A remote monitoring-enabled home exercise prescription for patients with interstitial lung disease at risk for exercise-induced desaturation.

Rationale: Alternatives to center-based pulmonary rehabilitation are needed to improve patient access to this important therapy. A critical challenge to overcome is how to maximize safety of unsupervised exercise for at-risk patients. We investigated if a novel remote monitoring-enabled mobile health (mHealth) program is safe, feasible, and effective for patients who experience exercise-induced hemoglobin desaturation.

Causal mechanisms of a scapular stabilization intervention for patients with subacromial pain syndrome: a secondary analysis of a randomized controlled trial.

Background: Causal mediation analysis is one way to bridge this gap by exploring the causal pathways of a given intervention. The aim of this study was to assess whether scapular motion, position, and periscapular muscle strength are mediators for pain and shoulder disability outcomes following a scapular stabilization intervention for patients with subacromial pain syndrome.

Methods: Sixty patients were randomized into two groups: scapular stabilization or periscapular strengthening exercises.

Effects of adding scapular stabilization exercises to a periscapular strengthening exercise program in patients with subacromial pain syndrome: A randomized controlled trial.

Background: Interventions focused on the scapula should be considered in treating subacromial pain syndrome (SAPS). However, the effect of adding scapular stabilization exercises to protocols of progressive strengthening of the shoulder complex muscles on a non-multimodal approach remains unclear.

Objective: To investigate the effect of adding scapular stabilization exercises, emphasizing retraction, and depression of the scapula, to a progressive periscapular strengthening protocol on disability, pain, muscle strength, and ROM in patients with SAPS.

Comparisons of physical exposure between workers harvesting apples on mobile orchard platforms and ladders, part 1: Back and upper arm postures.

This study compared farmworkers' exposure to non-neutral postures using a new mobile platform apple harvesting method and the traditional method using ladders. Twenty-four workers were recruited and assigned into three groups: ladder workers (n = 8) picking apples from full trees using a ladder, mobile platform workers (n = 8) picking apples from upper part of the trees while standing on a moving platform, and ground-based mobile platform workers (n = 8) picking apples from lower part of the trees which the mobile platform workers left out. Upper arm and back inclinations were continuously monitored during harvesting using tri-axial accelerometers over full work shifts (~8 h).

Comparisons of physical exposure between workers harvesting apples on mobile orchard platforms and ladders, part 2: Repetitive upper arm motions.

Farmworkers are exposed to physical risk factors including repetitive motions. Existing ergonomic assessment methods are primarily laboratory-based and, thus, inappropriate for use in the field. This study presents an approach to characterize the repetitive motions of the upper arms based on direct measurement using accelerometers.

Acute effect of flexible bar exercise on scapulothoracic muscles activation, on isometric shoulder abduction force and proprioception of the shoulder of individuals with and without subacromial pain syndrome.

Background: There is currently no evidence about the effects of neuromuscular facilitation after the use of a flexible bar on scapulothoracic muscle activity in individuals with subacromial pain syndrome. The study aimed to assess the acute effect of flexible bar exercise and subjective fatigue on scapulothoracic muscle activity, shoulder proprioception, and shoulder abduction force of subjects with and without symptoms of subacromial pain syndrome.

Method: Fifty subjects with subacromial pain syndrome and 50 asymptomatic subjects were recruited.

Scapular-focused exercise treatment protocol for shoulder impingement symptoms: Three-dimensional scapular kinematics analysis.

Background: The present study aimed to describe the effects of a periscapular strengthening and neuromuscular training protocol in three-dimensional scapular kinematics and resting positioning in participants with shoulder impingement symptoms. Self-reported function was also evaluated.

Method: The study group comprised 50 subjects with shoulder impingement syndrome (control group, n=25; treatment group, n=25).

Biomechanical Analysis of the Closed Kinetic Chain Upper-Extremity Stability Test.

Context: The closed kinetic chain upper-extremity stability (CKCUES) test is a functional test for the upper extremity performed in the push-up position, where individuals support their body weight on 1 hand placed on the ground and swing the opposite hand until touching the hand on the ground, then switch hands and repeat the process as fast as possible for 15 s.

Objective: To study scapular kinematic and kinetic measures during the CKCUES test for 3 different distances between hands.

Design: Experimental.

Critical and Theoretical Perspective on Scapular Stabilization: What Does It Really Mean, and Are We on the Right Track?

