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Shoulder biomechanics and rehabilitation

Research profile

In New Zealand, the societal and economic burden of musculoskeletal disorders is very high. Shoulder pain is the third most common musculoskeletal complaint, impacts on daily-living and occupational activities and can have a slow recovery. The one-month prevalence is 34%. From 2005 to 2013, the direct cost of physiotherapy interventions for shoulder injuries was $134 million ($14 million/year).

Standard exercise therapy is the first approach for the management of shoulder pain, and has moderate to strong effect on pain and function. Despite that, shoulder pain has slow recovery and only 50% of new episodes presenting full recovery within 6 months. New strategies are needed to improve the treatment effects, speed of recovery, and recurrence rates of shoulder pain.

This research programme translates findings from laboratory-based research into clinical trials. The ultimate aim of this research programme is to design and test novel shoulder rehabilitation programme, and improve the effectiveness of shoulder rehabilitation, both within New Zealand and internationally.

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Research interests

  • Clinical trials
  • Process evaluation of clinical trials
  • Systematic reviews
  • Implementation science: translating findings into healthcare services
  • Clinical biomechanics
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Publications

Castro, M.P.; Fonseca, P.; Tribuzi, S.; dos Santos, M.; Coelho, E.F.; Ribeiro, D.C.; Vilas-Boas, J.P. (2019) Functional shoulder ratios with high velocities of shoulder internal rotation are most sensitive to determine shoulder rotation torque imbalance: a cross-sectional study with elite handball players and controls. Sports Biomechanics, 2019 Feb;18(1):39-50.

Sole, G.; Mącznik, A.K.; Ribeiro, D.C.; Jaykaran, P.; Wassinger, C. (2019) Perspectives of participants with rotator cuff-related pain to a neuroscience-informed pain education session: an exploratory mixed method study. Disability and Rehabilitation (accepted).

Ho, A.J.; Cudlip, A.C.; Ribeiro, D.C.; Dickerson, C.R. (2019) Examining upper extremity muscle demand during selected push-up variants. Journal of Electromyography and Kinesiology 44, 165-172.

Ribeiro, D.C.; Belgrave, A; Naden, A.; Fang, H.; Matthews, P.; Parsthottam, S. (2018). The prevalence of myofascial trigger points in neck and shoulder-related disorders: a systematic review of the literature. BMC Musculoskeletal Disorders, 19, 252.

Tangrood, Z.J.; Gisselman, A.S.; Sole, G.; Ribeiro, D.C. (2018) Clinical course of pain and disability in patients with subacromial shoulder pain: a systematic review protocol. BMJ Open, 8:e019393. doi: 10.1136/bmjopen-2017-019393.

Hall, M.L.; Mackie, A.C.; Ribeiro, D.C. (2018). Effects of dry needling trigger point therapy in the shoulder region on patients with upper extremity pain and dysfunction: a systematic review and meta-analysis. Physiotherapy, 104 (2), 167-177.

Ribeiro, D.C.; Milosavljevic, S.; Abbott, J.H. (2017). Sample size estimation for cluster randomized controlled trials. Musculoskeletal Science and Practice, 34, 102-111.

Ribeiro, D.C.; Day, A.; Dickerson, C. R. (2017). Grade -IV inferior glenohumeral mobilization does not immediately alter shoulder and scapular muscle activity: A repeated-measures study in asymptomatic individuals. Journal of Manual and Manipulative Therapy (in press).

Ribeiro, D.C.; Sole, G.; Venkat, R.; Shemmell, J. (2017). Differences between clinician- and self-administered shoulder sustained mobilization on scapular and shoulder muscle activity during shoulder abduction: A repeated-measures study on asymptomatic individuals. Musculoskeletal Science and Practice, 30, 25-33.

Spall, P.; Ribeiro, D.C.; Sole, G. (2016). Electromyographic activity of shoulder girdle muscles in patients with symptomatic and asymptomatic rotator cuff tears: a systematic review and meta-analysis. Physical Medicine and Rehabilitation, 8, 9, 894-906. Impact Factor: 1.5.

Ribeiro, D.C.; Shemmell, J.; Falling, C.; Sole, G. (2016). Shoulder muscle activity during the modified dynamic relocation test and side-lying shoulder external rotation: a cross-sectional study on asymptomatic individuals. Journal of Manual and Manipulative Therapy, 24, 5, 277-284. Impact Factor: 0.8, H Index: 23.

Ribeiro, D.C.; Castro, M.P.; Sole, G.; Vicenzino, B. (2016). The initial effects of a sustained glenohumeral postero-lateral glide during elevation on shoulder muscle activity: a repeated measures study on asymptomatic shoulders. Manual Therapy, 22, 101-108, Impact Factor: 1.7; H Index: 57.

