---

Background and Objective: Several studies have demonstrated the importance of a coordinated, synchronized action of a scapular and glenohumeral muscles. Minimal alteration in performance and coordination of these muscles have the potential to lead to joint dysfunction. The impingement syndrome is the most common diagnosis of shoulder pain. The purpose of this study was to determine whether strength deficits could be detected in patients with shoulder impingement. Materials and Methods: This case – control study was done on 15 patients with impingement syndrome and 15 healthy matched persons by nonprobability sampling in Tehran, Iran during 2008. Strength of glenohumeral and scapulothoracic muscles was tested with a hand held dynamometer. Independent and paired t-test were used to statistically analyze between and within groups differences. Results: Compared to non impaired subjects, those with impingement syndrome demonstrated a significantly lower strength of shoulder muscles (P<0.05). The strength deficit between involved and noninvolved sides of patients was determined (P<0.05). In impingement syndrome patients, the external-to-internal rotator muscles strength ratio was significantly lower than on the control group (P<0.05). Conclusion: The result of this study suggest that strength deficit of shoulder muscles may be an important aspect of the impingement syndrome. Muscular strength assessment should be considered in evaluation and effective treatment of a patient. Physical therapy treatment should be emphasize strengthening of weak muscles.

---

Background and Objective: Proprioceptive, vestibular and visual senses control human movements. This study was carried out to compare the posture of head and shoulder in blind, deaf and ordinary pupiles. Materials and Methods: This descriptive and analytic study was done on 16 blind, 30 deaf and 60 ordinary pupiles in Ardabil city, Noth-west of Iran. Sagital and frontal planes Photos for each child was used for determination of head and shoulder deviation. Results: Forward head in blind group significantly was lower than deaf and ordinary pupiles (P<0.05). Rounded shoulder in blind and deaf pupiles significantly was lower than ordinary pupiles (P<0.05). Uneven shoulders in deaf pupiles significantly was lower than ordinary and blind children (P<0.05). Lateral flexion of the head in blind and deaf pupiles significantly was higher than ordinary children (P<0.05). Conclusion: There is a relationship between sensory impairment and postural problems paticularly in blindness Pupils.

---

Background and Objective: Four percent of fractures were happened in clavicle bone. This study was done to evaluate the outcomes of superior reconstruction plating method in middle third of clavicle fracture. Materials and Methods: This descriptive study was carried out on 31 patients with middle third of clavicle fracture in Tehran-Iran, during 2009-12. The patients were treated surgically with superior reconstruction plating method. The treatment outcomes were determined by regular follow up in constant shoulder score, duration of :::::union::::: and complications of surgery. Results: The mean value of constant shoulder score was 87.6 which are reduced by chronical age. Non :::::union::::: rate and infection occurred in 3.2% and 6.5% of subjects. Duration of :::::union::::: and pre-scapular pain is increased by chronical age. Conclusion: Superior reconstruction plating method is recommended for middle third of clavicle fractures due to low complication, high constant shoulder score and lower treatment cost.

---

Background and Objective: The shoulder joint is continuously under various pressures. Shoulder impingement syndrome is the most common problem. Stability of the shoulder is due to the interaction between static and dynamic stability which is caused through mediation of sensorimotor system (proprioception). This study was investigated to determine the effect of 6 weeks resistance training with elastic-band on proprioception in male athletes with shoulder impingement syndrome. Method: In this quasi-experimental study, 30 adult males with shoulder syndrome divided into control and interventional groups. Subjects in interventional group were received resistance exercises with elastic-band for six weeks. The shoulder joint proprioception, perior and at the end of study in 0, 45 and 90 angle were measured using isokinetic, Biodex System 3. Results: Significant improvement in the shoulder joint proprioception in 0, 45 and 90 angle were observed in interventional group in comparision with controls (P<0.05). Conclusion: Six weeks of resistance training with elastic-band improved shoulder joint proprioception of males with impingement syndrome.

