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A l’initiative du Groupement
d’Isocinétisme Belge et Luxembourgeois 6ème Journée Belge
d’ISOCINETISME Vendredi 14 et samedi 15 mars
2008 INFLUENCE OF POST-TRAUMATIC TIME ON MUSCULAR BALANCE OF THE SHOULDER IN
WHEELCHAIR ATHETES – A PRELIMINARY STUDY V. GREMEAUX1, M. DENIER2, C.
FATTAL 3, P. CODINE 4 , P.L. BERNARD 2 1 Pôle
Rééducation-Réadaptation, Inserm U 887, CHU Dijon. 2 Laboratoire
« Efficience et Déficience Motrices », EA 2991, UFR STAPS, Montpellier. 3 Centre
Mutualiste PROPARA, Montpellier 4 Clinique
La Pinède, 66240 Saint Estève. Email :
vincent.gremeaux@chu-dijon.fr Introduction:
the scapulo-humeral joint of
wheelchair athletes undergoes considerable musclejoint stress [1, 4, 6].
Several studies have reported muscular adaptations that occur with physical
activities [2, 3] in these patients. Objective:
to determine the influence of
post-traumatic time on rotator muscle of the shoulder strength of paraplegic
athletes. Material
and methods: Nine paraplegic athletes, free
from shoulder pain, without history of surgery, practicing wheelchair tennis
and basketball were recruited. Group 1 was composed of 4 “Recent Paraplegic
Athletes” (RPA) (males, post-traumatic time: 12 months - 4 years, neurological
level between T3-T12). Group 2 was composed of 5 “Ancient Paraplegic
Athletes” (APA) (3 males and 2 females, post-traumatic time > 8 years;
neurological level between T4- T10). Subjects were evaluated on an isokinetic
dynamometer in the Davies modified position [5] on a concentric mode, at 60,
120 and 180°.s-1. Analysed data were peak torque (PT), mean power (MP) and
the Medial/Lateral rotator ratios calculated for PT and MP. Results:
We found no between groups
differences for PT and MP at the three speeds on both dominant (D) and
non-dominant (ND) side. For the PT ratios, significant
differences were found among groups on D side at 60°s-1 (p<0.05) and 120°s-1
(p<0.02) (RPA>APA). We also found significant differences in each group
between D and ND side but only for RPA at 120°s-1 (p<0.02) and 180°.s-1 (p<0.02). For the MP ratios, we observed
significant differences among groups on D and ND side at 60°.s-1 (p<0.05)
(RPA>APA). We also found significant differences in each group between D and
ND side only for the RPA at 60°s-1 (p<0.05). Discussion:
based on this comparison of small
groups of subjects, we could assume that sport practice may contribute to
normalise mean ratios in wheelchair paraplegic. More serious analysis with
larger groups should improve and knowledge of wheelchair users scapular muscular
adaptations and its role in shoulder diseases. REFERENCES 1. Bayley JV, Cochran TP, Sledge CB. The weight bearing
shoulder: the impingement syndrome in paraplegics. J Bone Joint Surg 1987; 69
(5): 676-678. 2.
Bernard PL, Codine P. Isokinetic
shoulder of paraplegics: observation of global and specific muscle ratio. Int J
Rehabil Res 1997; 20: 91-98. 3. Bernard PL, Codine P, Minier J. Isokinetic shoulder
rotator muscles in wheelchair athletes. Spinal Cord 2004; 42 (4) : 222-229. 4. Burnham RS, May L, Nelson E, Steadward R, Reid DC.
Shoulder pain in wheelchair athletes: the role of muscle imbalance. Am J
Sports Med 1993; 21 (2): 238-242. 5. Davies GJ. A compendium of isokinetics in clinical usage.
Sand S publishers, 4th ed, Wisconsin (1992). 6. Ferrara M, Davis R. Injuries to elite wheelchair
athletes. Paraplegia 1990; 28: 335-341. -22 - Figure
1.a and 1.b : Means and Sds of medial/lateral
rotator muscle ratios of peak torque for the two groups of subjects (1.a) at
the three test speeds (60, 120, 180°.s-1) and for the the two side (1.b). (D
: dominant side ND: non-dominant side).
Figure
2.a and 2.b : Means and Sds of medial/lateral
rotator muscles ratios of mean power for the two groups of subjects (2.a) at
the three test speeds (60, 120, 180°.s-1) and for the the two side (2.b). (D
: dominant side ND: non-dominant side).
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