Department of Physical Therapy, University of New England, Portland, ME, USA.
Einstein Sports Medicine, East Norriton, PA, USA.
Physiother Theory Pract. 2021 Nov;37(11):1227-1234. doi: 10.1080/09593985.2019.1686670. Epub 2019 Nov 7.
Inhibition of rotator cuff activation and force after local experimental pain has been previously shown. Clinically, strength is often indexed to the uninvolved side in order to quantify deficits during injury and recovery. This study assessed the effect of experimental subacromial pain on contralateral shoulder external rotation (ER) force and activation. We hypothesized that subacromial pain would not affect contralateral shoulder external rotation force and voluntary activation (VA) of the contralateral infraspinatus because we believe that the effects of acute experimental pain will largely exert an ipsilateral, spinal segmental effect. Twenty healthy adults were tested. External rotation force and VA were tested while participants performed maximum voluntary isometric contractions of shoulder external rotation, during which a brief electrical stimulus was applied to the infraspinatus muscle at an intensity that maximized external rotation force. To elicit pain, 1.5 ml of 5% hypertonic saline was injected into the contralateral subacromial space. Mean (SD) pain immediately after injection was 6.3/10 (0.85) resulting in a 7.6% decline in contralateral external rotation force ( < .01) and 3.3% decline in infraspinatus muscle VA ( = .48). A subset of participants (n = 9) showed a more substantial decline in both force (15.4%; < .000001; d = -3.53) and VA (8.7%; = .045; d = -0.98). Experimental shoulder pain had a modest effect on contralateral ER force and VA in a subset of participants; therefore, it may be important to index or compare strength bilaterally throughout rehabilitation to capture this bilateral effect as pain resolves.
先前已经证明,局部实验性疼痛会抑制肩袖的激活和力量。临床上,为了量化损伤和康复期间的缺陷,通常会将力量与未受影响的一侧进行比较。本研究评估了实验性肩峰下疼痛对对侧肩部外旋(ER)力量和激活的影响。我们假设肩峰下疼痛不会影响对侧肩部外旋力量和对侧冈下肌的自愿激活(VA),因为我们认为急性实验性疼痛的影响主要会产生同侧、脊髓节段的影响。本研究纳入了 20 名健康成年人。在参与者进行最大自主等长肩部外旋收缩时,同时测试了外旋力量和 VA,在此期间,冈下肌肌肉内短暂施加了一个强度足以最大化外旋力量的电刺激。为了诱发疼痛,将 1.5 毫升 5%高渗盐水注入对侧肩峰下空间。注射后立即平均(SD)疼痛评分为 6.3/10(0.85),导致对侧外旋力量下降 7.6%(<0.01),冈下肌 VA 下降 3.3%(=0.48)。一部分参与者(n=9)在力量(15.4%;<0.000001;d=-3.53)和 VA(8.7%;=0.045;d=-0.98)均出现了更大的下降。在一部分参与者中,实验性肩部疼痛对侧 ER 力量和 VA 有适度影响;因此,在疼痛缓解过程中,为了捕获这种双侧影响,在康复过程中双侧指数或比较力量可能很重要。