***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: BACKGROUND Muscle fatigue is known to decrease shoulder proprioceptive acuity , potentially contributing to injuries . It has been suggested that Kinesio taping can improve proprioception . Therefore , the aim of this study was to investigate the effects of Kinesio taping on shoulder joint position sense after muscle fatigue . METHODS Twenty-four healthy subjects were evaluated in a r and omized , crossover , single-blind study design . Shoulder joint position sense was assessed during active repositioning tests at the target angles of 50 ° , 70 ° and 90 ° of arm elevation in scapular plane , in three sessions : control ( no taping ) , Kinesio taping ( Kinesio taping applied over the deltoid muscle with tension ) and sham ( Kinesio taping applied over deltoid without tension )  . Joint position sense was assessed three times : before taping ; following taping application or rest , in the control session ; and following a fatigue protocol . The constant error ( repositioned angle-target angle ) was considered for statistical analysis , using a 3-way repeated-measure ANOVA ( within subject factors : taping , time and target angle ) . FINDINGS There was no interaction or main effect involving taping . An interaction between time and angle was found and the simple effect showed that the constant error increased following fatigue at 70 ° and 90 ° , but not at 50 ° . INTERPRETATION The results of this study does not support the use of Kinesio taping applied over the deltoid muscle for compensating or preventing shoulder joint position sense deficits caused by muscle fatigue of shoulder abductors Purpose The repetitive micro traumatic stresses placed on the athletes shoulder joint complex during the throwing motion challenge the surrounding tissues . The purpose of this study was to compare shoulder rotational strength , range of motion and proprioception between the throwing athletes and non-athletic persons . Methods Fifteen throwing athletes and 15 non-athletes participated in a nonr and om case – control study . Strength of shoulder rotational movements was tested with a h and held dynamometer . The ranges of  internal and external rotation of shoulder were measured by a st and ard goniometer . The ability of subjects to replicate the target position and kinesthetic sense was examined on the subjects ’ right shoulder by using a continuous passive motion device . Independent and paired t tests were used to statistically analyze between and within group differences . Results No significant difference was detected on the range of internal rotation between throwing athletes and non-athletic c and i date s ( P=0.3 ) . The range of external rotation was significantly more in athletic subjects ( P=0.03 ) . The results also showed that throwing athletes demonstrated a significantly higher isometric strength of shoulder external and internal rotation than the non-athletic group ( P<0.05 ) . However , the comparison of the internal and external rotation strength of dominant side in each group showed that throwing athletes showed a significant lower isometric strength of shoulder external rotation than internal rotation ( P<0.001 ) . It was also demonstrated higher joint position acuity in the throwing athletes than non athlete subjects ( P=0.01 ) . Conclusion The repetitive nature of overhead throwing and the high forces that it causes result in adaptive changes of the dominant extremity . Throwing can lead to mobility , strength and neural adaptation BACKGROUND A proper knee rehabilitation after a surgical reconstruction of the anterior cruciate ligament ( ACL ) should start immediately after the injury and it should be focused on recovery of symmetry , proprioception , swelling reduction , gait training , hyperextension exercises , and even mental preparation . AIM Aim of this study was to test a neurocognitive rehabilitative approach based on proprioceptive exercises and proper motor strategy choices , compared with conventional rehabilitation , assessing baropodometric , gait and clinical changes . DESIGN R and omized controlled trial . SETTING Ambulatory University Centre . POPULATION Fourteen subjects ( 27.9±5.2 years ) underwent to a surgical reconstruction of ACL were divided into the two groups . METHODS The subjects were r and omly assigned into a group who received a specific neurocognitive and perceptive rehabilitation treatment ( TG ) , and into a control group who received the common physical therapy ( CG ) . The following outcome measures were assessed pre-intervention , one , three and six months later : static and dynamic baropodometry , Visual Analog Scale for pain , Short Form SF-36 , Range of Motion , trophism of thigh region , edema , Manual Muscle Test , magneto-resonance imaging assessment . RESULTS Lower impairment was observed in TG in respect of CG in terms of load asymmetry during static baropodometry ( from 7 % to 3 % vs. from 10 % to 7 % , interaction time per treatment : P=0.037 ) , less wide steps during gait ( effect size=1.05 vs. 0.38 for CG ) , swelling ( treatment effect : P=0.012 ) . A significantly higher improvement ( from 35 % to 100 % ) in terms of