Scapular Mechanisms of Movement-Related Shoulder Dysfunction

项目总结 临床医生依靠运动检查来为肩部功能障碍的治疗计划提供信息。然而， 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、个性化治疗的发展。这项研究的长期目标是 是了解与运动相关的发展和肩部功能障碍的治疗。总体目标 这个项目的目的是确定肌肉激活和肩袖受压或肩袖阻塞作为替代指标 对于变形，在两个特定的肩胛骨运动组。假设是，那些 显示肩胛骨过度前倾的运动模式会使前锯齿肌相对减少 肌肉活动和相对增加的来自喙肩弓的肩袖压缩。个人 表现出肩胛骨偏侧运动模式的人下斜方肌会相对减少。 活动度和相对增加的肩袖对肩袖的阻碍。假说将通过以下方式进行检验 有两个明确的目标。1：确定肩峰胸肌在手臂上激活的不同程度 两个特定的肩胛骨运动组之间的抬高。实现这一目标的方法将是将 参与者进入基于双平面视频的头顶到达运动学的两种运动模式 射线照相术和光学运动捕捉。同时采集的肌电图会记录肌肉活动 将在不同组之间进行比较。2：确定在何种程度上 在手臂抬高过程中，两种特定的肩胛骨运动模式会导致肩峰下压迫或 肩袖的肾盂阻塞。实现这一目标的方法将是重建每个参与者的手臂 使用他们的肱骨、肩胛骨和冈上肌(肩袖)肌腱和他们特定的手臂的模型进行运动 升起运动学。当肌腱与CA弓或关节突接触时， 模型的交集将被量化为肌腱变形的替代。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 在有两种特定肩胛骨运动模式的个体中。预计这些贡献将是巨大的。 因为它们将为针对特定运动模式的临床治疗计划提供一个框架 和肌肉活动模式，应该是个体化治疗的目标。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，以及成为一名独立生物力学研究人员所需的研究技能的指导培训。 研究活动和培训将在明尼苏达大学进行。这所大学很宽敞 研究基础设施、康复科学的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训练创造了理想的环境。

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.