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在无负荷和最大负荷等速向心和离心肩部屈伸运动过程中的肩胛骨运动学

Scapular kinematics during unloaded and maximal loaded isokinetic concentric and eccentric shoulder flexion and extension movements.

作者信息

Wochatz Monique, Rabe Sophie, Engel Tilman, Mueller Steffen, Mayer Frank

机构信息

University of Potsdam, University Outpatient Clinic, Sports Medicine and Sports Orthopaedics, Am Neuen Palais 10 - Haus 12, D-14469 Potsdam, Germany.

University of Potsdam, Center of Rehabilitation Research, Am Neuen Palais 10 - Haus 12, D-14469 Potsdam, Germany.

出版信息

J Electromyogr Kinesiol. 2021 Apr;57:102517. doi: 10.1016/j.jelekin.2021.102517. Epub 2021 Jan 17.

Abstract

Characterization of scapular kinematics under demanding load conditions might aid to distinguish between physiological and clinically relevant alterations. Previous investigations focused only on submaximal external load situations. How scapular movement changes with maximal load remains unclear. Therefore, the present study aimed to evaluate 3D scapular kinematics during unloaded and maximal loaded shoulder flexion and extension. Twelve asymptomatic individuals performed shoulder flexion and extension movements under unloaded and maximal concentric and eccentric loaded isokinetic conditions. 3D scapular kinematics assessed with a motion capture system was analyzed for 20° intervals of humeral positions from 20° to 120° flexion. Repeated measures ANOVAs were used to evaluate kinematic differences between load conditions for scapular position angles, scapulohumeral rhythm and scapular motion extent. Increased scapular upward rotation was seen during shoulder flexion and extension as well as decreased posterior tilt and external rotation during eccentric and concentric arm descents of maximal loaded compared to unloaded conditions. Load effects were further seen for the scapulohumeral rhythm with greater scapular involvement at lower humeral positions and increased scapular motion extent under maximal loaded shoulder movements. With maximal load applied to the arm physiological scapular movement pattern are induced that may imply both impingement sparing and causing mechanisms.

摘要

在高负荷条件下对肩胛骨运动学特征进行表征,可能有助于区分生理性改变和临床相关改变。以往的研究仅关注次最大外部负荷情况。肩胛骨运动在最大负荷下如何变化仍不清楚。因此,本研究旨在评估在无负荷以及最大负荷下肩部屈伸过程中的三维肩胛骨运动学。12名无症状个体在无负荷、最大向心和离心负荷等速条件下进行肩部屈伸运动。使用运动捕捉系统评估三维肩胛骨运动学,分析肱骨从屈曲20°到120°之间每隔20°位置时的情况。重复测量方差分析用于评估负荷条件之间在肩胛骨位置角度、肩肱节律和肩胛骨运动范围方面的运动学差异。与无负荷条件相比,在最大负荷下,肩部屈伸过程中可见肩胛骨向上旋转增加,在最大负荷下离心和向心手臂下降过程中可见后倾和外旋减少。在肩肱节律方面也观察到负荷效应,在较低肱骨位置时肩胛骨参与度更高,在最大负荷肩部运动时肩胛骨运动范围增加。当手臂施加最大负荷时,会诱发生理性肩胛骨运动模式,这可能意味着既有避免撞击的机制,也有导致撞击的机制。

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