肩胸旋转减少对肩峰下近侧的影响。
The Impact of Decreased Scapulothoracic Upward Rotation on Subacromial Proximities.
出版信息
J Orthop Sports Phys Ther. 2019 Mar;49(3):180-191. doi: 10.2519/jospt.2019.8590. Epub 2019 Jan 18.
BACKGROUND
Decreased scapulothoracic upward rotation has been theorized to increase an individual's risk for rotator cuff compression by reducing the clearance for the tendons in the subacromial space (ie, subacromial proximities). However, the impact of decreased scapulothoracic upward rotation on subacromial proximities has not been tested during dynamic in vivo shoulder motion.
OBJECTIVE
To determine the impact of decreased scapulothoracic upward rotation on subacromial proximities.
METHODS
Shoulder kinematics were quantified in 40 participants, classified as having high or low scapulothoracic upward rotation, during scapular plane abduction using single-plane fluoroscopy and 2-D/3-D shape-matching. Subacromial proximities were calculated as (1) the normalized minimum distance between the coracoacromial arch and humeral rotator cuff insertion, and (2) the surface area of the humeral rotator cuff insertion in immediate proximity to the coracoacromial arch. The effect of decreased scapulothoracic upward rotation on subacromial proximities was assessed using 2-factor mixed-model analyses of variance. The prevalence of contact between the coracoacromial arch and rotator cuff was also quantified.
RESULTS
Subacromial distances were generally smallest below 70° of humerothoracic elevation. With the arm at the side, the normalized minimum distance for participants in the low scapulothoracic upward rotation group was 34.8% smaller compared to those in the high upward rotation group (P = .049). Contact between the coracoacromial arch and rotator cuff tendon occurred in 45% of participants.
CONCLUSION
Decreased scapulothoracic upward rotation shifts the range of risk for subacromial rotator cuff compression to lower angles. However, the low prevalence of contact suggests that subacromial rotator cuff compression may be less common than traditionally presumed. J Orthop Sports Phys Ther 2019;49(3):180-191. Epub 18 Jan 2019. doi:10.2519/jospt.2019.8590.
背景
肩胛骨胸壁上旋减少被认为通过减少肩峰下空间（即肩峰下间隙）的肌腱间隙来增加冈上肌腱受压的风险。然而，在动态活体肩部运动中，肩胛骨胸壁上旋减少对肩峰下间隙的影响尚未得到测试。
目的
确定肩胛骨胸壁上旋减少对肩峰下间隙的影响。
方法
使用单平面荧光透视和 2 维/3 维形状匹配，在 40 名参与者的肩胛骨平面外展过程中对肩部运动进行了定量评估，这些参与者分为肩胛骨胸壁上旋高或低。根据（1）喙突肩峰弓和肱骨肩袖插入之间的归一化最小距离，（2）喙突肩峰弓附近肱骨肩袖插入的表面积来计算肩峰下间隙。使用双因素混合模型方差分析评估肩胛骨胸壁上旋减少对肩峰下间隙的影响。还定量评估了喙突肩峰弓和肩袖之间接触的发生率。
结果
肩峰下距离通常在肩胸抬高 70°以下时最小。手臂在体侧时，低肩胛骨胸壁上旋组的归一化最小距离比高肩胛骨胸壁上旋组小 34.8%（P =.049）。在 45%的参与者中，喙突肩峰弓和肩袖肌腱之间发生了接触。
结论
肩胛骨胸壁上旋减少将肩峰下冈上肌腱受压的风险范围转移到较低的角度。然而，接触的低发生率表明肩峰下冈上肌腱受压可能比传统上认为的要少见。
美国骨科运动物理治疗杂志 2019 年；49（3）：180-191。2019 年 1 月 18 日在线发表。doi：10.2519/jospt.2019.8590。
Zotero 插件