Hall Laurie C, Middlebrook Erin E, Dickerson Clark R
Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
Clin Biomech (Bristol). 2011 Jul;26(6):579-84. doi: 10.1016/j.clinbiomech.2011.02.006. Epub 2011 Mar 31.
Despite a high prevalence of rotator cuff impingements or tears in the elderly population, little research has focused on how this injured population adapts to perform tasks of daily living. The current study investigated the influence of rotator cuff impingements in this population on kinematics and shoulder loading differences, while completing activities of daily living.
Upper limb and trunk movement was measured for thirteen asymptomatic elderly and ten elderly subjects with rotator cuff impingements during five range of motion tasks and six activities of daily living. Thoracohumeral kinematics was derived from this data.
Symptomatic populations showed significantly decreased ranges of flexion/extension, abduction and internal and external rotation when compared to the asymptomatic population. The asymptomatic population had a 44% larger range of angle of elevation than the symptomatic population. Task was found to be a main effect for most variables examined including angle of elevation. Participants with impingements had significantly lower ranges of humeral rotations during the tasks with ranges of 40° (SD 40°) and 51° (SD 36°) respectively. Perineal care, hair-combing and reaching tasks were the most demanding in terms of the required range of motion. The reaching tasks resulted in the highest shoulder moment.
Developing adaptations for perineal care, hair-combing and reaching tasks should be prioritized when working with persons with rotator cuff impingements, as these tasks demanded the largest ranges of motion while producing high shoulder moments. Substantial differences existed between the experimental groups for a number of kinematic measures.
尽管肩袖撞击或撕裂在老年人群中普遍存在，但很少有研究关注这一受伤群体如何适应日常生活任务。本研究调查了该人群中肩袖撞击对运动学和肩部负荷差异的影响，同时完成日常生活活动。
在五项运动范围任务和六项日常生活活动中，测量了13名无症状老年人和10名患有肩袖撞击的老年人的上肢和躯干运动。胸肱运动学数据由此得出。
与无症状人群相比，有症状人群的屈伸、外展以及内旋和外旋范围明显减小。无症状人群的抬高角度范围比有症状人群大44%。发现任务是包括抬高角度在内的大多数检查变量的主要影响因素。患有撞击的参与者在任务期间的肱骨旋转范围明显较低，分别为40°（标准差40°）和51°（标准差36°）。会阴护理、梳头和够物任务在所需运动范围方面要求最高。够物任务导致最高的肩部力矩。
在为患有肩袖撞击的人提供护理时，应优先考虑为会阴护理、梳头和够物任务制定适应性措施，因为这些任务需要最大的运动范围，同时会产生较高的肩部力矩。在一些运动学测量方面，实验组之间存在显著差异。
