Shah Kshamata M, Ruth Clark B, McGill Janet B, Lang Catherine E, Mueller Michael J
Program in Physical Therapy, Washington University School of Medicine in St. Louis, USA.
Program in Physical Therapy, Washington University School of Medicine in St. Louis, USA.
Clin Biomech (Bristol). 2015 Mar;30(3):308-13. doi: 10.1016/j.clinbiomech.2014.12.013. Epub 2015 Jan 6.
Limited joint mobility at the shoulder is an understudied problem in people with diabetes mellitus. The purpose of this study was to determine the differences in shoulder kinematics between a group with diabetes and those without diabetes.
Fifty-two participants were recruited, 26 with diabetes and 26 non-diabetes controls (matched for age, BMI and sex). Three-dimensional position of the trunk, scapula and humerus were collected using electromagnetic tracking sensors during scapular plane elevation and rotation movements.
Glenohumeral external rotation was reduced by 11.1°-16.3° (P<0.05) throughout the humerothoracic elevation range of motion, from neutral to peak elevation, in individuals with diabetes as compared to controls. Peak humerothoracic elevation was decreased by 10-14°, and peak external rotation with the arm abducted was decreased 22° in the diabetes group compared to controls (P<0.05). Scapulothoracic and glenohumeral internal rotation motions were not different between the two groups.
Shoulder limited joint mobility, in particular decreased external rotation, was seen in individuals with diabetes as compared to control participants. Future research should investigate causes of diabetic limited joint mobility and strategies to improve shoulder mobility and prevent additional detrimental changes in movement and function.
肩部关节活动受限在糖尿病患者中是一个研究较少的问题。本研究的目的是确定糖尿病组与非糖尿病组在肩部运动学方面的差异。
招募了52名参与者，其中26名患有糖尿病，26名作为非糖尿病对照组（年龄、体重指数和性别相匹配）。在肩胛平面抬高和旋转运动过程中，使用电磁跟踪传感器收集躯干、肩胛骨和肱骨的三维位置。
与对照组相比，糖尿病患者在整个肩胸抬高运动范围内（从中立位到最大抬高），盂肱关节外旋减少了11.1°-16.3°（P<0.05）。糖尿病组的肩胸最大抬高角度比对照组降低了10-14°，手臂外展时的最大外旋角度降低了22°（P<0.05）。两组之间的肩胛胸壁关节和盂肱关节内旋运动没有差异。
与对照参与者相比，糖尿病患者出现肩部关节活动受限，尤其是外旋减少。未来的研究应调查糖尿病患者关节活动受限的原因以及改善肩部活动度和预防运动及功能进一步有害变化的策略。
