Skip to main content
Top
Published in: International Journal of Computer Assisted Radiology and Surgery 2/2018

01-02-2018 | Original Article

Shoulder strengthening exercises adapted to specific shoulder pathologies can be selected using new simulation techniques: a pilot study

Authors: Caecilia Charbonnier, Alexandre Lädermann, Bart Kevelham, Sylvain Chagué, Pierre Hoffmeyer, Nicolas Holzer

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 2/2018

Login to get access

Abstract

Purpose

Shoulder strength training exercises represent a major component of rehabilitation protocols designed for conservative or postsurgical management of shoulder pathologies. Numerous methods are described for exercising each shoulder muscle or muscle group. Limited information is available to assess potential deleterious effects of individual methods with respect to specific shoulder pathologies. Thus, the goal of this pilot study was to use a patient-specific 3D measurement technique coupling medical imaging and optical motion capture for evaluation of a set of shoulder strength training exercises regarding glenohumeral, labral and subacromial compression, as well as elongation of the rotator cuff muscles.

Methods

One volunteer underwent magnetic resonance imaging (MRI) and motion capture of the shoulder. Motion data from the volunteer were recorded during three passive rehabilitation exercises and twenty-nine strengthening exercises targeting eleven of the most frequently trained shoulder muscles or muscle groups and using four different techniques when available. For each exercise, glenohumeral and labral compression, subacromial space height and rotator cuff muscles elongation were measured on the entire range of motion.

Results

Significant differences in glenohumeral, subacromial and labral compressions were observed between sets of exercises targeting individual shoulder muscles. Muscle lengths computed by simulation compared to MRI measurements showed differences of 0–5%.

Conclusions

This study represents the first screening of shoulder strengthening exercises to identify potential deleterious effects on the shoulder joint. Motion capture combined with medical imaging allows for reliable assessment of glenohumeral, labral and subacromial compression, as well as muscle-tendon elongation during shoulder strength training exercises.
Appendix
Available only for authorised users
Footnotes
1
Indeed, the tested subject participated in two different studies. The first MRI done for 3D reconstruction was part of a previous study [7]. We reused the MRI data and 3D reconstructed models from this previous study, but we had to perform this second MRI to validate the muscle simulation, since these data were not acquired previously.
 
