Scapular Mechanisms of Movement-Related Shoulder Dysfunction

运动相关肩部功能障碍的肩胛机制

• 批准号: 10634496
• 负责人: GAURA SAINI
• 金额: $ 4.56万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10634496
• 关键词: 3-Dimensional; Activities of Daily Living; Address; Affect; Anatomy; Animal Model; Anterior; Aptitude; Biofeedback Training; Biomechanics; Classification; Clinical; Clinical Treatment; Data; Decision Making; Denervation; Development; Disease; Dyskinetic syndrome; Economic Burden; Electromyography; Environment; Evaluation; Exercise; Fellowship; Functional disorder; Goals; Grouping; Head; Impairment; Individual; Joint structure of shoulder region; Joints; Laboratories; Link; Literature; Mechanics; Medical Imaging; Mentors; Mentorship; Minnesota; Mission; Modeling; Motion; Movement; Muscle; Musculoskeletal; Nerve; Obstruction; Optics; Outcome; Paralysed; Participant; Patients; Pattern; Positioning Attribute; Proxy; Public Health; Quality of life; Recovery; Recreation; Rehabilitation therapy; Research; Research Activity; Research Infrastructure; Research Personnel; Research Training; Rotator Cuff; Science; Shoulder; Statistical Data Interpretation; Structure; Surface; Tendon structure; Testing; Training; United States National Institutes of Health; Universities; Work; arm; career; clinical examination; effective intervention; effective therapy; evidence base; humerus; improved; in vivo; individualized medicine; joint loading; kinematics; laboratory experience; multidisciplinary; precision medicine; programs; radiological imaging; rehabilitation science; scapula; skills; supraspinatus muscle; trapezius muscle; treatment planning

PROJECT SUMMARY Clinicians rely on examination of movement to inform treatment planning for shoulder dysfunction. However, the links between scapular movement abnormalities, muscle activation, and rotator cuff deformation remain unclear, limiting the development of precise, individualized treatment of each patient. The long-term goal of this research is to understand movement-related development and treatment of shoulder dysfunction. The overall objectives for this project are to identify muscle activation and rotator cuff compression or glenoid obstruction, as proxies for deformation, in two specific scapular movement groups. The hypotheses are that individuals who demonstrate an excessive scapular anterior tilt movement pattern will have relatively reduced serratus anterior muscle activity and relatively increased rotator cuff compression from the coracoacromial (CA) arch. Individuals who demonstrate a scapular lateralization movement pattern will have relatively reduced lower trapezius muscle activity and relatively increased rotator cuff obstruction from the glenoid. The hypotheses will be tested through two specific aims. 1: Determine the extent to which scapulothoracic muscle activation differs during arm elevation between two specific scapular movement groups. The approach for this aim will be to classify participants into the two movement patterns based on overhead reaching kinematics derived from biplane video radiography and optical motion capture. Simultaneously collected electromyography will record muscle activity of key scapulothoracic muscles which will be compared between groups. 2: Determine the extent to which two specific scapular movement patterns during arm elevation result in subacromial compression or glenoid obstruction of the rotator cuff. The approach for this aim will be to recreate each participant’s arm motion using models of their humerus, scapula, and supraspinatus (rotator cuff) tendon and their specific arm raising kinematics. In instances when the tendon and the CA arch or glenoid make contact, the volume of intersection of the models will be quantified as a proxy for tendon deformation. This proposed research will contribute to science through the elucidation of patterns of muscle activation and rotator cuff tendon deformation in individuals with two specific scapular movement patterns. These contributions are expected to be significant because they will provide a framework for clinical treatment planning with regard to specific movement patterns and muscle activity patterns that should be targeted for individualized treatment. This proposed study is part of a fellowship training plan including medical imaging and advanced statistical analysis coursework, guided lab training, and mentored training in research skills needed to become an independent biomechanical researcher. Research activities and training will take place at the University of Minnesota. The University’s expansive research infrastructure, the multi-disciplinary Program in Rehabilitation Science, and the Minnesota Rehabilitation Biomechanics Laboratory create an ideal environment for completing this research and training.

项目概要 临床医生依靠运动检查来制定肩部功能障碍的治疗计划。然而， 肩胛运动异常、肌肉激活和肩袖变形之间的联系仍不清楚， 限制了对每位患者进行精确、个体化治疗的发展。本研究的长期目标 是了解肩部功能障碍的运动相关发展和治疗。总体目标 该项目的目标是确定肌肉激活和肩袖压缩或关节盂阻塞，作为代理 对于变形，在两个特定的肩胛运动组中。假设是那些 表现出肩胛骨过度前倾的运动模式将导致前锯肌相对减少 肌肉活动和来自喙肩峰 (CA) 弓的肩袖压力相对增加。个人 表现出肩胛骨偏侧化运动模式的人，下斜方肌会相对减少 活动和肩关节盂阻塞相对增加。假设将通过以下方式进行检验 两个具体目标。 1：确定手臂期间肩胛胸肌激活的差异程度 两个特定肩胛运动组之间的抬高。实现这一目标的方法是分类 参与者根据双翼飞机视频导出的头顶伸展运动学了解两种运动模式 放射线照相和光学动作捕捉。同时采集的肌电图将记录肌肉活动 将在组间进行比较的关键肩胛胸肌。 2：确定程度 手臂抬高过程中两种特定的肩胛骨运动模式会导致肩峰下压缩或 肩袖的关节盂阻塞。实现这一目标的方法是重新创建每个参与者的手臂 使用肱骨、肩胛骨和冈上肌（肩袖）肌腱及其特定手臂的模型进行运动 提高运动学。在肌腱与 CA 弓或关节盂接触的情况下， 模型的交集将被量化为肌腱变形的代表。这项拟议的研究将 通过阐明肌肉激活和肩袖肌腱变形的模式为科学做出贡献 具有两种特定肩胛运动模式的个体。这些贡献预计将是巨大的 因为它们将为针对特定运动模式的临床治疗计划提供框架 以及应针对个体化治疗的肌肉活动模式。这项拟议的研究是 奖学金培训计划，包括医学成像和高级统计分析课程、指导实验室 培训，并指导成为独立生物力学研究员所需的研究技能培训。 研究活动和培训将在明尼苏达大学进行。大学的广阔 研究基础设施、康复科学多学科计划和明尼苏达州 康复生物力学实验室为完成这项研究和培训创造了理想的环境。