Sousa Catarina de Oliveira, Camargo Paula Rezende, Ribeiro Ivana Leão, Reiff Rodrigo Bezerra de Menezes, Michener Lori Ann, Salvini Tania Fátima
Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil; Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil.
Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil.
J Electromyogr Kinesiol. 2014 Aug;24(4):520-30. doi: 10.1016/j.jelekin.2014.04.015. Epub 2014 May 9.
This study described the three-dimensional shoulder motion during the arm elevation in individuals with isolated acromioclavicular osteoarthritis (ACO) and ACO associated with rotator cuff disease (RCD), as compared to controls. Seventy-four participants (ACO=23, ACO+RCD=25, Controls=26) took part of this study. Disability was assessed with the DASH, three-dimensional kinematics were collected during arm elevation in the sagittal and scapular planes, and pain was assessed with the 11-point numeric pain rating scale. For each kinematic variable and demographic variables, separate linear mixed-model 2-way ANOVAs were performed to compare groups. Both ACO groups had higher DASH and pain scores. At the scapulothoracic joint, the isolated ACO group had greater internal rotation than control, and the ACO+RCD group had greater upward rotation than both other groups. At the sternoclavicular joint, both groups with ACO had less retraction, and the isolated ACO group had less elevation and posterior rotation. At the acromioclavicular joint, the isolated ACO group had greater upward rotation, and both ACO groups had greater posterior tilting. Patients with ACO had altered shoulder kinematics, which may represent compensatory responses to reduce pain and facilitate arm motion during arm elevation and lowering.
本研究描述了孤立性肩锁关节骨关节炎(ACO)患者以及合并肩袖疾病(RCD)的ACO患者在手臂抬高过程中的三维肩部运动,并与对照组进行了比较。74名参与者(ACO组=23例,ACO+RCD组=25例,对照组=26例)参与了本研究。使用DASH评估残疾情况,在矢状面和肩胛面手臂抬高过程中收集三维运动学数据,并用11点数字疼痛评分量表评估疼痛程度。对于每个运动学变量和人口统计学变量,进行单独的线性混合模型双向方差分析以比较各组。两个ACO组的DASH和疼痛评分均较高。在肩胛胸壁关节,孤立性ACO组的内旋大于对照组,ACO+RCD组的上旋大于其他两组。在胸锁关节,两个ACO组的后缩较少,孤立性ACO组的抬高和后旋较少。在肩锁关节,孤立性ACO组的上旋较大,两个ACO组的后倾较大。ACO患者的肩部运动学发生改变,这可能是在手臂抬高和放下过程中减轻疼痛并促进手臂运动的代偿反应。