Literature
1.
go back to reference Ainsworth R, Lewis J (2007) Exercise therapy for the conservative management of full thickness tears of the rotator cuff: a systematic review. Br J Sports Med 41(4):200–210CrossRefPubMedPubMedCentral Ainsworth R, Lewis J (2007) Exercise therapy for the conservative management of full thickness tears of the rotator cuff: a systematic review. Br J Sports Med 41(4):200–210CrossRefPubMedPubMedCentral
2.
go back to reference van den Bergen G (1997) Efficient collision detection of complex deformable models using aabb trees. J Gr Tools 2(4):1–14CrossRef van den Bergen G (1997) Efficient collision detection of complex deformable models using aabb trees. J Gr Tools 2(4):1–14CrossRef
3.
go back to reference Blemker SS, Delp S (2005) Three-dimensional representation of complex muscle architectures and geometries. Ann Biomed Eng 33(5):661–673CrossRefPubMed Blemker SS, Delp S (2005) Three-dimensional representation of complex muscle architectures and geometries. Ann Biomed Eng 33(5):661–673CrossRefPubMed
4.
go back to reference Bury J, West M, Chamorro-Moriana G, Littlewood C (2016) Effectiveness of scapula-focused approaches in patients with rotator cuff related shoulder pain: a systematic review and meta-analysis. Man Ther 25:35–42CrossRefPubMed Bury J, West M, Chamorro-Moriana G, Littlewood C (2016) Effectiveness of scapula-focused approaches in patients with rotator cuff related shoulder pain: a systematic review and meta-analysis. Man Ther 25:35–42CrossRefPubMed
5.
go back to reference Charbonnier C, Assassi L, Volino P, Magnenat-Thalmann N (2009) Motion study of the hip joint in extreme postures. Vis Comput 25(9):873–882CrossRef Charbonnier C, Assassi L, Volino P, Magnenat-Thalmann N (2009) Motion study of the hip joint in extreme postures. Vis Comput 25(9):873–882CrossRef
6.
go back to reference Charbonnier C, Chagué S, Kolo F, Chow J, Lädermann A (2014) A patient-specific measurement technique to model the kinematics of the glenohumeral joint. Orthop Traumatol Surg Res 100(7):715–719CrossRefPubMed Charbonnier C, Chagué S, Kolo F, Chow J, Lädermann A (2014) A patient-specific measurement technique to model the kinematics of the glenohumeral joint. Orthop Traumatol Surg Res 100(7):715–719CrossRefPubMed
7.
go back to reference Charbonnier C, Chagué S, Kolo F, Lädermann A (2015) Shoulder motion during tennis serve: dynamic and radiological evaluation based on motion capture and magnetic resonance imaging. Int J CARS 10(8):1289–1297CrossRef Charbonnier C, Chagué S, Kolo F, Lädermann A (2015) Shoulder motion during tennis serve: dynamic and radiological evaluation based on motion capture and magnetic resonance imaging. Int J CARS 10(8):1289–1297CrossRef
8.
go back to reference Charbonnier C, Kevelham B, Chagué S, Läderman A, Ziltener JL, Hoffmeyer P, Holzer N (2015) A simplified technique to estimate rotator cuff elongation during complex shoulder motion. In: 29th international congress of computer assisted radiology and surgery, Barcelona, Spain, Int J CARS Charbonnier C, Kevelham B, Chagué S, Läderman A, Ziltener JL, Hoffmeyer P, Holzer N (2015) A simplified technique to estimate rotator cuff elongation during complex shoulder motion. In: 29th international congress of computer assisted radiology and surgery, Barcelona, Spain, Int J CARS
9.
go back to reference Christensen B, Andersen K, Rasmussen S, Andreasen E, Nielsen L, Jensen S (2016) Enhanced function and quality of life following 5 months of exercise therapy for patients with irreparable rotator cuff tears–an intervention study. BMC Musculoskelet Disord 17(1):1–8CrossRef Christensen B, Andersen K, Rasmussen S, Andreasen E, Nielsen L, Jensen S (2016) Enhanced function and quality of life following 5 months of exercise therapy for patients with irreparable rotator cuff tears–an intervention study. BMC Musculoskelet Disord 17(1):1–8CrossRef
10.
go back to reference Collin P, Lädermann A, Bourg ML, Walch G (2013) Subscapularis minor-an analogue of the teres minor? Orthop Traumatol Surg Res 99(4 Suppl):S255–S258CrossRefPubMed Collin P, Lädermann A, Bourg ML, Walch G (2013) Subscapularis minor-an analogue of the teres minor? Orthop Traumatol Surg Res 99(4 Suppl):S255–S258CrossRefPubMed
11.
