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多平面手臂运动过程中优势肩与非优势肩之间的三维肩胛运动学比较。

A comparison of 3D scapular kinematics between dominant and nondominant shoulders during multiplanar arm motion.

作者信息

Lee Sang Ki, Yang Dae Suk, Kim Ha Yong, Choy Won Sik

机构信息

Department of Orthopedic Surgery, Eulji University College of Medicine, Daejeon, Korea.

出版信息

Indian J Orthop. 2013 Mar;47(2):135-42. doi: 10.4103/0019-5413.108882.

Abstract

BACKGROUND

Generally, the scapular motions of pathologic and contralateral normal shoulders are compared to characterize shoulder disorders. However, the symmetry of scapular motion of normal shoulders remains undetermined. Therefore, the aim of this study was to compare 3dimensinal (3D) scapular motion between dominant and nondominant shoulders during three different planes of arm motion by using an optical tracking system.

MATERIALS AND METHODS

Twenty healthy subjects completed five repetitions of elevation and lowering in sagittal plane flexion, scapular plane abduction, and coronal plane abduction. The 3D scapular motion was measured using an optical tracking system, after minimizing reflective marker skin slippage using ultrasonography. The dynamic 3D motion of the scapula of dominant and nondominant shoulders, and the scapulohumeral rhythm (SHR) were analyzed at each 10° increment during the three planes of arm motion.

RESULTS

There was no significant difference in upward rotation or internal rotation (P > 0.05) of the scapula between dominant and nondominant shoulders during the three planes of arm motion. However, there was a significant difference in posterior tilting (P = 0.018) during coronal plane abduction. The SHR was a large positive or negative number in the initial phase of sagittal plane flexion and scapular plane abduction. However, the SHR was a small positive or negative number in the initial phase of coronal plane abduction.

CONCLUSIONS

Only posterior tilting of the scapula during coronal plane abduction was asymmetrical in our healthy subjects, and depending on the plane of arm motion, the pattern of the SHR differed as well. These differences should be considered in the clinical assessment of shoulder pathology.

摘要

背景

一般来说,通过比较患侧肩部与对侧正常肩部的肩胛骨运动来表征肩部疾病。然而,正常肩部肩胛骨运动的对称性仍未确定。因此,本研究的目的是使用光学跟踪系统比较优势肩和非优势肩在三种不同手臂运动平面中的三维肩胛骨运动。

材料与方法

20名健康受试者在矢状面屈曲、肩胛面外展和冠状面外展中完成了五次升降重复动作。在使用超声检查将反光标记皮肤滑动最小化后,使用光学跟踪系统测量三维肩胛骨运动。在手臂运动的三个平面中,每隔10°增量分析优势肩和非优势肩肩胛骨的动态三维运动以及肩肱节律(SHR)。

结果

在手臂运动的三个平面中,优势肩和非优势肩肩胛骨的向上旋转或内旋没有显著差异(P>0.05)。然而,在冠状面外展期间,后倾存在显著差异(P = 0.018)。在矢状面屈曲和肩胛面外展的初始阶段,SHR为较大的正数或负数。然而,在冠状面外展的初始阶段,SHR为较小的正数或负数。

结论

在我们的健康受试者中,仅冠状面外展期间肩胛骨的后倾是不对称的,并且根据手臂运动平面的不同,SHR的模式也有所不同。在肩部病理学的临床评估中应考虑这些差异。

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