Alteration in Shoulder Kinematics and Associated Muscle Activity in People With Idiopathic Scoliosis
Alteration in Shoulder Kinematics and Associated Muscle Activity in People With Idiopathic Scoliosis
复制标题
DOI：
10.1097/brs.0b013e3181cd5923
复制
发表时间：
2010-05-15
期刊：
影响因子：
3
通讯作者：
Tsauo, Jau-Yih
中科院分区：
文献类型：
--
作者：
Lin, Jiu-Jenq;Chen, Wei-Hsiu;Tsauo, Jau-Yih
研究设计。一项关于青少年特发性脊柱侧凸(IS)的横断面对照研究。目的：评估IS患者是否存在肩部功能障碍及相关的肩部运动学和肌肉活动障碍。有证据表明，肩部运动学与肩部疼痛和功能障碍有关。尽管与肩部运动学改变相关的发病率可能发生在IS受试者中，但还没有发表报告来解决这一假说。在这项研究中，使用三维电磁跟踪器和肌电图仪评估了13名女性IS患者和13名年龄性别占优势的手匹配对照的肩部运动学和相关肌肉活动[上斜方肌(UT)、下斜方肌(LT)、前锯肌(SA)和中三角肌(MD)]。此外，对两组患者的自评肩关节屈曲功能量表(FLEX-SF)进行评定。IS患者的FLEX-SF评分低于对照组(P=0.01)。在凸侧，肩胛骨在静息状态下有更多的前倾(P=0.006)。凹侧在静息状态下肩胛骨向上旋转较多(P=0.01)。在肌电波幅方面，凸侧LT收缩活动较高，凹侧LT和SA收缩活动较低(P=0.007.0 5和<0.0 1)。运动时肩关节后倾角与FLEX-SF功能评分呈中度正相关(R=0.51)。LT肌肉活动度与Flex-SF功能评分呈中度负相关(R=-0.54)。考虑到IS的渐进性和胸椎、肩胛骨和手臂之间的运动学联系，IS患者在康复计划中需要考虑IS凸侧不充分的后倾倒运动和高LT肌肉活动。
Study Design. A cross-sectional control- matched study in adolescents with idiopathic scoliosis (IS).Objective. To evaluate whether subjects with IS had shoulder dysfunction and associated impairment in shoulder kinematics and muscular activation.Summary of Background Data. Evidence indicates that shoulder kinematics are related to shoulder pain and dysfunction. Despite the degree of morbidity associated with altered shoulder kinematics likely to occur in subjects with IS, no report has been published to address this hypothesis.Methods. In this investigation, shoulder kinematics (scapular tipping, scapular upward rotation, and scapulohumeral rhythm) and associated muscular activities [upper trapezius (UT), lower trapezius (LT), serrantus anterior (SA), and middle deltoid (MD)] were evaluated with a 3-dimensional electromagnetic tracking device and electromyography during arm elevations in 13 female subjects with IS and 13 age-gender-dominant hand-matched controls. Additionally, self-reported Flexilevel Scale of Shoulder Function (FLEX-SF) was evaluated between the 2 groups.Results. Subjects with IS demonstrated lower FLEX-SF scores than the controls (P = 0.01). For the convex side, more anterior tilt of the scapula in resting position was identified (P = 0.006). For the concave side, more scapular upward rotation in resting position was identified (P = 0.01). For the EMG amplitude, higher LT contraction activity on the convex side and lower LT and SA contraction activity on the concave side were established (P = 0.007 and less than 0.01, respectively). A moderate positive association was found between scapular posterior tipping during movement and FLEX-SF functional score (R = 0.51). A moderate negative association was found between LT muscular activity and FLEX-SF functional score (R = -0.54).Conclusion. Given the progressive nature of IS and kinematic linkage among the thoracic spine, scapula, and arm, inadequate posterior tipping movement and high LT muscular activity on the convex side of IS are important to consider in rehabilitation programs for subjects with IS.