In vivo assessment of shoulder stability in dynamic rehabilitation exercises: A scoping review

• Published in: Gait & posture Vol. 116; pp. 30 - 39
• Main Authors: Ramírez-Pérez, Laura, Kerr, Graham K., Cuesta-Vargas, Antonio I.
• Format: Journal Article
• Language: English
• Published: England Elsevier B.V 01.02.2025
• Subjects: Assessment; Biomechanical Phenomena; Biomechanics; Electromyography; Exercise Therapy - methods; Humans; In vivo; Joint Instability - physiopathology; Joint Instability - rehabilitation; Shoulder; Shoulder Joint - physiology; Stability; Biomechanics; In vivo; Stability; Shoulder; Assessment
• ISSN: 0966-6362; 1879-2219; 1879-2219
• DOI: 10.1016/j.gaitpost.2024.11.010

The shoulder complex, which has the highest prevalence of instability, is currently, the subject of considerable debate regarding the methodologies used to assess shoulder stability during dynamic exercises. The primary aim is to summarize evidence on various methodologies used to evaluate shoulder stability during dynamic exercises. This scoping review included cross-sectional studies focusing on various evaluation techniques to assess shoulder forces, kinetics, and stability during dynamic movements. In analyzing each study, the selected data included population profile, sample size, exercise type, and evaluation methodology used. Twenty-seven studies with a total of 1187 subjects were included. Among the studies, various dynamic exercises were evaluated, including throwing exercises, movements with dumbbells or elastic bands, push-ups, and functional tasks. Most evaluation techniques were combined, with eleven studies using surface electromyography; seven used dynamometers to obtain direct strength measurements; two used six-force axis sensors; one utilized force platforms; and one was focused on the loss of speed using linear velocity transducers. Furthermore, motion capture systems such as high-speed cameras were used in fourteen studies. In conclusion, surface electromyography and high-speed cameras are the primary techniques for measuring muscle activity and kinetic and kinematic data. However, they do not directly measure glenohumeral stability, meaning further research is needed to develop reliable methodologies for this purpose. This study holds significant relevance in the field of shoulder instability and has clear clinical implications, as it establishes the primary tools for estimating glenohumeral stability, which could enable patient stratification and the design of optimal intervention programs based on these measurements. •Kinetic and kinematic data could be extrapolated as an indirect measure of glenohumeral stability.•The most reliable technique to evaluate stability in functional tasks is surface electromyography.•The strength measured through isokinetic dynamometers presents a direct relationship with the dynamic shoulder stability.•High-speed cameras stand out as valid instrument for the three-dimensional analysis of functionality in a complex spectrum.•There is an absence of precise and direct techniques of evaluation that could be applicable to the clinical context.