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      Changes in joint space width during Kaltenborn traction according to traction grade in healthy adults

      research-article
      , PT, MSc 1 , , PT, PhD 2 , , PT, PhD 1 , *
      Journal of Physical Therapy Science
      The Society of Physical Therapy Science
      Joint space width, Glenohumeral joint, Traction

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          Abstract

          [Purpose] The aim of this study was to analyze the joint space width of the humeral head and glenoid fossa during traction under 2 grade conditions (grade 2/grade 3). [Subjects and Methods] The subjects were 20 healthy male adults who had not experienced any shoulder injury. Three radiographs were obtained with the subjects in the supine position (resting, grades 2 and 3). The glenohumeral joint space was examined on radiography. Joint space width was measured by a radiologist at the points described by Petersson and Redlund-Johnell. A radiologist blinded to the variable “resting” or “traction” performed all radiographic measurements. The joint space widths were compared by using one-way repeated-measures analysis of variance. [Results] The results of this study indicated significant differences in the changes in joint space width according to traction grade. Compared to resting, grades 2 and 3 traction significantly increased joint space width. However, no significant difference in joint space width was found between grades 2 and 3 traction. [Conclusion] Although no significant differences were found between grades 2 and 3 traction during glenohumeral joint traction, the increase in joint space width between the glenoid fossa and humeral head was highest during grade 3 traction.

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          Most cited references7

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          Comparison of Maitland and Kaltenborn mobilization techniques for improving shoulder pain and range of motion in frozen shoulders

          [Purpose] This study compared the use of the Maitland mobilization and Kaltenborn mobilization techniques for improving pain and range of motion in patients with frozen shoulders. [Subjects and Methods] The subjects were 20 patients with frozen shoulder who visited Hospital H, Ulsan, Korea. The subjects were divided randomly into two groups to receive Maitland or Kaltenborn mobilization to the affected shoulder. Grade III anteroposterior oscillation and posterior translation were used for the Maitland and Kaltenborn mobilization groups, respectively. Pain and range of motion of external and internal rotation were evaluated pre- and post-intervention in both groups. Paired t-tests were used to compare the pre- and post-intervention results in both groups, and independent t-tests were used to compare groups. [Results] Both groups exhibited significant decreases in pain post-intervention. Moreover, the range of motion of internal and external rotation increased significantly post-intervention in both groups. However, there was no significant difference between groups with respect to pain improvement or range of motion. [Conclusion] The posterior Maitland and Kaltenborn mobilization techniques are effective for improving pain and range of motion in frozen shoulder patients. Therefore, we recommend both techniques for such patients.
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            Effect of arm elevation and rotation on the strain in the repaired rotator cuff tendon. A cadaveric study.

            In 14 cadaveric shoulders, a rotator cuff tear (2 cm wide and 1.5 cm long) was created and repaired under a 3-kg tensile force with the arm in adduction. Strain on the repaired tendon was measured at 0 degrees, 15 degrees, 30 degrees, and 45 degrees of elevation in the sagittal, scapular, and coronal planes and from 60 degrees of internal rotation to 60 degrees of external rotation. The strain in all of the planes decreased significantly with the arm elevated more than 30 degrees. With 30 degrees of elevation in the scapular and coronal planes, the strain increased in internal rotation and decreased in external rotation. In all of the positions measured, the strain in the sagittal plane was significantly greater than in the other planes. We concluded that more than 30 degrees of elevation in the coronal or scapular plane and rotation ranging from 0 degrees to 60 degrees of external rotation compose the safe range of motion after repair of the rotator cuff.
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              An evidence-based review on the validity of the Kaltenborn rule as applied to the glenohumeral joint.

              Kaltenborn's convex-concave rule is a familiar concept in joint treatment techniques and arthrokinematics. Recent investigations on the glenohumeral joint appear to question this rule and thus accepted practice guidelines. An evidence-based systematic review was conducted to summarize and interpret the evidence on the direction of the accessory gliding movement of the head of the humerus (HOH) on the glenoid during physiological shoulder movement. Five hundred and eighty-one citations were screened. Data from 30 studies were summarized in five evidence tables with good inter-extracter agreement. The quality of the clinical trials rated a mean score of 51.27% according to the Physiotherapy Evidence Database scale (inter-rater agreement: kappa=-0.6111). Heterogeneity among studies precluded a quantitative meta-analysis. Weighting of the evidence according to Elwood;s classification and the Agency for Health Care Policy and Research classification guidelines indicated that evidence was weak and limited. Poor methodological quality, weak evidence, heterogeneity and inconsistent findings among the reviewed studies regarding the direction of translation of the HOH on the glenoid, precluded the drawing of any firm conclusions from this review. Evidence, however, indicated that not only the passive, but also the active and control subsystems of the shoulder may need to be considered when determining the direction of the translational gliding of the HOH. The indirect method, using Kaltenborn's convex-concave rule as applied to the glenohumeral joint, may therefore need to be reconsidered.
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                Author and article information

                Journal
                J Phys Ther Sci
                J Phys Ther Sci
                JPTS
                Journal of Physical Therapy Science
                The Society of Physical Therapy Science
                0915-5287
                2187-5626
                30 January 2016
                January 2016
                : 28
                : 1
                : 246-249
                Affiliations
                [1) ] Department of Physical Therapy, The Graduate School, Daegu University, Republic of Korea
                [2) ] Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Republic of Korea
                Author notes
                [* ]Corresponding author. Jin-yong Lim, Department of Physical Therapy, The Graduate School, Daegu University: 15 Jilyang, Gyeongsan-si, Gyeongbuk-do 712-714, Republic of Korea. (E-mail: wlsdyd80@ 123456naver.com )
                Article
                jpts-2015-779
                10.1589/jpts.28.246
                4756013
                26957767
                9f5eb810-65f1-407a-add4-1c48f09f6ba7
                2016©by the Society of Physical Therapy Science. Published by IPEC Inc.

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License.

                History
                : 14 September 2015
                : 16 October 2015
                Categories
                Original Article

                joint space width,glenohumeral joint,traction
                joint space width, glenohumeral joint, traction

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