Yoon Seung-Hyun, Lee Doo-Hyung, Jung Myung-Chul, Park Young Uk, Lim Seong-Yeon
From the Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, South Korea (S-HY); Ajou Sports Medicine Center, Ajou University Hospital, Suwon, South Korea (S-HY, D-HL); Department of Orthopaedic Surgery, Ajou University School of Medicine, Suwon, South Korea (D-HL, YUP, S-YL); and Department of Industrial Engineering, Ajou University, Suwon, South Korea (M-CJ).
Am J Phys Med Rehabil. 2016 Nov;95(11):e169-e176. doi: 10.1097/PHM.0000000000000587.
The aim of this study was to evaluate the activity of rotator cuff (RC) muscles during activities of daily living.
Motion analysis was conducted with 14 volunteers. Activation of RC (subscapularis, supraspinatus, and infraspinatus) was assessed using electromyography (EMG). Walking was performed with or without a shoulder immobilizer. Eating was conducted with or without the support of the elbow with the contralateral hand. Washing the hair was simulated while standing or leaning forward; washing the body was simulated while standing or holding the elbow; and washing the face was simulated using both hands while leaning forward.
During walking, RC's peak EMG activities remained below 7% maximum voluntary isometric contraction at all times, regardless of the use of immobilizers. Eating caused mild EMG activities (14%-32%), whereas eating with elbow support resulted in significantly lower EMG activities in the supraspinatus and infraspinatus. Washing the hair standing moderately activated RC (23%-57%), whereas leaning forward decreased it to 6% to 36%. Washing the body while holding the elbow decreased infraspinatus activation to 4% from 10% when standing. Washing the face with both hands and leaning forward resulted in high-peak EMG activities in the upper subscapularis (37%).
There was no difference in RC activity level between walking with or without immobilizers. From the point of muscle contraction, an immobilizer is not mandatory. Holding the elbow with the contralateral hand while eating or washing can help decrease the load in the supraspinatus and infraspinatus.
本研究旨在评估日常生活活动期间肩袖（RC）肌肉的活动情况。
对14名志愿者进行了运动分析。使用肌电图（EMG）评估RC（肩胛下肌、冈上肌和冈下肌）的激活情况。在有或没有肩部固定器的情况下进行行走。在有或没有对侧手支撑肘部的情况下进行进食。模拟站立或前倾时洗头；模拟站立或握住肘部时洗身体；模拟前倾时用双手洗脸。
在行走过程中，无论是否使用固定器，RC的肌电图峰值活动始终保持在最大自主等长收缩的7%以下。进食会引起轻度肌电图活动（14%-32%），而用肘部支撑进食会导致冈上肌和冈下肌的肌电图活动显著降低。站立洗头会适度激活RC（23%-57%），而前倾会将其降低至6%至36%。握住肘部洗身体会使冈下肌的激活从站立时的10%降至4%。双手前倾洗脸会导致肩胛下肌上部出现高峰值肌电图活动（37%）。
使用或不使用固定器行走时，RC的活动水平没有差异。从肌肉收缩的角度来看，固定器并非必需。进食或洗漱时用对侧手握住肘部有助于减轻冈上肌和冈下肌的负荷。
