López-Pascual Juan, Page Álvaro, Serra-Añó Pilar
Instituto de Biomecánica de Valencia, Universitat Politècnica de València, Valencia, Spain.
Departament de Física Aplicada, Universitat Politècnica de València, València, Spain.
PLoS One. 2017 Aug 25;12(8):e0183954. doi: 10.1371/journal.pone.0183954. eCollection 2017.
Obtaining kinematic patterns that depend on the shoulder injury may be important when planning rehabilitation. The main goal of this study is to explore whether the kinematic patterns of continuous and repetitive shoulder elevation motions are different according to the type of shoulder injury in question, specifically tendinopathy or rotator cuff tear, and to analyze the influence of the load handled during its assessment. For this purpose, 19 individuals with tendinopathy and 9 with rotator cuff tear performed a repetitive scaption movement that was assessed with stereophotogrammetry. Furthermore, static range of motion (ROM) and isometric strength were evaluated with a goniometer and a dynamometer, respectively. Dynamic measurements of maximum elevation (Emax), variablility of the maximum angle (VMA), maximum angular velocity (Velmax), and time to maximum velocity (tmaxvel) were found to be significantly different between the tendinopathy group (TG) and the rotator cuff tear group (RTCG). No differences were found in the ROM assessed with goniometry and the isometric strength. The effect of increasing the load placed in the hand during the scaption movement led to significant differences in Emax, VMA, tmaxvel and repeatability. Therefore, only the dynamic variables showed sufficient capability of detecting differences in functional performance associated with structural shoulder injury. The differences observed in the kinematic variables between patients with tendinopathy and rotator cuff tear seem to be related to alterations in thoracohumeral rhythm and neuromuscular control. Kinematic analysis may contribute to a better understanding of the functional impact of shoulder injuries, which would help in the assessment and treatment of shoulder pain.
在规划康复治疗时,获取取决于肩部损伤的运动模式可能很重要。本研究的主要目的是探讨连续重复肩部抬高动作的运动模式是否因所讨论的肩部损伤类型(具体为肌腱病或肩袖撕裂)而有所不同,并分析评估过程中所处理负荷的影响。为此,19名患有肌腱病的个体和9名患有肩袖撕裂的个体进行了重复的前锯肌运动,并通过立体摄影测量法进行评估。此外,分别使用角度计和测力计评估静态活动范围(ROM)和等长力量。结果发现,肌腱病组(TG)和肩袖撕裂组(RTCG)之间的最大抬高(Emax)、最大角度变异性(VMA)、最大角速度(Velmax)和达到最大速度的时间(tmaxvel)的动态测量值存在显著差异。在通过角度测量评估的ROM和等长力量方面未发现差异。在前锯肌运动过程中增加手部负荷的影响导致Emax、VMA、tmaxvel和重复性出现显著差异。因此,只有动态变量显示出足够的能力来检测与肩部结构损伤相关的功能表现差异。肌腱病患者和肩袖撕裂患者在运动学变量上观察到的差异似乎与胸肱节律和神经肌肉控制的改变有关。运动学分析可能有助于更好地理解肩部损伤的功能影响,这将有助于评估和治疗肩部疼痛。