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肩胛上神经阻滞后的肱骨头平移

Humeral head translation after a suprascapular nerve block.

作者信息

San Juan Jun G, Kosek Peter, Karduna Andrew R

机构信息

Tensegrity Physical Therapy, Eugene, OR.

出版信息

J Appl Biomech. 2013 Aug;29(4):371-9. doi: 10.1123/jab.29.4.371. Epub 2012 Aug 22.

Abstract

Subacromial impingement syndrome is the most common shoulder disorder. Abnormal superior translation of the humeral head is believed to be a major cause of this pathology. The first purpose of the study was to examine the effects of suprascapular nerve block on superior translation of the humeral head and scapular upward rotation during dynamic shoulder elevation. The secondary purpose was to assess muscle activation patterns during these motions. Twenty healthy subjects participated in the study. Using fluoroscopy and electromyography, humeral head translation and muscle activation were measured before and after a suprascapular nerve block. The humeral head was superiorly located at 60 degrees of humeral elevation, and the scapula was more upwardly rotated from 30 to 90 degrees of humeral elevation after the block. The differences were observed during midrange of motion. In addition, the deltoid muscle group demonstrated increased muscle activation after the nerve block. The study's results showed a compensatory increase in humeral head translation, scapular upward rotation, and deltoid muscle activation due to the nerve block. These outcomes suggest that increasing muscular strength and endurance of the supraspinatus and infraspinatus muscles could prevent any increased superior humeral head translation. This may be beneficial in reducing shoulder impingement or rotator cuff tears over time.

摘要

肩峰下撞击综合征是最常见的肩部疾病。肱骨头异常向上移位被认为是这种病理状况的主要原因。本研究的首要目的是检查肩胛上神经阻滞对动态肩部上举过程中肱骨头向上移位和肩胛骨向上旋转的影响。次要目的是评估这些动作过程中的肌肉激活模式。20名健康受试者参与了本研究。通过荧光透视和肌电图,在肩胛上神经阻滞前后测量肱骨头移位和肌肉激活情况。阻滞术后,在肱骨上举60度时肱骨头位置上移,在肱骨上举30至90度时肩胛骨向上旋转更明显。这些差异在运动中期被观察到。此外,三角肌群在神经阻滞后肌肉激活增加。研究结果表明,由于神经阻滞,肱骨头移位、肩胛骨向上旋转和三角肌激活出现代偿性增加。这些结果提示,增加冈上肌和冈下肌的肌肉力量和耐力可以防止肱骨头向上移位增加。随着时间推移,这可能有助于减少肩部撞击或肩袖撕裂。

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