go back to reference Collin P, Matsumura N, Lädermann A, Denard P, Walch G (2014) Relationship between massive chronic rotator cuff tear pattern and loss of active shoulder range of motion. J Shoulder Elbow Surg 23(8):1195–1202CrossRefPubMed Collin P, Matsumura N, Lädermann A, Denard P, Walch G (2014) Relationship between massive chronic rotator cuff tear pattern and loss of active shoulder range of motion. J Shoulder Elbow Surg 23(8):1195–1202CrossRefPubMed
12.
go back to reference Collin P, Gain S, Huu FN, Lädermann A (2015) Is rehabilitation effective in massive rotator cuff tears? Orthop Traumatol Surg Res 101(4 Suppl):S203–S205CrossRefPubMed Collin P, Gain S, Huu FN, Lädermann A (2015) Is rehabilitation effective in massive rotator cuff tears? Orthop Traumatol Surg Res 101(4 Suppl):S203–S205CrossRefPubMed
13.
go back to reference Collin P, Treseder T, Denard P, Neyton L, Walch G, Lädermann A (2015) What is the best clinical test for assessment of the teres minor in massive rotator cuff tears? Clin Orthop Rel Res 473(9):2959–2966CrossRef Collin P, Treseder T, Denard P, Neyton L, Walch G, Lädermann A (2015) What is the best clinical test for assessment of the teres minor in massive rotator cuff tears? Clin Orthop Rel Res 473(9):2959–2966CrossRef
14.
go back to reference Denard P, Lädermann A, Burkhart S (2011) Prevention and management of stiffness after arthroscopic rotator cuff repair: systematic review and implications for rotator cuff healing. Arthroscopy 27(6):842–848CrossRefPubMed Denard P, Lädermann A, Burkhart S (2011) Prevention and management of stiffness after arthroscopic rotator cuff repair: systematic review and implications for rotator cuff healing. Arthroscopy 27(6):842–848CrossRefPubMed
15.
go back to reference Denard P, Koo S, Murena L, Burkhart S (2012) Pseudoparalysis: the importance of rotator cable integrity. Orthopedics 35:e1353–e1357CrossRefPubMed Denard P, Koo S, Murena L, Burkhart S (2012) Pseudoparalysis: the importance of rotator cable integrity. Orthopedics 35:e1353–e1357CrossRefPubMed
16.
go back to reference Downie B, Miller B (2012) Treatment of rotator cuff tears in older individuals: a systematic review. J Shoulder Elbow Surg 21(9):1255–1261CrossRefPubMed Downie B, Miller B (2012) Treatment of rotator cuff tears in older individuals: a systematic review. J Shoulder Elbow Surg 21(9):1255–1261CrossRefPubMed
17.
go back to reference Fees M, Decker T, Snyder-Mackler L, Michael A (1998) Upper extremity weight-training modifications for the injured athlete: a clinical perspective. Am J Sports Med 26(5):732–742CrossRefPubMed Fees M, Decker T, Snyder-Mackler L, Michael A (1998) Upper extremity weight-training modifications for the injured athlete: a clinical perspective. Am J Sports Med 26(5):732–742CrossRefPubMed
18.
go back to reference Gerber C, Sebesta A (2000) Impingement of the deep surface of the subscapularis tendon and the reflection pulley on the anterosuperior glenoid rim: a preliminary report. J Shoulder Elbow Surg 9(6):483–490CrossRefPubMed Gerber C, Sebesta A (2000) Impingement of the deep surface of the subscapularis tendon and the reflection pulley on the anterosuperior glenoid rim: a preliminary report. J Shoulder Elbow Surg 9(6):483–490CrossRefPubMed
19.
go back to reference Lädermann A, Chagué S, Kolo F, Charbonnier C (2016) Kinematics of the shoulder joint in tennis players. J Sci Med Sport 19(1):56–63CrossRefPubMed Lädermann A, Chagué S, Kolo F, Charbonnier C (2016) Kinematics of the shoulder joint in tennis players. J Sci Med Sport 19(1):56–63CrossRefPubMed
20.
go back to reference Lädermann A, Denard P, Tirefort J, Kolo F, Chagué S, Cunningham G, Charbonnier C (2016) Does surgery for instability of the shoulder truly stabilize the glenohumeral joint? A prospective comparative cohort study. Medicine 95(31):e4369CrossRefPubMedPubMedCentral Lädermann A, Denard P, Tirefort J, Kolo F, Chagué S, Cunningham G, Charbonnier C (2016) Does surgery for instability of the shoulder truly stabilize the glenohumeral joint? A prospective comparative cohort study. Medicine 95(31):e4369CrossRefPubMedPubMedCentral
21.
go back to reference Levy O, Roberts S, Copeland S (2005) The role of anterior deltoid re-education in patients with massive irreparable degenerative rotator cuff tears. Orthop Proc 87–B(3 Suppl):384–384 Levy O, Roberts S, Copeland S (2005) The role of anterior deltoid re-education in patients with massive irreparable degenerative rotator cuff tears. Orthop Proc 87–B(3 Suppl):384–384
