Podium 15
Tracks
Breakout 1
| Sunday, September 8, 2024 |
| 9:35 AM - 10:05 AM |
| Plenary Room Auditorium |
Speaker
Mrs Pradnya Gadkari
Auckland Shoulder Clinic
Strength, perceived function and physical performance in surgically stabilised shoulders following traumatic anterior shoulder dislocations
Presentation Abstract
Background: Dynamic glenohumeral stability is influenced by muscle strength. Decreased dynamic stability at the shoulder may contribute to decrease in sports performance post-surgery.
Purpose: To examine bilateral glenohumeral external and internal rotator muscle strength after anterior stabilisation surgery and investigate the relationships between strength deficits and function.
Methods: Twenty-five participants participated (aged 24±6 years), 6-12 months post-surgery and cleared for return-to-sports. Bilateral maximal isometric internal and external rotator strength (iMVC) was examined using a Biodex dynamometer in sitting (arm in 90-degree abduction). Limb symmetry indices (LSI) were calculated for the iMVCs. The Shoulder Instability-Return-to-Sport Injury (SIRSI) was administered. Physical performance was assessed using the Shoulder Arm Return to Sports battery of tests (SARTS).
Results: Eighty percent of the participants had returned to sports. There were significant deficits (p <0.05) for iMVC of external rotators between the affected (mean±SD: 16.3±5.5 Nm) and unaffected shoulder (mean±SD: 21.3±7.0 Nm, LSI = 78.5% ± 21.6). Similarly, a significant deficit was observed in internal rotators iMVC (mean±SD affected: 37.0 Nm vs unaffected: 43.0 Nm, LSI = 83.5% ± 15.3).
Participants with higher internal rotator LSI had higher confidence in return to sports (SI-RSI; r = 0.403, p<0.05, r2=0.162). No significant associations were observed between iMVC and SARTS tests.
Conclusions: Participants had not met return-to-sports criteria for iMVC at a time of clearance for return to sports.
Implications: Isometric muscle strength recovery can take longer than 6 months after anterior stabilisation surgery. The SARTS tests assesses different constructs (muscle power, endurance, control/coordination) and involves larger muscle groups, which may explain lack of association between iMVC and the SARTS. The internal rotator LSI contributed a small proportion of change in self-confidence, accounting for 16% of the variance of the SIRSI.
Purpose: To examine bilateral glenohumeral external and internal rotator muscle strength after anterior stabilisation surgery and investigate the relationships between strength deficits and function.
Methods: Twenty-five participants participated (aged 24±6 years), 6-12 months post-surgery and cleared for return-to-sports. Bilateral maximal isometric internal and external rotator strength (iMVC) was examined using a Biodex dynamometer in sitting (arm in 90-degree abduction). Limb symmetry indices (LSI) were calculated for the iMVCs. The Shoulder Instability-Return-to-Sport Injury (SIRSI) was administered. Physical performance was assessed using the Shoulder Arm Return to Sports battery of tests (SARTS).
Results: Eighty percent of the participants had returned to sports. There were significant deficits (p <0.05) for iMVC of external rotators between the affected (mean±SD: 16.3±5.5 Nm) and unaffected shoulder (mean±SD: 21.3±7.0 Nm, LSI = 78.5% ± 21.6). Similarly, a significant deficit was observed in internal rotators iMVC (mean±SD affected: 37.0 Nm vs unaffected: 43.0 Nm, LSI = 83.5% ± 15.3).
Participants with higher internal rotator LSI had higher confidence in return to sports (SI-RSI; r = 0.403, p<0.05, r2=0.162). No significant associations were observed between iMVC and SARTS tests.
Conclusions: Participants had not met return-to-sports criteria for iMVC at a time of clearance for return to sports.
Implications: Isometric muscle strength recovery can take longer than 6 months after anterior stabilisation surgery. The SARTS tests assesses different constructs (muscle power, endurance, control/coordination) and involves larger muscle groups, which may explain lack of association between iMVC and the SARTS. The internal rotator LSI contributed a small proportion of change in self-confidence, accounting for 16% of the variance of the SIRSI.
Biography
Pradnya is a physiotherapist working at Auckland Shoulder Clinic & at Middlemore hospital. She has completed MHSc from AUT and has over twenty years of clinical experience. Her area of interest is shoulder injuries, more specifically shoulder instability.
Pradnya likes to be involved in clinical research and is currently involved in shoulder research projects.