---

Background and Objective: One of the most common musculoskeletal injuries in modern societies is neck and shoulder pains which often lead to postural disorders and soft tissue shortenings. This study was done to compare the length of shoulder girdle’s muscles in healthy subjects and patients with shoulder and neck pain.

Methods: This case-control study was done on16 patients with chronic neck- shoulder pain as cases and 15 healthy subjects as control group. Length of upper trapezius, pectoralis major and minor muscles was evaluated with functional tests. Also, the range of shoulder abduction and external rotation and cervical flexion and lateral flexion were measured by goniometer.

Results: Significant differences between patient and control groups were found in pectoralis major and minor muscles length in involved side (P<0.05) and also in neck active range of lateral flexion (P<0.05). Furthermore, there were significant differences between shoulder active range of abduction and external rotation (P<0.05) in the groups.

Conclusion: This study confirmed a significant reduction in range of motion in the neck and shoulder and also a remarkably shortening in the muscles of in the involved side.

---

Background and Objective: Proprioception an important role in shoulder joint function. Exercise and throat of the upper extremity are complex and skinny movements that apply a great deal of stress on the shoulder joint. This study was done to evaluate the relationship between proprioception and rotator muscles strength in dominant and non-dominant side with shoulder pain of wheelchair basketball athletes.
Methods: In this descriptive-analytic study, 50 wheelchair basketball athletes were selected in non-random sampling way from wheelchair basketball gyms from Alborz and Tehran in Iran. WUSPI, MMT system and repositioning error test with felexometere were used for assessment of shoulder pain, rotator muscles strength and proprioception respectively.
Results: There was a significant difference between dominant and non-dominant side rotators strength and proprioception (P<0.05). There was a significant relationship between internal rotators strength and proprioception in dominate side with shoulder pain (P<0.05). There was not a significant relationship between external rotators strength and proprioception in non-dominate side with shoulder pain.
Conclusion: Repeated pattern of movements in the wheelchair basketball athletes at the long time causes muscle imbalance in strength shoulder joint. It is known as a risk factor in shoulder injuries.

---

Background and Objective: Recent conservative management of sub-acromial shoulder impingement (SSI) includes general strengthening exercises, especially for internal (IR) and external (ER) shoulder rotators. Despite various studies, so far, there is no directly investigated for indicating the difference in muscle strength between patients with SSI and normal subjects. This study was done to compare the shoulder joint muscles’ strength in male students with and without SSI.
Methods: This case-control study was conducted on  Twenty-four students with SSI as case group and 24 normal students as controls.The subjects in both groups matched for hand dominance and physical activity level, completed isokinetic shoulder IR and ER testing. In the case group, 18 patients had the symptoms in their dominant and 6 patients in their non-dominant side. Both sides IR and ER of shoulder were measured separately using continuous reciprocal concentric and eccentric contraction cycles at speed of 60 and 120 degrees per second, respectively. Values of peak torque were compared between the case and control groups.
Results: There was a significant difference between the two groups only when the symptomatic SSI shoulder was the dominant shoulder. Eccentric and concentric ER peak torque at 120 degree per second (22.20±7.01, 11.36±3.36), eccentric ER peak torque at 60 degree per second (20.53±6.15) and eccentric IR peak torque at 60 degree per second and 120 degree per second were significantly lower in the symptomatic dominant shoulder case group in compared to the dominant shoulder control group (P<0.05).
Conclusion: Changes in eccentric and concentric peak torque in SSI group may be related to limb dominance, which may have implications for strengthening regimes. Therefore, clinicians and therapeutic exercise expertise may benefit from eccentric isokinetic exercises for shoulder IR and ER rotators in order to design a treatment plan for patients with SSI.

