Özet
Çalık, M. Shoulder Proprioception in Partial and Full Thickness Supraspinatus Tears. Hacettepe University, Graduate School of Health Sciences, Sports Physiotherapy Program, Master of Science Thesis, Ankara, 2018. This study was planned to evaluate shoulder proprioception in partial and full-thickness supraspinatus tears which is frequently encountered in clinic. The study was conducted on 21 partial supraspinatus tears (53.7±12.7 years, 26.6±2.9 kg/m2), 20 full-thickness supraspinatus tears (57.2±5.6 years, 27.6±1.9 kg/m2) and 20 asymptomatic individuals without any shoulder problems (19.5±0.9 years, 22.7±3.2 kg/m2) as control group. The shoulder proprioception was assessed with an Isomed 2000 isokinetic dynamometer using an active position repeat test at 40° and 100° target angles during scapular planar elevation. The actual angular value and deviation from the target angle as absolute error were recorded as degree. At rest, night and activity during the test pain were evaluated with visual analogue scale. The American Shoulder and Elbow Surgeons (ASES) form was used to determine functional activity level of the tear shoulder. Kruskall Wallis and Mann-Whitney U test were used for comparison of groups for nonparametric data and One-way ANOVA tests were used for parametric data. Spearman correlation analysis was used to assess the relationship between active joint position sensation with pain and functional activity. At the end of the study, it was seen that absolute value of the active joint position sense decreased during the 40° and 100° elevation on the the individuals with partial and full-thickness supraspinatus tears both tear and contralateral sides compared to the control group (p<0.05). Compared to the actual value of the active joint position sense, it was found to be deficit in full-thickness tear group on the tear and contralateral sides at 100 degrees elevation compared to the partial tear and asymptomatic group (p <0.05). It was found a positive correlation between active joint position sense at 40° target angle and resting pain (p<0.05, r=0.31), night pain (p<0.001, r=0.37), activity pain (p<0.05, r=0.32) and pain during 40°elevation (p<0.001; r=0.48). Similarly, it was found a positive correlation between active joint position sense at 100° target angle and resting pain (p<0.001, r=0.47), night pain (p<0.05, r=0.35), activity pain (p<0.05, r=0.41) and pain during 40°elevation (p<0.001; r=0.50). There was no correlation between shoulder functional activity level and active joint position sense (p>0.05). It was seen that individuals with partial and full-thickness supraspinatus tears in terms of absolute value had decreased active joint position sense in both affected and contralateral shoulders and proprioceptive deficit in both shoulders. In actual value, it was determined that the individuals who were full-thickness tear were affected both on the tear and contralateral sides. As a result, this deficit recorded according to asymptomatic individuals has to be improved in rehabilitation programs. Considering that special treatment of the affected extremity was frequently performed in rehabilitation programs, contralateral training was considered not to be neglected. However, the reduction of pain are thought to contribute to the development of the proprioceptive sense because of the effect of pain on the joint position sense.
Künye
1. Donatelli R. Physical Therapy of the Shoulder. 3th ed. Churchill Livingstone; 2004.
2. Levy O, Relwani J, Zaman T, Even, T, Venkateswaran B, Copeland S. Measurement of blood flow in the rotator cuff using laser doppler flowmetry. J Bone Joint Surg Br. 2008;90(7):893-8.
3. Kane SM, Dave A, Haque A, Langston K. The incidence of rotator cuff disease in smoking and non-smoking patients: a cadaveric study. Orthopedics. 2006;29:363–66.
4. Abboud JA, Kim JS. The effect of hypercholesterolemia on rotator cuff disease. Clin Orthop Relat Res. 2010;468:1493-7.
5. Rudzki JR, Adler RS, Warren RF, Kadrmas WR, Verma N, Pearle AD et al. Contrast-enhanced ultrasound characterization of the vascularity of the rotator cuff tendon: age- and activity-related changes in the intact asymptomatic rotator cuff. J Shoulder Elbow Surg. 2008;17(1 suppl):96S–100S.
6. Neer CS. Impingement lesions. Clin Orthop Relat Res. 1983;173:70-7.
7. Paley KJ, Jobe FW, Pink MM, Kvitne RS, ElAttrache NS. Arthroscopic findings in the overhand throwing athlete: evidence for posterior internal impingement of the rotator cuff. Arthroscopy. 2000;16:35–40.
