Shirato Rikiya, Aoki Mitsuhiro, Iba Kousuke, Wada Takuro, Hidaka Egi, Fujimiya Mineko, Yamashita Toshihiko
Department of Orthopaedic Surgery, Sapporo Medical University, South-1, West-16, Chuo-ku, Sapporo 060-8556, Japan.
School of Rehabilitation Sciences, Health Sciences University of Hokkaido, Kanazawa 1757, Tobetsu-cho, Ishikari-gun 061-0293, Japan.
Clin Biomech (Bristol). 2017 Nov;49:1-7. doi: 10.1016/j.clinbiomech.2017.08.008. Epub 2017 Aug 18.
Stretching exercises based on wrist flexion-ulnar deviation with elbow extension, forearm pronation, and additional index or middle finger flexion have been used to stretch the wrist extensors for lateral epicondylitis. The purpose of this study was to quantify the strain on the tendon origin of the extensor carpi radialis brevis in cadaver specimens during these stretching exercises.
We used 8 fresh frozen/thawed cadaveric upper extremities. The strain on the extensor carpi radialis brevis tendon origin was measured by the addition of 4 types of traction (no traction, wrist flexion-ulnar deviation, and index or middle finger flexion in combination with wrist flexion-ulnar deviation) in 7 sequential elbow flexion angles during forearm pronation. Two types of varus stress load to the elbow (none, gravity on the forearm) were also applied.
A significant increase in strain was obtained by wrist traction with 0°, 15° and 30° of elbow flexion (P<0.05). The strain was also significantly increased by adding finger traction (P<0.05) and varus stress load (P<0.05). A maximum strain value of 5.30 (SD 1.73) % was obtained when traction on the middle finger in combination with traction of the wrist was added at 15° elbow flexion with varus stress load.
The present study provides data about the amount of strain on the extensor carpi radialis brevis tendon during stretching exercises of the wrist and finger extensors. The results of this study could be applied to stretching exercises for patients with lateral epicondylitis.
基于腕关节屈曲 - 尺侧偏斜、肘关节伸展、前臂旋前以及额外的示指或中指屈曲的伸展运动，已被用于拉伸外侧上髁炎患者的腕伸肌。本研究的目的是量化在这些伸展运动过程中，尸体标本上桡侧腕短伸肌腱起点处的应变。
我们使用了8个新鲜冷冻/解冻的尸体上肢。在前臂旋前过程中，通过在7个连续的肘关节屈曲角度下施加4种类型的牵引（无牵引、腕关节屈曲 - 尺侧偏斜以及示指或中指屈曲与腕关节屈曲 - 尺侧偏斜相结合），测量桡侧腕短伸肌腱起点处的应变。还对肘关节施加了两种类型的内翻应力负荷（无、前臂受重力）。
在肘关节屈曲0°、15°和30°时进行腕部牵引，应变显著增加（P<0.05）。通过增加手指牵引（P<0.05）和内翻应力负荷（P<0.05），应变也显著增加。在肘关节屈曲15°且有内翻应力负荷的情况下，同时进行中指牵引和腕部牵引时，获得的最大应变值为5.30（标准差1.73）%。
本研究提供了有关腕部和手指伸肌伸展运动过程中桡侧腕短伸肌腱应变大小的数据。本研究结果可应用于外侧上髁炎患者的伸展运动。
