Several tools have been used to assess muscular stiffness. Myotonometry stands out as an accessible, handheld, and easy to use tool. The purpose of this review was to summarize the psychometric properties and methodological considerations of myotonometry and its applicability in assessing scapular muscles. Myotonometry seems to be a reliable method to assess several muscles stiffness, as trapezius. This method has been demonstrated fair to moderate correlation with passive stiffness measured by shear wave elastography for several muscles, as well as with level of muscle contraction, pinch and muscle strength, Action Research Arm Test score and muscle or subcutaneous thickness. Myotonometry can detect scapular muscles stiffness differences between pre- and post-intervention in painful conditions and, sometimes, between symptomatic and asymptomatic subjects.

Shoulder rehabilitation is a process that requires physical therapy sessions to recover the mobility of the affected limbs. However, these sessions are often limited by the availability and cost of specialized technicians, as well as the patient’s travel to the session locations. This paper presents a novel smartphone-based approach using a pose estimation algorithm to evaluate the quality of the movements and provide feedback, allowing patients to perform autonomous recovery sessions. This paper reviews the state of the art in wearable devices and camera-based systems for human body detection and rehabilitation support and describes the system developed, which uses MediaPipe to extract the coordinates of 33 key points on the patient’s body and compares them with reference videos made by professional physiotherapists using cosine similarity and dynamic time warping. This paper also presents a clinical study that uses QTM, an optoelectronic system for motion capture, to validate the methods used by the smartphone application. The results show that there are statistically significant differences between the three methods for different exercises, highlighting the importance of selecting an appropriate method for specific exercises. This paper discusses the implications and limitations of the findings and suggests directions for future research.

Therapeutic exercise has been considered a useful tool to rehabilitate shoulder pain, namely through its influence on scapular dynamics. Accordingly, the effectiveness of scapular therapeutic exercise needs to be explored. The present study aims to evaluate the effectiveness of scapular therapeutic exercises in shoulder pain and to identify the most effective exercise type (focal or multijoint) and ways of delivering them (as dose and progression). Search was conducted at EMBASE, Cochrane Library, MEDLINE via PubMed, Web of Science, PEDro (Physiotherapy Evidence Database), and trial registration databases. The meta-analysis considered randomized controlled/crossover trials that compared the effect of scapular exercises against other types of intervention in the shoulder pain, shoulder function, scapular motion, and/or muscular activity. The risk of bias was assessed through the PEDro scale. From the 8318 records identified, 8 (high to low risk of bias– scoring from 4 to 8 on the PEDro scale) were included. The overall data, before sensitivity analysis, indicated that the scapular therapeutic exercises are: a) more effective than comparators in improving shoulder function (standardized mean difference [SMD] = 0.52 [95% Cl: 0.05, 0.99], P = .03, I² = 76%); and b) as effective as comparators in reducing shoulder pain (SMD = 0.32 [95% Cl: −0.09, 0.73], P = .13, I² = 70%). Subgroup analysis revealed that scapular exercises are more effective in improving shoulder function when the program duration is equal to or higher than 6 weeks (SMD = 0.43 [95% Cl: 0.09, 0.76] P = .01, I² = 21%) and/or when the maximum number of exercise repetitions per session is lower than 30 (SMD = 0.79 [95% Cl: 0.15, 1.42], P = .01, I² = 77%). Only 1 study considered scapular motion as an outcome measure, revealing therapeutic exercise effectiveness to improve scapular range of motion. Intervention programs involving scapular therapeutic exercises are effective in improving shoulder function, presenting benefits when performed for 6 or more weeks and/or when used up to a maximum of 30 repetitions per exercise, per session.

The epidemiological demands of aging point to the need for characterizing older adults regarding health and disability. This systematic review aims to summarize the indicators (instruments) identifying different components of disability as a result of aging exposition in community-dwelling older adults, considering the International Classification of Functioning, Disability, and Health framework. Taking the PRISMA 2020 recommendations as a reference, studies with community-dwelling older adults, reporting the development and/or age disability modifications were included. Two reviewers analyzed the observational studies searched in the MEDLINE, CINAHL, Web of Science, Scopus, and Embase databases. Of the 137 potentially eligible studies, 49 were included in this review. Several indicators (instruments) demonstrated older adults’ disabilities according to the different domains of the ICF. Objective measures assessed Body Structures, Body Functions, and Environmental Factors and included handgrip strength (dynamometry, n = 8), cognitive function (Mini-Mental State examination, n = 7), gait speed (walk test, n = 6), and endurance (Chair stand-test, n = 4). Self-reported measures assessed Activities and Participation, but not the Body Structures, and included the basic and instrumental activities of daily living (ADL) (the Katz Index of ADL, n = 4 studies, the Lawton and Brody Instrumental ADL, n = 4 studies). The summary of the measures gathered can guide researchers and health professionals to select indicators (instruments) to assess and monitor older adults’ disabilities resulting from aging exposition, to support the development of new wearables, and to provide improvements to the existing ones, allowing the tailored assessment of different health and disability dimensions.

In chronic shoulder pain, adaptations in the nervous system such as in motoneuron excitability, could contribute to impairments in scapular muscles, perpetuation and recurrence of pain and reduced improvements during rehabilitation. The present cross-sectional study aims to compare trapezius neural excitability between symptomatic and asymptomatic subjects. In 12 participants with chronic shoulder pain (symptomatic group) and 12 without shoulder pain (asymptomatic group), the H reflex was evoked in all trapezius muscle parts, through C3/4 nerve stimulation, and the M-wave through accessory nerve stimulation. The current intensity to evoke the maximum H reflex, the latency and the maximum peak-to-peak amplitude of both the H reflex and M-wave, as well as the ratio between these two variables, were calculated. The percentage of responses was considered. Overall, M-waves were elicited in most participants, while the H reflex was elicited only in 58–75% or in 42–58% of the asymptomatic and symptomatic participants, respectively. A comparison between groups revealed that the symptomatic group presented a smaller maximum H reflex as a percentage of M-wave from upper trapezius and longer maximal H reflex latency from the lower trapezius (p < 0.05). Subjects with chronic shoulder pain present changes in trapezius H reflex parameters, highlighting the need to consider trapezius neuromuscular control in these individuals’ rehabilitation.

Neuromuscular re-education through therapeutic exercise has a determinant role in chronic shoulder pain rehabilitation. Smartphones are an interesting strategy to extend the rehabilitation to a home-based scenario as it can increase the attraction and involvement of users by providing feedback. Objective: To analyze the concurrent validity of a smartphone’s application based on 2D video analysis against the gold-standard 3D optoelectronic system for assessing movement quality during upper limb therapeutic exercises. Methods: Fifteen young adults were evaluated while executing two different shoulder exercises with a smartphone’s 2D video and a 3D optoelectronic system simultaneously in two conditions: (1) with the supervision and instructions of a physiotherapist (guided exercise), and (2) without the feedback of the physiotherapist (non-guided exercise). The data obtained during the guided and non-guided exercises were compared to calculate the movement quality index based on the approximation of the non-guided exercise to the guided exercise for the head, trunk, and shoulder’s range of movement. The agreement of the movement quality index assessed with the smartphone application and the optoelectronic system was carried out through Bland–Altman analysis. Results: The Bland–Altman analysis indicates the range of agreement and bias tendency. This tendency demonstrates that the percentage of difference between the two methods increases as the movement quality index decreases. Conclusions: There is agreement between the movement quality evaluated by a gold-standard method and the developed application, although the proposed method appears to have less sensitivity for evaluating movements with lower quality index.