8. Bigliani LU, Ticker JB, Flatow EL, Soslowsky LJ, Mow VC. The relationship of acromial architecture to rotator cuff disease. Clin Sports Med. 1991;10(4):823-38.
9. Stayner LR, Cummings J, Andersen J, Jobe CM. Shoulder dislocations in patients older than 40 years of age. Orthop Clin North Am. 2000;31:231–9.
10. Glaser DL, Sher JS, Ricchetti ET, Williams GR, Soslowsky LJ. Anatomy, biomechanics, and pathophysiology of rotator cuff disease. Williams GR, Iannotti J eds, Disorders of the Shoulder, Philadelphia, PA: Lippincott Williams & Wilkins; 2007.
11. Warner JJP, Lephart SM, Fu FH. Role of propri¬oception in pathoetiology of shoulder instability. Clin Orthop Rel Res. 1996;330:35–9.
12. Rockwood CA, Matsen FA. The shoulder. WB Sounders, Philadelphia; 2008.
13. Lephart SM, Henry TJ. The physiological basis for open and closed kinetic chain rehabilitation for the upper extremity. J Sport Rehab. 1996;5:71–87.
14. Myers JB, Ju YY, Hwang JH, McMahon PJ, Rodosky MW, Lephart SM. Reflexive muscle activation alterationsin shoulders with anterior glenohumeral instability. Am J Sports Med. 2004;32:1013-21.
15. Machner A, Merk H, Becker R, Rohkohl K, Wissel H, Pap G. Kinesthetic sense of the shoulder in patients with impingement syndrome. Acta Orthop Scand. 2003;74:85-8.
16. Ludewig PM, Cook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Phys Ther. 2000;80:276-91.
17. Cuomo F, Birdzell MG, Zuckerman JD. The effect of degenerative arthritis and prosthetic arthroplasty on shoulder proprioception. J Shoulder Elbow Surg. 2005;14:345-8.
18. Myers JB, Lephart SM. The role of the sensorimotor system in the athletic shoulder. J Athl Train. 2000; 35:351-36.
19. Anderson VB, Wee E. Impaired joint proprioception at higher shoulder elevations in chronic rotator cuff pathology. Arch Phys Med Rehabil. 2011;92:1146-51.
20. Neumann DA. Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation: Mosby/Elsevier; 2010.
21. Baltacı, G. Omuz Yaralanmalarında Rehabilitasyon. Ankara: Pelikan Yayıncılık; 2015.
22. Wilk KE, Reinold MM, Andrews JR. The Athlete's Shoulder: Churchill Livingstone/Elsevier; 2009.
23. Lippert LS. Clinical Kinesiology and Anatomy: F. A. Davis Company; 2011.
24. Sharkey NA, Marder RA. The rotator cuff opposes superior translation of the humeral head. Am J Sports Med. 1995;23:270–75.
25. Escamilla RF, Yamashiro K, Paulos L, Andrews JR. Shoulder muscle activity and function in common shoulder rehabilitation exercises. Sports Med. 2009;39:663–85.
26. Volk AG, Vangsness CT Jr. An anatomic study of the supraspinatus muscle and tendon. Clin Orthop Relat Res. 2001;384:280–5.
27. Roh MS, Wang VM, April EW. Anterior and posterior musculotendinous anatomy of the supraspinatus. J Shoulder Elbow Surg. 2000;9:436–40.
28. Vahlensieck M, an Haack K, Schmidt HM. Two portions of the supraspinatus muscle: a new finding about the muscles macroscopy by dissection and magnetic resonance imaging. Surg Radiol Anat. 1994;16:101–4.
29. Codman EA. The Shoulder. Rupture of the Supraspinatus Tendon and Other Lesions in or About the Subacromial Bursa. Boston: Thomas Todd; 1934.
30. Massimini DF, Warner JJP, Li G. Non-invasive determination of coupled motion of the scapula and humerus– an in-vitro validation. J Biomech. 2011;44:408–12.
31. McClure PW, Michener LA, Sennett BJ, Karduna AR. Direct 3-dimensional measurement of scapular kinematics during dynamic movements in vivo. J Shoulder Elbow Surg. 2001;10:269–77.
32. Bourne DA, Choo AMT, Regan WD, MacIntyre DL, Oxland TR. Three-dimensional rotation of the scapula during functional movements: an in vivo study in healthy volunteers. J Shoulder Elbow Surg. 2007;16:150–62.
