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减压技术和轮椅转移过程中的三维肩部运动学

Three-dimensional shoulder kinematics during a pressure relief technique and wheelchair transfer.

作者信息

Nawoczenski Deborah A, Clobes Shannon M, Gore Stephanie L, Neu Jennifer L, Olsen John E, Borstad John D, Ludewig Paula M

机构信息

Department of Physical Therapy, Ithaca College, University of Rochester Campus, Rochester, NY, USA.

出版信息

Arch Phys Med Rehabil. 2003 Sep;84(9):1293-300. doi: 10.1016/s0003-9993(03)00260-0.

DOI:10.1016/s0003-9993(03)00260-0
PMID:13680564
Abstract

OBJECTIVE

To assess 3-dimensional scapulothoracic and glenohumeral kinematics in able-bodied subjects during a weight-relief raise and while transferring to and from a wheelchair.

DESIGN

Repeated-measures analysis of variance.

SETTING

Research laboratory.

PARTICIPANTS

Twenty-five able-bodied subjects without spinal cord injury or shoulder symptoms (20 men, 5 women; age range, 20-37y).

INTERVENTIONS

Completion of weight-relief raise and transfer tasks.

MAIN OUTCOME MEASURES

An electromagnetic motion capture system tracked 3-dimensional position and orientation of the thorax, scapula, and humerus. Absolute angular values assessed included scapular downward and upward rotation, internal and external rotation, and posterior and anterior tipping all relative to the thorax, as well as humeral internal and external rotation relative to the scapula. Data were compared across 3 phases of the weight-relief raise and for transfer direction (leading arm, trailing arm).

RESULTS

Key findings included significantly increased anterior tipping and internal rotation of the scapula and decreased scapular upward rotation and external rotation of the humerus during the weight-relief raise. The leading arm showed significantly greater scapular anterior tipping and internal rotation and less scapular upward rotation and humeral external rotation than the trailing arm during the final phase of the transfer.

CONCLUSIONS

Both the weight-relief raise and transfer result in scapular and humeral positions and directions of motion that may negatively impact the available subacromial space. This may present increased risk for injury or progression of shoulder pain in persons who must routinely perform these tasks.

摘要

目的

评估身体健全的受试者在减轻体重抬起动作以及进出轮椅过程中肩胛胸壁关节和盂肱关节的三维运动学情况。

设计

重复测量方差分析。

设置

研究实验室。

参与者

25名无脊髓损伤且无肩部症状的身体健全受试者(20名男性,5名女性;年龄范围20 - 37岁)。

干预措施

完成减轻体重抬起动作和转移任务。

主要观察指标

电磁运动捕捉系统追踪胸廓、肩胛骨和肱骨的三维位置和方向。评估的绝对角度值包括肩胛骨相对于胸廓的向下和向上旋转、内旋和外旋,以及前后倾斜,还有肱骨相对于肩胛骨的内旋和外旋。对减轻体重抬起动作的三个阶段以及转移方向(主导臂、非主导臂)的数据进行比较。

结果

主要发现包括在减轻体重抬起动作期间,肩胛骨的前倾角和内旋显著增加,肩胛骨的向上旋转和肱骨的外旋减少。在转移的最后阶段,主导臂的肩胛骨前倾角和内旋显著大于非主导臂,而肩胛骨的向上旋转和肱骨的外旋则小于非主导臂。

结论

减轻体重抬起动作和转移都会导致肩胛骨和肱骨的位置及运动方向,可能对肩峰下间隙产生负面影响。这可能会增加必须经常执行这些任务的人群受伤或肩部疼痛加重的风险。

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