Hotta Gisele Harumi, Queiroz Paulo Otávio Pimenta, de Lemos Tenysson Will, Rossi Denise Martineli, Scatolin Ramon de Oliveira, de Oliveira Anamaria Siriani
Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
Clin Biomech (Bristol). 2018 Oct;58:7-13. doi: 10.1016/j.clinbiomech.2018.07.004. Epub 2018 Jul 5.
Given the changes in the patterns of muscular activation and scapular movement in individuals with subacromial pain syndrome, the use of neuromuscular training has been considered in rehabilitation protocols. There is currently no evidence of the effects of the use of three-dimensional (3D) kinematic biofeedback on individuals with subacromial pain syndrome. This study aimed to determine the immediate effect of scapular motor control exercises using 3D kinematic biofeedback on the scapular kinematics, inter-segment coordination and pain of individuals with subacromial pain syndrome.
The kinematics of the scapulothoracic joint of 26 subjects with subacromial pain syndrome were assessed in the movement arm elevation and lowering in the sagittal plane before and after performance of three scapula-focused exercises using kinematic biofeedback. The individuals were familiarized with the selected exercises to acquire a greater scapular posterior tilt, while kinematic biofeedback, with visual and auditory stimuli, was used in real time. Scapular kinematics, pain, and subjective perception of exertion were the pre- and post-test measures.
In the movement of arm elevation and lowering, no differences were found in scapular tilt and on coordination between the segments pre- and post-test and the effect size was considered small.
Our results demonstrate that the performance of scapula-focused exercises using kinematic biofeedback does not cause immediate changes in the magnitude of scapular movement. However, inter-segmental coordination showed evidence of changes for scapular tilt in the lowering of the arm and internal rotation in the elevation and the lowering of the arm in individuals with subacromial pain syndrome.
鉴于肩峰下疼痛综合征患者肌肉激活模式和肩胛运动的变化,康复方案中已考虑采用神经肌肉训练。目前尚无证据表明三维(3D)运动生物反馈对肩峰下疼痛综合征患者的影响。本研究旨在确定使用3D运动生物反馈进行肩胛运动控制练习对肩峰下疼痛综合征患者的肩胛运动学、节段间协调性和疼痛的即时影响。
对26例肩峰下疼痛综合征患者在矢状面进行手臂上举和放下运动时的肩胛胸壁关节运动学进行评估,在使用运动生物反馈进行三项以肩胛为重点的练习前后各进行一次评估。让受试者熟悉所选练习以获得更大的肩胛后倾,同时实时使用带有视觉和听觉刺激的运动生物反馈。肩胛运动学、疼痛和主观用力感受是测试前后的测量指标。
在手臂上举和放下运动中,测试前后肩胛倾斜度和节段间协调性均无差异,效应量较小。
我们的结果表明,使用运动生物反馈进行以肩胛为重点的练习不会立即引起肩胛运动幅度的变化。然而,节段间协调性显示,肩峰下疼痛综合征患者在手臂放下时肩胛倾斜以及手臂上举和放下时内旋方面存在变化迹象。