33. Fung M, Kato S, Barrance PJ, Elias JJ, McFarland EG, Nobuhara K et al. Scapular and clavicular kinematics during humeral elevation: a study with cadavers. J Shoulder Elbow Surg. 2001;10:278–85.
34. Graichen H, Stammberger T, Bonel H, Haubner M, Englmeier KH, Reiser M et al. Magnetic resonance- based motion analysis of the shoulder during elevation. Clin Orthop Relat Res. 2000;370:154–63.
35. Ludewig PM, Phadke V, Braman JP, Hassett DR, Cieminski CJ, LaPrade RF. Motion of the shoulder complex during multiplanar humeral elevation. J Bone Joint Surg Am. 2009;91:378–89.
36. Provencher CMT, Makani A, McNeil JW, Pomerantz ML, Golijanin P, Gross D. The Role of the Scapula in Throwing Disorders. Sports Med Arthrosc. 2014;22:80–7.
37. Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology Part III: the SICK scapula, scapular dyskinesis, the kinetic chain, and rehabilitation. Arthroscopy. 2003;19:641–61.
38. Talkhani IS, Kelly CP. Movement analysis of asymptomatic normal shoulders: a preliminary study. J Shoulder Elbow Surg. 2001;10:580–4.
39. Parsons IM, Apreleva M, Fu FH, Woo SL. The effect of rotator cuff tears on reaction forces at the glenohumeral joint. J Orthop Res. 2002;20:439–46.
40. Freedman L, Munro RR. Abduction of the arm in the scapular plane: scapular and glenohumeral movements. J Bone Joint Surg Am. 1966;48(8):1503-10.
41. Hashimoto T, Nobuhara K, Hamada T. Pathologic evidence of degeneration as a primary cause of rotator cuff tear. Clin Orthop Relat Res. 2003;415:111–20.
42. Gerber C, Terrier F, Ganz R. The role of the coracoid process in the chronic impingement syndrome. J Bone Joint Surg Br. 1985;67:703–8.
43. Kim HJ, Kim JY, Kee YM, Rhee YG. Bursal-Sided Rotator Cuff Tears: Simple Versus Everted Type. Am J Sports Med. 2018;46(2):441-8.
44. Karthikeyan S, Griffin DR, Parsons N, Lawrence TM, Modi CS, Drew S et al. Microvascular blood flow in normal and pathologic rotator cuffs. J Shoulder Elbow Surg. 2015;24(12):1954-60.
45. Lohr JF, Uhthoff HK. The microvascular pattern of the supraspinatus tendon. Clin Orthop Relat Res. 1990;254:35-8.
46. Fukuda H, Hamada K, Yamanaka K. Pathology and pathogenesis of bursal-side rotator cuff tears viewed from en bloc histologic sections. Clin Orthop Relat Res. 1990;254:75–80.
47. Goodmurphy CW, Osborn J, Akesson EJ, Johnson S, Stanescu V, Regan WD. An immunocytochemical analysis of torn rotator cuff tendon taken at the time of repair. J Shoulder Elbow Surg. 2003;12(4):368-74.
48. Sharma P, Maffulli N. Tendon injury and tendinopathy: healing and repair. J Bone Joint Surg Am. 2005;87:187–202.
49. Lewis JS. Rotator cuff tendinopathy. Br J Sports Med. 2009;43:236–41.
50. O’Brien M. Structure and metabolism of tendons. Scand J Med Sci Sports. 1997;7:55-61.
51. Hess GP, Cappiello WL, Poole RM, Hunter SC. Prevention and treatment of overuse tendon injuries. Sports Med. 1989;8:371-84.
52. Kirkendall DT, Garrett WE. Function and biomechanics of tendons. Scand J Med Sci Sports. 1997;7:62-6.
53. Matthews TJ, Hand GC, Rees JL, Athanasou NA, Carr AJ. Pathology of the torn rotator cuff tendon. Reduction in potential for repair as tear size increases. J Bone Joint Surg Br. 2006;88:489-95.
54. Millar NL, Hueber AJ, Reilly JH, Xu Y, Fazzi UG, Murrell GA et al. Inflammation is present in early human tendinopathy. Am J Sports Med. 2010;38:2085-91.
