title: Effects of external rotation on anteroposterior translations in the shoulder: a pilot study.
abstract: BACKGROUND
  Using physical examination to make the diagnosis of shoulder instability can be difficult, because typical examination maneuvers are qualitative, difficult to standardize, and not reproducible. Measuring shoulder translation is especially difficult, which is a particular problem, because measuring it inaccurately may result in improper treatment of instability.
  
  
  OBJECTIVE
  The objective of this study was to use a magnetic motion tracking system to quantify the effects of external rotation of the abducted shoulder on a simulated simple translation test in healthy subjects. Specifically, we hypothesized that (1) increasing external rotation of the abducted shoulder would result in decreasing translation; (2) intraobserver repeatability would be less than 2 mm at all external rotation positions; and (3) mean side-to-side differences would be less than 2 mm at all external rotation positions.
  
  
  METHODS
  The intraobserver repeatability and side-to-side differences of AP translation were quantified with a noninvasive magnetic motion tracking system and automated data analysis routine in nine healthy subjects at four positions of external rotation with the arm abducted. A shoulder positioning apparatus was used to maintain the desired arm position.
  
  
  RESULTS
  No differences in translations between the positions of external rotation were found (p = 0.48). Intraobserver repeatability was 1.1 mm (SD, 0.8 mm) and mean side-to-side differences were small: 2.7 mm (SD, 2.8 mm), 2.8 mm (SD, 1.8 mm), 2.5 mm (SD, 1.8 mm), and 4.0 mm (SD, 2.6 mm) at 0°, 20°, 40°, and 60° of external rotation, respectively.
  
  
  CONCLUSIONS
  The intraobserver repeatability was strong and the side-to-side differences in translation were small with the magnetic motion tracking system, which is encouraging for development of an improved quantitative test to assess shoulder translation for fast and low-cost diagnosis of shoulder instability.
  
  
  CONCLUSIONS
  Clinicians may not have to position the contralateral, normal, abducted shoulder in precisely the same position of external rotation as the injured shoulder while performing side-to-side comparisons.
authors: Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
authors: Andrew J
authors: AJ
authors: Brown
authors: Richard E
authors: RE
authors: Debski
authors: Carrie A
authors: CA
authors: Voycheck
authors: Patrick J
authors: PJ
authors: McMahon
mesh_terms: D001331:Automation; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007593:Joint Instability / Q000175:diagnosis* / Q000503:physiopathology; D008280:Magnetics; D008297:Male; D015588:Observer Variation; D010808:Physical Examination; D010865:Pilot Projects; D011237:Predictive Value of Tests; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D012783:Shoulder Dislocation / Q000175:diagnosis* / Q000503:physiopathology; D012785:Shoulder Joint / Q000503:physiopathology*; D055815:Young Adult