Translations of the humerus in persons with shoulder impingement symptoms
Translations of the humerus in persons with shoulder impingement symptoms
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DOI：
10.2519/jospt.2002.32.6.248
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发表时间：
2002-06-01
影响因子：
6.1
通讯作者：
Cook, TA
中科院分区：
文献类型：
--
作者：
Ludewig, PM;Cook, TA
研究设计：协方差和相关分析的两组混合模型分析。目的：确定有肩部撞击症状的患者与无症状对照组之间肱骨平移是否存在差异，如果存在，则确定肩部活动范围（ROM）测量是否与异常平移相关。背景：肱骨头的异常平移被认为会减少可用的肩峰下空间，并导致肩部撞击症状的发生或进展。这些异常平移也被理论认为与后囊紧缩和肩关节活动度降低有关。 方法和测量：在无负载、2.3 公斤和 4.6 公斤手负载条件下，在肩胛平面上抬高手臂时，对有症状的建筑工人和无症状对照组进行三维肱骨平移跟踪。对 3 个运动阶段（30 度 - 60 度、60 度 - 90 度和 90 度 - 120 度）进行组间比较，并通过 Pearson 相关分析确定肱骨平移与跨体内收和肩部内旋 ROM 测量之间的关联。 结果：有肩部症状的人在肱骨前后平移方面表现出微小但显着的变化。肱骨抬高 90 度 - 120 度阶段的这些变化与可用的跨体内收 ROM 呈中度负相关。结论：所确定的运动学偏差与肩峰下间隙可能的减小一致。有必要进一步研究后囊紧度、肩袖功能和异常肱骨平移之间的关系，以更好地描述可能导致肩部撞击症状的潜在运动机制并完善康复技术。
Study Design: Two-group mixed-model analysis of covariance and correlation analysis.Objectives: To determine whether differences in humeral translations exist between patients with shoulder impingement symptoms and an asymptomatic comparison group, and if so, to determine if shoulder range-of-motion (ROM) measures are associated with abnormal translations.Background: Abnormal translations of the humeral head are believed to reduce the available subacromial space and to contribute to the development or progression of shoulder impingement symptoms. These abnormal translations have also been theorized to be related to tightness of the posterior capsule and decreased shoulder ROM.Methods and Measures: Three-dimensional humeral translations were tracked in symptomatic construction workers and an asymptomatic comparison group while elevating the arm in the scapular plane under no-load, 2.3-kg, and 4.6-kg hand-load conditions. Between-group comparisons were made across 3 phases of motion (30degrees-60degrees, 60degrees-90degrees, and 90degrees-120degrees) and the association between humeral translations and cross-body adduction and shoulder internal rotation ROM measures were determined by Pearson correlation analysis.Results: Persons with shoulder symptoms demonstrated small but significant changes in anterior-posterior translations of the humerus. These changes for the 90degrees-120degrees phase of humeral elevation were moderately negatively associated with available cross-body adduction ROM.Conclusions: The identified kinematic deviations are consistent with possible reductions of the subacromial space. Further study of relationships between posterior capsule tightness, rotator cuff function, and abnormal humeral translations is warranted to better delineate underlying kinematic mechanisms that may contribute to shoulder impingement symptoms and to refine rehabilitation techniques.