Hung You-jou, Darling Warren G
Department of Nursing and Rehabilitation Sciences, Angelo State University, ASU Station #10923, San Angelo, TX, 76909, USA.
Physiother Res Int. 2014 Mar;19(1):34-43. doi: 10.1002/pri.1558. Epub 2013 Jun 13.
The purpose of the study was to investigate whether individuals with anterior glenohumeral joint (GHJ) instability exhibit different scapular orientation from individuals with healthy shoulders in a planar shoulder movement and a functional three-dimensional (3D) reaching task.
This is a between-groups study with repeated measures. Ten people with anterior GHJ instability and 15 people with healthy shoulders participated in the study. For the planar shoulder movement task, participants were asked to abduct the shoulder from the resting position to pre-determined target angles (45°, 90°, and 135° of shoulder abduction) in the frontal plane. For the 3D reaching task, participants were asked to move the unconstrained arm to a remembered target location in space. Scapular orientation about three rotational axes was analysed at the target location and compared between the two groups of subjects.
For planar abduction, participants with GHJ instability and those with healthy shoulders exhibited similar scapular orientation changes in upward-downward rotation, anterior-posterior tipping and medial-lateral rotation. For 3D reaching, participants with GHJ instability and those with healthy shoulders also exhibited similar scapular orientation changes pointing to targets at various locations.
Results of this study show that scapular orientation changes associated with shoulder abduction and functional reaching activities were similar in people with GHJ instability and those with healthy shoulders. The current study suggests that anterior GHJ instability has little impact on scapular kinematics during upper limb movements in a chronic condition without pain, muscle weakness or limited range of motion. Altered scapular kinematics may not contribute to the high recurrence rate of anterior GHJ dislocation.
本研究旨在调查在平面肩部运动和功能性三维（3D）伸手任务中，肩肱关节（GHJ）前侧不稳定的个体与肩部健康的个体相比，肩胛方位是否存在差异。
这是一项采用重复测量的组间研究。10名肩肱关节前侧不稳定的患者和15名肩部健康的个体参与了本研究。对于平面肩部运动任务，要求参与者在额状面将肩部从休息位外展至预先确定的目标角度（肩部外展45°、90°和135°）。对于3D伸手任务，要求参与者将未受约束的手臂移动到记忆中的空间目标位置。在目标位置分析肩胛关于三个旋转轴的方位，并在两组受试者之间进行比较。
在平面外展时，肩肱关节不稳定的参与者和肩部健康的参与者在上下旋转、前后倾斜和内外旋转方面表现出相似的肩胛方位变化。在3D伸手任务中，肩肱关节不稳定的参与者和肩部健康的参与者在指向不同位置目标时也表现出相似的肩胛方位变化。
本研究结果表明，在肩肱关节不稳定的个体和肩部健康的个体中，与肩部外展和功能性伸手活动相关的肩胛方位变化相似。当前研究表明，在慢性状态下，无疼痛、肌肉无力或活动范围受限的情况下，肩肱关节前侧不稳定对上肢运动时的肩胛运动学影响很小。肩胛运动学改变可能并非导致肩肱关节前侧脱位高复发率的原因。
