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The purpose of this study was to examine the association of breast cancer-related lymphedema on shoulder girdle kinematics and upper extremity function. The study included 67 breast cancer survivors with and without unilateral lymphedema. Individuals were divided into non-lymphedema, moderate and severe lymphedema groups according to the volumetric measurement difference between the affected and unaffected upper extremities. A three-dimensional motion monitor-electromagnetic system was used to analyze scapular movements during the elevation and depression phases of the upper extremity elevation in the scapular plane. Shoulder range of motion was assessed with a digital inclinometer. Upper extremity function was assessed with the ‘Disabilities of the Arm, Shoulder, and Hand Questionnaire–Short Form (Quick-DASH)’. The scapular upward rotation was lower for the severe lymphedema group than for the non-lymphedema group in the 90–60–30° depression phases of arm elevation (p < .05). The scapular anterior tilt was higher for the severe lymphedema group than for the non-lymphedema group in the 30° depression phase of arm elevation (p < .05). Shoulder abduction range of motion was the lowest in the severe lymphedema group (p < .05). The non-lymphedema group had the lowest quick-DASH score and the severe lymphedema group had the highest score (p < .05). There were statistically significant moderate associations between the quick-DASH scores and scapular movements in all groups (p < .05). The development, presence and/or severity of lymphedema were associated with impaired shoulder-girdle kinematics and decreased upper extremity function. However, a need exists for longitudinal studies comparing individuals with and without lymphedema and healthy controls.

Purpose Neuromuscular control is important for joint stabilization. Supraspinatus muscle plays an essential role in the perception of proprioceptive sense. The aim of this study is to investigate active joint position sense (AJPS) both in patients with partial and full-thickness supraspinatus tears and in healthy participants. Methods Twenty patients with partial supraspinatus tears, 20 patients with full-thickness supraspinatus tears, and 20 healthy participants, aged 40–65 years, were included in the study. Proprioceptive sense was assessed with AJPS measurement. Absolute error was calculated to evaluate joint position sense. Results Active joint position sense was decreased in partial and full-thickness tears on both in affected and contralateral shoulders compared to control group ( p  < 0.05). There was no difference between groups with partial and full-thickness tears on the affected and contralateral shoulders at 40° and 100° elevation ( p  > 0.05). Conclusion AJPS was affected after supraspinatus injury. It was seen as proprioceptive deficit in patients with partial and full-thickness tears in both affected and contralateral shoulders.

Performing shoulder-abduction exercises with scapular retraction has been theorized to reduce the potential for shoulder impingement. However, objective data to support this premise are lacking.   To evaluate the influence of active scapular retraction on acromiohumeral distance (AHD) at 4 shoulder-abduction angles using real-time ultrasound.   Cross-sectional study.   University laboratory.   Twenty asymptomatic individuals (10 men, 10 women; age = 22.9 ± 2.8 years, height = 169.3 ± 9.5 cm, mass = 65.5 ± 12.9 kg) were recruited.   Real-time ultrasound images of AHD were obtained during nonretracted and retracted scapular conditions at 0°, 45°, 60°, and 90° of shoulder abduction. A 2-factor analysis of variance with repeated measures was used to evaluate the influence of shoulder retraction on AHD across shoulder-abduction angles.   A scapular-retraction condition × shoulder-abduction-angle interaction for AHD was found ( F = 4.56, P = .006). The AHD was smaller at 0° (10.5 versus 11.2 mm, respectively; t = 2.22, P = .04) but larger at 90° (9.4 versus 8.7 mm, respectively; t = -2.30, P = .04) of shoulder abduction during the retracted than the nonretracted condition. No differences in AHD were observed between conditions at 45° ( t = 1.45, P = .16) and 60° ( t = 1.17, P = .86) of abduction.   The observed differences in AHD at 0° and 90° of shoulder abduction were small and did not exceed the established minimal detectable change for either angle. Our findings suggest that active scapular retraction during shoulder abduction has a minimal influence on AHD at 0° and 90° in healthy individuals. Further investigations are needed to determine whether scapular retraction influences AHD in individuals with subacromial impingement.

