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Takeno_Dissertation_August2020.pdf (4.14 MB)

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Neuromuscular Function of the Shoulder Girdle and Upper Extremity Muscles in Individuals with Glenohumeral Labral Repair

Takeno, Katsumi
http://rave.ohiolink.edu/etdc/view?acc_num=toledo1596111099423871

Abstract Details

2020, Doctor of Philosophy, University of Toledo, Exercise Science.
Neuromuscular dysfunction in shoulder girdle and upper extremity muscles is commonly observed in individuals with glenohumeral labral repair as an under-appreciated consequence of joint injury. Postoperative neural impairments from muscular, spinal and supraspinal pathways are hypothesized to contribute to the persistent muscle weakness, which may negatively affect shoulder-specific function and perceived quality of life in this population. Although identifying the specific origin of impairment has been theorized to help inform targeted treatment approaches to facilitate muscular recovery, there is limited evidence regarding origin of these neural impairments in individuals with glenohumeral labral repair. In order for the assessment and interventions to be effective, understanding comprehensive profile of neuromuscular function is an important step to allow clinicians to make evidence-based clinical decision in the course of rehabilitation. The focus of manuscript 1 was to compare peripheral, spinal and supraspinal measures of neuromuscular function in the upper extremity musculature between individuals with glenohumeral labrum repair and uninjured matched controls. We found unilateral weakness in shoulder abduction strength, unilateral impairment in corticospinal excitability for the upper trapezius, and bilateral impairment in spinal-level motoneuron pool excitability for the flexor carpi radialis in individuals with glenohumeral labral repair compared to uninjured controls. The focus of manuscript 2 was to determine the relationships between objective upper extremity muscle function and patient-reported outcomes in individuals with glenohumeral labral repair. We found lesser wrist flexor strength and lower corticospinal excitability explained worse perceived regional function. Lesser activity level explained better physical health, and elder age explained better mental health. The focus of manuscript 3 was to determine whether commonly described measures of neuromuscular function can discriminate between individuals with glenohumeral labrum repair and uninjured matched controls. We found that both symmetrical and unilateral shoulder abduction strength, Hoffmann reflex for flexor carpi radialis and active motor threshold for upper trapezius provided meaningful information regarding presence or absence of glenohumeral labral repair. Among them, symmetrical shoulder abduction strength best explains variance of individuals’ health status in this population. Overall, our results demonstrate that neuromuscular impairments are present among individuals with glenohumeral labral repair beyond 6 months from surgery. The identified impairments suggest potential origins of neuromuscular dysfunction to be addressed during post-operative rehabilitation.
Grant Norte (Committee Chair)
Christopher Ingersoll (Committee Member)
Sadik Khuder (Committee Member)
Neal Glaviano (Committee Member)
243 p.
Health Sciences; Kinesiology; Neurosciences; Sports Medicine
muscle activation; spinal reflexive pathway; corticospinal pathway; motor neuron; quality of life; limb symmetry; neuromuscular function; shoulder stabilizer; Hoffmann reflex; active motor threshold; predictive value; ROC

Recommended Citations

Citations

  • Takeno, K. (2020). Neuromuscular Function of the Shoulder Girdle and Upper Extremity Muscles in Individuals with Glenohumeral Labral Repair [Doctoral dissertation, University of Toledo]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1596111099423871

    APA Style (7th edition)

  • Takeno, Katsumi. Neuromuscular Function of the Shoulder Girdle and Upper Extremity Muscles in Individuals with Glenohumeral Labral Repair. 2020. University of Toledo, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=toledo1596111099423871.

    MLA Style (8th edition)

  • Takeno, Katsumi. "Neuromuscular Function of the Shoulder Girdle and Upper Extremity Muscles in Individuals with Glenohumeral Labral Repair." Doctoral dissertation, University of Toledo, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1596111099423871

    Chicago Manual of Style (17th edition)

toledo1596111099423871
159
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This open access ETD is published by University of Toledo and OhioLINK.