55. Riley GP, Harrall RL, Constant CR, Chard MD, Cawston TE, Hazleman BL. Tendon degeneration and chronic shoulder pain: changes in the collagen composition of the human rotator cuff tendons in rotator cuff tendinitis. Ann Rheum Dis. 1994;53:359-66.
56. Kumagai J, Sarkar K, Uhthoff HK. The collagen types in the attachment zone of rotator cuff tendons in the elderly: an immunohistochemical study. J Rheumatol. 1994;21: 2096-100.
57. Benjamin M, Qin S, Ralphs JR. Fibrocartilage associated with human tendons and their pulleys. J Anat. 1995;187(Pt 3):625–33.
58. Evans EJ, Benjamin M, Pemberton DJ. Fibrocartilage in the attachment zones of the quadriceps tendon and patellar ligament of man. J Anat. 1990;171:155–62.
59. Ellman H. Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop Relat Res. 1990;254:64–74.
60. Ruotolo C, Fow JE, Nottage WM. The supraspinatus footprint: an anatomic study of the supraspinatus insertion. Arthroscopy. 2004;20:246–9.
61. Gartsman GM. Partial-thickness rotator cuff tears. In: Shoulder arthroscopy. Elsevier, Philadelphia; 2003.
62. Wolff AB, Sethi P, Sutton KM, Covey AS, Magit DP, Medvecky M. Partial-thickness rotator cuff tears. J Am AcadOrthop Surg. 2006;14:715–25.
63. Nakajima T, Rokuuma N, Hamada K, Tomatsu T, Fukuda H. Histologic andbiomechanical characteristics of the supraspinatus tendon: Reference to rotator cuff tearing. J Shoulder Elbow Surg. 1994;3:79–87.
64. Kim HM, Dahiya N, Teefey SA, Middleton WD, Stobbs G, Steger-May K, et al. Location and initiation of degenerative rotator cuff tears: an analysis of three hundred and sixty shoulders. J Bone Joint Surg Am. 2010;92:1088–96.
65. Fukuda H, Hamada K, Nakajima T, Tomonaga A. Pathology and pathogenesis of the intratendinous tearing of the rotator cuff viewed from en bloc histologic sections. Clin Orthop Relat Res. 1994;304:60–7.
66. Hijioka A, Suzuki K, Nakamura T, Hojo T. Degenerative change and rotator cuff tears. An anatomical study in 160 shoulders of 80 cadavers. Arch Orthop Trauma Surg. 1993;112:61–4.
67. Fukuda H. The management of partial-thickness tears of the rotator cuff. J Bone Joint Surg Br. 2003;85(1):3-11.
68. Walch G, Boileau P, Noel E, Donell ST. Impingement of the deep surface of the supraspinatus tendon on the posterosuperior glenoid rim: An arthroscopic study. J Shoulder Elbow Surg. 1992;1:238–45.
69. Düzgün İ. Rotator Kılıf Tamiri Sonrası Yavaş Ve Hızlı Rehabilitasyon Protokollerinin Karşılaştırılması. Doktora Tezi, Hacettepe Üniversitesi, Sağlık Bilimleri Enstitüsü, Spor Fizyoterapistliği Programı, 2008.
70. Kibler WBK, Sciascia A, Wolf BR, Warme B, Khun JE. Non acute shoulder injuries. Kibler WBK (ed), Orthopaedic Knowledge Update 4: Sports Medicine. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2009.
71. Lin KC, Krishan SG, Burkhead WZ. Rotator cuff. In: DeLee JC, Drez D, Miller MD (eds), DeLee and Drez’s Orthopaedic Sports Medicine: Principles and Practice, Third Edition. Philadelphia, PA: Saunders Elsevier; 2010.
72. Yamaguchi K, Tetro AM, Blam O, et al. Natural history of asymptomatic rotator cuff tears: a longitudinal analysis of asymptomatic tears detected sonographically. J Shoulder Elbow Surg. 2001;10:199–203.
73. Esch JC, Leek BT. Biology of healing and tissue repair. In: Angelo RL, Esch JC, Ryu RKN (eds), AANA Advanced Arthroscopy. The shoulder. New York: Saunders Elsevier; 2010.
74. Snyder SJ. Arthroscopic classifi cation of rotator cuff lesions and surgical decision making. In: Shoulder arthroscopy. Lippincott William & Wilkins, Philadelphia; 2002.
