Shoulder kinesthesia after anterior glenohumeral joint dislocation.

This article was presented in poster format at the Sixty-Third Annual Conference of the American Physical Therapy Association, San Antonio, TX, June 28-July 2,1987. The study was supported in part by the Montana Chapter of the American Physical Therapy Association and was submitted June 24, 1987; was with the authors for revision for 34 weeks; and was accepted June 9.1988. Reprinted from Physical Therapy with the permission of the American Physical Therapy Association. [Smith RL, Brunolli J: Shoulder kinesthesia after anterior glenohumeral joint dislocation. Phys Ther 69:106-112, 1989.]The purpose of this study was to examine kinesthesia in normal (uninjured) shoulders and in shoulders with a history of glenohumeral joint dislocations. Both shoulders of 10 healthy subjects and 8 subjects with a history of unilateral anterior dislocation were tested for accuracy of angular reproduction, threshold to sensation of movement, and end-range reproduction using a motor-driven shoulder-wheel apparatus. An analysis of variance revealed significant differences (p < 0.001) between the injured and uninjured shoulders for all three tests. Post hoc analysis showed significant differences (p < 0.02) between the involved shoulders and all uninvolved shoulders. No significant difference was found among the uninvolved shoulders. The results of this study indicate that kinesthetic deficits occur after glenohumeral dislocation and may result in abnormal neuromuscular coordination and subsequent reinjury of the shoulder. Clinicians should consider rehabilitation of shoulder kinesthesia using therapeutic activation of the shoulder joint and muscle receptors when treating patients with previous dislocations. J Orthop Sports Phys Ther 1990;11(11):507-513.