Positioning efficacy and comfort profile of shoulder support braces: A randomized repeated-measures study using three-dimensional kinematic analysis

Abstract

Background: Shoulder bracing is very common in musculoskeletal rehabilitation. Objective: In this study, the positioning efficacy of shoulder support braces was investigated by analyzing their three-dimensional kinematic properties, as well as their perceived comfort was investigated with user ratings. Study design: A randomized repeated-measures study. Methods: Seventeen asymptomatic participants were included. Scapular, humeral, and thoracic kinematics for all participants were measured using an electromagnetic tracking device in 6 experiments in randomized order: no brace, neutral brace, abduction brace, internal rotation brace, 15-degree external rotation brace (ER15-B), and 30-degree external rotation brace (ER30-B). Also, comfort ratings were obtained during each session. Results: Internal rotation brace achieved a mean of 29.34° of humerothoracic internal rotation while providing increased scapular internal rotation and upward rotation (p < 0.05). Abduction brace achieved a mean of 45.39° of humerothoracic and 39.58° of glenohumeral elevation coupled with increased scapular upward rotation, posterior tilt, and humeral internal rotation (p < 0.05). 30-Degree external rotation brace achieved a mean of 33.25° of glenohumeral external rotation and resulted in increased scapular external rotation, upward rotation, posterior tilt, and humeral external rotation (p < 0.05). Abduction brace, internal rotation brace, ER15-B, and ER30-B moved the thoracic spine into a more axial rotation in the contralateral direction. Internal rotation brace, ER15-B, and ER30-B were rated more uncomfortable when compared with the no brace condition, with no significant differences observed among the braces. Conclusions: The positioning efficacy was enhanced when an abduction pillow and external rotation wedge were applied. Selection of commercially available shoulder support braces should involve consideration of whether it can achieve the desired position and orientation as well as its comfort profile.