Comparing supraspinatus to acromion proximity and kinematics of the shoulder and thorax between manual wheelchair propulsion styles: A pilot study
Comparing supraspinatus to acromion proximity and kinematics of the shoulder and thorax between manual wheelchair propulsion styles: A pilot study
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DOI：
10.1016/j.clinbiomech.2020.01.016
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发表时间：
2020-04-01
影响因子：
1.8
通讯作者：
Cloud-Biebl, Beth A.
中科院分区：
文献类型：
--
作者：
Madansingh, Stefan, I;Fortune, Emma;Cloud-Biebl, Beth A.
背景资料：在手动轮椅推进过程中重复的盂肱关节运动与脊髓损伤患者的肩痛有关。肩关节健康维护的临床指南鼓励半圆弧推进，以减少负载频率。本研究旨在确定估计冈上肌肩峰压缩风险，肩，胸部运动学之间的差异（1）弧和半圆形推进;和（2）自我选择和教练strategies.Methods：肩和胸部运动学轮椅推进过程中被捕获，注意个别自我选择的风格。然后指导参与者表演其他感兴趣的风格，弧形和/或半圆形。肱骨和肩胛骨的CT骨模型使用盂肱运动学进行动画，以估计冈上肌肱骨附件和肩峰之间的最小距离。压缩风险被定义为每个推进阶段的最小距离低于5 mm的比例。评估压缩风险，最小距离和运动学在整个propulsion.Findings事件之间的条件进行了比较：10个人与脊髓损伤（9名男性）参加。弧形和半圆形推进在压缩风险或推进阶段的最小距离方面没有显着差异。与教练风格相比，自选风格产生了较低的压缩风险和较大的接近值。弧形和半圆形推进的盂肱关节水平外展和胸廓屈曲不同。多个盂肱和humerothoracic的差异之间出现了自我选择和coached conditions.Interpretation：冈上肌压缩过程中观察到的弧和半圆推进，这表明风险可能是不可避免的，在这项任务。自我选择的风格产生的风险较小，可能与教练风格不熟悉有关。
Background: Repetitive glenohumeral joint movement during manual wheelchair propulsion has been associated with shoulder pain in individuals with spinal cord injury. Clinical guidelines for shoulder health maintenance encourage semi-circular over arc propulsion to reduce loading frequency. This study aimed to determine the difference in estimated supraspinatus to acromion compression risk, and shoulder, thorax kinematics between (1) arc and semi-circular propulsion; and (2) self-selected and coached strategies.Methods: Shoulder and thorax kinematics were captured during wheelchair propulsion, noting individually self-selected styles. Participants were then coached to perform the other style(s) of interest, arc and/or semi-circular. CT bone models of the humerus and scapula were animated using glenohumeral kinematics to estimate the minimum distance between the supraspinatus humeral attachment and the acromion. Compression risk was defined as the proportion of each propulsion phase where the minimum distance fell below 5 mm. Comparisons were made between conditions evaluating compression risk, minimum distances and kinematics at events throughout propulsion.Findings: Ten individuals with spinal cord injury (9 male) participated. Arc and semi-circular propulsion did not significantly differ in compression risk or minimum distance across propulsion phases. Self-selected styles yielded lower compression risk and larger proximity values compared to coached styles. Glenohumeral horizontal abduction and thorax flexion differed between arc and semi-circular propulsion. Multiple glenohumeral and humerothoracic differences emerged between self-selected and coached conditions.Interpretation: Supraspinatus compression was observed during both arc and semi-circular propulsion, suggesting risk may be unavoidable in this task. Self-selected styles yield less risk, likely related to coached style unfamiliarity.