title: Shoulder limited joint mobility in people with diabetes mellitus.
abstract: BACKGROUND
  Limited joint mobility at the shoulder is an understudied problem in people with diabetes mellitus. The purpose of this study was to determine the differences in shoulder kinematics between a group with diabetes and those without diabetes.
  
  
  METHODS
  Fifty-two participants were recruited, 26 with diabetes and 26 non-diabetes controls (matched for age, BMI and sex). Three-dimensional position of the trunk, scapula and humerus were collected using electromagnetic tracking sensors during scapular plane elevation and rotation movements.
  
  
  RESULTS
  Glenohumeral external rotation was reduced by 11.1°-16.3° (P<0.05) throughout the humerothoracic elevation range of motion, from neutral to peak elevation, in individuals with diabetes as compared to controls. Peak humerothoracic elevation was decreased by 10-14°, and peak external rotation with the arm abducted was decreased 22° in the diabetes group compared to controls (P<0.05). Scapulothoracic and glenohumeral internal rotation motions were not different between the two groups.
  
  
  CONCLUSIONS
  Shoulder limited joint mobility, in particular decreased external rotation, was seen in individuals with diabetes as compared to control participants. Future research should investigate causes of diabetic limited joint mobility and strategies to improve shoulder mobility and prevent additional detrimental changes in movement and function.
authors.affiliation: Program in Physical Therapy, Washington University School of Medicine in St. Louis, USA. Electronic address: kshamata16@gmail.com.
authors.forename: Kshamata M
authors.initials: KM
authors.lastname: Shah
authors.affiliation: Program in Physical Therapy, Washington University School of Medicine in St. Louis, USA.
authors.forename: B
authors.initials: B
authors.lastname: Ruth Clark
authors.affiliation: Division of Endocrinology, Metabolism and Lipid Research, Department of Medicine, Washington University School of Medicine in St. Louis, USA.
authors.forename: Janet B
authors.initials: JB
authors.lastname: McGill
authors.affiliation: Program in Physical Therapy, Program in Occupational Therapy, Department of Neurology, Washington University School of Medicine in St. Louis, USA.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Lang
authors.affiliation: Program in Physical Therapy and Department of Radiology, Washington University School of Medicine in St. Louis, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mueller
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D003920:Diabetes Mellitus / Q000503:physiopathology*; D055590:Electromagnetic Phenomena; D005260:Female; D006801:Humans; D006811:Humerus / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009068:Movement; D016059:Range of Motion, Articular; D012399:Rotation; D012540:Scapula / Q000503:physiopathology; D012785:Shoulder Joint / Q000503:physiopathology*; D060726:Torso / Q000503:physiopathology
keywords: Diabetes mellitus; Kinematics; Limited joint mobility; Shoulder