball throwing tests did not aggravate pain significantly, making them safe for clinical use.
ULSP significantly differentiated patients from controls, while bilateral SMBT only showed a trend.
ULSP significantly differentiated patients from controls, while bilateral SMBT only showed a trend.
Implications:
Adults with RCRSP may benefit from the ULSP test as a functional power test.
This test requires a weighted ball and provides a continuous measure of shoulder strength. The SMBT correlated highly with the ULSP, but further research on a larger sample would be needed to determine whether one throwing test would suffice.
Funding acknowledgements: This study received no funding.
Keywords:
Rotator cuff tendinopathy
Seated medicine ball throw
Upper limb seated shot put
Rotator cuff tendinopathy
Seated medicine ball throw
Upper limb seated shot put
Topics:
Musculoskeletal: upper limb
Community based rehabilitation
Musculoskeletal: upper limb
Community based rehabilitation
Did this work require ethics approval? Yes
Institution: University of Haifa
Committee: Faculty of Social Welfare and Health Sciences Ethics Committee
Ethics number: 082/21
All authors, affiliations and abstracts have been published as submitted.
