Bekker Michel J, Vegter Riemer J K, van der Scheer Jan W, Hartog Johanneke, de Groot Sonja, de Vries Wiebe, Arnet Ursina, van der Woude Lucas H V, Veeger Dirkjan H E J
Swiss Paraplegic Research, Guido A. Zächstrasse 4, CH, 6207 Nottwil, Switzerland; Research Institute MOVE, Department of Human Movement Sciences, Free University Amsterdam, Van der Boechorststraat 7, NL, 1081BT Amsterdam, The Netherlands; Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, NL-9713AV Groningen, The Netherlands.
Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, NL-9713AV Groningen, The Netherlands.
Clin Biomech (Bristol). 2018 May;54:54-61. doi: 10.1016/j.clinbiomech.2018.03.008. Epub 2018 Mar 14.
Altered scapular kinematics have been associated with shoulder pain and functional limitations. To understand kinematics in persons with spinal cord injury during manual handrim wheelchair propulsion, a description of normal scapular behaviour in able-bodied persons during this specific task is a prerequisite for accurate interpretation. The primary aim of this study is to describe scapular kinematics in able-bodied persons during manual wheelchair propulsion.
Sixteen able-bodied, novice wheelchair users without shoulder complaints participated in the study. Kinematic and kinetic data were collected during a standardized pose in the anatomic posture, frontal-plane arm elevation and low-intensity steady-state handrim wheelchair propulsion and upper-body Euler angles were calculated.
Scapulothoracic joint orientations in a static position were 36.7° (SD 5.4°), 6.4° (SD 9.1°) and 9.1° (SD 5.7°) for respectively protraction, lateral rotation and anterior tilt. At 80° of arm elevation in the frontal plane, the respective values of 33.4° (SD 8.0°), 23.9° (SD 5.4°) and 4.1° (SD 11.3°) were found. During the push phase of manual wheelchair propulsion, the mean scapular rotations were respectively 32.7° (SD 7.1°), 7.1° (SD 9.2°) and 9.8° (SD 8.3°).
The orientation of the scapula in a static pose, during arm elevation and in manual wheelchair propulsion in able-bodied participants showed similar patterns to a previous study in persons with para- and tetraplegia. These values provide a reference for the investigation of the scapular movement pattern in wheelchair-dependent persons and its relation to shoulder complex abnormalities.
肩胛骨运动学改变与肩部疼痛和功能受限有关。为了解脊髓损伤患者在手动轮椅推进过程中的运动学情况，准确解释这一特定任务中健全人正常的肩胛骨行为是前提条件。本研究的主要目的是描述健全人在手动轮椅推进过程中的肩胛骨运动学情况。
16名无肩部问题的健全新手轮椅使用者参与了本研究。在解剖姿势的标准化姿势、额面手臂抬高以及低强度稳态手动轮椅推进过程中收集运动学和动力学数据，并计算上身欧拉角。
在静态位置，肩胛胸壁关节的前伸、外旋和前倾方向分别为36.7°（标准差5.4°）、6.4°（标准差9.1°）和9.1°（标准差5.7°）。在额面手臂抬高80°时，相应的值分别为33.4°（标准差8.0°）、23.9°（标准差5.4°）和4.1°（标准差11.3°）。在手动轮椅推进的推阶段，肩胛骨的平均旋转分别为32.7°（标准差7.1°）、7.1°（标准差9.2°）和9.8°（标准差8.3°）。
健全参与者在静态姿势、手臂抬高以及手动轮椅推进过程中肩胛骨的方向与之前一项针对截瘫和四肢瘫患者的研究显示出相似模式。这些值为研究依赖轮椅者的肩胛骨运动模式及其与肩部复合体异常的关系提供了参考。
