使用电磁跟踪设备测量肩周炎患者的三维肩部运动模式。
Measurement of three dimensional shoulder movement patterns with an electromagnetic tracking device in patients with a frozen shoulder.
作者信息
Vermeulen H M, Stokdijk M, Eilers P H C, Meskers C G M, Rozing P M, Vliet Vlieland T P M
机构信息
Department of Physical Therapy and Occupational Therapy, Leiden University Medical Centre, The Netherlands.
出版信息
Ann Rheum Dis. 2002 Feb;61(2):115-20. doi: 10.1136/ard.61.2.115.
OBJECTIVE
To compare three dimensional movement patterns of the affected and non-affected shoulder in patients with a frozen shoulder before and after physical therapy.
METHODS
Patients with a unilateral frozen shoulder were assessed before and after three months of treatment. Three dimensional movement analysis was performed with the "Flock of Birds" electromagnetic tracking device while the patient raised their arms in three directions. Slopes of the regression lines of glenohumeral joint rotation versus scapular rotation, reflecting the scapulohumeral rhythm, were calculated. All assessments were made for both the affected and the unaffected side. Additional assessments included conventional range of motion (ROM) measurements and visual analogue scales (VAS) (0-100 mm) for shoulder pain at rest, during movement, and at night.
RESULTS
Ten patients with a unilateral frozen shoulder were included. The slopes of the curves of the forward flexion, scapular abduction, and abduction in the frontal plane of the affected and the unaffected side were significantly different in all three movement directions. Mean differences were 0.267, 0.215, and 0.464 (all p values <0.005), respectively. Mean changes of the slopes of the affected side after treatment were 0.063 (p=0.202), 0.048 (p=0.169), and 0.264 (p=0.008) in forward flexion, scapular abduction, and abduction in the frontal plane, respectively. All patients showed significant improvement in active ROM (all p<0.005), and the VAS for pain during movement and pain at night (p<0.05).
CONCLUSIONS
With a three dimensional electromagnetic tracking system the abnormal movement pattern of a frozen shoulder, characterised by the relatively early laterorotation of the scapula in relation to glenohumeral rotation during shoulder elevation, can be described and quantified. Moreover, the system is sufficiently sensitive to detect clinical improvements. Its value in other shoulder disorders remains to be established.
目的
比较肩周炎患者在物理治疗前后患侧与非患侧肩部的三维运动模式。
方法
对单侧肩周炎患者在治疗前及治疗三个月后进行评估。使用“飞鸟”电磁跟踪装置在患者手臂向三个方向抬起时进行三维运动分析。计算反映肩胛肱骨节律的肱盂关节旋转与肩胛旋转回归线的斜率。对患侧和未患侧均进行所有评估。额外评估包括常规活动范围（ROM）测量以及用于评估静息时、运动时和夜间肩部疼痛的视觉模拟量表（VAS，0 - 100 mm）。
结果
纳入10例单侧肩周炎患者。在所有三个运动方向上，患侧与未患侧在向前屈曲、肩胛外展和额面外展时曲线的斜率均存在显著差异。平均差异分别为0.267、0.215和0.464（所有p值<0.005）。治疗后患侧在向前屈曲、肩胛外展和额面外展时斜率的平均变化分别为0.063（p = 0.202）、0.048（p = 0.169）和0.264（p = 0.008）。所有患者的主动活动范围均有显著改善（所有p<0.005），运动时疼痛和夜间疼痛的VAS评分也有改善（p<0.05）。
结论
使用三维电磁跟踪系统，可以描述和量化肩周炎的异常运动模式，其特征为在肩部抬高过程中肩胛相对于肱盂关节旋转相对较早地出现外旋。此外，该系统对检测临床改善足够敏感。其在其他肩部疾病中的价值仍有待确定。
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