Graichen H, Bonel H, Stammberger T, Haubner M, Rohrer H, Englmeier K H, Reiser M, Eckstein F
Anatomische Anstalt, Ludwig Maximilians Universität München, Germany.
AJR Am J Roentgenol. 1999 Apr;172(4):1081-6. doi: 10.2214/ajr.172.4.10587151.
The aim of this study was to per form a three-dimensional analysis of the width of the subacromial space during passive and active arm abduction in healthy volunteers and patients with impingement syndrome.
The shoulders of 10 healthy subjects and 10 patients with impingement syndrome were imaged with an open MR system during abduction, with and without activation of the shoulder muscles. An apparatus was designed for applying an adduction force of 10 N to the distal humerus during image acquisition, and the minimal acromiohumeral distance was measured after three-dimensional reconstruction.
In the 10 healthy volunteers, muscle activity led to a significant decrease (-32%; p < .05) of the acromiohumeral distance at 60 degrees of abduction, whereas at 120 degrees of abduction the distance was significantly increased (+44%; p < .05). In these volunteers, muscle activation caused no significant effect at 90 degrees of abduction. However, in the 10 patients with impingement syndrome, muscle activity led to a significant decrease in the width of the subacromial space compared with that of the healthy contralateral side (-68%; p < .05).
Muscle activity and arm position were found to cause systematic changes in the width of the subacromial space. However, functional deficits of the supraspinous muscle in patients with early-stage impingement syndrome were not apparent during muscle relaxation.
本研究旨在对健康志愿者和撞击综合征患者在被动和主动手臂外展过程中的肩峰下间隙宽度进行三维分析。
使用开放式磁共振成像系统对10名健康受试者和10名撞击综合征患者的肩部在手臂外展时进行成像，包括肩部肌肉激活和未激活的情况。设计了一种装置，在图像采集过程中对肱骨远端施加10 N的内收力，并在三维重建后测量最小肩峰肱骨距离。
在10名健康志愿者中，肌肉活动导致在60度外展时肩峰肱骨距离显著减小（-32%；p < 0.05），而在120度外展时该距离显著增加（+44%；p < 0.05）。在这些志愿者中，肌肉激活在90度外展时未产生显著影响。然而，在10名撞击综合征患者中，与健康对侧相比，肌肉活动导致肩峰下间隙宽度显著减小（-68%；p < 0.05）。
发现肌肉活动和手臂位置会导致肩峰下间隙宽度发生系统性变化。然而，在肌肉放松期间，早期撞击综合征患者的冈上肌功能缺陷并不明显。
