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手臂抬高过程中锁骨的三维运动:可靠性及描述性数据

Three-dimensional clavicular motion during arm elevation: reliability and descriptive data.

作者信息

Ludewig Paula M, Behrens Stacy A, Meyer Susan M, Spoden Shawn M, Wilson Laura A

机构信息

Program in Physical Therapy, Department of Physical Medicine and Rehabilitation, The University of Minnesota, Minneapolis, MN 55455, USA.

出版信息

J Orthop Sports Phys Ther. 2004 Mar;34(3):140-9. doi: 10.2519/jospt.2004.34.3.140.

Abstract

STUDY DESIGN

Cross-sectional.

OBJECTIVES

To determine the reliability of a surface sensor measurement of clavicular motion during arm elevation and to describe 3-dimensional clavicular motion in an asymptomatic population.

BACKGROUND

Abnormal scapular motion on the thorax has been implicated in shoulder pathology. Without the ability to measure clavicular motion, it is not possible to identify if abnormal scapular motions derive from the sternoclavicular or acromioclavicular joints.

METHODS AND MEASURES

Thirty-nine subjects participated in the investigation, including an asymptomatic group (n = 30) and a group with a history or current symptoms of shoulder pathology (n = 9). Clavicular angles relative to the thorax were tracked with surface electromagnetic sensors on the thorax, clavicle, and humerus as subjects completed humeral flexion, scapular plane abduction, and abduction. Within-day reliability was assessed using intraclass correlation coefficients and SEM. Descriptive statistics quantified sternoclavicular joint motions for the various arm movements.

RESULTS

Reliable measurements were obtained, with intraclass correlation coefficients ranging from 0.93 to 0.99, and SEMs from 0.9 degrees to 1.8 degrees. Between-day reliability SEM values were generally 2 degrees to 4 degrees. During elevation of the arm, the clavicle with respect to the thorax generally undergoes elevation (11 degrees-15 degrees maximum), retraction (15 degrees-29 degrees maximum), and posterior long-axis rotation (15 degrees-31 degrees maximum), with variability between subjects and planes of motion regarding the magnitude of motion.

CONCLUSION

Rehabilitation approaches attempting to improve shoulder motion should benefit from improved knowledge of 3-dimensional contributions of the clavicle to normal and abnormal scapular kinematics.

摘要

研究设计

横断面研究。

目的

确定手臂抬高过程中锁骨运动的表面传感器测量的可靠性,并描述无症状人群的三维锁骨运动。

背景

肩胛骨在胸廓上的异常运动与肩部病理状况有关。如果无法测量锁骨运动,就无法确定异常的肩胛骨运动是否源自胸锁关节或肩锁关节。

方法与测量

39名受试者参与了该研究,包括无症状组(n = 30)和有肩部病理状况病史或当前症状的组(n = 9)。当受试者完成肱骨屈曲、肩胛骨平面外展和外展动作时,使用置于胸廓、锁骨和肱骨上的表面电磁传感器追踪锁骨相对于胸廓的角度。使用组内相关系数和标准误评估日内可靠性。描述性统计量化了各种手臂运动时胸锁关节的运动情况。

结果

获得了可靠的测量结果,组内相关系数范围为0.93至0.99,标准误为0.9度至1.8度。日间可靠性标准误值一般为2度至4度。在手臂抬高过程中,锁骨相对于胸廓通常会经历抬高(最大11度 - 15度)、后缩(最大15度 - 29度)和长轴向后旋转(最大15度 - 31度),不同受试者和运动平面之间在运动幅度方面存在差异。

结论

试图改善肩部运动的康复方法应受益于对锁骨在正常和异常肩胛骨运动学中的三维作用的深入了解。

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