Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences in Poznan, Poznań, Poland; Rehasport Clinic, Poznań, Poland.
Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences in Poznan, Poznań, Poland; Rehasport Clinic, Poznań, Poland.
J Shoulder Elbow Surg. 2019 Mar;28(3):561-569. doi: 10.1016/j.jse.2018.08.034. Epub 2018 Nov 28.
Proprioception is an important element of shoulder dynamic stability. It has been shown to be affected in cases of capsular or labral injuries of the glenohumeral joint. Therefore, this study was conducted to investigate bilateral shoulder proprioception by active reproduction of joint position both in patients with post-traumatic recurrent unilateral shoulder instability and in normal healthy volunteers.
We compared 41 patients, comprising 11 female and 30 male patients with an average age of 25.6 years (range, 18-39 years), with post-traumatic unilateral anterior shoulder instability with a control group of 27 healthy volunteers with no history of shoulder problems and with normal shoulder function during examination. All patients were examined using a high-accuracy computer-controlled electronic goniometer (Propriometer). The error of active reproduction of joint position (EARJP) was measured in abduction, flexion, external rotation, and internal rotation in both shoulders.
We observed a significant deficit in the EARJP in the unstable shoulders within the instability group. Surprisingly, similar results were recorded for the contralateral, unaffected shoulders within this group of patients compared with the control group. Joint acuity increased with higher elevation of the arm position.
Unilateral shoulder injuries, resulting in instability, affect proprioception in both shoulders, as demonstrated by an increased EARJP. This is the first report of unilateral shoulder instability coexisting with inferior proprioception in both shoulders.
本体感觉是肩部动态稳定性的一个重要因素。已经表明，在肩盂肱关节的囊或盂唇损伤的情况下，本体感觉会受到影响。因此，这项研究旨在通过主动再现关节位置来研究创伤后复发性单侧肩不稳定患者和正常健康志愿者的双侧肩部本体感觉。
我们比较了 41 名患者，包括 11 名女性和 30 名男性，平均年龄 25.6 岁（范围 18-39 岁），患有创伤后单侧前肩不稳定，并与 27 名无肩部问题且在检查期间肩部功能正常的健康志愿者对照组进行比较。所有患者均使用高精度计算机控制电子角度计（Propriometer）进行检查。在不稳定组中，在两个肩部的外展、屈曲、外旋和内旋中测量主动再现关节位置的误差（EARJP）。
我们观察到不稳定肩的 EARJP 明显不足。令人惊讶的是，与对照组相比，该组患者的对侧未受影响的肩部也记录到了类似的结果。关节锐度随手臂位置的升高而增加。
导致不稳定的单侧肩部损伤会影响双侧肩部的本体感觉，表现为 EARJP 增加。这是单侧肩不稳定同时存在双侧肩部本体感觉下降的首次报道。