Castro, M.P.; Ribeiro, D.C.; Forte, F.C. ; Toledo, J.M.; Aldabe, D.; Loss, J.F. (2014). Shoulder kinematics is not influenced by external load during elevation in the scapular plane. Journal of Applied Biomechanics, 30, 66-74. H Index: 33

Toledo, J.M.; Ribeiro, D.C.; Castro, M.P.; Körbes, T.S.; Rusch, M.W.; Loss, J.F. (2013). Comparison of shoulder resultant net moment between three different exercises and load conditions. Physiotherapy Theory and Practice, 29, 2, 124-32. H Index: 23

Castro, M.P.; Ribeiro, D.C.; Forte, F.C. ; Toledo, J.M.; Krug, R.C.; Loss, J.F. (2012). Estimated force and moment of shoulder external rotation muscles: differences between transverse and sagittal plane. Journal of Applied Biomechanics, 28, 6, 701-707. H Index: 33

Wassinger, C. ; Osborne, H. ; Ribeiro, D. C. (2011). Traumatic Pneumothorax Sustained via Fine Wire Electromyography Insertion at the Shoulder. Physiotherapy, 97, 4, 357-359

Ribeiro, D.C.; Loss, J.F. (2010). 3D model for analysis of resultant proximal reaction forces and moments for the upper limb. Portuguese Journal of Sport Science, 10, 1, 137-146.

Ribeiro, D.C.; Loss, J.F.; Toledo, J.M.; Castro, M.P.; Krumholz, F.M. ; Marques, F.O. (2010) Analysis of the joint reaction forces during different shoulder movements with and without external load: a preliminary study. Portuguese Journal of Sport Science, 10, 1, 129-136.

Ribeiro, D.C.; Loss, J.F. (2010). Assessment of the propagation of uncertainty on link segment model results. Motor Control, 14, 411-423.

Ribeiro, D.C.; Toledo, J.M.; Krug, R.C.; Loss, J.F. (2009). Comparison between two models for estimation of shoulder muscles forces. Journal of Applied Biomechanics, 25, 43-53.

Forte, F.C. ; Castro, M.P.; Toledo, J.M.; Ribeiro, D. C.; Loss, J.F. (2009). Scapular kinematics and scapulohumeral rhythm during resisted shoulder abduction - Implications to the clinical practice. Physical Therapy in Sport, 10, 105-111.

Toledo, J.M.; Krug, R.C.; Castro, M.; Ribeiro, D.C.; Loss, J.F. (2008). Torque and force production during shoulder external rotation: differences between transverse and sagittal planes. Journal of Applied Biomechanics, 24, 51-57.

Castro, M.P.; Marques, F.O.; Costa, J.M.; Toledo, J.M.; Krug, R.C.; Ribeiro, D.C.; Loss, J.F. (2008). Model for force and moment prediction of shoulder external rotation muscles in the transverse plane. Portuguese Journal of Sport Science, 2, 259-270.

Ribeiro, D.C.; Estivalet, M.G.; Loss, J.F. (2008). Muscle force during shoulder abduction. Portuguese Journal of Sport Science, 8, 321-329.

Toledo, J.M.; Ribeiro, D.C.; Loss, J.F. (2007). Mechanical criterions for shoulder exercises progression. Brazilian Journal of Physical Therapy, 11, 49-56

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Conference presentations

Ribeiro, D.C.; Sole, G; Shemmell, J.; Vicenzino, B. (2018). The initial effects on shoulder muscle activity of shoulder mobilization with movement during shoulder abduction: a repeated-measures study on patients with pain-limited shoulder elevation. Oral presentation, Proceedings of the XXII Congress of the International Society of Electrophysiology & Kinesiology (ISEK), (pp. 245).

Shemmell, J.; Stinear, J.; MacKinnon, C.; Ribeiro, D.C.; Falling, C. (2018). Multiple descending pathways may contribute to the response of the gastrocnemius to transcranial magnetic stimulation. Oral presentation, Proceedings of the XXII Congress of the International Society of Electrophysiology & Kinesiology (ISEK), (pp. 7).

Ribeiro, D.C.; Sole, G.; Venkat, R.; Shemmell, J. (2017). Differences between clinician- and self-administered shoulder sustained mobilization on scapular and shoulder muscle activity during shoulder abduction: A repeated-measures study on asymptomatic individuals. Oral presentation, International Society of Biomechanics, Brisbane.

Ribeiro, D.C.; Day, A.; Dickerson, C. R. (2017) Grade -IV inferior glenohumeral mobilization does not immediately alter shoulder and scapular muscle activity: A repeated-measures study in asymptomatic individuals. Oral presentation, International Society of Biomechanics, Brisbane (to be held in July).

Ribeiro D.C.; Shemmell, J; Falling, C; Sole, G. (2015). Muscle co-contraction at the shoulder during the dynamic relocation test: a cross-sectional study with asymptomatic individuals. Oral Presentation, International Society of Biomechanics, Glasgow.

