Sensorimotor control deficiency in recurrent anterior shoulder instability assessed with a stabilometric force platform.

Edouard P1, Gasq D2, Calmels P3, Degache F4.

Abstract
BACKGROUND:
Deficiencies in both afferent proprioceptive information and efferent motor responses have been independently reported in patients with recurrent anterior shoulder instability. We used a validated force platform method to analyze the association between the stabilometric parameters of the upper limb as representative of the shoulder's sensorimotor control and clinical glenohumeral joint instability.

METHODS:
We enrolled 32 patients with unilateral recurrent anterior post-traumatic shoulder dislocation, on the dominant side in 13 patients (DIG) and the non-dominant side in 19 patients (NDIG) and 16 healthy nonathletic subjects (CG). Displacements of the Center of Pressure were measured by a Win-Posturo Medicapteurs force platform in the upper limb weight-bearing position with the lower limbs resting on a table up to the anterior superior iliac spines. The association between stabilometric values and clinical shoulder instability was analyzed by side-to-side comparisons and comparisons to a control group.

RESULTS:
For CG and NDIG, there were no side-to-side differences. For DIG, stabilometric values were significantly higher on the dominant pathological shoulder side than on the healthy contralateral non-dominant side (P < .01). The percentage of side-to-side differences was higher in DIG than CG (P < .01).

CONCLUSION:
Sensorimotor control deficiency was associated with recurrent anterior shoulder instability, especially in patients with the pathological shoulder on their dominant side. Using a force platform to assess sensorimotor control of the shoulder is feasible in patients with shoulder instability, and can allow assessment of the global sensorimotor control deficiency present in unstable shoulders.

Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

KEYWORDS:
Stabilometry; center of pressure; dislocation; metrology; neuromuscular control; shoulder assessment; shoulder instability

PMID: 24007652 DOI: 10.1016/j.jse.2013.06.005
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