Sharma Amit, Sharma Ankur, Mishra Abhishek, Maini Dhruv, Sharma Parul, Verma Tarun
1Lady Hardinge Medical College, New Delhi, India.
2Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India.
Indian J Orthop. 2020 Jan 13;54(3):374-380. doi: 10.1007/s43465-019-00003-7. eCollection 2020 May.
Pectoralis Minor Index (PMI) is a proposed parameter to evaluate the pectoralis minor length (PML), eliminating the effect of subject's variability of height. Neither a PMI standard value nor any cutoff value to label a shortened pectoralis minor (PM) has been accepted yet, which can be applied to every individual. Moreover, the length of the PM has never been correlated to any fixed reference in the body. Hence, we estimated the PML in the Indian population and investigated its correlation to the individual's hand length.
A cross-sectional study was conducted including 100 adult subjects without any shoulder pathology. Subjects with history of fracture/treatment involving upper limb/spine were excluded. Two assessors evaluated the height, PM length and hand length of subjects. PMI and hand correlation was evaluated using their mean values.
Mean PML and PMI for dominant and non-dominant shoulder were calculated to be 18.11/18.21 cm and 10.53/10.59, respectively. Mean hand length of dominant and non-dominant hand was found to be 18.27 cm and 18.31 cm, respectively. Pearson correlation coefficient between right/left PML with right/left hand length was 0.67 and 0.63, respectively, suggesting a good correlation ( < 0.01).
PMI varies in different ethnic groups, which makes PMI a less reliable indicator for managing shoulder pain in ethnic groups where reference values are yet not available. Contralateral PMI can be used as a reference value in unilateral shoulder pathologies with short PML. Hand length can become an important parameter in evaluating painful shoulders even in bilateral pathologies. Hand length can be used as an easy and quick technique to compare the PML and effect of physiotherapy in patients with diagnosis of short PML, attending follow-up OPD. Though, a study comparing PML of normal subjects and patients with shoulder pain will be further required in different ethnic groups for further validation of this study.
胸小肌指数(PMI)是一个用于评估胸小肌长度(PML)的参数,可消除受试者身高差异的影响。目前尚未有被广泛接受的PMI标准值或用于判定胸小肌(PM)缩短的临界值,无法应用于个体。此外,胸小肌的长度从未与身体中的任何固定参考值相关联。因此,我们对印度人群的PML进行了估计,并研究了其与个体手长的相关性。
进行了一项横断面研究,纳入100名无肩部病变的成年受试者。排除有上肢/脊柱骨折/治疗史的受试者。两名评估人员对受试者的身高、胸小肌长度和手长进行评估。使用平均值评估PMI与手长的相关性。
优势肩和非优势肩的平均PML和PMI分别计算为18.11/18.21厘米和10.53/10.59。优势手和非优势手的平均手长分别为18.27厘米和18.31厘米。右侧/左侧PML与右侧/左侧手长之间的Pearson相关系数分别为0.67和0.63,表明相关性良好(<0.01)。
PMI在不同种族群体中存在差异,这使得PMI在尚无参考值的种族群体中作为管理肩痛的指标可靠性较低。对侧PMI可作为PML缩短的单侧肩部病变的参考值。即使在双侧病变中,手长也可能成为评估疼痛肩部的重要参数。手长可作为一种简便快捷的技术,用于比较诊断为PML缩短且正在接受门诊随访的患者的PML和物理治疗效果。不过,不同种族群体还需要进一步开展正常受试者与肩痛患者PML比较的研究,以进一步验证本研究结果。