Ribeiro D.C.; Castro, M.P.; Sole, G; Vicenzino, B. (2015). The initial effects on shoulder muscle activity of sustained glenohumeral postero-lateral glide: a repeated measures study on asymptomatic shoulders. Oral Presentation, World Confederation for Physical Therapy, Singapore

Ribeiro D.C.; Shemmell, J; Falling, C; Sole, G. (2014). The dynamic relocation test: differences in muscle activity between rotator cuff and superficial shoulder muscles. Linking the chain – Physiotherapy New Zealand conference

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Research funding

Process evaluation of trials: maximising the potential for implementation
Sir Charles Hercus Health Research Fellowship (2018)

Maurice Phyllis & Paykel Trust – Travel Award (2017)
Amount: $1,500
Principal Investigator: Dr Daniel Cury Ribeiro

The efficacy of tailored rehabilitation for patients with shoulder pain: a feasibility randomized controlled trial
HRC Feasibility Trial (2017)
Amount: $ 213,067
Principal Investigator: Dr Daniel Cury Ribeiro
Co-investigators: Assoc. Prof. J Haxby Abbott, Dr Gisela Sole

Exploring the effects shoulder mobilization on scapular and shoulder muscle activities
University of Otago Research Grant (2016)
Amount: $ 20,344
Principal Investigator: Dr Daniel Cury Ribeiro
Co-investigators: Assoc. Prof. Clark R Dickerson

The efficacy of tailored rehabilitation for patients with shoulder pain: a feasibility randomized controlled trial
Physiotherapy New Zealand (PNZ) Scholarship Trust Fund (2016)
Amount: $ 4,655
Principal Investigator: Dr Daniel Cury Ribeiro
Co-investigators: Assoc. Prof. J Haxby Abbott, Dr Gisela Sole

Maurice and Phyllis Paykel Trust – Equipment Grant (2015)
Amount: $ 6,000
Principal Investigator: Dr Daniel Cury Ribeiro

Royal Society of New Zealand - James G. Hay Travel Award (2015)
Amount: $2,000
Principal Investigator: Dr Daniel Cury Ribeiro

Maurice Phyllis & Paykel Trust – Travel Award (2015)
Amount: $1,000
Principal Investigator: Dr Daniel Cury Ribeiro

Health Sciences summer research scholarship – Otago Medical Research Foundation (2014)
The initial effects of shoulder mobilization on shoulder muscle activity: a repeated-measures study in asymptomatic shoulders
Amount: $ 4,000
Supervisor: Dr Daniel Cury Ribeiro

Jack Thomson, Otago Medical Research Foundation (2014)
Shoulder muscle activity: a study on patients with pain-limited shoulder elevation
Amount: $24,455
Principal investigator: Dr Daniel Cury Ribeiro
Co-Investigators: Dr Gisela Sole, Prof. Bill Vicenzino

University of Otago Research Grant Amount (2014)
Can we optimize rotator cuff muscle activity? Exploring the effects of shoulder exercises on rotator cuff muscle control
Amount: $ 18,826
Principal investigator: Dr Daniel Cury Ribeiro
Co-Investigators: Dr Gisela Sole, Dr Jonathan Shemmell

Jack Thomson, Otago Medical Research Foundation (2013)
Can we optimize rotator cuff muscle activity? Exploring the effects of shoulder exercises on rotator cuff muscle control.
Amount: $ 10,127
Principal investigator: Dr Daniel Cury Ribeiro
Co-Investigators: Dr Gisela Sole

Health Sciences summer research scholarship – Otago Medical Research Foundation (2013)
Shoulder muscle activity during an innovative shoulder rehabilitation exercise
Amount: $ 4,000
Supervisor: Dr Daniel Cury Ribeiro

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Research students

Current

Zohreh Jafarian (PhD candidate)

Past

Abbey Patterson (Honours student – 2018)
Olivia de Ronde (Summer student – 2018)
Michelle Louise Hall (Master of Physiotherapy student – 2016)
Jun Kato (Master of Manipulative Physiotherapy student - 2015)
Ramu Venkat (Master of Manipulative Physiotherapy student - 2015)
Ashley Day (Health Sciences summer research scholarship awardee - 2014)
Carrie Falling (Health Sciences summer research scholarship awardee - 2013)

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Research Team

Principal Investigator

Dr Daniel Ribeiro

Research collaborators

Prof J Haxby Abbott (University of Otago)
A/P Gisela Sole (University of Otago)
Prof Bill Vicenzino (The University of Queensland – Australia)
Prof Clark Dickerson (University of Waterloo – Canada)
Prof Sallie Lamb (University of Oxford)
Dr Jon Shemmell (University of Wollongong)
Dr Marcelo Peduzzi de Castro (UDESC - Brazil)
Prof Jefferson Loss (UFRGS – Brazil)
Dr Joelly Toledo (UniRitter – Brazil)

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Further information

To find out more about this study please email the Project leader, Dr Dan Ribeiro daniel.ribeiro@otago.ac.nz

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