Mrs Charlotte Marshall
Professional Practice Fellow
University Of Otago
Changes in Physical Impairments in Femoroacetabular Impingement Syndrome Following Arthroscopic Surgery: Systematic Review and Meta-Analysis
Presentation Abstract
Background:
Femoroacetabular impingement syndrome (FAIS) is a motion-related condition that can cause hip pain in active young adults. Evidence supports an association with chondral pathology and a 2.2-2.4 times increased risk of hip osteoarthritis. Arthroscopic surgery is a technique performed to normalise hip morphology associated with FAIS. Knowledge regarding physical impairments associated with the condition is limited to inform rehabilitation requirements and optimise patients outcomes.
Purpose:
The purpose of this systematic review was to investigate changes in physical impairments in those with FAIS pre and post arthroscopic surgery.
Methods:
Six databases (CINAHL, EMBASE, MEDLINE, PubMed, SportsDiscus, and Web of Science) were searched for English-language studies reporting on pre and post-operative physical impairments using physical outcome measures. Reporting quality was assessed using the Grading of Recommendations Assessment, Development and Evaluations (GRADE) framework, the Cochrane Risk of Bias tools and for pooled data (standardised mean difference (SMD), and 95% Confidence Intervals (CI)).
Results:
Seventeen studies were included (two randomised controlled trials; fifteen pre/post intervention studies), varying from low-critical risk of bias and very low reporting quality on the GRADE. Post-operatively, in the meta-analysis, participants with FAIS walked with a higher peak hip flexion moment (SMD 0.5, 95%CI [0.12-0.88]; heterogeneity I2=0%, P=0.82). Effects of surgery on hip strength are inconsistent, but suggest improved flexion, extension, abduction, adduction and external rotation. Additionally, post-operative FAIS patients demonstrated decreased peak hip extension moments during walking and squatting; decreased gluteus maximus contraction time and motor-control alterations.
Conclusions:
The review suggests that people with FAIS displayed changes in their physical impairments pre to post surgery. Further research is required to understand the effect of arthroscopic surgery on physical impairments in specific subgroups of FAIS (cam vs. pincer vs. combined morphology).
Femoroacetabular impingement syndrome (FAIS) is a motion-related condition that can cause hip pain in active young adults. Evidence supports an association with chondral pathology and a 2.2-2.4 times increased risk of hip osteoarthritis. Arthroscopic surgery is a technique performed to normalise hip morphology associated with FAIS. Knowledge regarding physical impairments associated with the condition is limited to inform rehabilitation requirements and optimise patients outcomes.
Purpose:
The purpose of this systematic review was to investigate changes in physical impairments in those with FAIS pre and post arthroscopic surgery.
Methods:
Six databases (CINAHL, EMBASE, MEDLINE, PubMed, SportsDiscus, and Web of Science) were searched for English-language studies reporting on pre and post-operative physical impairments using physical outcome measures. Reporting quality was assessed using the Grading of Recommendations Assessment, Development and Evaluations (GRADE) framework, the Cochrane Risk of Bias tools and for pooled data (standardised mean difference (SMD), and 95% Confidence Intervals (CI)).
Results:
Seventeen studies were included (two randomised controlled trials; fifteen pre/post intervention studies), varying from low-critical risk of bias and very low reporting quality on the GRADE. Post-operatively, in the meta-analysis, participants with FAIS walked with a higher peak hip flexion moment (SMD 0.5, 95%CI [0.12-0.88]; heterogeneity I2=0%, P=0.82). Effects of surgery on hip strength are inconsistent, but suggest improved flexion, extension, abduction, adduction and external rotation. Additionally, post-operative FAIS patients demonstrated decreased peak hip extension moments during walking and squatting; decreased gluteus maximus contraction time and motor-control alterations.
Conclusions:
The review suggests that people with FAIS displayed changes in their physical impairments pre to post surgery. Further research is required to understand the effect of arthroscopic surgery on physical impairments in specific subgroups of FAIS (cam vs. pincer vs. combined morphology).
Biography
Charlotte Marshall is a PhD candidate investigating the effects of arthroscopic surgery on femoroacetabular impingement syndrome. She holds a Masters in Sports Physiotherapy, a Post-Graduate Diploma and a Degree in Physiotherapy. Having worked as a clinical, academic and research physiotherapist, she has teaching experience at the University of Melbourne and Swinburne University of Technology, Australia and holds a Graduate Certificate in Learning and Teaching (HE). In addition, she has a Graduate Certificate in Research and Innovation Management. Her research interest include hip, lower limb biomechanics and education. Currently, she works as a Professional Practice Fellow at the University of Otago.
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