3-D scapular kinematics during arm elevation: Effect of motion velocity.

Background. No three-dimensional (3-D) data exist on the influence of motion velocity on scapular kinematics. The effect of arm elevation velocity has been studied only in a two-dimensional setting. Methods. Thirty healthy subjects performed dominant (right) arm elevation in two planes, sagittal and frontal, and at slow and fast self-selected arm speed. Scapular orientation and humeral elevation were measured at 30Hz recording frequency with use of a 6-degree-of-freedom electromagnetic system (Polhemus Fastrak(a)). Motion was computed according to the International Society of Biomechanics standards. Scapular orientation was also determined with the arm held in different static positions. Findings. We obtained a full 3-D kinematic description of scapula achieving a reliable, complex 3-D motion during humeral elevation and lowering. The maximal sagittal arm elevation showed a characteristic "M"-shape pattern of protraction/retraction curve. Scapular rotations did not differ significantly between slow and fast movements. Moreover, protraction/retraction and tilt angular values did not differ significantly between static and dynamic tasks. However, scapular lateral rotation values differed between static and dynamic measurements during sagittal and frontal arm elevation. Lateral scapular rotation appears to be less in static than in dynamic measurement, particularly in the sagittal plane. Interpretation. Interpolation of statically recorded positions of the bones cannot reflect the kinematics of the scapula

Magnetic Resonance Imaging of Adhesive Capsulitis: Correlation with Clinical Staging

The purpose of this study was to evaluate non-contrast magnetic resonance imaging (MRI) findings of adhesive capsulitis and correlate them with clinical stages of adhesive capsulitis. This will hopefully define a role for shoulder MR imaging in the diagnosis of adhesive capsulitis as well as in potentially directing appropriate treatment. Forty-seven consecutive non-contrast magnetic resonance imaging examinations of 46 patients with a clinical diagnosis of adhesive capsulitis were retrospectively reviewed and correlated with clinical staging. Specific MRI criteria correlated with the clinical stage of adhesive capsulitis, including the thickness and signal intensity of the joint capsule and synovium as well as the presence and severity of scarring in the rotator interval. Routine MRI of the shoulder without intraarticular administration of gadolinium can be used to diagnose all stages of adhesive capsulitis, including stage 1, where findings may be subtle on clinical examination. We believe that future studies assessing the role of MRI in guiding the initiation of appropriate treatment should be undertaken

Reliability of the standard goniometry and diagrammatic recording of finger joint angles: a comparative study with healthy subjects and non-professional raters

<p>Abstract</p> <p>Background</p> <p>Diagrammatic recording of finger joint angles by using two criss-crossed paper strips can be a quick substitute to the standard goniometry. As a preliminary step toward clinical validation of the diagrammatic technique, the current study employed healthy subjects and non-professional raters to explore whether reliability estimates of the diagrammatic goniometry are comparable with those of the standard procedure.</p> <p>Methods</p> <p>The study included two procedurally different parts, which were replicated by assigning 24 medical students to act interchangeably as 12 subjects and 12 raters. A larger component of the study was designed to compare goniometers side-by-side in measurement of finger joint angles varying from subject to subject. In the rest of the study, the instruments were compared by parallel evaluations of joint angles similar for all subjects in a situation of simulated change of joint range of motion over time. The subjects used special guides to position the joints of their left ring finger at varying angles of flexion and extension. The obtained diagrams of joint angles were converted to numerical values by computerized measurements. The statistical approaches included calculation of appropriate intraclass correlation coefficients, standard errors of measurements, proportions of measurement differences of 5 or less degrees, and significant differences between paired observations.</p> <p>Results</p> <p>Reliability estimates were similar for both goniometers. Intra-rater and inter-rater intraclass correlation coefficients ranged from 0.69 to 0.93. The corresponding standard errors of measurements ranged from 2.4 to 4.9 degrees. Repeated measurements of a considerable number of raters fell within clinically non-meaningful 5 degrees of each other in proportions comparable with a criterion value of 0.95. Data collected with both instruments could be similarly interpreted in a simulated situation of change of joint range of motion over time.</p> <p>Conclusions</p> <p>The paper goniometer and the standard goniometer can be used interchangeably by non-professional raters for evaluation of normal finger joints. The obtained results warrant further research to assess clinical performance of the paper strip technique.</p