Defining the glenohumeral range of motion required for overhead shoulder mobility: an observational study

Linda Dyer; Samy Bouaicha; Jaap Swanenburg; Hermann Schwameder

doi:10.33393/aop.2024.3015

Authors

Linda Dyer Department of Physiotherapy, Balgrist University Hospital, University of Zurich, Zurich - Switzerland https://orcid.org/0009-0009-1530-4879
Samy Bouaicha Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich - Switzerland https://orcid.org/0000-0002-1111-9213
Jaap Swanenburg Department of Chiropractic Medicine, Balgrist University Hospital, Zurich - Switzerland https://orcid.org/0000-0002-1754-9206
Hermann Schwameder Department of Sport and Exercise Science, Paris Lodron University of Salzburg, Salzburg - Austria https://orcid.org/0000-0002-0380-8801

DOI:

https://doi.org/10.33393/aop.2024.3015

Keywords:

Glenohumeral, Postoperative, Range of motion, Rehabilitation, Shoulder, Stiffness

Abstract

Background: Recovery of overhead mobility after shoulder surgery is time-consuming and important for patient satisfaction. Overhead stretching and mobilization of the scapulothoracic and glenohumeral (GH) joints are common treatment interventions. The isolated GH range of motion (ROM) of flexion, abduction, and external rotation required to move above 120° of global shoulder flexion in the clinical setting remains unclear. This study clarified the GH ROM needed for overhead mobility.

Methods: The timely development of shoulder ROM in patients after shoulder surgery was analyzed. Passive global shoulder flexion, GH flexion, abduction, and external rotation ROM were measured using goniometry and visually at 2-week intervals starting 6-week postsurgery until the end of treatment. Receiver operating characteristic curves were used to identify the GH ROM cutoff values allowing overhead mobility.

Results: A total of 21 patients (mean age 49 years; 76% men) after rotator cuff repair (71%), Latarjet shoulder stabilization (19%), and arthroscopic biceps tenotomy (10%) were included. The ROM cutoff value that accurately allowed overhead mobility was 83° for GH flexion and abduction with the area under the curve (AUC) ranging from 0.90 to 0.93 (p < 0.001). The cutoff value for GH external rotation was 53% of the amount of movement on the opposite side (AUC 0.87, p < 0.001).

Conclusions: Global shoulder flexion above 120° needs almost full GH flexion and abduction to be executable. External rotation ROM seems less important as long as it reaches over 53% of the opposite side.

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Author Biography

Linda Dyer, Department of Physiotherapy, Balgrist University Hospital, University of Zurich, Zurich - Switzerland

Shoulder & Elbow Team Leader

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