Schnorenberg Alyssa J, French Margaret E, Riebe Justin M, Grindel Steven I, Slavens Brooke A
Department of Occupational Science and Technology, College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI 53201, USA; Department of Biomedical Engineering, College of Engineering, Marquette University, Milwaukee, WI 53201, USA.
Department of Occupational Science and Technology, College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI 53201, USA.
J Electromyogr Kinesiol. 2022 Feb;62:102331. doi: 10.1016/j.jelekin.2019.07.001. Epub 2019 Jul 2.
This study investigated shoulder complex joint kinematics and functional outcomes before and after full-thickness supraspinatus rotator cuff repair. Nine adults (mean age 63.4 ± 6.2 years) participated in three test sessions: 0-12 weeks pre-operatively, 9-12 weeks, and 22-30 weeks post-operatively. Upper extremity kinematics of the surgical arm's glenohumeral, acromioclavicular, sternoclavicular and thoracohumeral joints over the duration of a hair combing task were quantified with motion analysis using inverse kinematics. The UCLA Shoulder Rating and Simple Shoulder Test shoulder health outcomes were administered at each session to determine patients' perceived function of their surgical shoulder. Results indicated multiple significant increases over time among the three joints comprising the shoulder complex in the coronal and transverse planes, despite no increases in thoracohumeral motion, and suggest that thoracohumeral motion alone does not provide a comprehensive assessment. Interestingly, more significant increases were observed at the 6-month evaluation than the 3-month evaluation, which is not aligned with the standard rehabilitation endpoint. Thus, our findings suggest that clinicians should evaluate all joints of the shoulder complex during longer-term rehabilitation assessment. Ultimately, knowledge of patients' pre-operative and post-operative shoulder complex kinematics may help to improve rehabilitation to promote improved patient outcomes.
本研究调查了全层冈上肌肩袖修复术前和术后肩部复合体关节的运动学及功能结果。9名成年人（平均年龄63.4±6.2岁）参与了三个测试阶段：术前0至12周、术后9至12周以及术后22至30周。在梳理头发任务过程中，使用反向运动学通过运动分析对手术侧手臂的盂肱、肩锁、胸锁和胸肱关节的上肢运动学进行了量化。在每个阶段进行加州大学洛杉矶分校（UCLA）肩部评分和简易肩部测试，以确定患者对其手术肩部功能的感知。结果表明，尽管胸肱运动没有增加，但在冠状面和横断面上，构成肩部复合体的三个关节随时间有多次显著增加，这表明仅胸肱运动并不能提供全面评估。有趣的是，在6个月评估时观察到的增加比3个月评估时更显著，这与标准康复终点不一致。因此，我们的研究结果表明，临床医生在长期康复评估期间应评估肩部复合体的所有关节。最终，了解患者术前和术后肩部复合体的运动学可能有助于改善康复，以促进更好的患者预后。
