BAŞ ÜSTÜ AKTİVİTE YAPAN SPORCULARDA KAS ENERJİ TEKNİKLERİNİN POSTERİOR OMUZ GERGİNLİĞİ VE GLENOHUMERAL İNTERNAL ROTASYON DEFİSİTİNDEKİ ETKİNLİĞİ: SİSTEMATİK DERLEME

Year 2023, Volume: 34 Issue: 2, 273 - 282, 31.08.2023

Gonca Şahiner Pıçak , Sevgi Sevi Yesılyaprak

https://doi.org/10.21653/tjpr.1123541

Abstract

Amaç: Posterior omuz gerginliği (POG) ve glenohumeral internal rotasyon defisiti (GİRD), baş üstü sporcularda sık görülen biyomekanik değişikliklerdir. Kanıtlar, POG ve GİRD varlığının subakromiyal ağrı sendromuyla ilişkili olduğunu göstermiştir. POG’u iyileştirmek için sıklıkla posterior omuz germe egzersizleri yapılır. Kas Enerjisi Teknikleri (KET) uzun süredir rehabilitasyonda etkin bir şekilde kullanılmakta ve son yıllarda KET’in GİRD üzerindeki etkilerini araştıran çalışmaların sayısı artmaktadır. Sporcular antrenmanda genellikle statik germe tekniklerini kullanırlar, ancak GİRD, baş üstü aktivite yapan sporcularda yaygın bir şekilde görülmeye devam etmektedir. GİRD'de KET’in etkisinin ortaya çıkarılması, sporcularda GİRD oluşumunu etkin bir şekilde önleyebilecek germe egzersizinin belirlenmesinde faydalı olabilir.
Yöntem: Sistematik bir literatür taraması gerçekleştirdik. İlgili çalışmalar uygun elektronik veri tabanlarından (CINAHL, Cochrane Review, Pubmed (MEDLINE), Web of Science ve Google Scholar©) araştırıldı ve dahil edilmek üzere değerlendirildi.
Sonuçlar: Sistematik literatür araştırması 178 ilgili makale ile sonuçlandı ve derlemeye 8 makale dahil edildi. Sonuç ölçümü olarak GİRD’in dahil edilen tüm çalışmalarda değerlendirilirken, POG’un 4 çalışmada değerlendirildiği belirlendi.
Tartışma: Bu sistematik literatür derlemesine göre MET, baş üstü aktivite yapan sporcularda GİRD ve POG’un iyileştirilmesinde tavsiye edilmektedir. Gelecekteki araştırmalar semptomatik omuzlara odaklanmalı ve KET germelerinin uzun süreli etkilerini araştırmalıdır.

Keywords

Yaralanmalar, Mobilite, Fizik Tedavi

EFFECTIVENESS OF MUSCLE ENERGY TECHNIQUES ON GLENOHUMERAL INTERNAL ROTATION DEFICIT IN OVERHEAD ATHLETES: A SYSTEMATIC REVIEW

Abstract

Purpose: Posterior shoulder tightness (PST) and Glenohumeral Internal Rotation Deficit (GIRD) are frequent biomechanical changes in overhead athletes. Evidence has shown that PST and the presence of GIRD increase subacromial pain syndrome. Posterior shoulder stretching exercises are used to improve posterior shoulder tightness. Muscle Energy Techniques (MET) are a long-established and effective approach, and the number of studies investigating the effects of MET on GIRD has been increasing in recent years. Despite the use of static stretching techniques in training, GIRD continues to be common in athletes performing overhead activities. Therefore, revealing the effects of MET on GIRD might be effective in determining the type of stretching most appropriate for preventing GIRD in athletes.
Methods: We performed a systematic literature review, assessing the relevance of studies for inclusion and selecting the studies from appropriate electronic databases (CINAHL, Cochrane Review, Pubmed (MEDLINE), Web of Science as well as Google Scholar©).
Results: The present systematic literature search generated 178 relevant citations and 8 articles were included in the final review. As an outcome measure, GIRD was assessed in all eight, whereas PST was assessed in four.
Conclusion: According to this systematic literature review, MET is effective in the improvement of GIRD and PST in overhead athletes. Future research should focus on symptomatic shoulders and investigate the long-term benefits of MET.

