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An Ultrasonographic Analysis of the Structures of the Subacromial Space, As They Relate to the Postures of Upper String Musicians Elliot V

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An Ultrasonographic Analysis of the Structures of the Subacromial Space, As They Relate to the Postures of Upper String Musicians Elliot V Marshall University Marshall Digital Scholar Theses, Dissertations and Capstones 2016 An Ultrasonographic Analysis of the Structures of the Subacromial Space, as They Relate to the Postures of Upper String Musicians Elliot V. Smithson [email protected] Follow this and additional works at: http://mds.marshall.edu/etd Part of the Musculoskeletal Diseases Commons, Musculoskeletal, Neural, and Ocular Physiology Commons, and the Sports Sciences Commons Recommended Citation Smithson, Elliot V., "An Ultrasonographic Analysis of the Structures of the Subacromial Space, as They Relate to the Postures of Upper String Musicians" (2016). Theses, Dissertations and Capstones. Paper 994. This Thesis is brought to you for free and open access by Marshall Digital Scholar. It has been accepted for inclusion in Theses, Dissertations and Capstones by an authorized administrator of Marshall Digital Scholar. For more information, please contact [email protected], [email protected]. AN ULTRASONOGRAPHIC ANALYSIS OF THE STRUCTURES OF THE SUBACROMIAL SPACE, AS THEY RELATE TO THE POSTURES OF UPPER STRING MUSICIANS A thesis submitted to the Graduate College of Marshall University In partial fulfillment of the requirements for the degree of Master of Science in Athletic Training by Elliot V. Smithson Approved by Dr. Mark K. Timmons, Committee Chairperson Dr. Gary McIlvain Dr. Elizabeth Reed Smith Marshall University May 2016 i APPROVAL OF THESIS/DISSERTATION We, the faculty supervising the work of Elliot V. Smithson, affirm that the thesis, An Ultrasonographic Analysis of the Structures of the Subacromial Space, As They Relate to the Postures of Upper string Musicians, meets the high academic standards for original scholarship and creative work established by the Master’s of Athletic Training Program and the Marshall University School of Kinesiology. This work also conforms to the editorial standards of our discipline and the Graduate College of Marshall University. With our signatures, we approve the manuscript for publication. Dr. Mark K. Timmons, PhD, ATC, School of Kinesiology, Committee Chairperson Date Dr. Gary McIlvain, EdD, ATC, LAT, School of Kinesiology Date Dr. Elizabeth Reed Smith, DMA, School of Music Date ii Copyright 2016 iii Elliot Victor Smithson ALL RIGHTS RESERVED iv ACKNOWLEDGEMENTS The author wishes to express sincere appreciation to the faculty of the Marshall University Departments of Kinesiology and Music. I would also like to thank the following people for their assistance during the course of this project: my committee members: Dr. Mark Timmons (Advisor), Dr. Gary McIlvain, and Dr. Elizabeth Reed Smith, the upper string musicians who participated in this study, and last but not least my wonderfully supportive family and friends. v CONTENTS List of Tables-------------------------------------------------------------------------------------------------xii List of Figures-----------------------------------------------------------------------------------------------xiii Abstract-------------------------------------------------------------------------------------------------------xiv Chapter 1. Introduction---------------------------------------------------------------------------------------1 Purpose------------------------------------------------------------------------------------------------1 Significance-------------------------------------------------------------------------------------------1 Null Hypothesis---------------------------------------------------------------------------------------3 Alternative Hypothesis------------------------------------------------------------------------------3 Limitations--------------------------------------------------------------------------------------------4 Delimitations------------------------------------------------------------------------------------------4 Assumptions------------------------------------------------------------------------------------------5 Major Operational Definitions----------------------------------------------------------------------5 Chapter 2. Review of Literature-----------------------------------------------------------------------------7 Introduction-------------------------------------------------------------------------------------------7 Epidemiology-----------------------------------------------------------------------------------------8 Kinesiology of Upper String Musicians---------------------------------------------------------12 Shoulder Impingement Syndrome----------------------------------------------------------------15 Systematic Reviews--------------------------------------------------------------------------------16 vi Scapular Kinematics--------------------------------------------------------------------------------18 Diagnostic Ultrasound-----------------------------------------------------------------------------19 Patient Reported Outcome Measures------------------------------------------------------------20 Significance------------------------------------------------------------------------------------------22 Further research-------------------------------------------------------------------------------------22 Chapter 3. Methods------------------------------------------------------------------------------------------23 Purpose-----------------------------------------------------------------------------------------------23 Participants------------------------------------------------------------------------------------------23 Participant Recruitment-------------------------------------------------------------------23 Participants---------------------------------------------------------------------------------24 IRB Consideration ------------------------------------------------------------------------24 Exclusion Criteria--------------------------------------------------------------------------25 Inclusion Criteria: -------------------------------------------------------------------------25 Study Design----------------------------------------------------------------------------------------25 Independent variables --------------------------------------------------------------------26 Bilateral Comparisons of AHD, Tendon Thickness, and Occupation Ratio--------------------------------------------------------------------------------26 Unilateral Comparison of the AHD in the Bow-Arm------------------------26 vii Unilateral Comparison of the AHD in the Support-Arm--------------------26 Dependent Variables----------------------------------------------------------------------26 Bilateral Comparisons of AHD, Tendon Thickness, and Occupation Ratio--------------------------------------------------------------------------------26 Unilateral Comparison of the AHD in the Bow-Arm------------------------26 Unilateral Comparison of the AHD in the Support-Arm--------------------26 Instrumentation -------------------------------------------------------------------------------------27 Procedure --------------------------------------------------------------------------------------------28 Demographics------------------------------------------------------------------------------28 Measurements------------------------------------------------------------------------------28 Special Tests--------------------------------------------------------------------------------28 Surveys--------------------------------------------------------------------------------------29 Diagnostic Ultrasound Methods------------------------------------------------------------------30 Tendon Thickness-------------------------------------------------------------------------31 Acromiohumeral Distance----------------------------------------------------------------31 Bilateral Supraspinatus Tendon Thickness---------------------------------------------32 Bilateral Resting AHD--------------------------------------------------------------------32 viii Unilateral Comparison of AHD in Bow-Arm------------------------------------------33 Unilateral Comparison of AHD in the Support-Arm---------------------------------33 Statistical Analysis---------------------------------------------------------------------------------34 Bilateral Supraspinatus Tendon Thickness---------------------------------------------34 Bilateral Resting AHD--------------------------------------------------------------------34 Occupation Ratio--------------------------------------------------------------------------35 Unilateral Comparison of AHD in Bow-Arm-----------------------------------------35 Unilateral Comparison of AHD in the Support-Arm---------------------------------35 Chapter 4. Results--------------------------------------------------------------------------------------------41 Bilateral Resting AHD-----------------------------------------------------------------------------41 Bilateral Supraspinatus Tendon Thickness------------------------------------------------------41 Occupation Ratio------------------------------------------------------------------------------------41 Unilateral Comparison of AHD in Bow-Arm---------------------------------------------------42 Unilateral Comparison of AHD in the Support-Arm------------------------------------------42 Summary of Hypothesis Testing-----------------------------------------------------------------43 Hypothesis 1: Supported-----------------------------------------------------------------43 Hypothesis 2: Not Supported-------------------------------------------------------------43 Hypothesis 3: Supported------------------------------------------------------------------43
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