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Biomedical subjects

J Michael Wiater

Publications and source records attributed to J Michael Wiater.

6 recordsLinked to original sources
PubMed2004

Shoulder outcome measures: a comparison of 6 functional tests.

BACKGROUND: Several shoulder function scores are used in research, with no universally adopted standard. This study compares 6 shoulder outcome scales. HYPOTHESIS: Correlations exist between shoulder outcome scales, allowing conversion between scales. Shoulder scales are correlated with age. STUDY DESIGN: Regression and correlation study. METHODS: Seventy subjects with shoulder pain completed 6 shoulder outcome scales. Pearson correlations were calculated between the total scores of the 6 instruments, between the components of the scales, and with age. Regression equations were calculated between scales. RESULTS: The range of r values for total scores was 0.495 < or = r < or = 0.770, P < or = .01. In general, a scale's components were themselves highly correlated and added little new information to the scale (0.260 < or = r < or = 0.705, P < or = .05). Most of the scale scores were highly correlated with age (0.291 < or = r < or = 0.582, P < or = .05). Constant's reported corrections for age reduced (from r = -0.582 to r = -0.250, P < .05) but did not eliminate age as a confounding variable. CONCLUSIONS: Correlations exist between shoulder outcome scales, but existing shoulder scales are not equivalent in their assessments of function; they contain redundant information and, in some cases, may reflect a patient's age better than his/her shoulder function. The utility of conversion equations is minimized as a result of low to moderate correlations between scales.

Female↗
PubMed2004

Predicting shoulder strength using allometry: implications for shoulder outcome assessments.

INTRODUCTION: Shoulder strength is an integral component of shoulder function. In assessing shoulder function many functional scales rely on direct or indirect measures of strength. Strength, and thus these scales, is often highly correlated with age. We propose an allometric method for assessing shoulder strength. Allometric modeling has provided accurate predictions of biologic growth and physiologic function in both human and animal studies. Allometry utilizes the relationship between the two homologous structures on the left and right sides of the body, providing in effect an internal control and thus eliminating many confounding effects, e.g. age and level of activity. METHODS: Twenty patients with unilateral shoulder dysfunction underwent strength testing of their affected and unaffected shoulder. Strength testing of the bilateral shoulders was also assessed in twenty people without shoulder pain in order to delineate the effect of hand dominance on strength in those without shoulder pain. Absolute and predicted strength deficits of the involved shoulder were calculated via regression analysis. Pearson's correlation coefficients were computed between age and strength. RESULTS: Utilizing the contralateral extremity as an internal control eliminates age as a confounding variable in predicting strength outcomes (r = 0.093). CONCLUSION: Allometric concepts, applied to shoulder strength assessment, eliminates age as a confounding variable. Strength testing of both shoulders should be considered in the development of future shoulder outcome scales in order to eliminate the strong influence of age.

Adult↗
PubMed2004

Theory and technique of translational manipulation for adhesive capsulitis.

Manipulation of the glenohumeral joint with the patient under anesthesia has long been used as a treatment modality for refractory shoulder stiffness. Recently, translational manipulation of the glenohumeral joint under interscalene brachial plexus regional block has been shown to be efficacious in the treatment of adhesive capsulitis and to present a low risk of iatrogenic injury. The theory and technique of glenohumeral translational manipulation for the treatment of adhesive capsulitis are presented here.

Arthralgia↗
PubMedDate not supplied

An anatomic study of the humeral insertion of the inferior glenohumeral capsule.

To define inferior humeral capsular anatomy better, 12 cadaveric shoulders were dissected and an inferior capsular shift was performed. Two types of inferior humeral attachments were identified. In 7 specimens, the anterior capsular insertion bifurcated at the 8-o'clock position (on a right specimen) into a superior internal fold adjacent to the articular cartilage and an inferior external fold on the humeral surgical neck. In 5 specimens, the capsular insertion did not split but inserted over a broad area on the surgical neck. In all specimens, there was a re-confluence of the two folds at the 4-o'clock position. The inferior humeral capsular attachment may extend as far as 2 cm inferior to the articular surface and can be divided into two distinct types, split and broad, each with distinct internal and external folds of the capsule. Failure to release both of these folds limits the ability to shift the capsule superiorly by tethering the capsule inferiorly.

Adult↗
PubMedDate not supplied

Detection of acromioclavicular joint pathology in asymptomatic shoulders with magnetic resonance imaging.

The purpose of this study was to determine the prevalence of acromioclavicular joint (ACJ) arthritis with magnetic resonance imaging (MRI) evaluation in asymptomatic patients. Fifty shoulders in 42 patients were evaluated with the use of standard MRI techniques. There were 18 men and 24 women with an average age of 35 years (range, 19 to 72). ACJ arthritic changes were graded on a scale from 1 to 4 (none, mild, moderate, and severe), based on the amount of subacromial fat effacement, joint space narrowing, irregularity, capsular distension, and osteophyte formation. Forty-one (82%) of 50 shoulders had abnormalities consistent with arthritis on MRI. Patients were divided into two groups according to age: those older than 30 years and those 30 years old or younger. In the 30-and-under age group, 68% of the shoulders had arthritic changes, whereas in the over-30 age group, 93% had arthritic changes. Furthermore, in a comparison of the two groups, more advanced arthritic changes were found in the over-30 age group (P <.05). Clinical decisions to resect the ACJ should correlate the physical examination with the MRI findings because many patients may be clinically asymptomatic.

Acromioclavicular Joint↗