75. Harryman DT, Mack LA, Wang K, Jackins SE, Richardson ML, Matsen FA. Repairs of the rotator cuff. Correlation of functional results with integrity of the cuff. J Bone Joint Surg Am. 1991;73:982–9.
76. Sherrington CS. On the proprio-ceptive system, especially in its reflex aspect. Brain. 1906;29(4):467-82.
77. Smith R. “The sixth sense”: Towards a history of muscular sensation. Gesnerus. 2011;68:218-71.
78. Houglum PA. The ABCs of the proprioception. Houglum PA, editor. Therapeutic exercise for musculoskeletal injuries. 2nd ed. Champaign, IL: Human Kinetics; 2005.
79. Johansson H, Pedersen J, Bergenheim M, Djupsjobacka M. Peripheral afferents of the knee: Their effects on central mechanisms regulating muscle stiffness, joint stability, and proprioception and coordination. Lephart SM, Fu FH, editors. Proprioception and neuromuscular control in joint stability. Illinois: Human Kinetics; 2000.
80. Kaya D. Omuz propriosepsiyon egzersizleri. Baltacı, G, editör. Omuz Yaralanmalarında Rehabilitasyon. Ankara: Pelikan Yayıncılık(2015).
81. Purves D. Neuroscience, 5th ed. Sunderland, MA: Sinauer Associates; 2012
82. Riemann BL, Lephart SM. The sensorimotor system, part I: The physiologic basis of functional joint stability. J Athl Train. 2002;37:71-9.
83. Johansson H, Sjolander P, Sojka P. A sensory role for the cruciate ligaments. Clin Orthop. 1991;268:161–78.
84. Dye SF. The functional anatomy of the cere¬bellum: an overview. Lephart SM, Fu FH, editors. Proprioception and Neuromuscular Control in Joint Stability. Champaign, IL: Human Kinetics; 2000.
85. Proske U, Gandevia SC. The kinaesthetic senses. J Physiol. 2009;587:4139-46.
86. Freeman, M, Wyke, B. The innervation of the knee joint: An anatomical and histological study in the cat．Journal of Anatomy. 1967;101:505-32.
87. Andrews, JR, Harrelson GL, Wilk KE. Physical Rehabilitation of the Injured Athlete. 4th ed. Phladelphia: Elsevier Saunders; 2012.
88. Riemann BL, Lephart SM. The Sensorimotor System, Part II: The Role of Proprioception in Motor Control and Functional Joint Stability. J Athl Train. 2002;37:80-4.
89. Maenhout AG, Palmans T, De Muynck M, De Wilde LF, Cools A. The impact of rotator cuff tendinopathy on proprioception, measuring force sensation. J Shoulder and Elbow Surg. 2012;21:1080-6.
90. Myers JB, Lephart SM. Sensorimotor deficits contributing to glenohumeral instability. Clin Orthop Relat Res.2002; 98-104.
91. Vangsness CT Jr, Ennis M, Taylor JG, Atkinson R. Neural anatomy of the glenohumeral ligaments, labrum, and subacromial bursa. Arthroscopy. 1995;11:180-84.
92. Ide K, Shirai Y, Ito H, Ito H. Sensory nerve supply in the human subacromial bursa. J Shoulder Elbow Surg. 1996;5:371-82.
93. Shimoda F. Innervation, especially sensory innervation of the knee joint and motor organs around it in early stage of human embryo. Arch Hisol Jpn. 1955;9:91-108.
94. Kikuchi T. Histological studies on the sensory innervation of the shoulder joint. J Iwate Med Assoc. 1968;20:554-67.
95. Windhorst U. Muscle proprioceptive feedback and spinal networks. Brain Res Bull. 2007;73:155-202.
96. Suprak DN. Shoulder joint position sense is not enhanced at end range in an unconstrained task. Hum Mov Sci. 2011;30:424-35.
97. Nyland JA, Caborn DNM, Johnson DL. The human glenohumeral joint: a proprioceptive and stability alliance. Knee Surg Sports Traumatol Arthrosc. 1998;6:50-61.
98. Maass S, Baumann KI, Halata Z. Topography of corpuscular mechanoreceptors in the shoulder joint region of Monodelphis domestica. Anat Rec. 2001;263:35-40.