SF-36 was recorded only in TG for physical activity ( P=0.027 ) . CG showed a quite higher walking speed ( treatment effect : P=0.049 ) . CONCLUSION Even if further studies are needed on larger sample s , the obtained results showed that a neurocognitive rehabilitative approach could be an effective treatment after ACL-reconstruction : in TG we observed a more rapid load symmetrization , the reduction of step width and a more rapid resolution of edema . CLINICAL REHABILITATION IMPACT Posture , gait , clinical features and quality of life could benefit from a neurocognitive rehabilitation after ACL surgical reconstruction Experiments were carried out to test the hypothesis that , in the absence of vision , position sense at the human forearm is generated by the combined input from muscle spindles in elbow flexor muscles and signals of central origin giving rise to a sense of effort . In a forearm position-matching task , to remove a possible contribution from the sense of effort , the reference arm was held supported at the test angle .  Subjects were less accurate in matching elbow position of the supported forearm than when it was unsupported . Adding a 2 kg weight to the unsupported reference arm led subjects to make matching errors consistent with an increase in the effort signal . Evidence of a contribution from muscle spindles was provided by showing that the direction of position matching errors could be systematic ally altered by flexion or extension conditioning of the reference arm before its placement at the test angle . Such changes in errors with conditioning could be shown to be present when the reference arm was supported , unsupported , or unsupported and weighted . It is concluded that both peripheral signals from muscle spindles and signals of central origin , associated with the motor comm and required to maintain arm position against the force of gravity , can provide information about forearm position It is hypothesized that proprioceptive information plays an important role in joint stabilization and that muscle fatigue may alter proprioceptive ability . The purpose of this study was to determine what effect shoulder muscle fatigue has on glenohumeral proprioception and to examine the relationship between arm dominance and shoulder proprioception . Eighty subjects without a history of glenohumeral pathology participated . Each was seated on an isokinetic dynamometer with a r and omly selected shoulder positioned in 90 degrees of abduction and elbow flexion . With vision blinded , the arm was passively positioned in 75 degrees of external rotation for 10 seconds , then passively returned to the neutral starting position . Three trials each of active and passive repositioning ( 2 degrees/sec ) were recorded . Following a fatigue protocol , both active and passive repositioning were reassessed . Testing order was r and omized . A significant difference was detected between pre- and post-fatigue scores . No significant difference was detected between dominant and nondominant extremities . No relationship between arm dominance and shoulder proprioception was established . It is concluded that shoulder proprioception is diminished in the presence of shoulder muscle fatigue , suggesting clinical rehabilitation protocol s must emphasize increasing muscular endurance Position sense testing has increased as a tool for augmenting evaluation of joint injury . In the present study , we investigated the inter-day reliability for four different types of position sense tests using a fully automated system . The tests included ( 1 ) passive presentation/active replication , ( 2 ) passive presentation/passive replication , ( 3 ) semi-passive presentation/semi-passive replication ( where semi-passive denotes passive movement during antagonist muscle contraction ) , and ( 4 ) active presentation/active replication . The absolute difference between presented target and replicated position was used as a measure of position sense accuracy .  Ten healthy subjects who were blindfolded and seated with the arm in a moveable rig performed the tests on two occasions , separated by 3 - 4 days . For each type of position sense test , horizontal abduction from a starting position of 0 degrees ( relative to the sagittal plane ) to target positions of 32 degrees and 64 degrees , and horizontal adduction from a starting position of 80 degrees to 48 degrees and 16 degrees were conducted . A two-way ANOVA revealed no differences in absolute error between days or between testing procedures . However , intra-class correlations ( ICC ) , which are most often used to express test-retest reliability , were moderate at best , ranging from 0.40 to 0.61 for the four types of position sense tests . Hence , the present study indicates that the ability of repositioning tests to detect alterations in proprioceptive function is limited , suggesting that their use in clinical evaluation be approached with prudence Introduction Over the last decade , proprioceptive function gained increasing attention in joint disorders such as instability of the shoulder . Common tests for evaluation of proprioception are limited by their complexity and high technical dem and s. Thus , they are hardly applicable during daily routine . Our hypothesis was that the simplified “ laser-pointer assisted angle reproduction test ” ( LP-ART ) presented here allows for clinical ly feasible assessment of proprioceptive shoulder function . Methods Active angle reproduction capability as an aspect of sensorimotor function was evaluated with the new method in patients with shoulder instability ( n = 24 ) and healthy controls ( n = 24 ) . 