肩关节的多轴被动和主动刚度

Multi-axis passive and active stiffnesses of the glenohumeral joint.

作者信息

Makhsous Mohsen, Lin Fang, Zhang Li-Qun

机构信息

Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL, USA.

出版信息

Clin Biomech (Bristol). 2004 Feb;19(2):107-15. doi: 10.1016/j.clinbiomech.2003.11.009.

DOI:10.1016/j.clinbiomech.2003.11.009

PMID:14967572

Abstract

OBJECTIVE

To investigate passive and active glenohumeral stiffness in the anterior, posterior, superior, and inferior directions at different lateral positions of the humerus.

DESIGN

Glenohumeral stiffness along multiple axes was determined in fresh-frozen shoulder specimens under both passive (no simulated muscle contraction) and active (with simulated muscle contraction) conditions.

BACKGROUND

Glenohumeral laxity has been evaluated in various studies with focus on one of the multiple directions. However, glenohumeral stiffness characterizing the force-displacement relationship and stability has not been evaluated in all four directions under passive and active conditions.

METHODS

The humeral head was translated in the posterior, anterior, inferior and superior directions relative to the glenoid with different lateral positions, and multi-axis glenohumeral stiffness generated by passive and active structures were investigated.

RESULTS

Without muscle loading, glenohumeral stiffness in the superior direction ( Ksup = 5.83 N/mm) was higher than that in the inferior ( Kinf = 4.32 ), anterior ( Kant = 3.67 ), and posterior ( Kpost = 2.89 ) directions ( P < 0.008 ), and Kinf was higher than Kpost ( P = 0.011 ). Stiffness in the different directions were correlated to each other ( P < 0.001 ), and shifting the humerus laterally increased stiffness in all directions ( P < 0.05 ) except for the superior direction. With moderate muscle loads, the glenohumeral joint became significantly stiffer in all four directions ( P < 0.05 ) with less difference among different directions.

CONCLUSIONS

Glenohumeral stiffnesses are different in the different directions but are correlated to each other and contribute jointly to glenohumeral stability. Muscle contractions can increase glenohumeral stiffness significantly.

摘要

目的

研究肱骨在不同外侧位置时，肩关节在前后上下方向的被动和主动僵硬情况。

设计

在新鲜冷冻的肩部标本中，分别在被动（无模拟肌肉收缩）和主动（有模拟肌肉收缩）条件下，测定肩关节在多个轴向上的僵硬程度。

背景

在各种研究中，已对肩关节松弛度进行了评估，重点关注多个方向中的一个。然而，表征力-位移关系和稳定性的肩关节僵硬程度，尚未在被动和主动条件下的所有四个方向上进行评估。

方法

使肱骨头相对于肩胛盂在不同外侧位置下，在前后下上方向进行平移，研究被动和主动结构产生的多轴肩关节僵硬情况。

结果

在无肌肉负荷时，肩关节在上方向的僵硬程度（Ksup = 5.83 N/mm）高于下方向（Kinf = 4.32）、前方向（Kant = 3.67）和后方向（Kpost = 2.89）（P < 0.008），且Kinf高于Kpost（P = 0.011）。不同方向的僵硬程度相互关联（P < 0.001），肱骨向外侧移位会增加除上方向外所有方向的僵硬程度（P < 0.05）。在中等肌肉负荷下，肩关节在所有四个方向上均显著变硬（P < 0.05），不同方向之间的差异较小。