Ludewig Paula M, Cook Thomas M
Department of Physical Medicine and Rehabilitation, The University of Minnesota, Minneapolis, USA.
J Orthop Sports Phys Ther. 2002 Jun;32(6):248-59. doi: 10.2519/jospt.2002.32.6.248.
Two-group mixed-model analysis of covariance and correlation analysis.
To determine whether differences in humeral translations exist between patients with shoulder impingement symptoms and an asymptomatic comparison group, and if so, to determine if shoulder range-of-motion (ROM) measures are associated with abnormal translations.
Abnormal translations of the humeral head are believed to reduce the available subacromial space and to contribute to the development or progression of shoulder impingement symptoms. These abnormal translations have also been theorized to be related to tightness of the posterior capsule and decreased shoulder ROM.
Three-dimensional humeral translations were tracked in symptomatic construction workers and an asymptomatic comparison group while elevating the arm in the scapular plane under no-load, 2.3-kg, and 4.6-kg hand-load conditions. Between-group comparisons were made across 3 phases of motion (30 degrees-60 degrees, 60 degrees-90 degrees, and 90 degrees-120 degrees) and the association between humeral translations and cross-body adduction and shoulder internal rotation ROM measures were determined by Pearson correlation analysis.
Persons with shoulder symptoms demonstrated small but significant changes in anterior-posterior translations of the humerus. These changes for the 90 degrees-120 degrees phase of humeral elevation were moderately negatively associated with available cross-body adduction ROM.
The identified kinematic deviations are consistent with possible reductions of the subacromial space. Further study of relationships between posterior capsule tightness, rotator cuff function, and abnormal humeral translations is warranted to better delineate underlying kinematic mechanisms that may contribute to shoulder impingement symptoms and to refine rehabilitation techniques.
两组协方差混合模型分析及相关性分析。
确定有肩部撞击症状的患者与无症状对照组之间肱骨平移是否存在差异，若存在差异，则确定肩部活动范围（ROM）测量值是否与异常平移相关。
肱骨头的异常平移被认为会减少肩峰下间隙，并导致肩部撞击症状的发生或进展。这些异常平移也被认为与后关节囊紧张和肩部ROM降低有关。
在无症状建筑工人和无症状对照组中，于无负荷、2.3千克和4.6千克手部负荷条件下，在肩胛平面内抬高手臂时跟踪三维肱骨平移。在运动的三个阶段（30度至60度、60度至90度和90度至120度）进行组间比较，并通过Pearson相关性分析确定肱骨平移与体侧内收和肩部内旋ROM测量值之间的关联。
有肩部症状的人肱骨前后平移有微小但显著的变化。肱骨抬高90度至120度阶段的这些变化与可用的体侧内收ROM呈中度负相关。
所确定的运动偏差与肩峰下间隙可能减小一致。有必要进一步研究后关节囊紧张、肩袖功能和肱骨异常平移之间的关系，以更好地描绘可能导致肩部撞击症状的潜在运动机制，并完善康复技术。
