Heuberer Philipp, Kranzl Andreas, Laky Brenda, Anderl Werner, Wurnig Christian
Department of Orthopaedics, St. Vincent Hospital Vienna, Stumpergasse 13, 1060, Vienna, Austria,
Arch Orthop Trauma Surg. 2015 Apr;135(4):549-63. doi: 10.1007/s00402-015-2180-3. Epub 2015 Feb 27.
Restoring optimal strength and biomechanics of a pathologic shoulder knowledge of activity patterns of healthy glenohumeral muscles is mandatory. Yet, data on normal shoulder muscle activity are not always conclusive. The study was undertaken (a) to evaluate muscle activity patterns in the healthy shoulder using surface and fine-wire electromyography (EMG), and (b) to assess method's suitability in the clinical setting especially regarding painfulness and practicability.
Surface and fine-wire EMG was performed on 11 healthy subjects (2f/9 m, Ø age 28 years) to assess 14 muscles including rotator cuff muscles during 8 planar standardised shoulder movements (abduction, forward flexion, internal and external rotation in neutral, 45° and 90° abduction). Pain was assessed using the visual analogue scale before testing, after inserting the fine-wire electrodes, after maximal voluntary contraction, before and after exercises, and after electrode removal.
The most important finding regarding EMG activity patterns in the healthy shoulder was that the subscapularis activity was found to play a major role in abduction and forward flexion. Furthermore, this study was able to show that EMG measurements, especially fine-wire EMG, is prone to high failure rates (up to 32%); however, pain was not a limiting factor.
The present study (1) revealed a new insight, especially finding the subscapularis activity playing a major role in abduction and forward flexion of the healthy shoulder; and (2) motion analysis system and the use of fine-wire electrodes were prone to failure; however, pain was not a limiting factor.
Basic Science, Electrodiagnostic Study.
恢复病理性肩部的最佳强度和生物力学，了解健康盂肱肌的活动模式是必不可少的。然而，关于正常肩部肌肉活动的数据并不总是确凿的。本研究旨在：（a）使用表面肌电图和细针肌电图评估健康肩部的肌肉活动模式；（b）评估该方法在临床环境中的适用性，特别是在疼痛程度和实用性方面。
对11名健康受试者（2名女性/9名男性，平均年龄28岁）进行表面肌电图和细针肌电图检查，以评估14块肌肉，包括肩袖肌群，在8种平面标准化肩部运动（外展、前屈、中立位、45°和90°外展位的内旋和外旋）中的活动情况。在测试前、插入细针电极后、最大自主收缩后、运动前后以及电极移除后，使用视觉模拟量表评估疼痛程度。
关于健康肩部肌电图活动模式的最重要发现是，发现肩胛下肌活动在外展和前屈中起主要作用。此外，本研究能够表明，肌电图测量，尤其是细针肌电图，容易出现高失败率（高达32%）；然而，疼痛并不是一个限制因素。
本研究（1）揭示了一个新的见解，特别是发现肩胛下肌活动在健康肩部的外展和前屈中起主要作用；（2）运动分析系统和细针电极的使用容易出现故障；然而，疼痛并不是一个限制因素。
基础科学，电诊断研究。