15 patients had traumatic , 9 non-traumatic anterior instability ( 6 bilateral ) , 17 were treated surgically , 13 non-operatively . Tests were performed in flexion and abduction in different angles ( 55 ° , 90 ° , 125 ° ) in r and omized order . Results Angle reproduction capability was worst below shoulder level ( 55 ° ) in all groups . Best results were achieved at shoulder level ( 90 ° ) . Healthy controls showed overall better results than patients with instability . Patients after surgical stabilization had better results in 55 ° and 90 ° abduction compared to instability patients before surgery . Conclusions The new LP-ART presented here is a technically simple , yet effective instrument for evaluation of the proprioceptive function of the shoulder . In contrast to former test setups it is feasible in daily routine . Compared to healthy controls , patients with unstable shoulder joints show significant proprioceptive disorders that can be quantified by the LP-ART BACKGROUND Traditional rehabilitation improves pain and function in patients with shoulder impingement syndrome .  Neurocognitive rehabilitation has shown to be highly effective after surgical reconstruction of the anterior cruciate ligament . However , its effects in patients with shoulder impingement syndrome have not yet been established . AIM The aim of the study was to compare the effects of neurocognitive therapeutic exercise , based on proprioception and neuromuscular control , on pain and function in comparison to traditional therapeutic exercise in patients with shoulder impingement syndrome . DESIGN Single-blind r and omized , non-inferiority clinical trial . SETTING Outpatient clinic of Geriatrics and Physiatrics , University Hospital . POPULATION Forty-eight patients with shoulder impingement syndrome ( Neer stage I ) and pain lasting for at least three months . METHODS Participants were r and omly allocated ( 1:1 ) to either neurocognitive therapeutic exercise or traditional therapeutic exercise . Both treatments were provided one-hour session , three times a week for five weeks . The primary outcome measure was the short form of the Disability of the Arm , Shoulder and H and Question naire ( Quick-DASH question naire ) for the assessment of physical ability and symptoms of the upper extremity . SECONDARY OUTCOME MEASURES Constant-Murley shoulder outcome score for the determination of range of motion , pain and strength ; American Shoulder and Elbow Surgeons Society st and ardized shoulder assessment form for the evaluation of physical ability in daily-living tasks ; a visual analogue scale for pain assessment at rest and during movements ; Likert score for the estimation of participant satisfaction . ENDPOINTS before treatment , end of treatment , 12 and 24 weeks after the completion of each intervention for all outcome measures , except for the Likert score that was evaluated only at the end of treatment . FOLLOW-UP 24 weeks . RESULTS At the end of treatment and at follow-up , both treatment groups experienced improvements in all outcomes measures relative to baseline values , except for the visual analogue scale at rest that was unaffected by traditional therapeutic exercise . For all outcome measures , changes over time were greater in the neurocognitive therapeutic exercise group relative to the traditional therapeutic exercise group . The level of satisfaction with treatment was higher for participants in the neurocognitive therapeutic exercise group . CONCLUSION Neurocognitive rehabilitation is effective in reducing pain and improving function in patients with shoulder impingement syndrome , with benefits maintained for at least 24 weeks . CLINICAL REHABILITATION IMPACT skills and function of the shoulder can greatly benefit from neurocognitive rehabilitation Background : Taping of the shoulder is common in many sports , particularly Australian football , a contact sport that often involves marking ( catching ) the ball overhead and has a high incidence of shoulder instability . Hypothesis : Taping of the shoulder reduces glenohumeral joint laxity and improves proprioception without impairing function . Study design : Crossover study design . Methods : 33 male players aged 18–31 years were recruited from a local Australian football club . The dominant shoulder of each player was tested with and without taping in a r and omised fashion by an examiner blinded to the presence or absence of taping . The tests were ( 1 ) inferior glenohumeral joint laxity 
    Output:
    
Conclusion : Based on the results of the included studies , the evaluation of shoulder proprioception is most reliable when using a passive protocol with an isokinetic dynamometer for internal rotation at 90 ° of shoulder abduction .