Co-occurrence of outlet impingement syndrome of the shoulder and restricted range of motion in the thoracic spine - a prospective study with ultrasound-based motion analysisReportar como inadecuado




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BMC Musculoskeletal Disorders

, 11:135

First Online: 29 June 2010Received: 28 October 2009Accepted: 29 June 2010

Abstract

BackgroundShoulder complaints, and especially the outlet-impingement syndrome, are a common condition. Among other things, poor posture has been discussed as a cause. A correlation between impingement syndrome and restricted mobility of the thoracic spine T has been described earlier, but there has been no motion analysis of the thoracic spine to show these correlations. In the present prospective study, we intended to find out whether there is a significant difference in the thoracic sagittal range of motion ROM between patients with a shoulder outlet impingement syndrome and a group of patients who had no shoulder pathology. Secondly, we wanted to clarify whether Ott-s sign correlates with ultrasound topometric measurements.

MethodsTwo sex- and age-matched groups 2 × n = 39 underwent a clinical and an ultrasound topometric examination. The postures examined were sitting up straight, sitting in maximal flexion and sitting in maximal extension. The disabilities of the arm, shoulder and hand DASH score obtained by means of a self-assessment questionnaire and the Constant score were calculated. Lengthening and shortening of the dorsal projections of the spine in functional positions was measured by tape with Ott-s sign.

ResultsOn examination of the thoracic kyphosis in the erect seated posture there were no significant differences between the two groups p = 0.66. With ultrasound topometric measurement it was possible to show a significantly restricted segmental mobility of the thoracic spine in the study group compared with the control group p = 0.01. An in-depth look at the mobility of the subsegments T1-4, T5-8 and T9-12 revealed that differences between the groups in the mobility in the lower two sections of the thoracic spine were significant T5-8: p = 0.03; T9-12: p = 0.02. The study group had an average Constant score of 35.1 points and the control group, 85.5 p < 0.001. On the DASH score the patient group reached 34.2 points and the control group, 1.4 p < 0.001. The results of Ott-s sign differed significantly between the two collectives p = 0.0018, but showed a weak correlation with the ultrasound topometric measurements study group flexion-extension: r = 0.36-0.43, control group flexion-extension: r = 0.29-0.26.

ConclusionThe mobility of the thoracic spine should receive more attention in the diagnosis and therapy of patients with shoulder outlet impingement syndrome.

AbbrevationsROMrange of motion

DASHdisabilities of the arm, shoulder and hand

Tthoracic spine

Ccervical spine

HHypothesis

CIconfidence interval.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2474-11-135 contains supplementary material, which is available to authorized users.

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Autor: Christina Theisen - Ad van Wagensveld - Nina Timmesfeld - Turgay Efe - Thomas J Heyse - Susanne Fuchs-Winkelmann - Markus 

Fuente: https://link.springer.com/







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