Objectives: Smoking is known to reduce wound healing, increase the risk of infection, and reduce angiogenesis by inhibiting vascular endothelial growth factor. All these factors can be associated with the development of lymphedema. The aim of this study was to investigate the effects of smoking habits on lymphedema severity and upper limb functionality in patients who have undergone unilateral mastectomy as part of breast cancer treatment. Methods: The study included 75 participants who have undergone unilateral radical or modified radical mastectomy. Participants were divided into non-smoker (n=59) and smoker (5 and more cigarettes per day) (n=16) groups according to their smoking habits. Participants’ detailed demographic and medical history were recorded, the severity of lymphedema was determined according to the volumetric difference between the affected and unaffected upper extremities, upper extremity functionality was assessed with the ‘Disabilities of the Arm, Shoulder, and Hand Questionnaire–Short Form (DASH)’. Results: The study groups were homogeneous in terms of age, education level, marital status, mastectomy type, number of axillar lymph node dissection, chemotherapy and radiotherapy treatments (p>0.05), although the smoker group had higher body mass index values (p=0.027). Smoker group had statistically higher volumetric difference and DASH scores than non-smoker group, respectively (p=0.016, p=0.037). Conclusion: The results of this study reveals that smoking may have negative effects on lymphedema severity and DASH scores in patients who have undergone unilateral mastectomy. DASH scores may be influenced by the volumetric difference between the affected and unaffected extremities. Further studies with larger sample sizes are needed to better understand the effects of smoking on lymphedema severity and upper extremity functionality.

The aim of this study is to investigate the effects of scapular taping on scapular kinematics by three-dimensional electromagnetic system during shoulder elevation in facioscapulohumeral muscular dystrophy patients. A total of 11 patients with facioscapulohumeral muscular dystrophy were included in the study. Scapular anterior-posterior tilt, upward-downward rotation, and internal-external rotations were evaluated using the three-dimensional electromagnetic system during the elevation of the upper limbs in the scapular plane before and after kinesio taping. For maximum humerothoracic elevation, there were no differences between the patients before and after taping on both dominant (p = 0.72) and non-dominant sides (p = 0.64). For scapular internal rotation, upward rotation, and posterior tilt, there were no differences between patients before and after taping during humerothoracic elevation on both dominant and non-dominant sides (p > 0.05). These results showed us that the excessive and abnormal movements of the scapula observed during the humeral elevation in facioscapulohumeral muscular dystrophy patients cannot be supported with flexible methods like kinesio taping. Therefore, we recommend to evaluate the scapula position by applying flexible and rigid taping to the patients who can reach over 90o in humerothoracic elevation in future studies.

Foam rolling have gained popularity among elite athletes, but the effect of the speed parameter of foam rolling has not yet been determined. Our objective was to investigate the impact of different application speeds of foam roller on the mechanical properties of the quadriceps femoris muscle. Eighteen male professional basketball athletes (age 23 ± 4 years, body mass index 24.43 ± 1.59 kg/m2) participated in this study. We used a crossover design to randomize the order of the treatment speeds (30 beats per minute-FAST, 15 beats per minute-SLOW, and a self-determined speed-SELF) with a one-week washout period between each session. We measured dominant quadriceps femoris muscle tone, elasticity, and stiffness using the Myoton device before and after the interventions. We found that the average rate for SELF was 33 ± 10 beats per minute, making SELF the fastest. All application speeds showed similar results in pre-intervention measurements of the mechanical properties of the tissues (P > 0.05). However, post hoc analysis revealed that a decrease was evident in SLOW compared to SELF in muscle tone in post-intervention measurements (P = 0.037). Also, we noted that comparison of pre- and post-intervention on FAST and SLOW showed a significant reduction in muscle tone (P = 0.002, P = 0.008). Slower foam rolling prior to training or competition may lead to a delay in the reaction time due to the reduction in tonus, that can increase the injury risks. Alternatively, the significant reduction in tonus may be useful in regulating the increased tonus after training and competition.

