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桡骨远端骨折后用贴扎法重新定位肩胛骨:使用三维运动系统的运动学分析

Repositioning the scapula with taping following distal radius fracture: Kinematic analysis using 3-dimensional motion system.

作者信息

Turgut Elif, Ayhan Cigdem, Baltaci Gul

机构信息

Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey.

Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey.

出版信息

J Hand Ther. 2017 Oct-Dec;30(4):477-482. doi: 10.1016/j.jht.2017.07.001. Epub 2017 Aug 8.

Abstract

STUDY DESIGN

Cross-sectional and controlled laboratory study using pretest-posttest design.

INTRODUCTION

Patients with distal radius fracture (DRfx) report proximal segment problems. Taping is commonly recommended because it provides improved posture and function.

PURPOSE OF THE STUDY

This study aimed to investigate the 3-dimensional scapular kinematics and the effect of taping on the kinematics in participants with DRfx.

METHODS

Twenty participants with a unilateral history of DRfx and 20 healthy controls participated. Scapular kinematics was assessed using an electromagnetic system. Three separate strips of elastic taping were applied for participants with DRfx over the arm, scapula, and middle and lower trapezius muscles through the paravertebral muscles. Afterward, the scapular kinematics was reassessed in taped condition.

RESULTS

When participants with DRfx and healthy controls compared, the scapula was more downwardly rotated at 120° of humerothoracic elevation (mean difference [MD], 9.06°) and at 120° (MD, 9.04°), 90° (MD, 5.6°) of humerothoracic lowering, more upwardly rotated at 30° of humerothoracic lowering (MD, 5.1°). Taping showed a significant effect on kinematics; specifically, the scapula was more externally rotated (38.9° untaped vs 31.1° taped) and posteriorly tilted (-9.2° untaped vs -4.8° taped) during humerothoracic elevation and lowering for participants with DRfx.

DISCUSSION

Participants with DRfx showed different scapular kinematics and taping resulted in changes on tested kinematic parameters during humeral movements. Differences in scapular motion during elevation with taping showed a specific pattern.

CONCLUSIONS

Overall, taping maintained a position likely to produce optimal rotator cuff function during early rehabilitation of patients with DRfx.

LEVEL OF EVIDENCE

N/A.

摘要

研究设计

采用前测-后测设计的横断面对照实验室研究。

引言

桡骨远端骨折(DRfx)患者报告有近端节段问题。通常建议使用贴扎,因为它能改善姿势和功能。

研究目的

本研究旨在调查DRfx患者的三维肩胛骨运动学以及贴扎对其运动学的影响。

方法

20名有单侧DRfx病史的参与者和20名健康对照者参与研究。使用电磁系统评估肩胛骨运动学。通过椎旁肌为DRfx参与者在手臂、肩胛骨以及斜方肌中下束上粘贴三条独立的弹性贴扎带。之后,在贴扎状态下重新评估肩胛骨运动学。

结果

将DRfx患者与健康对照者比较时,在肩胸抬高120°时肩胛骨向下旋转更多(平均差值[MD],9.06°),在肩胸降低120°(MD,9.04°)、90°(MD,5.6°)时也是如此,在肩胸降低30°时向上旋转更多(MD,5.1°)。贴扎对运动学有显著影响;具体而言,对于DRfx患者,在肩胸抬高和降低过程中,肩胛骨在贴扎时比未贴扎时更向外旋转(未贴扎时为38.9°,贴扎时为31.1°)且向后倾斜(未贴扎时为-9.2°,贴扎时为-4.8°)。

讨论

DRfx患者表现出不同的肩胛骨运动学,贴扎导致肱骨运动期间测试的运动学参数发生变化。贴扎时抬高过程中肩胛骨运动的差异呈现出特定模式。

结论

总体而言,在DRfx患者的早期康复过程中,贴扎维持了一个可能产生最佳肩袖功能的位置。

证据水平

无。

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