Comparison of glenohumeral joint kinematics between swimmers clinically classified with multidirectional instability and asymptomatic controls

Abstract

The clinical classification of glenohumeral joint instability is characterized by presumed increased humeral translations in conjunction with symptoms of instability. Prior research reports inconsistent kinematic differences in glenohumeral kinematics between individuals clinically classified with multidirectional instability and asymptomatic controls. Differing clinical classifications and motion tracking methods likely contribute to this gap. This analysis aimed to compare three-dimensional (3D) glenohumeral joint kinematics during active arm raising between individuals clinically classified with multidirectional instability and asymptomatic matched controls. Twenty competitive swimmers (13 female; mean age: 24.85; standard deviation (SD): 12.51) clinically classified with multidirectional instability via a comprehensive clinical examination and 10 asymptomatic matched controls (6 female: mean age: 24.70; SD: 7.04) were enrolled. Active, unweighted, scapular plane abduction was recorded with dynamic biplane video radiography, and glenohumeral joint kinematics were reconstructed with 2D/3D shape-matching. The variables compared between groups included: humeral position along the anterior/posterior and superior/inferior axes of the glenoid, positional dispersion of the humeral instantaneous helical axis, and humeral contact path length on the glenoid. The average humeral position between 30°-90° of glenohumeral elevation was significantly more anterior (+0.8 mm, P  < 0.001, effect size = 0.57) in individuals classified with multidirectional instability compared to controls. No other significant differences were detected. Our findings indicate that individuals classified with multidirectional instability possess significantly greater average humeral head position in the anterior direction. However, these individuals do not possess markedly different glenohumeral joint kinematics in superior/inferior humeral position, humeral instantaneous helical axis positional dispersion, or humeral contact path length compared to asymptomatic individuals during unweighted arm elevation. Further exploration is necessary to identify novel kinematic variables that accurately quantify group differences in joint stability.