99. Zuckerman JD, Gallagher MA, Cuomo F, Rokito A. The effect of instability and subsequent anterior shoulder repair on proprioceptive ability. J Shoulder Elbow Surg. 2003;12:105-9.
100. Barden JM, Balyk R, Raso VJ, Moreau M, Bagnall K. Dynamic upper limb proprioception in multidirectional shoulder instability. Clin Orthop Relat Res. 2004:181-9.
101. Lephart SM, Myers JB, Bradley JP, Fu FH. Shoulder proprioception and function following thermal capsulorraphy. Arthroscopy. 2002;18:770-8.
102. Niessen MH, Veeger DH, Janssen TW. Effect of body orientation on proprioception during active and passive motions. Am J Phys Med Rehabil. 2009;88:979-85.
103. Erickson RIC, Karduna AR. Three-dimensional repositioning tasks show differences in joint position sense between active and passive shoulder motion. Journal of Orthopaedic Research. 2012;30:787-92.
104. Ager AL, Roy JS, Roos M, Belley AF, Cools A, Hébert LJ. Shoulder proprioception: How is it measured and is it reliable? A systematic review. J Hand Ther. 2017;30(2):221-31.
105. Balke M, Liem D, Dedy N, Thorwesten L, Balke M, Poetzl W et al. The laser-pointer assisted angle reproduction test for evaluation of proprioceptive shoulder function in patients with instability. Arch Orthop Trauma Surg. 2011;131:1077-84.
106. Duzgun I, Simsek IE, Yakut Y, Baltaci G, Uygur F. Assessing shoulder position sense using angle reproduction test in healthy individuals: A pilot study. Fizyoterapi ve Rehabilitasyon. 2011;22:240-4.
107. Lubiatowski P, Ogrodowicz P, Wojtaszek M, Kaniewski R, Stefaniak J, Dudziński W et al. Measurement of active shoulder proprioception: dedicated system and device. Eur J Orthop Surg Traumatol. 2013;23:177-83.
108. Sole G, Osborne H, Wassinger C. The effect of experimentally-induced subacromial pain on propri¬oception. Man Ther. 2015;20:166-70.
109. Dover G, Powers ME. Reliability of Joint Position Sense and Force-Reproduction Measures During Internal and External Rotation of the Shoulder. J Athl Train. 2003;38:304-10.
110. Yang JL, Chen S, Jan MH, Lin YF, Lin JJ. Proprioception assessment in subjects with idiopathic loss shoulder range of motion: Joint position sense and a novel proprioceptive feedback index. J Orthop Res. 2008;26(9):1218-24.
111. Suprak DN, Ostering LR, Donkelaar PV, Karduna AR. Shoulder joint position sense improves with external load. J Motor Behavior. 2007;39:517-25.
112. Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011;152(10):2399-404.
113. Boonstra AM, Preupe, HRS, Reneman MF, Posthumus JB, Stewart RE. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. Int J Rehabil Res. 2008;31(2), 165-9.
114. Tashjian RZ, Deloach J, Porucznik CA, Powell AP. Minimal clinically important differences (MCID) and patient acceptable symptomatic state (PASS) for visual analog scales (VAS) measuring pain in patients treated for rotator cuff disease. J Shoulder Elbow Surg. 2009;18(6):927-32.
115. Wylie JD, Suter T, Potter MQ, Granger EK, Tashjian RZ. Mental Health Has a Stronger Association with Patient-Reported Shoulder Pain and Function Than Tear Size in Patients with Full-Thickness Rotator Cuff Tears. J Bone Joint Surg Am. 2016;17;98(4):251-6.
116. Bartko JJ. The intraclass correlation coefficient as a measure of reliability. Psychol Rep. 1966;19(1):3-11.
117. Sahin E, Dilek B, Baydar M, Gundogdu M, Ergin B, Manisali M et al. Shoulder proprioception in patients with subacromial impingement syndrome. J Back Musculoskelet Rehabil. 2017;30(4):857-862.
118. Fabis J, Rzepka R, Fabis A, Zwierzchowski J, Kubiak G, Stanula A et al. Shoulder proprioception e lessons we learned from idiopathic frozen shoulder. BMC Musculoskelet Disord. 2016;17:123-31.
119. Edmonds G, Kirkley A, Birmingham TB, Fowler PJ. The effect of early athroscopic stabilization compared to nonsurgical treatment of proprioception after primary traumatic anterior shoulder dislocation. Knee Surg Sports Traumatol Arthrosc. 2003;11:116-21.
