Crétual Armel, Bonan Isabelle, Ropars Mickaël
M2S Lab (Mouvement Sport Santé), University Rennes 2, ENS Rennes - UEB, Avenue Robert Schuman, Campus de Ker Lann, 35170 Bruz, France; MimeTIC Team, INRIA Rennes, Campus Universitaire de Beaulieu, 35042 Rennes, France.
M2S Lab (Mouvement Sport Santé), University Rennes 2, ENS Rennes - UEB, Avenue Robert Schuman, Campus de Ker Lann, 35170 Bruz, France; Physical Medicine and Rehabilitation Department, Pontchaillou University Hospital, 2 rue Henri Le Guilloux, 35033 Rennes, France.
Man Ther. 2015 Jun;20(3):433-9. doi: 10.1016/j.math.2014.10.020. Epub 2014 Nov 11.
At first sight, shoulder mobility is frequently evaluated through mono-axial amplitude. Interestingly, for diagnosing shoulder hyperlaxity or frozen shoulder, external rotation of the arm whilst at the side (ER1) is commonly used. However, by definition, a mono-axial amplitude does not fully reflect shoulder global mobility. Our goal was to propose a novel index for measuring shoulder global mobility and secondly to evaluate the link between main mono-axial amplitudes and this new index. Twenty-eight female subjects (mean age 24.8 years) without upper limb pathology participated in the study. The movements of their right dominant arm were measured with an opto-electronic motion capture system. They performed 5 mono-axial maximal amplitude motions (axial rotations in three different postures, flexion/extension and abduction from rest) and a global range of motion exploring all the reachable space around the three axes of rotation. From this, we computed the correlation coefficient between the volume of the reachable space and each possible linear combination of the 5 mono-axial amplitudes. Even though ER1 is often chosen to assess global mobility, it demonstrated the lowest correlation with measured joint mobility. To assess shoulder global mobility, clinical routine examination should more take into account external/internal rotation with the shoulder abducted, then abduction and finally flexion/extension. However, further clinical testing in other populations has to be done to evaluate the potential generalization of this result.
乍一看，肩部活动度通常通过单轴幅度来评估。有趣的是，在诊断肩部过度松弛或肩周炎时，常采用手臂在身体一侧时的外旋（ER1）。然而，根据定义，单轴幅度并不能完全反映肩部的整体活动度。我们的目标是提出一种测量肩部整体活动度的新指标，其次是评估主要单轴幅度与这一新指标之间的联系。28名无上肢病变的女性受试者（平均年龄24.8岁）参与了该研究。使用光电运动捕捉系统测量她们右优势手臂的运动。她们进行了5种单轴最大幅度运动（三种不同姿势下的轴向旋转、屈伸以及从静止状态开始的外展）以及探索围绕三个旋转轴的所有可达空间的整体活动范围。据此，我们计算了可达空间体积与5种单轴幅度的每种可能线性组合之间的相关系数。尽管ER1常被选来评估整体活动度，但它与测量的关节活动度的相关性最低。为评估肩部整体活动度，临床常规检查应更多地考虑肩部外展时的外旋/内旋，然后是外展，最后是屈伸。然而，必须在其他人群中进行进一步的临床测试，以评估这一结果的潜在普遍性。
