Contemori Samuele, Panichi Roberto, Biscarini Andrea
University of Perugia, Department of Experimental Medicine, Piazza Gambuli 1, 06132 Perugia, Italy.
Hum Mov Sci. 2019 Apr;64:55-66. doi: 10.1016/j.humov.2019.01.005. Epub 2019 Jan 16.
According to scapulohumeral rhythm, shoulder abduction is followed through scapular upward rotation to ensure joint mobility and stability. Of interest, the shoulder abduction can be performed holding the scapula in different positions and in association with scapular elevation, with possible effects on shoulder muscle activity. Therefore, the aim of the study was to analyze the activity of relevant shoulder muscles and the activity ratios between the scapulothoracic muscles, during shoulder abduction performed in different combinations of scapular position (neutral, retracted, protracted) and scapular elevation. The electromyographic activity of middle deltoid, serratus anterior, upper, middle and lower fibers of trapezius was recorded during shoulder abduction movements executed holding the scapula in neutral, retracted and protracted position, and subsequently a shoulder elevation movement. The activation of each muscle and the scapulothoracic muscles activity ratios were determined every 15 degrees, from 15° to 120° of abduction. Scapular retraction led to higher activation of the entire trapezius muscle, whereas protraction induced higher upper trapezius, middle deltoid and serratus anterior activity, along with lower activity of middle and lower trapezius. Shoulder elevation led to higher activity of the upper trapezius and middle deltoid. Moreover, it induced lower activation of the serratus anterior and middle and lower trapezius, thus leading to high ratios between the upper trapezius and the other scapulothoracic muscles, especially between 15 and 75 degrees of abduction. This study highlights that shoulder abduction performed with scapular protraction and in combination with scapular elevation leads to increased activity of the middle deltoid and upper trapezius, resulting in imbalances between the scapulothoracic muscles that could hamper the optimal scapulohumeral rhythm. The abduction performed in the aforementioned scapular conditions also induce potential reciprocal inhibition effects between the movers and stabilizers muscles of scapula, suggesting different motor control strategies of integrating a common shoulder movement with various modification of the scapular position.
根据肩肱节律,肩关节外展通过肩胛骨向上旋转来完成,以确保关节的活动度和稳定性。有趣的是,肩关节外展可以在将肩胛骨保持在不同位置并伴有肩胛骨抬高的情况下进行,这可能会对肩部肌肉活动产生影响。因此,本研究的目的是分析在肩胛骨位置(中立位、后缩、前伸)和肩胛骨抬高的不同组合下进行肩关节外展时,相关肩部肌肉的活动以及肩胛胸壁肌肉之间的活动比率。在将肩胛骨保持在中立位、后缩位和前伸位进行肩关节外展运动以及随后的肩关节抬高运动过程中,记录了三角肌中部、前锯肌、斜方肌上、中、下纤维的肌电图活动。在外展15°至120°的过程中,每隔15°测定一次每块肌肉的激活情况以及肩胛胸壁肌肉的活动比率。肩胛骨后缩导致整个斜方肌的激活程度更高,而前伸则诱导斜方肌上部、三角肌中部和前锯肌的活动增加,同时斜方肌中部和下部的活动降低。肩关节抬高导致斜方肌上部和三角肌中部的活动增加。此外,它还诱导前锯肌以及斜方肌中部和下部的激活程度降低,从而导致斜方肌上部与其他肩胛胸壁肌肉之间的比率升高,尤其是在外展15°至75°之间。本研究强调,在肩胛骨前伸并伴有肩胛骨抬高的情况下进行肩关节外展会导致三角肌中部和斜方肌上部的活动增加,从而导致肩胛胸壁肌肉之间的失衡,这可能会妨碍最佳的肩肱节律。在上述肩胛骨条件下进行的外展还会在肩胛骨的运动肌和稳定肌之间诱导潜在的相互抑制作用,这表明在将常见的肩部运动与肩胛骨位置的各种改变相结合时存在不同的运动控制策略。