Publication: Shoulder mobility and strength assessment using biodex 3tm system following conservative treatment of middle clavicle fracture
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Date
2022
Authors
Sheng, Yap Yan
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Abstract
Introduction Clavicle fractures are common injuries. Loss of shoulder mobility and strength are common problems reported after conservative treatment of clavicle fracture, which cause significant deterioration of occupational and sports performance. This study investigates the alterations in shoulder mobility and strength following conservative treatment of middle clavicle fractures. Methodology A cross-sectional study was conducted in Health Campus USM to compare shoulder mobility and strength between subjects who underwent conservative treatment of middle clavicle fracture for at least 12 months, and the healthy subjects. 25 subjects with unilateral middle clavicle fractures were recruited by simple random sampling. 25 healthy subjects with age, gender, and limb dominance matched with the subjects in the Clavicle Fracture Group were recruited. Limb dominance was determined by Laterality Quotient generated from Edinburgh Handedness Inventory (EHI). Weight and height were measured to calculate lean body mass (LBM) using Boer's Formula. A digital goniometer was used to measure the active range of motion (ROM) for six shoulder motions (external rotation, internal rotation, forward flexion, extension, abduction, and adduction). The isokinetic peak torque of shoulder motions was measured using Biodex 3™ System Dynamometer in two different test velocities (60 and 180/s). Normalized peak torque (NPT) was calculated by dividing measured peak torque values with LBM. Chi-Square Test was used to analyze the descriptive demographic characteristics of the study subjects. Independent T-test and Mann-Whitney U Test were used to analyze the active ROM and NPT difference between the Clavicle Fracture Group and the No Fracture Group. Statistical analysis was performed using SPSS Software Version 26 (SPSS Inc, Chicago, IL). Results Subjects in the Clavicle Fracture Group have significantly lower active ROM in almost all planes of shoulder motions (except shoulder extension), as compared to the No Fracture Group. The Clavicle Fracture Group showed significantly lower NPT at both test velocities for shoulder external rotation. NPT at 180/s for shoulder extension is significantly lower in the Clavicle Fracture Group, but the NPT at 60/s showed no significant difference between the groups. For shoulder abduction and adduction, NPT at 60/s is significantly lower in the Clavicle Fracture Group, despite no significant difference between the groups at 180/s. Conclusions Conservative treatment of middle clavicle fracture may not address the residual deficits in glenohumeral joint mobility and strength. Surgical treatment should be considered to improve functional outcome. Future studies should investigate rehabilitation regimes that improve joint mobility and muscle group-specific strengthening tailored for patients with middle clavicle fractures.
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Keywords
clavicle fracture , conservative