22.
go back to reference McCann P, Wootten M, Kadaba M, Bigliani L (1993) A kinematic and electromyographic study of shoulder rehabilitation exercises. Clin Orthop Relat Res 288:179–188 McCann P, Wootten M, Kadaba M, Bigliani L (1993) A kinematic and electromyographic study of shoulder rehabilitation exercises. Clin Orthop Relat Res 288:179–188
23.
go back to reference Meister K, Andrews J, Batts J, Wilk K, Baumgarten T (1999) Symptomatic thrower’s exostosis. arthroscopic evaluation and treatment. Am J Sports Med 27(2):133–136CrossRefPubMed Meister K, Andrews J, Batts J, Wilk K, Baumgarten T (1999) Symptomatic thrower’s exostosis. arthroscopic evaluation and treatment. Am J Sports Med 27(2):133–136CrossRefPubMed
24.
go back to reference Miller R, Popchak A, Vyas D, Tashman S, Irrgang J, Musahl V, Debski R (2016) Effects of exercise therapy for the treatment of symptomatic full-thickness supraspinatus tears on in vivo glenohumeral kinematics. J Shoulder Elbow Surg 25:641–649CrossRefPubMed Miller R, Popchak A, Vyas D, Tashman S, Irrgang J, Musahl V, Debski R (2016) Effects of exercise therapy for the treatment of symptomatic full-thickness supraspinatus tears on in vivo glenohumeral kinematics. J Shoulder Elbow Surg 25:641–649CrossRefPubMed
25.
go back to reference Moor B, Wieser K, Slankamenac K, Gerber C, Bouaicha S (2014) Relationship of individual scapular anatomy and degenerative rotator cuff tears. J Shoulder Elbow Surg 23(4):536–541CrossRefPubMed Moor B, Wieser K, Slankamenac K, Gerber C, Bouaicha S (2014) Relationship of individual scapular anatomy and degenerative rotator cuff tears. J Shoulder Elbow Surg 23(4):536–541CrossRefPubMed
26.
go back to reference Mueller M, Heidelberger B, Hennix M, Ratcliff J (2007) Position based dynamics. J Vis Commun Image Represent 18(2):109–118CrossRef Mueller M, Heidelberger B, Hennix M, Ratcliff J (2007) Position based dynamics. J Vis Commun Image Represent 18(2):109–118CrossRef
27.
go back to reference Neer C (1972) Anterior acromioplasty for the chronic impingement syndrome in the shoulder. J Bone Joint Surg 54(1):41–50CrossRefPubMed Neer C (1972) Anterior acromioplasty for the chronic impingement syndrome in the shoulder. J Bone Joint Surg 54(1):41–50CrossRefPubMed
28.
go back to reference Provot X (1997) Collision and self-collision handling in cloth model dedicated to design garments. In: Thalmann D, van de Panne M (eds) Computer animation and simulation ’97. Eurographics. Springer, Vienna, pp 177–189 Provot X (1997) Collision and self-collision handling in cloth model dedicated to design garments. In: Thalmann D, van de Panne M (eds) Computer animation and simulation ’97. Eurographics. Springer, Vienna, pp 177–189
29.
go back to reference Reijneveld E, Noten S, Michener L, Cools A, Struyf F (2016) Clinical outcomes of a scapular-focused treatment in patients with subacromial pain syndrome: a systematic review. Br J Sports Med 51(5):436–441 Reijneveld E, Noten S, Michener L, Cools A, Struyf F (2016) Clinical outcomes of a scapular-focused treatment in patients with subacromial pain syndrome: a systematic review. Br J Sports Med 51(5):436–441
30.
go back to reference Reinold M, Wilk K, Fleisig G, Zheng N, Barrentine S, TC T, Cody R, Andrews GJJ (2004) Electromyographic analysis of the rotator cuff and deltoid musculature during common shoulder external rotation exercises. J Orthop Sports Phys Ther 34:385–394CrossRefPubMed Reinold M, Wilk K, Fleisig G, Zheng N, Barrentine S, TC T, Cody R, Andrews GJJ (2004) Electromyographic analysis of the rotator cuff and deltoid musculature during common shoulder external rotation exercises. J Orthop Sports Phys Ther 34:385–394CrossRefPubMed
31.
go back to reference Reinold M, Escamilla R, Wilk K (2009) Current concepts in the scientific and clinical rationale behind exercises for glenohumeral and scapulothoracic musculature. J Orthop Sports Phys Ther 39:105–117CrossRefPubMed Reinold M, Escamilla R, Wilk K (2009) Current concepts in the scientific and clinical rationale behind exercises for glenohumeral and scapulothoracic musculature. J Orthop Sports Phys Ther 39:105–117CrossRefPubMed
