Muscle compensation strategies to maintain glenohumeral joint stability with increased rotator cuff tear severity: A simulation study
Muscle compensation strategies to maintain glenohumeral joint stability with increased rotator cuff tear severity: A simulation study
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DOI：
10.1016/j.jelekin.2019.07.005
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发表时间：
2022-01-21
影响因子：
2.5
通讯作者：
Vidt, Meghan E.
中科院分区：
文献类型：
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作者：
Khandare, Sujata;Arce, Richard A.;Vidt, Meghan E.
老年人的肩袖撕裂 (RCT) 可能会导致肌肉力量下降，破坏盂肱关节的力量平衡，从而损害关节稳定性。我们的目标是使用计算模型确定 RCT 严重程度的增加如何影响盂肱关节负荷和肌肉激活模式。肌肉体积测量用于衡量标称上肢模型的峰值等长肌肉力量，以代表平均老年男性的力量产生特征。 RCT 严重程度的增加表现为冈上肌、冈下肌和肩胛下肌的峰值等长肌力的系统性降低。评估了肩胛骨和额状面的五种静态姿势。结果显示，在肩胛骨和额状面中，盂肱关节接触力峰值在 RCT 严重程度增加的情况下保持相对一致（平均变化分别为 1.5% 和-4.2%），并且即使在大规模 RCT 模型中，横向力偶也保持相对平衡。完整肌肉（如小圆肌）的预测肌肉激活随着 RCT 严重程度的增加而增加（肩胛骨和额叶面平均分别为 5-30% 和 4-17%）。这表明，即使有严重的 RCT，系统也会优先考虑盂肱关节的稳定性，并且未受影响的肌肉发挥代偿作用，帮助稳定关节。
Rotator cuff tear (RCT) in older adults may cause decreased muscle forces and disrupt the force balance at the glenohumeral joint, compromising joint stability. Our objective was to identify how increased RCT severity affects glenohumeral joint loading and muscle activation patterns using a computational model. Muscle volume measurements were used to scale a nominal upper limb model's peak isometric muscle forces to represent force generating characteristics of an average older adult male. Increased RCT severity was represented by systematically decreasing peak isometric muscle forces of supraspinatus, infraspinatus, and subscapularis. Five static postures in both scapular and frontal planes were evaluated. Results revealed that in both scapular and frontal planes, the peak glenohumeral joint contact force magnitude remained relatively consistent across increased RCT severity (average 1.5% and-4.2% change, respectively), and a relative balance of the transverse force couple is maintained even in massive RCT models. Predicted muscle activations of intact muscles, like teres minor, increased (average 5-30% and 4-17% in scapular and frontal planes, respectively) with greater RCT severity. This suggests that the system is prioritizing glenohumeral joint stability, even with severe RCT, and that unaffected muscles play a compensatory role to help stabilize the joint.