Characterization of tissue resistance during a dorsally directed translational mobilization of the glenohumeral joint

Ar Tyan Hsu, Larry Ho, Jia Hao Chang, Guan Liang Chang, Tom Hedman

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objectives: To quantify forces applied by therapists during dorsal glide translational mobilization of the glenohumeral joint, to determine the relationship of tissue resistance to the load-displacement relation of the glenohumeral joint, and to determine the safety of the forces applied by the therapists during dorsal glide translational mobilization. Design: A fresh cadaver shoulder specimen mounted on a 6-axis load cell was used to register forces applied by therapists during dorsal glide translational mobilization of the glenohumeral joint in a test-retest pattern. Setting: Biomechanics laboratory. Participants: Twelve experienced orthopedic physical therapists. Intervention: Not applicable. Main Outcome Measures: Forces exerted by therapists during passive dorsal glide translational mobilization in the loose-packed position and in the end range of abduction, with different grades of movements. The movements did not include any manipulation or thrust-type procedures. Simulated dorsal glide procedures were performed by the material testing system to construct the load-displacement curve of the glenohumeral specimen. The corresponding locations of the forces applied by therapists were interpolated and plotted on the load-displacement curve. Results: The peak force values measured during mobilization were characterized by large intertherapist variability: coefficients of variation ranged from 40.97% to 77.49%. Test-retest reliability for intrasession measures was high (ICC2,1 range, .90-.94); intersession reliability was poor (ICC2,1 range, .01-.54). The mean forces ranged from 18.36 to 38.76N. When interpolated to the load-displacement curve, the mean peak forces obtained fell mostly in the toe and the linear elastic regions of the load-displacement curve. Conclusion: Force parameters measured during dorsal glide mobilization were characterized by large intertherapist variability with high intrasession and poor intersession test-retest reliability. The mobilization forces applied by experienced orthopedic physical therapists fall safely in the toe and the linear elastic regions of the load-displacement curve.

Original languageEnglish
Pages (from-to)360-366
Number of pages7
JournalArchives of Physical Medicine and Rehabilitation
Volume83
Issue number3
DOIs
Publication statusPublished - 2002 Jan 1

Fingerprint

Shoulder Joint
Physical Therapists
Toes
Reproducibility of Results
Orthopedics
Materials Testing
Cadaver
Biomechanical Phenomena
Outcome Assessment (Health Care)
Safety

Keywords

  • Joint mobilization
  • Physical therapy
  • Range of motion
  • Rehabilitation
  • Shoulder joint

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

Characterization of tissue resistance during a dorsally directed translational mobilization of the glenohumeral joint. / Hsu, Ar Tyan; Ho, Larry; Chang, Jia Hao; Chang, Guan Liang; Hedman, Tom.

In: Archives of Physical Medicine and Rehabilitation, Vol. 83, No. 3, 01.01.2002, p. 360-366.

Research output: Contribution to journalArticle

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abstract = "Objectives: To quantify forces applied by therapists during dorsal glide translational mobilization of the glenohumeral joint, to determine the relationship of tissue resistance to the load-displacement relation of the glenohumeral joint, and to determine the safety of the forces applied by the therapists during dorsal glide translational mobilization. Design: A fresh cadaver shoulder specimen mounted on a 6-axis load cell was used to register forces applied by therapists during dorsal glide translational mobilization of the glenohumeral joint in a test-retest pattern. Setting: Biomechanics laboratory. Participants: Twelve experienced orthopedic physical therapists. Intervention: Not applicable. Main Outcome Measures: Forces exerted by therapists during passive dorsal glide translational mobilization in the loose-packed position and in the end range of abduction, with different grades of movements. The movements did not include any manipulation or thrust-type procedures. Simulated dorsal glide procedures were performed by the material testing system to construct the load-displacement curve of the glenohumeral specimen. The corresponding locations of the forces applied by therapists were interpolated and plotted on the load-displacement curve. Results: The peak force values measured during mobilization were characterized by large intertherapist variability: coefficients of variation ranged from 40.97{\%} to 77.49{\%}. Test-retest reliability for intrasession measures was high (ICC2,1 range, .90-.94); intersession reliability was poor (ICC2,1 range, .01-.54). The mean forces ranged from 18.36 to 38.76N. When interpolated to the load-displacement curve, the mean peak forces obtained fell mostly in the toe and the linear elastic regions of the load-displacement curve. Conclusion: Force parameters measured during dorsal glide mobilization were characterized by large intertherapist variability with high intrasession and poor intersession test-retest reliability. The mobilization forces applied by experienced orthopedic physical therapists fall safely in the toe and the linear elastic regions of the load-displacement curve.",
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