Seo Joong-Bae, Yoon Sung-Hyun, Lee Joon-Yeul, Kim Jun-Kyom, Yoo Jae-Sung
Department of Orthopedic Surgery, Dankook University College of Medicine, Cheonan, Korea.
Clin Orthop Surg. 2018 Mar;10(1):47-54. doi: 10.4055/cios.2018.10.1.47. Epub 2018 Feb 27.
A variety of treatment options suggest that the optimal treatment strategy for lateral elbow tendinopathy (LET) is not known, and further research is needed to discover the most effective treatment for LET. The purpose of the present study was to verify the most effective position of eccentric stretching for the extensor carpi radialis brevis (ECRB) using ultrasonic shear wave elastography.
A total of 20 healthy males participated in this study. Resting position was defined as 90° elbow flexion and neutral position of the forearm and wrist. Elongation of the ECRB was measured for four stretching maneuvers (forearm supination/pronation and wrist extension/flexion) at two elbow angles (90° flexion and full extension). The shear elastic modulus, used as the index of muscle elongation, was computed using ultrasonic shear wave elastography for the eight aforementioned stretching maneuverangle combinations.
The shear elastic modulus was the highest in elbow extension, forearm pronation, and wrist flexion. The shear elastic moduli of wrist flexion with any forearm and elbow position were significantly higher than the resting position. There was no significant difference associated with elbow and forearm positions except for elbow extension, forearm pronation, and wrist flexion positions.
This study determined that elbow extension, forearm pronation, and wrist flexion was the most effective eccentric stretching for the ECRB .
多种治疗选择表明,外侧肘肌腱病(LET)的最佳治疗策略尚不清楚,需要进一步研究以发现LET最有效的治疗方法。本研究的目的是使用超声剪切波弹性成像技术验证桡侧腕短伸肌(ECRB)离心拉伸的最有效位置。
共有20名健康男性参与本研究。休息位定义为肘关节屈曲90°,前臂和腕关节处于中立位。在两个肘关节角度(屈曲90°和完全伸展)下,对四种拉伸动作(前臂旋前/旋后和腕关节伸展/屈曲)时的ECRB伸长情况进行测量。使用超声剪切波弹性成像技术,针对上述八种拉伸动作与角度的组合计算作为肌肉伸长指标的剪切弹性模量。
在肘关节伸展、前臂旋前和腕关节屈曲时,剪切弹性模量最高。在任何前臂和肘关节位置下,腕关节屈曲时的剪切弹性模量均显著高于休息位。除肘关节伸展、前臂旋前和腕关节屈曲位置外,肘关节和前臂位置之间无显著差异。
本研究确定,肘关节伸展、前臂旋前和腕关节屈曲是对ECRB最有效的离心拉伸动作。