College of Science Health & Engineering, La Trobe University, Australia; St. John of God Hospital, Australia.
School of Allied Health, La Trobe University, Australia.
J Sci Med Sport. 2018 Sep;21(9):885-889. doi: 10.1016/j.jsams.2018.02.007. Epub 2018 Mar 2.
To determine whether patients with symptomatic rotator cuff pathology had more glenohumeral joint translation and different patterns of rotator cuff muscle activity compared to controls.
Repeated measurements of glenohumeral translation and muscle activity in two positions and six testing conditions in two groups.
Twenty participants with a symptomatic and diagnosed rotator cuff tear and 20 age, and gender matched controls were included. Neuromuscular activity was tested by inserting intramuscular electrodes in the rotator cuff muscles. Anterior and posterior glenohumeral translations were measured using real time ultrasound in testing conditions (with and without translation force, with and without isometric internal and external rotation), in two positions (shoulder neutral, 90° of abduction) and two force directions (anterior, posterior).
Symptomatic pathology group demonstrated increased passive glenohumeral translation with posterior translation force (p<0.05). Overall, rotator cuff muscle contraction in the pathology group limited joint translation in a similar manner to the control group, but they did not show the normal direction specific pattern in the neutral posterior position (p<0.03). The pathology group demonstrated reduced EMG activity in the upper infraspinatus muscle relative to the reference position (p<0.02) with anterior translation force and in the supraspinatus (p<0.05) muscle with anterior and posterior translation force in the abducted position.
Symptomatic pathology resulted in increased passive glenohumeral joint translation. Although there were some reductions in muscle activity with injury, their rotator cuff still controlled glenohumeral translation. These results highlight the need to consider joint translation in the assessment and management of patients with rotator cuff injury.
比较有症状的肩袖病变患者与对照组在盂肱关节活动度和肩袖肌肉活动方面的差异。
两组患者分别在两种体位和六种测试条件下，重复测量盂肱关节活动度和肌肉活动。
纳入 20 例有症状且确诊为肩袖撕裂的患者和 20 名年龄和性别匹配的对照组。通过插入肩袖肌肉的肌内电极来测试神经肌肉活动。在测试条件下（有和没有关节活动度、有和没有等长内旋和外旋）、两种体位（肩中立位、外展 90°）和两种力的方向（前向、后向），使用实时超声测量盂肱关节的前后活动度。
症状性病变组在施加后向关节活动度力时，被动盂肱关节活动度增加（p<0.05）。总体而言，病变组肩袖肌肉收缩限制关节活动度的方式与对照组相似，但在中立后位时，他们没有表现出正常的方向特异性模式（p<0.03）。病变组在前向关节活动度力作用下，上肩胛下肌的肌电图活动相对参考位置减少（p<0.02），在前向和后向关节活动度力作用下，外展位时，肩胛上肌的肌电图活动减少（p<0.05）。
症状性病变导致被动盂肱关节活动度增加。尽管肌肉活动有一些减少，但他们的肩袖仍能控制盂肱关节的活动度。这些结果强调了在评估和管理肩袖损伤患者时需要考虑关节活动度。
