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坐位胸椎手法对年轻无症状参与者肩胛运动学和肩肱节律变化的影响:一项随机研究。

Effect of seated thoracic manipulation on changes in scapular kinematics and scapulohumeral rhythm in young asymptomatic participants: a randomized study.

作者信息

Rosa Dayana P, Alburquerque-Sendín Francisco, Salvini Tania F, Camargo Paula R

机构信息

Physical Therapist, Physical Therapy Graduate Program, Methodist University of Piracicaba, Piracicaba, SP, Brazil.

出版信息

J Manipulative Physiol Ther. 2013 Oct;36(8):546-54. doi: 10.1016/j.jmpt.2013.07.006. Epub 2013 Sep 5.

Abstract

OBJECTIVE

The purpose of this study was to evaluate the immediate effects of seated thoracic manipulation on scapulothoracic kinematics and scapulohumeral rhythm during arm flexion in young asymptomatic participants.

METHODS

A convenience sample of 42 young asymptomatic participants was randomly divided in 2 groups: manipulation and sham group. Measurements were taken before and after the intervention. All participants completed the Disabilities of the Arm, Shoulder, and Hand questionnaire to assess pain and physical function. The manipulation group received the manipulation (high velocity, low amplitude), which was performed by a physical therapist with the patient in the seated position and with the arms crossed over the chest and hands passed over the shoulders. For the sham group, the same procedure was performed, with the exception that the high-velocity thrust was not applied. Three-dimensional (3D) kinematic data were collected with the participants in a relaxed standing position using a 3D electromagnetic tracking system. All participants performed 3 repetitions of arm flexion before and after manipulation.

RESULTS

There were no differences (P = .79) in Disabilities of the Arm, Shoulder, and Hand scores when the manipulation (3.37 ± 3.72) was compared with the sham group (3.68 ± 4.27). The 3-way analysis of variance showed no significant interaction among group, angle, and time differences for the outcomes (scapulothoracic internal/external rotation [F = 0.43; P = .82], upward/downward rotation [F = 0.08; P = .99], tilt [F = 0.23; P = .94], and scapulohumeral rhythm [F = 4; P = .86]). The intragroup effect was small for the outcomes measured in both groups.

CONCLUSIONS

Thoracic manipulation in the seated position did not affect scapulohumeral rhythm and 3D scapular kinematics during arm flexion in young asymptomatic participants.

摘要

目的

本研究旨在评估坐位胸椎整复手法对年轻无症状受试者在手臂前屈过程中肩胛胸壁关节运动学及肩肱节律的即时影响。

方法

选取42名年轻无症状受试者作为便利样本,随机分为两组:整复组和假手术组。在干预前后进行测量。所有受试者均完成手臂、肩部和手部功能障碍问卷,以评估疼痛和身体功能。整复组接受整复手法(高速度、低幅度),由物理治疗师在患者坐位时进行,双臂交叉于胸前,双手置于肩部上方。假手术组进行相同操作,但不施加高速推力。使用三维电磁跟踪系统,在受试者放松站立位收集三维运动学数据。所有受试者在整复前后各进行3次手臂前屈动作。

结果

将整复组(3.37±3.72)与假手术组(3.68±4.27)的手臂、肩部和手部功能障碍评分进行比较,差异无统计学意义(P = 0.79)。三因素方差分析显示,对于各项指标(肩胛胸壁关节内/外旋转[F = 0.43;P = 0.82]、上/下旋转[F = 0.08;P = 0.99]、倾斜[F = 0.23;P = 0.94]以及肩肱节律[F = 4;P = 0.86]),组间、角度和时间差异之间均无显著交互作用。两组测量指标的组内效应均较小。

结论

坐位胸椎整复手法对年轻无症状受试者在手臂前屈过程中的肩肱节律及三维肩胛运动学无影响。

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