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Kinematic Mechanisms of Shoulder Impingement in SCI

SCI 中肩部撞击的运动学机制

基本信息

批准号：
6617107
负责人：
DEBORAH A NAWOCZENSKI
金额：
$ 16.64万
依托单位：
ITHACA COLLEGE
依托单位国家：
美国
项目类别：
财政年份：
2003
资助国家：
美国
起止时间：
2003-07-01 至 2006-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/6617107
关键词：
arm assistive device /technology biomechanics chronic pain clinical research human subject human therapy evaluation limb movement musculoskeletal disorder therapy paraplegia patient oriented research physical therapy rehabilitation shoulder spinal cord injury

项目摘要

DESCRIPTION (provided by applicant): Shoulder pain is a common and persistent problem among individuals with spinal cord injury (SCI), reported to range between 30 and 50% in subjects with paraplegia. The high prevalence of shoulder pain and impingement problems may be related to increased loading and the repetitive use of the upper limbs during functional tasks of daily living. Mechanisms of impingement have been linked to alterations in scapulothoracic and glenohumeral kinematics resulting in a reduction in the available subacromial space and subsequent soft tissue injury. Although faulty motion patterns have been identified in subjects with impingement syndrome without SCI, these kinematics have not been assessed during functional tasks in subjects with SCI. Further, quantitative evidence documenting specific patterns of abnormal scapular or humeral motion in directions that negatively impact the subacromial space in persons with SCI is not available. The specific aims of the current research study are to identify if detrimental three-dimensional scapulothoracic and glenohumeral kinematic patterns distinguish subjects with SCI and shoulder pain from those without shoulder pain during a weight relief raise and transfer activity. Forty subjects between the ages of 18 and 65 with a SCI resulting in paraplegia below the T2 neurological level will be recruited for the study. One half of these subjects will have a diagnosed history of shoulder pain and test positive for shoulder impingement on clinical examination. The comparison group will have no history or current symptoms of shoulder pain. Three-dimensional kinematics will be recorded using electromagnetic tracking sensors while subjects complete the weight relief raise and transfer tasks. Comparisons will be made between the groups for different phases of each task using an ANOVA model and follow-up testing. If altered scapular kinematic patterns can be identified, then interventions can be designed to modify, and more importantly, prevent further progression of these detrimental movement patterns through selective stretching and strengthening exercises

描述(由申请人提供)：肩痛是脊髓损伤(SCI)患者中常见且持续存在的问题，据报道，截瘫患者中肩痛的比例在30%至50%之间。肩痛和撞击问题的高发生率可能与负荷增加和日常生活功能任务中重复使用上肢有关。撞击的机制与肩峰胸骨和肩关节的运动学改变有关，从而导致可用肩峰下间隙的减少和随后的软组织损伤。尽管在没有脊髓损伤的撞击综合征受试者中发现了错误的运动模式，但在有脊髓损伤受试者的功能任务中还没有对这些运动学进行评估。此外，尚无定量证据记录SCI患者肩胛骨或肱骨向对肩峰下间隙产生负面影响的特定方向的异常运动模式。目前研究的具体目的是确定有害的三维肩峰和肩周骨运动学模式是否区分了在减重、举重和转移活动中有脊髓损伤和肩部疼痛的受试者和没有肩部疼痛的受试者。这项研究招募了40名年龄在18岁到65岁之间、有脊髓损伤导致的截瘫低于T2神经水平的受试者。这些受试者中有一半将有肩痛的诊断病史，并在临床检查中肩部撞击检测呈阳性。对照组将没有肩部疼痛的病史或当前症状。当受试者完成减重、举起和转移任务时，将使用电磁跟踪传感器记录三维运动学。将使用方差分析模型和后续测试对每项任务的不同阶段进行小组之间的比较。如果可以确定改变的肩胛骨运动模式，那么可以设计干预措施来改变，更重要的是，通过选择性的伸展和加强练习来防止这些有害的运动模式的进一步发展。

项目成果

期刊论文数量（3）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Effect of shoulder pain on shoulder kinematics during weight-bearing tasks in persons with spinal cord injury.

脊髓损伤患者负重任务期间肩部疼痛对肩部运动学的影响。

DOI：
10.1016/j.apmr.2012.02.034
发表时间：
2012
期刊：
Archives of physical medicine and rehabilitation
影响因子：
4.3
作者：
Nawoczenski,DeborahA;Riek,LindaM;Greco,Lindsey;Staiti,Katharine;Ludewig,PaulaM
通讯作者：
Ludewig,PaulaM

Comparative shoulder kinematics during free standing, standing depression lifts and daily functional activities in persons with paraplegia: considerations for shoulder health.

截瘫患者独立站立、站立抑郁举重和日常功能活动期间的肩部运动学比较：肩部健康的考虑因素。