Merolla Giovanni, De Santis Elisa, Campi Fabrizio, Paladini Paolo, Porcellini Giuseppe
Unit of Shoulder and Elbow Surgery, D. Cervesi Hospital, L.V Beethowen 46, 47841, Cattolica, Italy.
Musculoskelet Surg. 2010 Dec;94(3):119-25. doi: 10.1007/s12306-010-0082-7. Epub 2010 Nov 11.
A disturbance in scapulohumeral rhythm may cause negative biomechanic effects on rotator cuff (RC). Alteration in scapular motion and shoulder pain can influence RC strength. Purpose of this study was to assess supraspinatus and infraspinatus strength in 29 overhead athletes with scapular dyskinesis, before and after 3 and 6 months of rehabilitation aimed to restore scapular musculature balance. A passive posterior soft tissues stretching was prescribed to balance shoulder mobility. Scapular dyskinesis patterns were evaluated according to Kibler et al. Clinical assessment was performed with the empty can (EC) test and infraspinatus strength test (IST). Strength values were recorded by a dynamometer; scores for pain were assessed with VAS scale. Changes of shoulder IR were measured. The force values increased at 3 months (P < 0.01) and at 6 months (P < 0.01). Changes of glenohumeral IR and decrease in pain scores were found at both follow-up. Outcomes registered on pain and strength confirm the role of a proper scapular position for an optimal length-tension relationship of the RC muscles. These data should encourage those caring for athletes to consider restoring of scapular musculature balance as essential part of the athletic training.
肩肱节律紊乱可能会对肩袖(RC)产生负面的生物力学影响。肩胛骨运动的改变和肩部疼痛会影响肩袖力量。本研究的目的是评估29名患有肩胛骨运动障碍的上肢运动员在旨在恢复肩胛骨肌肉平衡的康复治疗前、治疗3个月和6个月后的冈上肌和冈下肌力量。采用被动的后部软组织拉伸来平衡肩部活动度。根据基布勒等人的方法评估肩胛骨运动障碍模式。通过空罐试验(EC)和冈下肌力量试验(IST)进行临床评估。用测力计记录力量值;用视觉模拟评分量表(VAS)评估疼痛评分。测量肩部内旋(IR)的变化。在3个月时(P < 0.01)和6个月时(P < 0.01)力量值增加。在两次随访时均发现盂肱关节内旋的变化和疼痛评分的降低。在疼痛和力量方面记录的结果证实了正确的肩胛骨位置对于肩袖肌肉最佳长度 - 张力关系的作用。这些数据应促使照顾运动员的人员将恢复肩胛骨肌肉平衡视为运动训练的重要组成部分。