120. Lephart SM, Warner JJP, Borsa PA, Fu FH. Proprioception of the shoulder joint in healthy, unstable, and surgically repaired shoulders. J Shoulder Elbow Surg. 1994;3(6):371-381.
121. Yamamoto A1, Takagishi K, Osawa T, Yanagawa T, Nakajima D, Shitara H et al. Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elbow Surg. 2010;19(1):116-20.
122. Fukuda H. The management of partial-thickness tears of the rotator cuff. J Bone Joint Surg Br 2003;85:3–11.
123. Gumina, S. Rotator Cuff Tear: Pathogenesis, Evaluation and Treatment. 1st ed, Springer; 2017.
124. Van Harmelen V, Skurk T, Röhrig K, Lee YM, Halbleib M, Aprath-Husmann I et al. Effect of BMI and age on adipose tissue cellularity and differentiation capacity in women. Int J Obes Relat Metab Disord. 2003;27(8):889-95.
125. Lephart SM, Jari R. The role of proprioception in shoulder instability. Oper Tech Sports Med. 2002;10(1):2-4.
126. Han J, Anson J, Waddington G, Adams R. Proprioception performance of bilateral upper lower limb joints: side-general and site specific effects. Exp Brain Res. 2013;226:313-323.
127. Morgan R, Herrington L. The effect of tackling on shoulder joint positioning sense in semi-professional rugby players. Phys Ther Sport. 2014;15:176-180.
128. Vafadar AK, Côté JN, Archambault PS. Inter-rater and Intra-rater reliability and validity of three measurement methods for shoulder position sense. J Sport Rehabil. 2016;19:2014-0309.
129. Deng HR, Shih YF. Test validity and intra-rater reliability in the measurement of scapular position sense in asymptomatic young adults. Man Ther. 2015;20: 503-507.
130. Kaya D, Callaghan MJ, Donmez G, Doral MN. Shoulder joint position sense is negatively correlated with free-throw percentage in professional basketball players. Isokinet Exerc Sci. 2012;20:189-196.
131. Zanca GG, Mattiello SM, Karduna AR. Kinesio taping of the deltoid does not reduce fatigue induced deficits in shoulder joint position sense. Clin Biomech. 2015;30:903-907.
132. Lönn J, Crenshaw AG, Djupsjobacka M, Johnansson H. Reliability of position sense testing assessed with a fully automated system. Clin Physiol. 2000;20(1): 30-37.
133. Suprak DN, Osternig LR, van Donkelaar P, Karduna AR. Shoulder joint position sense improves with elevation angle in a novel, unconstrained task. J Orthop Res. 2006;24(3):559-569.
134. Ramsay JRE, RiddochMJ. Position-matching in the upper limb: professional ballet dancers perform with outstanding accurary. Clin Rehabil. 2001;15:324-30.
135. Voight ML, Hardin JA, Blackburn TA, Tippett S, Canner GC. The effects of muscle fatigue on and the relationship of arm dominance to shoulder proprioception. J Orthop Sports Phys Ther. 1996;23(6):348-353.
136. Bradley T, Baldwick C, Fischer D, Murrell GAC. Effect of taping on the shoulders of Australian football players. Br J Sports Med. 2009;43:735-738.
137. Herrington L, Horsley I, Whitaker L, Rolf C. Does a tackling task effect shoulder joint position sense in rugby players. Phys Ther Sport. 2008;9:67-71.
138. Nodehi-Moghadam A, Khaki N, Kharazmi A, Eskandari Z. A comparative study on shoulder rotational strength, range of motion and proprioception between the throwing athletes and non-athletic persons. Asian J Sports Med. 2012;4(1): 34-41.
139. Zazulak B, Cholewicki J, Reeves PN. (2008). Neuromuscular control of trunk stability: clinical implications for sports injury prevention. J Am Acad Orthop Surg. 2008;16(9):497-505.
140. Zazulak B. T, Hewett TE, Reeves NP, Goldberg B, Cholewicki J. (2007). Deficits in neuromuscular control of the trunk predict knee injury risk: prospective biomechanical-epidemiologic study. Am J Sports Med. 2007;35(7):1123-30.
141. Janwantanakul P, Magarey ME, Jones MA, Dansie BR. Variation in shoulder position sense at mid and extreme range of motion. Arch Phys Med Rehabil. 2001;82(6):840-4.
