Shih Yi-Fen, Liao Pei-Wen, Lee Chun-Shou
Department of Physical Therapy and Assistive Technology, National Yang-Ming University, 155, Li-Nong Street Sec 2, Pei-Tou District, Taipei, Taiwan, 112.
Division of Physical therapy, Department of Rehabilitation, Taipei City Hospital-Renai Branch, Taipei, Taiwan.
BMC Musculoskelet Disord. 2017 Nov 28;18(1):499. doi: 10.1186/s12891-017-1867-8.
Contractile tissue plays an important role in mobility deficits in frozen shoulder (FS). However, no study has assessed the effect of the muscle release technique on the muscle activation and kinematics in individuals with FS. The purposes of this study were to assess the differences in shoulder muscle activity and kinematics between the FS and asymptomatic groups; and to determine the immediate effects of muscle release intervention in the FS group.
Twenty patients with FS and 20 asymptomatic controls were recruited. The outcome measures included muscle activity of the upper and lower trapezius (UT and LT), infraspinatus (ISp), pectoralis major (PM), and teres major (TM), shoulder kinematics (humeral elevation, scapular posterior tilt (PT) and upward rotation (UR), shoulder mobility, and pain. Participants in the FS group received one-session of heat and manual muscle release. Measurements were obtained at baseline, and immediately after intervention. Multivariate analysis of variance was used for data analysis. The level of significance was set at α=0.05.
Compared to the controls, the FS group revealed significantly decreased LT (difference =55.89%, P=0.001) and ISp muscle activity (difference =26.32%, P =0.043) during the scaption task, and increased PM activity (difference =6.31%, P =0.014) during the thumb to waist task. The FS group showed decreased humeral elevation, scapular PT, and UR (difference = 35.36°, 10.18°, 6.73° respectively, P <0.05). Muscle release intervention immediately decreased pain (VAS drop 1.7, P <0.001); improved muscle activity during scaption (UT: 12.68% increase, LT: 35.46% increase, P <0.05) and hand to neck (UT: 12.14% increase, LT: 34.04% increase, P <0.05) task; and increased peak humeral elevation and scapular PT during scaption (95.18°±15.83° to 98.24°±15.57°, P=0.034; 11.06°±3.94° to 14.36°±4.65°, P=0.002), and increased scapular PT during the hand to neck (9.47°±3.86° to 12.80°±8.33°, P=0.025) task. No statistical significance was found for other group comparisons or intervention effect.
Patients with FS presented with altered shoulder muscle activity and kinematics, and one-session of heat and manual muscle release showed beneficial effects on shoulder muscle performance, kinematics, mobility, and pain.
Retrospectively registered on Jan 18, 2016 (ACTRN 12616000031460 ).
收缩组织在肩周炎（FS）导致的活动能力缺陷中起重要作用。然而，尚无研究评估肌肉松解技术对肩周炎患者肌肉激活和运动学的影响。本研究的目的是评估肩周炎组与无症状组之间肩部肌肉活动和运动学的差异；并确定肌肉松解干预对肩周炎组的即时效果。
招募了20例肩周炎患者和20名无症状对照者。观察指标包括上、下斜方肌（UT和LT）、冈下肌（ISp）、胸大肌（PM）和大圆肌（TM）的肌肉活动、肩部运动学（肱骨抬高、肩胛骨后倾（PT）和上旋（UR））、肩部活动度和疼痛。肩周炎组参与者接受了一次热疗和手动肌肉松解。在基线时以及干预后立即进行测量。采用多变量方差分析进行数据分析。显著性水平设定为α=0.05。
与对照组相比，肩周炎组在肩胛骨平面外展任务期间LT（差异=55.89%，P=0.001）和ISp肌肉活动显著降低（差异=26.32%，P =0.043），在拇指到腰部任务期间PM活动增加（差异=6.31%，P =0.014）。肩周炎组肱骨抬高、肩胛骨PT和UR降低（差异分别为35.36°、10.18°、6.73°，P <0.05）。肌肉松解干预立即减轻了疼痛（视觉模拟评分下降1.7，P <0.001）；改善了肩胛骨平面外展（UT：增加12.68%，LT：增加35.46%，P <0.05）和手到颈部（UT：增加12.14%，LT：增加34.04%，P <0.05）任务期间的肌肉活动；并增加了肩胛骨平面外展期间的肱骨抬高峰值和肩胛骨PT（95.18°±15.83°至98.24°±15.57°，P=0.034；11.06°±3.94°至14.36°±4.65°，P=0.002），以及手到颈部任务期间的肩胛骨PT（9.47°±3.86°至12.80°±8.33°，P=0.025）。其他组间比较或干预效果未发现统计学意义。
肩周炎患者存在肩部肌肉活动和运动学改变，一次热疗和手动肌肉松解对肩部肌肉性能、运动学、活动度和疼痛显示出有益效果。
于2016年1月18日进行回顾性注册（ACTRN 12616000031460）。