---

Background and Objective: Alteration of scapular position and motion are called scapular dyskinesis (SD), that leads to symptoms such as pain in the shoulder joint. This study was performed to determine the effect of eight weeks scapular stabilization exercises on shoulder pain of archer men with scapular dyskinesis.
Methods: In this clinical trial study 30 archer men of recurve sport field with SD and shoulder pain were randomly divided into two intervention and control groups. Shoulder pain of all subjects was evaluated by using numeric pain rating scale. Then the interventional groups were received scapular stabilization exercises in three sessions per week for eight weeks. The control group performed only their normal daily exercises. At the end of the training, post-test was performed for both groups.
Results: The results of the present study showed that after scapular stabilization exercises, the reduction of dominant shoulder pain both during exercise and at rest was significant in interventional group in compared to controls (P<0.05). But in Non-dominant shoulder, there was significant effect in pain reduction only in intergroup (P<0.05) and there was no significant effect between interventional and control groups.
Conclusion: Scapular stabilization exercises can use to reduce the pain of dominant shoulder joint of archer sport men with scapular dyskinesis.

---

Posterior shoulder fracture dislocation (PSFD) is a rare and challenging injury. Early diagnosis and treatment can prevent serious complications and disability, reducing the risk of avascular necrosis of the humeral head and joint destruction. Several treatment options have been proposed, depending on the patient’s age, duration of dislocation, humeral head bone defect, length of the metaphysis attached to the reverse Hill-Sachs, osteopenia and functional demand, and concomitant diseases. Open anatomic reduction and internal fixation is a suitable option, particularly in young and active individuals. Humeral joint replacement is recommended for non-fixable 3- or 4-part fractures, particularly in elderly individuals with low demand and osteoporosis. This article reports a case of closed, irreducible PSFD that was treated with open reduction and internal fixation using a plate and deltopectoral approach.

---

Background and Objective: Adhesive capsulitis is one of the most common shoulder disorders, particularly in diabetic patients, and its treatment has been challenging. Adhesive capsulitis begins with a gradual increase in shoulder pain, spontaneous onset, and limitation of active and passive movements of the glenohumeral joint in all directions. In 90% of cases, it responds to conservative treatment; however, if there is no symptomatic improvement after 3-6 months of conservative treatment, surgical treatment, including arthroscopic or open capsular release, should be considered. The current study aimed to compare the efficacy of non-surgical and arthroscopic treatments on shoulder function and pain in diabetic patients with adhesive capsulitis.
Methods: This quasi-experimental study was conducted on 48 diabetic patients (16 males and 32 females; mean age: 53.56±15.93 years) with adhesive capsulitis referring to the orthopedics clinic of 5th Azar Educational and Therapeutic Center in Gorgan, Iran during 2021-2022. Initially, patients were placed under the supervision of shoulder fellowship for conservative treatment for 3 months, and patients without any clinical improvement and with resistant to conservative treatments after 6 months were included in the study. Patients were voluntarily decided to be assigned to one of two treatment groups: Non-surgical (conservative treatment) and arthroscopic surgical (arthroscopic shoulder release). The functional outcomes and limitations of shoulder movement of patients were compared based on the disabilities of the arm, shoulder, and hand (DASH) score in the pre-test and after 3 and 6 months of intervention. The data were presented using descriptive statistical indices. Then, the functional outcomes and limitations of shoulder movement were evaluated.
Results: The mean shoulder function score 3 and 6 months after the intervention was lower in the arthroscopic release surgery group (45.80±19.32 and 43.10±14.12) than in the conservative treatment group (67.89±17.46 and 72.10±15.16) (P<0.05). The mean and standard deviation of symptom scores, such as pain, burning, weakness, and stiffness of the shoulder, 3 and 6 months after the intervention were lower in the arthroscopic release surgery group (12.70±5.66 and 10.02±4.06) than in the conservative treatment group (19.83±8.17 and 21.14±9.37) (P<0.05).
Conclusion: The decreased shoulder function and symptom severity at 3 and 6 months after the intervention was more effective in the arthroscopic release surgery group than in the conservative treatment group.