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Rivista di Medicina, Traumatologia e Psicologia dello Sport

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The Journal of Sports Medicine and Physical Fitness 2017 Apr 13

DOI: 10.23736/S0022-4707.17.06874-8


lingua: Inglese

Multimodal assessment of sensorimotor shoulder function in patients with untreated anterior shoulder instability and asymptomatic handball players

Guillaume MORNIEUX 1, Anja HIRSCHMÜLLER 2, Albert GOLLHOFER 3, Norbert P. SÜDKAMP 2, Dirk MAIER 2

1 Faculty of Sport Sciences, University of Lorraine, EA3450, DevAH, Nancy, France; 2 Department of Orthopaedics and Trauma Surgery, Medical Centre Albert-Ludwigs, University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany; 3 Institute for Sport and Sport Science, Albert-Ludwigs-University of Freiburg, Freiburg, Germany


BACKGROUND: Functional evaluation of sensorimotor function of the shoulder joint is important for guidance of sports-specific training, prevention and rehabilitation of shoulder instability. Such assessment should be multimodal and comprise all qualities of sensorimotor shoulder function. This study evaluates feasibility of such multimodal assessment of glenohumeral sensorimotor function in patients with shoulder instability and handball players.
METHODS: Nine patients with untreated anterior instability of their dominant shoulder and 15 asymptomatic recreational handball players performed proprioceptive joint position sense and dynamic stabilisation evaluations on an isokinetic device, as well as a functional throwing performance task. Outcome measures were analysed individually and equally weighted in a shoulder-specific sensorimotor index (S-SMI). Finally, isokinetic strength evaluations were conducted.
RESULTS: We observed comparable sensorimotor functions of unstable dominant shoulders compared to healthy, contralateral shoulders (e.g. P=0.59 for S-SMI). Handball players demonstrated superior sensorimotor function of their dominant shoulders exhibiting a significantly higher throwing performance and S-SMI (P<0.001 and P=0.002, respectively), but comparable internal rotator peak torques for both shoulders (P>0.22).
CONCLUSIONS: The present study proves feasibility of multimodal assessment of shoulder sensorimotor function in overhead athletes and patients with symptomatic anterior shoulder instability. Untreated shoulder instability led to a loss of dominance-related sensorimotor superiority indicating functional internal rotation deficiency. Dominant shoulders of handball players showed a superior overall sensorimotor function but weakness of dominant internal rotation constituting a risk factor for occurrence of posterior superior impingement syndrome. The S-SMI could serve as a diagnostic tool for guidance of sports-specific training, prevention and rehabilitation of shoulder instability.

KEY WORDS: Glenohumeral instability - Overhead sports - Proprioception - Joint position sense - Perturbation - Internal impingement - Injury - Prevention

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