32.
go back to reference Snyder S, Pachelli A, Pizzo WD, Friedman M, Ferkel R, Pattee G (1991) Partial thickness rotator cuff tears: results of arthroscopic treatment. Arthroscopy 7(1):1–7CrossRefPubMed Snyder S, Pachelli A, Pizzo WD, Friedman M, Ferkel R, Pattee G (1991) Partial thickness rotator cuff tears: results of arthroscopic treatment. Arthroscopy 7(1):1–7CrossRefPubMed
33.
go back to reference Terrier A, Larrea X, Camine VM, Pioletti D, Farron A (2013) Importance of the subscapularis muscle after total shoulder arthroplasty. Clin Biomech 28:146–150CrossRef Terrier A, Larrea X, Camine VM, Pioletti D, Farron A (2013) Importance of the subscapularis muscle after total shoulder arthroplasty. Clin Biomech 28:146–150CrossRef
34.
go back to reference Voisin J, Ropars M, Thomazeau H (2014) The human acromion viewed from an evolutionary perspective. Orthop Traumatol Surg Res 100(8 Suppl):S355–S360CrossRefPubMed Voisin J, Ropars M, Thomazeau H (2014) The human acromion viewed from an evolutionary perspective. Orthop Traumatol Surg Res 100(8 Suppl):S355–S360CrossRefPubMed
35.
go back to reference Walch G, Boileau P, Noel E, Donell S (1992) Impingement of the deep surface of the supraspinatus tendon on the posterior glenoid rim: an arthroscopic study. J Shoulder Elbow Surg 1:238–245CrossRefPubMed Walch G, Boileau P, Noel E, Donell S (1992) Impingement of the deep surface of the supraspinatus tendon on the posterior glenoid rim: an arthroscopic study. J Shoulder Elbow Surg 1:238–245CrossRefPubMed
36.
go back to reference Walch G, Ascani C, Boulahia A, Nové-Josserand L, Edwards T (2002) Static posterior subluxation of the humeral head: An unrecognized entity responsible for glenohumeral osteoarthritis in the young adult. J Shoulder Elbow Surg 11(4):309–314CrossRefPubMed Walch G, Ascani C, Boulahia A, Nové-Josserand L, Edwards T (2002) Static posterior subluxation of the humeral head: An unrecognized entity responsible for glenohumeral osteoarthritis in the young adult. J Shoulder Elbow Surg 11(4):309–314CrossRefPubMed
37.
go back to reference Walch G, Nové-Josserand L, Liotard J, Noel E, Tavernier T, Barthélémy R (2005) L’Epaule: une approche pluridisciplinaire, Sauramps Medical, Montpellier, chap Le petit rond (teres minor): l’oublié de la coiffe, pp 237–244 Walch G, Nové-Josserand L, Liotard J, Noel E, Tavernier T, Barthélémy R (2005) L’Epaule: une approche pluridisciplinaire, Sauramps Medical, Montpellier, chap Le petit rond (teres minor): l’oublié de la coiffe, pp 237–244
38.
go back to reference Webb J, Blemker S, Delp S (2014) 3D finite element models of shoulder muscles for computing lines of actions and moment arms. Comput Meth Biomech Biomed Eng 17(8):829–837CrossRef Webb J, Blemker S, Delp S (2014) 3D finite element models of shoulder muscles for computing lines of actions and moment arms. Comput Meth Biomech Biomed Eng 17(8):829–837CrossRef
39.
go back to reference Wu G, van der Helm F, Veegerc H, Makhsouse M, Royf PV, Angling C, Nagelsh J, Kardunai A, McQuadej K, Wangk X, Wernerl F, Buchholzm B (2005) ISB recommendation on definitions of joint coordinate systems of various joints for the reporting of human joint motion–part II: shoulder, elbow, wrist and hand. J Biomech 38:981–992CrossRefPubMed Wu G, van der Helm F, Veegerc H, Makhsouse M, Royf PV, Angling C, Nagelsh J, Kardunai A, McQuadej K, Wangk X, Wernerl F, Buchholzm B (2005) ISB recommendation on definitions of joint coordinate systems of various joints for the reporting of human joint motion–part II: shoulder, elbow, wrist and hand. J Biomech 38:981–992CrossRefPubMed
Metadata
Title
Shoulder strengthening exercises adapted to specific shoulder pathologies can be selected using new simulation techniques: a pilot study
Authors
Caecilia Charbonnier
Alexandre Lädermann
Bart Kevelham
Sylvain Chagué
Pierre Hoffmeyer
Nicolas Holzer
Publication date
01-02-2018
Publisher
Springer International Publishing
Published in
International Journal of Computer Assisted Radiology and Surgery / Issue 2/2018
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI
https://doi.org/10.1007/s11548-017-1668-4

Other articles of this Issue 2/2018

International Journal of Computer Assisted Radiology and Surgery 2/2018 Go to the issue