Scapular Mechanisms of Movement-Related Shoulder Dysfunction

项目摘要 临床医生依靠运动检查来制定肩关节功能障碍的治疗计划。但 肩胛骨运动异常、肌肉激活和肩袖变形之间的联系尚不清楚， 限制了对每个患者进行精确的、个性化的治疗。这项研究的长期目标是 是了解运动相关的发展和治疗肩功能障碍。总体目标 这个项目的目的是识别肌肉激活和肩袖压迫或关节盂阻塞，作为代理 在两个特定的肩胛骨运动组中进行变形。假设是， 证明过度的肩胛骨前倾运动模式将具有相对减少的前锯肌 肌肉活动和相对增加的来自喙肩（CA）弓的肩袖压迫。 显示肩胛骨偏侧运动模式的患者的下斜方肌相对减少 活动和相对增加的肩袖阻塞从关节盂。这些假设将通过 两个具体目标。1：确定手臂运动期间肩胛胸肌激活的不同程度 两个特定肩胛骨运动组之间的抬高。实现这一目标的方法是将 基于从双平面视频导出的头顶到达运动学，将参与者分成两种运动模式 射线照相术和光学运动捕捉。同时收集的肌电图将记录肌肉活动 将在组间进行比较。2：确定在多大程度上 在手臂抬高过程中，两种特定的肩胛骨运动模式导致肩峰下压迫， 肩袖关节盂阻塞实现这一目标的方法将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 提升运动学。在肌腱和CA弓或关节盂接触的情况下， 模型的交叉将被量化为肌腱变形的代理。这项研究将 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 有两种特定肩胛骨运动模式的人预计这些贡献将是巨大的 因为它们将提供关于特定运动模式的临床治疗计划的框架 以及应该针对个性化治疗的肌肉活动模式。这项研究是 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，并指导培训的研究技能需要成为一个独立的生物力学研究人员。 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，康复科学的多学科计划，以及明尼苏达州 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。

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.