Neuromuscular compensation strategies adopted at the shoulder following bilateral subpectoral implant breast reconstruction.
Neuromuscular compensation strategies adopted at the shoulder following bilateral subpectoral implant breast reconstruction.
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DOI：
10.1016/j.jbiomech.2021.110348
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发表时间：
2021-05-07
影响因子：
2.4
通讯作者：
Lipps, David B.
中科院分区：
文献类型：
--
作者：
Leonardis, Joshua M.;Wolff, Whitney L.;Momoh, Adeyiza O.;Lipps, David B.
乳房切除术后立即二期胸大肌下植入体乳房再造需要手术切断胸大肌（PM）的胸肋纤维区域。PM的离断需要增加来自完整肩部肌肉组织的贡献以产生肩部扭矩。本研究旨在通过新型肌肉协同分析确定胸大肌下植入乳房再造患者采用的神经肌肉补偿策略。将14名接受双侧胸大肌下植入乳房再造（再造后>2.5年）的患者与10名健康对照进行比较。表面肌电图从16个肩部肌肉中获得，参与者在双侧五个二维手臂姿势中产生八个三维（3D）肩部扭矩。非负矩阵分解揭示了肌肉协同利用的优势和非优势肢体，和归一化的相似性指数评估组的整体协同结构的差异，每个实验组。双侧胸大肌下植入患者在优势臂和非优势臂上表现出与健康对照相似的肩部力量。我们的研究结果表明，在健康参与者和胸大肌下植入患者中，三维肩关节扭矩是由三块肩关节肌肉协同作用驱动的。在非优势臂上，三分之二的协同作用比两组之间偶然预期的更相似，而在优势臂上，只有一种协同作用比偶然预期的更相似。对3D肩关节扭矩产生背后的肌肉协同模式的更仔细分析表明，胸大肌下植入患者采用补偿性神经肌肉策略只与优势臂。
Immediate two-stage subpectoral implant breast reconstruction after mastectomy requires the surgical disinsertion of the sternocostal fiber region of the pectoralis major (PM). The disinsertion of the PM would need increased contributions from intact shoulder musculature to generate shoulder torques. This study aimed to identify neuromuscular compensation strategies adopted by subpectoral implant breast reconstruction patients using novel muscle synergy analyses. Fourteen patients treated bilaterally with subpectoral implant breast reconstruction (>2.5 years post-reconstruction) were compared to ten healthy controls. Surface electromyography was obtained from sixteen shoulder muscles as participants generated eight three-dimensional (3D) shoulder torques in five two-dimensional arm postures bilaterally. Non-negative matrix factorization revealed the muscle synergies utilized by each experimental group on the dominant and non-dominant limbs, and the normalized similarity index assessed group differences in overall synergy structure. Bilateral subpectoral implant patients exhibited similar shoulder strength to healthy controls on the dominant and non-dominant arms. Our results suggest that 3D shoulder torque is driven by three shoulder muscle synergies in both healthy participants and subpectoral implant patients. Two out of three synergies were more similar than is expected by chance between the groups on the non-dominant arm, whereas only one synergy is more similar than is expected by chance on the dominant arm. While bilateral shoulder strength is maintained following bilateral subpectoral implant breast reconstruction, a closer analysis of the muscle synergy patterns underlying 3D shoulder torque generation reveals that subpectoral implant patients adopt compensatory neuromuscular strategies only with the dominant arm.
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影响因子：
--
作者：
Bizzi, E.;Cheung, V. C. K.;Tresch, M.
通讯作者：
Tresch, M.
DOI：
10.2519/jospt.2005.35.4.227
发表时间：
2005-04-01
影响因子：
6.1
作者：
Borstad, JD;Ludewig, PM
通讯作者：
Ludewig, PM
影响因子：
2
作者：
de Freitas, Paulo Barbosa;Krishnan, Vennila;Jaric, Slobodan
通讯作者：
Jaric, Slobodan
影响因子：
3.7
作者：
Habermann, Elizabeth B.;Thomsen, Kristine M.;Boughey, Judy C.
通讯作者：
Boughey, Judy C.
影响因子：
1.5
作者：
Hage, J. Joris;van der Heeden, Jorine F.;Veeger, H. E. J.
通讯作者：
Veeger, H. E. J.