Ishikawa Hiroaki, Muraki Takayuki, Morise Shuhei, Yamamoto Nobuyuki, Itoi Eiji, Izumi Shin-Ichi
Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Japan.
Department of Rehabilitation, Sendai Medical Center, Sendai, Japan.
JSES Int. 2020 Dec 15;5(2):238-246. doi: 10.1016/j.jseint.2020.10.014. eCollection 2021 Mar.
Altered scapular motion is thought to be one of the factors associated with the development of symptomatic rotator cuff tears. However, the differences in kinematics and muscle activities of scapular upward/downward rotation between patients with symptomatic and asymptomatic tears are unclear. The purpose of this study was to compare the differences in kinematics and muscle activities of scapular rotation among patients with symptomatic and asymptomatic tears, and healthy individuals.
Twenty-three patients with rotator cuff tears and 9 healthy individuals (healthy group) participated in this study. Based on a visual analog scale (VAS, 0-100 mm), the patients were divided into symptomatic (13 patients; VAS ≥20 mm) and asymptomatic (10 patients; VAS <20 mm) groups. Scapular upward rotation was measured with a digital inclinometer. Elasticities of the upper trapezius, levator scapulae, and rhomboid major were assessed by using ultrasound real-time tissue elastography to quantify their muscle activities. All measurements were performed at 0°, 60°, 90°, and 120° of active arm elevation in the scapular plane.
Scapular upward rotation was significantly less in the symptomatic group (9.4° ± 5.6°) compared with the asymptomatic group (15.7° ± 6.0°; = .022) at 90° of arm elevation. The activity of the levator scapulae was significantly higher in the symptomatic group compared with the asymptomatic and healthy groups ( = .013 and = .005, respectively) at 90° of arm elevation. The activity of the upper trapezius was significantly higher in the symptomatic group compared with the healthy group ( = .015) at 120° of arm elevation.
Patients with symptomatic rotator cuff tears showed less scapular upward rotation and higher activity of the levator scapulae at 90° of arm elevation compared to patients with asymptomatic rotator cuff tears.
肩胛运动改变被认为是与有症状的肩袖撕裂发展相关的因素之一。然而，有症状和无症状撕裂患者之间肩胛上/下旋转的运动学和肌肉活动差异尚不清楚。本研究的目的是比较有症状和无症状撕裂患者以及健康个体之间肩胛旋转的运动学和肌肉活动差异。
23例肩袖撕裂患者和9名健康个体（健康组）参与了本研究。根据视觉模拟量表（VAS，0 - 100mm），将患者分为有症状组（13例；VAS≥20mm）和无症状组（10例；VAS＜20mm）。使用数字倾角仪测量肩胛上旋。通过超声实时组织弹性成像评估斜方肌上束、肩胛提肌和大菱形肌的弹性，以量化其肌肉活动。所有测量均在肩胛平面主动上肢抬高0°、60°、90°和120°时进行。
在手臂抬高90°时，有症状组的肩胛上旋（9.4°±5.6°）明显低于无症状组（15.7°±6.0°；P = 0.022）。在手臂抬高90°时，有症状组肩胛提肌的活动明显高于无症状组和健康组（分别为P = 0.013和P = 0.005）。在手臂抬高120°时，有症状组斜方肌上束的活动明显高于健康组（P = 0.015）。
与无症状肩袖撕裂患者相比，有症状肩袖撕裂患者在手臂抬高90°时肩胛上旋较少，肩胛提肌活动较高。