Keywords

Injuries, Mobility, Physical Therapy

References

• Laudner K, Sipes R. The Incidence of Shoulder Injury among Collegiate Overhead Athletes. J Intercoll Sport 2009. https://doi.org/10.1123/jis.2.2.260.
• Borsa PA, Laudner KG, Sauers EL. Mobility and stability adaptations in the shoulder of the overhead athlete: A theoretical and evidence-based perspective. Sport Med 2008;38:17–36. https://doi.org/10.2165/00007256-200838010-00003.
• Salamh PA, Liu X, Hanney WJ, Sprague PA, Kolber MJ. The efficacy and fidelity of clinical interventions used to reduce posterior shoulder tightness: a systematic review with meta-analysis. J Shoulder Elb Surg 2019;28:1204–1213. https://doi.org/10.1016/j.jse.2018.12.006.
• Kirsch JM, Bakshi NK, Ayeni OR, Khan M, Bedi A. Clinical Outcomes and Quality of Literature Addressing Glenohumeral Internal Rotation Deficit: A Systematic Review. HSS J 2020;16:233–241. https://doi.org/10.1007/s11420-019-09691-1.
• Dong W, Goost H, Lin XB, Burger C, Paul C, Wang ZL, et al. Treatments for shoulder impingement syndrome a prisma systematic review and network meta-analysis. Med (United States) 2015. https://doi.org/10.1097/MD.0000000000000510.
• Tyler TF, Nicholas SJ, Roy T, Gleim GW. Quantification of posterior capsule tightness and motion loss in patients with shoulder impingement. Am J Sports Med 2000. https://doi.org/10.1177/03635465000280050801.
• Muraki T, Yamamoto N, Zhao KD, Sperling JW, Steinmann SP, Cofield RH, et al. Effects of posterior capsule tightness on subacromial contact behavior during shoulder motions. J Shoulder Elb Surg 2012. https://doi.org/10.1016/j.jse.2011.08.042.
• Tyler TF, Nicholas SJ, Lee SJ, Mullaney M, McHugh MP. Correction of posterior shoulder tightness is associated with symptom resolution in patients with internal impingement. Am J Sports Med 2010. https://doi.org/10.1177/0363546509346050.
• Cools AM, Declercq G, Cagnie B, Cambier D, Witvrouw E. Internal impingement in the tennis player: Rehabilitation guidelines. Br J Sports Med 2008. https://doi.org/10.1136/bjsm.2007.036830.
• Cools AM, Johansson FR, Cagnie B, Cambier DC, Witvrouw EE. Stretching the Posterior Shoulder Structures in Subjects with Internal Rotation Deficit: Comparison of Two Stretching Techniques. Shoulder Elb 2012. https://doi.org/10.1111/j.1758-5740.2011.00159.x.
• Reed ML, Begalle RL, Laudner KG. ACUTE EFFECTS OF MUSCLE ENERGY TECHNIQUE AND JOINT MOBILIZATION ON SHOULDER TIGHTNESS IN YOUTH THROWING ATHLETES: A RANDOMIZED CONTROLLED TRIAL. Int J Sports Phys Ther 2018. https://doi.org/10.26603/ijspt20181024.
• McClure P, Balaicuis J, Heiland D, Broersma ME, Thorndike CK, Wood A. A randomized controlled comparison of stretching procedures for posterior shoulder tightness. J Orthop Sports Phys Ther 2007. https://doi.org/10.2519/jospt.2007.2337.
• Manske RC, Meschke M, Porter A, Smith B, Reiman M. A randomized controlled single-blinded comparison of stretching versus stretching and joint mobilization for posterior shoulder tightness measured by internal rotation motion loss. Sports Health 2010. https://doi.org/10.1177/1941738109347775.
• Maenhout A, Van Eessel V, Van Dyck L, Vanraes A, Cools A. Quantifying acromiohumeral distance in overhead athletes with glenohumeral internal rotation loss and the influence of a stretching program. Am J Sports Med 2012. https://doi.org/10.1177/0363546512454530.
• Tahran Ö, Yeşilyaprak SS. Effects of modified posterior shoulder stretching exercises on shoulder mobility, pain, and dysfunction in patients with subacromial impingement syndrome. Sports Health 2020;12:139–148.