Stabilization exercises have been a focus and mainstay of many therapeutic and performance training programs in the past decade. Whether the focus is core stabilization for the spine or scapular stabilization, clinicians and trainers alike have endorsed these programs, largely on the basis of conceptual theory and anecdotal experience. The notion that an unstable scapula is related to shoulder dysfunction and pathology is well accepted, but is it accurate? The aim of this perspective article is to challenge the concept of scapular stabilization through the application of biomechanical and motor control constructs.

Can clinical observation differentiate individuals with and without scapular dyskinesis?

Background: Altered scapular rotation and position have been named scapular dyskinesis. Visual dynamic assessment could be applied to classify this alteration based on the clinical observation of the winging of the inferior medial scapular border (Type I) or of the prominence of the entire medial border (Type II), or by the excessive superior translation of the scapula (Type III).

Objective: The aim of this study was to determine if there were differences in scapular rotations (Type I and II) and position (Type III) between a group of subjects with scapular dyskinesis, diagnosed by the clinical observation of an expert physical therapist, using a group of healthy individuals (Type IV).

Upper extremity joint stresses during walkerassisted ambulation in post-surgical patients.

Background: A walker is a common device prescribed for ambulatory assistance for individuals with balance difficulties or to reduce lower extremity demands following injury or surgery. The long-term use of a walker imposes significant demands on the patient's upper extremities that may lead to increased risk for development of secondary conditions such as wrist, elbow or shoulder pain.

Objective: To describe the joint kinematics, forces and moments of the wrist, elbow and shoulder in a sample of twenty patients that were using a walker as a result of total joint surgery of the hips and knees.

Effects of progressive resistance strength training on knee biomechanics during single leg step-up in persons with mild knee osteoarthritis.

Background: The goal of this study was to determine if increasing strength in primary knee extensors and flexors would directly affect net knee joint moments during a common functional task in persons with knee osteoarthritis.

Methods: An exploratory single sample clinical trial with pre-post treatment measures was used to study volunteers with clinical diagnosis of mild knee osteoarthritis (OA) in one knee. Subjects participated in an individually supervised training program 3 times a week for eight weeks consisting of progressive resistive exercises for knee extensors and knee flexors.

Activation of selected shoulder muscles during unilateral wall and bench press tasks under submaximal isometric effort.

Study Design: Controlled laboratory study.

Objective: To assess the activation of 7 shoulder muscles under 2 closed kinetic chain (CKC) tasks for the upper extremity using submaximal isometric effort, thus providing relative quantification of muscular isometric effort for these muscles across the CKC exercises, which may be applied to rehabilitation protocols for individuals with shoulder weakness.

Background: CKC exercises favor joint congruence, reduce shear load, and promote joint dynamic stability.

Scapular kinematics during transfers in manual wheelchair users with and without shoulder impingement.

Background: Scapular function during humeral elevation has been reported in groups with and without shoulder impingement pathology. To date, no one has assessed scapular kinematics during upper extremity loaded tasks that manual wheelchair users must perform on a daily basis. Therefore, the objective of this study was to compare scapular kinematics and muscle activation patterns during two different wheelchair transfers in groups of manual wheelchair users with and without shoulder impingement.

Upper-limb fatigue-related joint power shifts in experienced wheelchair users and nonwheelchair users.

This paper evaluates power transfer or shifting across upper-limb segments, resulting from fatigue-inducing wheelchair propulsion. Nineteen manual wheelchair users (WCUs) and ten nonwheelchair users (NUs) participated in this study. Subjects propelled an instrumented wheelchair ergometer at a workload corresponding to 75% of the peak oxygen uptake attained during a maximal-graded exercise tolerance test.

Anterior glenohumeral force/translation behavior with and without rotator cuff contraction during clinical stability testing.

Objective: Measure stiffness of the glenohumeral joint during clinical laxity testing with and without muscular contraction of the Internal rotators.

Design: Cross-sectional study of normal shoulders.

Background: Clinical examination for shoulder instability is based on subjective impression, and is only performed passively.

Reliability of biomechanical variables during wheelchair ergometry testing.

Wheelchair ergometer testing is used to characterize wheelchair propulsion mechanics. The reliability of kinematic and kinetic measures has not been investigated for wheelchair ergometer testing. In this study, test-retest reliability of biomechanical measurements on a wheelchair ergometer was determined during a submaximal endurance test.