title: The effects of a rotator cuff tear on activities of daily living in older adults: A kinematic analysis.
abstract: Rotator cuff tears (RCT) in older individuals may compound age-associated physiological changes and impact their ability to perform daily functional tasks. Our objective was to quantify thoracohumeral kinematics for functional tasks in 18 older adults (mean age=63.3±2.2), and compare findings from nine with a RCT to nine matched controls. Motion capture was used to record kinematics for 7 tasks (axilla wash, forward reach, functional pull, hair comb, perineal care, upward reach to 90°, upward reach to 105°) spanning the upper limb workspace. Maximum and minimum joint angles and motion excursion for the three thoracohumeral degrees of freedom (elevation plane, elevation, axial rotation) were identified for each task and compared between groups. The RCT group used greater minimum elevation angles for axilla wash and functional pull (p≤0.0124) and a smaller motion excursion for functional pull (p=0.0032) compared to the control group. The RCT group also used a more internally rotated maximum axial rotation angle than controls for functional reach, functional pull, hair comb, and upward reach to 105° (p≤0.0494). The most differences between groups were observed for axial rotation, with the RCT group using greater internal rotation to complete functional tasks, and significant differences between groups were identified for all three thoracohumeral degrees of freedom for functional pull. We conclude that older adults with RCT used more internal rotation to perform functional tasks than controls. The kinematic differences identified in this study may have consequences for progression of shoulder damage and further functional impairment in older adults with RCT.
authors.affiliation: Exercise Science and Health Promotion, Arizona State University, Phoenix, AZ, USA. Electronic address: mvidt@asu.edu.
authors.forename: Meghan E
authors.initials: ME
authors.lastname: Vidt
authors.affiliation: Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Winston-Salem, NC, USA; Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, USA.
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Santago
authors.affiliation: Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Marsh
authors.affiliation: Department of Physical Therapy, High Point University, High Point, NC, USA.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Hegedus
authors.affiliation: Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Tuohy
authors.affiliation: Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Gary G
authors.initials: GG
authors.lastname: Poehling
authors.affiliation: Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Freehill
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Miller
authors.affiliation: Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, USA.
authors.forename: Katherine R
authors.initials: KR
authors.lastname: Saul
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D008297:Male; D055595:Mechanical Phenomena; D008875:Middle Aged; D009068:Movement; D016059:Range of Motion, Articular; D012399:Rotation; D017006:Rotator Cuff / Q000503:physiopathology; D000070636:Rotator Cuff Injuries
keywords: Aging; Kinematics; Rotator cuff tear; Thoracohumeral; Upper limb