• Wilk KE, Hooks TR, Macrina LC. The modified sleeper stretch and modified cross-body stretch to increase shoulder internal rotation range of motion in the overhead throwing athlete. J Orthop Sports Phys Ther 2013. https://doi.org/10.2519/jospt.2013.4990.
• Mine K, Nakayama T, Milanese S, Grimmer K. Effectiveness of Stretching on Posterior Shoulder Tightness and Glenohumeral Internal-Rotation Deficit: A Systematic Review of Randomized Controlled Trials. J Sport Rehabil 2017;26.
• Fryer G. Muscle energy technique: An evidence-informed approach. Int J Osteopath Med 2011. https://doi.org/10.1016/j.ijosm.2010.04.004.
• Moore SD, Laudner KG, Mcloda TA, Shaffer MA. The immediate effects of muscle energy technique on posterior shoulder tightness: A randomized controlled trial. J Orthop Sports Phys Ther 2011. https://doi.org/10.2519/jospt.2011.3292.
• Avci EE, Sari Z, Ayberk B, Ozdal M, Altindag O. The Immediate Effects of Muscle Energy Technique on Range of Motion and Isokinetic Muscle Strength in Volleyball Players with Glenohumeral Internal Rotation Deficit: A Randomized Controlled Trial*. Eur J Ther 2021;27:199–205. https://doi.org/10.5152/eurjther.2021.20012.
• Chaitow L. Muscle Energy Techniques 2nd edition. Statew Agric L Use Baseline 2015 2015;1. https://doi.org/10.1017/CBO9781107415324.004.
• Mahajan R, Kataria C, Bansal K. Comparative effectiveness of muscle energy technique and static stretching for treatment of subacute mechanical neck pain. Int J Heal Rehabil Sci 2012;1:16–21.
• Phadke A, Bedekar N, Shyam A, Sancheti P. Effect of muscle energy technique and static stretching on pain and functional disability in patients with mechanical neck pain: A randomized controlled trial. Hong Kong Physiother J 2016;35:5–11.
• Mertens MG, Meert L, Struyf F, Schwank A, Meeus M. Exercise therapy is effective for improvement in range of motion, function, and pain in patients with frozen shoulder: a systematic review and meta-analysis. Arch Phys Med Rehabil 2021.
• Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Int J Surg 2021;88:105906.
• Cohen J. A power primer. Psychol Bull 1992;112:155.
• De Morton NA. The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. Aust J Physiother 2009;55:129–133.
• Akula, Indraja; Nagaraj, S; Pearlson K. Effect of Muscle Energy Technique on Glenohumeral Internal Rotation Deficit and Functional Outcomes in Over Head Athletes -A Pre-Post Experimental Study. Int J Heal Sci Res Int J Heal Sci Res 2017;1767:176–184.
• Bathia K, Eapen C. Effectiveness of Muscle Energy Technique and Passive Stretching on Posterior Shoulder Tightness in Cricket Bowlers-A Randomized Clinical Trial. Int J Sci Res 2013;5:2319–7064.
• Sehgal S, Sen S, Dhawan A. Effects of muscle energy technique in increasing range of motion and strength of glenohumeral internal rotator, in athletes with glenohumeral internal rotation deficit. Am J Sport Sci 2016;4:43–48.
• Kumar T, Kumar K, … CC-I, 2021 undefined. Effectiveness of Muscle Energy Technique versus Sleeper Stretch on Posterior Shoulder Tightness among Volley Ball Players. ResearchgateNet 2021.
• Kini KV, Rathod D, Kumar A. Comparison of Muscle Energy Technique vs Mulligan to Improve Gird in District Level Cricket Bowlers n.d.
• Painkra JP, Kumar S, Anwer S, Kumar R, Nezamuddin M, Equebal A. Reliability of an assessment of deep neck flexor muscle endurance test: A cross-sectional study. Int J Ther Rehabil 2014;21:227–231. https://doi.org/10.12968/ijtr.2014.21.5.227.