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The interaction between posterior capsule tightness and humeral retroversion: a study in cadavers and in vivo

Grant number: 15/14311-3
Support Opportunities:Scholarships abroad - Research Internship - Doctorate
Effective date (Start): April 01, 2016
Effective date (End): March 31, 2017
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:Paula Rezende Camargo
Grantee:Dayana Patricia Rosa
Supervisor: John David Borstad
Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil
Research place: Ohio State University, Columbus, United States  
Associated to the scholarship:14/10355-3 - Biomechanical and neurophysiological changes in subjects with posterior capsule tightness: evaluation and treatment, BP.DR


Studies consistently demonstrate that individuals who perform overhead throwing activities have decreased glenohumeral internal rotation (IR) and increased external rotation (ER) range of motion (ROM). Evidence for osseous and soft tissue adaptations such as increased humeral retroversion (HR), posterior capsule tightness (PCT), and/or posterior muscles tightness help explain these ROM changes. However, because these tissue adaptations have only been studied in isolation, the combined effects of osseous and soft tissue changes on ROM are not understood. This results in ambiguous clinical decision making, outcome assessments, and research design. Therefore, the purposes of this project are to determine how PCT and HR interact to influence ROM and to assess how these tissue adaptations impact the clinical measurements used to evaluate glenohumeral ROM. Twelve fresh-frozen cadaver specimens will be used to first study the interaction among PCT and increased HR. Established models for creating PCT and HR will be used to assess ROM during clinical measurements across four conditions: Baseline (the unaltered condition); Increased HR alone; PCT alone; and PCT plus Increased HR. Clinical measurements to be assessed include bicipital forearm angle (BFA), low flexion test (LF), glenohumeral IR, and cross-body adduction. In a subsequent study, 60 subjects will be recruited and divided in 4 groups based on their clinical measurements. The groups will include: a control group without PCT and normal HR; a PCT only group with LF side-to-side differences of >7°; a HR only group with BFA side-to-side differences of >15°; and a PCT and HR group. The same clinical measurements from the cadaver analysis will be quantified on both shoulders. This study will also assess posterior shoulder muscle stiffness. For both studies, statistical analysis will depend of normality of the data. Significance of 5% will be considered. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
ROSA, DAYANA P.; CAMARGO, PAULA R.; BORSTAD, JOHN D.. Effect of Posterior Capsule Tightness and Humeral Retroversion on 5 Glenohumeral Joint Range of Motion Measurements: A Cadaveric Study. AMERICAN JOURNAL OF SPORTS MEDICINE, v. 47, n. 6, p. 1434-1440, . (15/14311-3)
ROSA, DAYANA P.; CAMARGO, PAULA R.; BORSTAD, JOHN D.. The influence of posterior glenohumeral joint capsule tightness and humeral retroversion on clinical measurements. PHYSICAL THERAPY IN SPORT, v. 34, p. 148-153, . (15/14311-3)

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