Department of Physical Therapy, Northeastern University, Boston, MA 02115, USA.
J Orthop Sports Phys Ther. 2012 May;42(5):400-12. doi: 10.2519/jospt.2012.3579. Epub 2012 Jan 27.
Controlled laboratory study.
To determine the effect of the modified scapular assistance test (SAT) on 3-dimensional shoulder kinematics, strength, and linear measures of subacromial space in patients with subacromial impingement syndrome (SAIS).
Abnormal scapular kinematics have been identified in patients with SAIS. Increased scapular upward rotation and posterior tilt, as induced with manual assistance using the SAT, have been theorized to increase subacromial space and may alter shoulder strength.
Forty-two subjects (21 with SAIS and 21 controls) participated in this study. The anterior outlet of the subacromial space, measured via the acromiohumeral distance on ultrasound images, and 3-dimensional scapular kinematics, measured using motion analysis, were determined with the arm at rest, and at 45° and 90° of active elevation with and without the SAT. A dynamometer was used to measure isometric shoulder strength. Full factorial mixed-model analyses of variance evaluated the effects of the SAT on variables between groups.
There was an increase in scapular posterior tilt at all angles, upward rotation at rest and 45° of elevation, and acromiohumeral distance at 45° and at 90° with the SAT. The SAT did not alter normalized isometric strength. There were no differences in response to the SAT between the SAIS and control groups.
Manual scapular assistance using the SAT influences factors associated with SAIS, such as subacromial space and potentially scapular orientation during static arm elevation, but not more so in individuals with SAIS than in healthy individuals. The SAT performed statically may be a way to identify potential subgroups of individuals with SAIS for whom subacromial space narrowing may be a contributing factor.
对照实验室研究。
确定改良肩胛助力测试（SAT）对患有肩峰下撞击综合征（SAIS）患者的三维肩部运动学、力量和肩峰下空间线性测量值的影响。
已在患有 SAIS 的患者中发现异常的肩胛运动学。使用 SAT 通过手动辅助诱导的肩胛上旋和后倾增加，据推测会增加肩峰下空间，并可能改变肩部力量。
42 名受试者（21 名患有 SAIS 和 21 名对照组）参与了这项研究。通过超声图像上的肩峰肱骨头距离测量肩峰下前出口，通过运动分析测量三维肩胛运动学，在手臂休息时以及在主动抬高 45°和 90°时进行测量，同时进行 SAT 和不进行 SAT。使用测力计测量等长肩部力量。采用完全因子混合模型方差分析评估 SAT 对组间变量的影响。
在所有角度，SAT 都会增加肩胛后倾、休息时和 45°时的上旋以及 45°和 90°时的肩峰肱骨头距离。SAT 不会改变正常化等长力量。SAIS 和对照组之间对 SAT 的反应没有差异。
使用 SAT 的手动肩胛辅助会影响与 SAIS 相关的因素，例如肩峰下空间和在静态手臂抬高期间潜在的肩胛定向，但在患有 SAIS 的个体中并不比在健康个体中更为明显。静态执行的 SAT 可能是一种识别 SAIS 潜在亚组的方法，对于这些亚组，肩峰下空间变窄可能是一个促成因素。
