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面肩肱型肌营养不良患者肩胛骨运动的运动学分析

Kinematic analysis of scapular movements in patients with facioscapulohumeral muscular dystrophy.

作者信息

Savcun Demirci C, Turgut E, Ayvat E, Onursal Ö, Ayvat F, Yıldız T I, Düzgün I, Kılınç M, Aksu Yıldırım S

机构信息

Kırıkkale University, Turkey.

Hacettepe University, Turkey.

出版信息

J Electromyogr Kinesiol. 2018 Feb;38:88-93. doi: 10.1016/j.jelekin.2017.11.007. Epub 2017 Nov 14.

Abstract

The purpose of this study is to evaluate scapular movements by the three-dimensional electromagnetic system during shoulder elevation in FSHMD patients, and to compare the results with healthy individuals. 10 patients with FSHMD and 10 healthy individuals were included in the study. Scapular anterior-posterior tilt, upward-downward rotation and internal-external rotation at 30°, 60° and 90° were evaluated using the three-dimensional electromagnetic system during the elevation of the upper limbs in the scapular plane. Humerothoracic elevation levels on the dominant and non-dominant sides were found to be lower in the patients than healthy individuals (p < .001). Both scapula were rotated downwards at 30° (dominant/non-dominant p < .001) and 60° (dominant p = .009, non-dominant p = .04) of humerothoracic elevation, the scapula was rotated internally at 30° of humerothoracic elevation on the non-dominant side (p = .03), and the scapula was tilted posteriorly at 90° of humerothoracic elevation on the non-dominant side (p = .009) in patients. These existing abnormal patterns of the scapula in the patients increase the risk of impairment, pain, impingement and instability especially in the activities that require arm elevation. It is thought that physiotherapy approaches should first be emphasized to improve scapular stabilization and strengthening exercises should then be performed for the shoulder girdle muscles.

摘要

本研究的目的是通过三维电磁系统评估面肩肱型肌营养不良(FSHMD)患者在肩部抬高过程中的肩胛运动,并将结果与健康个体进行比较。10例FSHMD患者和10名健康个体纳入本研究。在肩胛平面上肢抬高过程中,使用三维电磁系统评估肩胛在30°、60°和90°时的前后倾斜、上下旋转和内外旋转。发现患者优势侧和非优势侧的肩胸抬高水平均低于健康个体(p<0.001)。在肩胸抬高30°(优势侧/非优势侧p<0.001)和60°(优势侧p=0.009,非优势侧p=0.04)时,双侧肩胛均向下旋转;在非优势侧,肩胸抬高30°时肩胛内旋(p=0.03);在非优势侧,肩胸抬高90°时肩胛后倾(p=0.009)。患者肩胛的这些异常模式增加了尤其是在需要手臂抬高的活动中出现功能障碍、疼痛、撞击和不稳定的风险。认为应首先强调物理治疗方法以改善肩胛稳定,然后应对肩胛带肌肉进行强化训练。

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