Alizadehkhaiyat Omid, Fisher Anthony C, Kemp Graham J, Vishwanathan Karthik, Frostick Simon P
Musculoskeletal Science Research Group, University of Liverpool, Liverpool L69 3GA, United Kingdom.
J Orthop Res. 2007 Dec;25(12):1651-7. doi: 10.1002/jor.20458.
The purpose of this study was to investigate strength, fatigability, and activity of upper limb musculature to elucidate the role of muscular imbalance in the pathophysiology of tennis elbow. Sixteen patients clinically diagnosed with tennis elbow, recruited from a university hospital upper limb orthopedic clinic, were compared with 16 control subjects with no history of upper limb musculoskeletal problem, recruited from university students and staff. Muscle strength was measured for grip, metacarpophalangeal, wrist, and shoulder on both sides. Electromyographic activity (RMS amplitude) and fatigue characteristics (median frequency slope) of five forearm and two shoulder muscles were measured during isometric contraction at 50% maximum voluntary contraction. All strength measurements showed dominance difference in C, but none in TE. In tennis elbow compared to controls, hand/wrist and shoulder strength and extensor carpi radialis (ECR) activity were reduced (p < 0.05), while fatigue was normal. A global upper limb weakness exists in tennis elbow. This may be due to disuse and deconditioning syndrome caused by fear avoidance, and needs to be addressed in prevention and treatment. Activation imbalance among forearm muscles (reduced extensor carpi radialis activity) in tennis elbow, probably due to protective pain-related inhibition, could lead to a widespread upper limb muscle imbalance.
本研究的目的是调查上肢肌肉组织的力量、疲劳性和活动情况，以阐明肌肉失衡在网球肘病理生理学中的作用。从大学医院上肢骨科门诊招募了16例临床诊断为网球肘的患者，并与16名无上肢肌肉骨骼问题病史的对照受试者进行比较，后者从大学生和工作人员中招募。测量双侧的握力、掌指关节、腕部和肩部的肌肉力量。在50%最大自主收缩的等长收缩过程中，测量五块前臂肌肉和两块肩部肌肉的肌电活动（均方根振幅）和疲劳特征（中位频率斜率）。所有力量测量结果显示对照组存在优势差异，但网球肘组无差异。与对照组相比，网球肘患者的手部/腕部和肩部力量以及桡侧腕伸肌（ECR）活动降低（p<0.05），而疲劳正常。网球肘患者存在全身性上肢无力。这可能是由于恐惧回避导致的废用和失健综合征，在预防和治疗中需要加以解决。网球肘患者前臂肌肉之间的激活失衡（桡侧腕伸肌活动降低），可能是由于与疼痛相关的保护性抑制，可能导致广泛的上肢肌肉失衡。