Objective: The goals of this study were to investigate and compare the effects of aerobic and spinal stabilization training on the knee muscle hamstring-to-quadriceps (H/Q) ratio in adult women. Methods: Seventy of 85 women who applied to the fitness center were randomly assigned to spinal stabilization or aerobic training groups (1, 2). Twenty-one women out of 35 sedentary women from the university who had not participated to any sport or exercise program were followed as controls. The training programs were conducted for 3 days/week for six months. All subjects were assessed before training, at the 3rd, and 6th month of training. Assessments were performed with the Isomed 2000 isokinetic system (D&R Ferstl GmbH, Hemau, Germany). The peak torque and total work of H/Q ratios were calculated. Repeated measures and the “as treated” protocol (spinal stabilization (n=28), aerobic training (n=23)) were used for the analysis. Results: The hamstring-to-quadriceps ratio of peak torques on the dominant side increased between pre-training (0.732±0.12) and the 6th month of training (0.847±0.11) in the aerobic training group (F=6.08; p=0.03). The H/Q ratio of the total work increased on the dominant side in the stabilization training group between pre-training (0.773±0.15) and the 3rd month (0.855±0.12), (F=6.402; p=0.002) of training. It increased pre-training (0.707±0.17) and in the 6th month of training (0.777±0.13) in aerobic training group. Conclusion: Both aerobic and stabilization trainings improved the total work of the H/Q ratio. Stabilization training could be recommended for prompt improvement of the H/Q ratio for sedentary women.

Context: The wall slide exercise is commonly used in clinic and research settings. Theraband positioning variations for hip exercises are investigated and used, but theraband positioning variations for upper extremity wall slide exercise, though not commonly used, are not investigated. Objective: To investigate the effect of different theraband positions (elbow and wrist) on scapular and shoulder muscles' activation in wall slide exercises and compare them to the regular wall slide exercise for the upper limbs. Study Design: Descriptive Laboratory Study. Setting: University Laboratory Patients or Other Participants: 20 participants with healthy shoulders Interventions: Participants performed regular and two different variations of wall slide exercises (theraband at wrist and theraband at elbow) in randomized order. Main Outcome Measures: Surface EMG activity of the trapezius muscles (upper [UT], middle [MT], and lower trapezius [LT]), infraspinatus (IS), middle deltoid (MD), and serratus anterior (SA). Results: Regular wall slide exercise elicited low activity in MD and moderate activity in SA muscles (32% MVIC), while theraband at wrist and elbow variations elicited low activity in MT, LT, IS, and MD muscles and moderate activity in SA muscles (46% and 34% MVICs, respectively). UT activation was absent to minimal (0–15% MVIC) in all wall slide exercise variations. Theraband at wrist produced lower UT/MT, UT/LT, and UT/SA levels. Conclusion: In shoulder rehabilitation, clinicians desiring to activate scapular stabilization muscles should consider using theraband at wrist variation; clinicians desiring to achieve more shoulder abduction activation and less scapular stabilization should consider theraband at elbow variation of upper extremity wall slide exercise.

The published version of this article unfortunately contained a mistake in Fig. 2. Only one graphic of different movement of scapula was published instead of three. The Figure is corrected here.

The wall-slide exercise is commonly used in clinic and research settings. Theraband positioning variations for hip exercises have been investigated and used, but Theraband positioning variations for upper extremity wall-slide exercises, although not commonly used, have not been examined. To evaluate the effect of different Theraband positions (elbow and wrist) on the activation of the scapular and shoulder muscles in wall-slide exercises and compare these variations with each other and with regular wall-slide exercises for the upper limbs. Descriptive laboratory study. University laboratory. A total of 20 participants (age = 23.8 ± 3 years, height = 176.5 ± 8.14 cm, mass = 75.3 ± 12.03 kg, body mass index = 24.23 ± 4.03) with healthy shoulders. Participants performed wall-slide exercises (regular and 2 variations: Theraband at the elbow and Theraband at the wrist) in randomized order. Surface electromyographic activity of the trapezius (upper trapezius [UT], middle trapezius [MT], and lower trapezius [LT]), infraspinatus, middle deltoid (MD), and serratus anterior (SA) muscles. Regular wall-slide exercises elicited low activity in the MD and moderate activity in the SA muscles (32% of maximal voluntary isometric contraction [MVIC] in the SA), whereas the Theraband-at-elbow and Theraband-at-wrist variations elicited low activity in the MT, LT, infraspinatus, and MD muscles and moderate activity in the SA muscle (46% and 34% of MVIC in the SA, respectively). The UT activation was absent to minimal (classified as 0% to 15% of MVIC) in all wall-slide exercise variations. The Theraband-at-wrist variation produced lower UT:MT, UT:LT, and UT:SA levels compared with the regular wall-slide exercise and Theraband-at-elbow variation. In shoulder rehabilitation, clinicians desiring to activate the scapular stabilization muscles should consider using the Theraband-at-wrist variation. Those seeking more shoulder-abduction activation and less scapular stabilization should consider using the Theraband-at-elbow variation of the upper extremity wall-slide exercise.