142. Guney H, Yuksel I, Kaya D, Doral MN. The relationship between quadriceps strength and joint position sense, functional outcome and painful activities in patellofemoral pain syndrome. Knee Surg Sports Traumatol Arthrosc. 2016;24(9):2966-72.
143. Kaya D, Doral MN, Nyland J, Toprak U, Turhan E, Donmez G et al. Proprioception level after endoscopically guided percutaneous Achilles tendon. Knee Surg Sports Traumatol Arthrosc. 2013;21(6):1238-44.
144. Shaffer SW, Harrison AL. Aging of the somatosensory system: a translational perspective. Phys Ther. 2007;87(2):193-207.
145. Yang JL, Jan MH, Hung CJ, Yang PL, Lin JJ. Reduced scapular muscle control and impaired shoulder joint position sense in subjects with chronic shoulder stiffness. J Electromyogr Kinesiol. 2010;20(2):206-11.
146. Goldberg BA, Nowinski RJ, Matsen FA. Outcome of nonoperative management of full-thickness rotator cuff tears. Clin Orthop. 2001:382:99–107
147. Bokor DJ, Hawkins RJ, Huckell GH, Angelo RL, Schickendantz MS. Results of nonoperative management of full-thickness tears of the rotator cuff. Clin Orthop. 1993;294:103–10.
148. Hawkins RH, Dunlop R. Nonoperative treatment of rotator cuff tears. Clin Orthop. 1995;21:178–88.
149. Felson DT, Gross KD, Nevitt MC, Yang M, Lane NE, Torner JC et al. The effects of impaired joint position sense on the development and progression of pain and structural damage in knee osteoarthritis. Arthritis Rheum. 2009;61(8):1070-6.
150. O'Sullivan PB, Burnett A, Floyd AN, Gadsdon K, Logiudice J, Miller D et al. Lumbar repositioning deficit in a specific low back pain population. Spine (Phila Pa 1976). 2003;28(10):1074-9.
151. Ibarra JM, Ge HY, Wang C, Martínez Vizcaíno V, Graven-Nielsen T, Arendt-Nielsen L. Latent myofascial trigger points are associated with an increased antagonistic muscle activity during agonist muscle contraction. J Pain. 2011;12(12):1282-8.
152. Jerosch J, Schmidt K, Prymka M. Proprioceptive capacities of patients with retropatellar knee pain with special reference to effectiveness of an elastic knee bandage. Unfallchirurg. 1997;100:719-23.
153. Koralewicz LM, Engh GA. Comparison of proprioception in arthritic and age-matched normal knees. J Bone Joint Surg. 2000;82:1582-8.
154. Roberts D, Friden T, Stomberg A, Lindstrand A, Moritz U. Bilateral proprioceptive defects in patients with a unilateral anterior cruciate ligament reconstruction: A comparison between patients and healthy individuals. J Orthop Res. 2000;18:565-71.
155. Çetinkaya O. Medial menisküs yırtıklarında propriyosepsiyon. [Uzmanlık Tezi]. Manisa: Celal Bayar Universitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı; 2005.
156. Akseki D, Akaya G, Erduran M, Pinar H. Proprioception of the knee joint in patellofemoral pain syndrome. Acta Orthop Traumatol Turc. 2008;42:316-21.
157. Bressel E, Larsen BT, McNair PJ, Cronin J. Ankle joint proprioception and passive mechanical properties of calf muscles after an Achilles tendon rupture: a comparison with matched controls. Clin Biomech. 2004;19:284–91.
158. Hortoba´gyi T, Lambert NJ, Hill JP. Greater cross education following training with muscle lengthening than shortening. Med Sci Sports Exerc. 1997;29:107–12.
159. Muellbacher W, Facchini S, Boroojerdi B, Hallett M. Changes in motor cortex excitability during ipsilateral hand muscle activation in humans. Clin Neurophysiol. 2000;111:344–9.
160. Hurley MV, Scott DL, Rees J, Newham DJ. Sensorimotor changes and functional performance in patients with knee osteoarthritis. Ann Rheum Dis. 1997;56(11):641–8.
161. Phillips D, Karduna A. No Relationship Between Joint Position Sense and Force Sense at the Shoulder. J Mot Behav. 2018;50(2):228-34.
