McCully Sean P, Suprak David N, Kosek Peter, Karduna Andrew R
Department of Anatomy, BioSciences Institute, University College Cork School of Medicine, Cork, Ireland.
J Biomech. 2007;40(8):1839-46. doi: 10.1016/j.jbiomech.2006.07.010. Epub 2006 Oct 10.
A balance exists between the deltoid and rotator cuff contribution to arm elevation. Both cadaver and computer models have predicted an increase in deltoid muscle force with dysfunction of the rotator cuff. The goal of the present study was to verify this phenomenon in vivo by examining the effects of paralysis of the supraspinatus and infraspinatus muscles with a suprascapular nerve block on the electrical activity of seven shoulder muscles. Electromyographic data were collected before and after the administration of the block. The block resulted in a significant increase in muscle activity for all heads of the deltoid, with a higher percentage increase noted at lower elevation angles. Although the deltoid activity was reduced as the subjects recovered from the block, even low levels of cuff dysfunction were found to result in increased deltoid activity. These results suggest that even small disruptions in the normal function of some rotator cuff muscles (e.g., due to fatigue or impingement syndrome), may result in an increase in deltoid activity. It is possible that such compensation may result in higher superior loads at the glenohumeral joint, possibly increasing the risk of tendon damage.
三角肌和肩袖肌群在手臂抬高过程中的作用存在一种平衡。尸体模型和计算机模型均预测,肩袖功能障碍会导致三角肌力量增加。本研究的目的是通过肩胛上神经阻滞使冈上肌和冈下肌麻痹,来检验其对七块肩部肌肉电活动的影响,从而在活体中验证这一现象。在实施阻滞前后收集肌电图数据。阻滞导致三角肌所有头的肌肉活动显著增加,在较低抬高角度时增加的百分比更高。尽管随着受试者从阻滞中恢复,三角肌活动有所降低,但即使是低水平的肩袖功能障碍也会导致三角肌活动增加。这些结果表明,即使某些肩袖肌肉的正常功能出现微小破坏(如因疲劳或撞击综合征),也可能导致三角肌活动增加。这种代偿可能会导致肱盂关节承受更高的上向负荷,从而可能增加肌腱损伤的风险。