Department of Rehabilitation Science, Human Motion Analysis Laboratory, Universidade Nove de Julho, São Paulo, Brazil.
Health Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
J Biomech. 2021 Dec 2;129:110806. doi: 10.1016/j.jbiomech.2021.110806. Epub 2021 Oct 11.
Subacromial shoulder pain (SSP) accounts for 44-65% of all cases of shoulder pain. Kinematic alterations in the upper limbs have been observed in individuals with SSP, although there is no consensus on such alterations in the literature. Therefore, the present study aimed to compare the three-dimensional kinematics of the scapula, trunk, and arm during shoulder flexion-extension and abduction-adduction movements in individuals with SSP and a control group using statistical parametric mapping (SPM). We evaluated 117 participants [61 with SSP and 56 in the control group (CG)]. The three-dimensional kinematic analysis was performed starting from arm extension/adduction (0%), moving to flexion/abduction, and ending returning to extension/adduction, respectively (100%) in both groups. SSP group flexed more their trunk (0-100%, p < 0.001) and rotated scapula internally (0-20%, p < 0.001 and 75-100%, p < 0.001); rotated upwards (17-32%, p < 0.005 and 58-87%, p < 0.003) and posteriorly tilted (28-79%,p < 0.001 and 81-95%,p < 0.006) less than CG group during arm abduction-adduction. Through arm flexion-extension, the SSP group flexed (38-82% p < 0.009) less their trunk, rotated upwards (5-10% p = 0.021) less their scapula, and posteriorly tilted scapula (0-100% p < 0.001) more than CG. Combining conventional variables used to describe motion in individuals with SSP, such as minimum and maximum values, range of motion, and results provided by SPM can furnish a detailed description of the compensations and limitations of the patient, enabling a better understanding of the function of the scapular girdle as well as improvements in the evaluation process and clinical decision making.
肩峰下疼痛(SSP)占所有肩部疼痛病例的 44-65%。患有 SSP 的个体上肢的运动学改变已经被观察到,尽管文献中对这种改变尚无共识。因此,本研究旨在使用统计参数映射(SPM)比较 SSP 患者和对照组在肩关节屈伸和外展内收运动中肩胛骨、躯干和手臂的三维运动学。我们评估了 117 名参与者[61 名患有 SSP 和 56 名对照组(CG)]。在两组中,分别从手臂伸展/外展(0%)开始,移动到手臂屈曲/内收,然后分别返回到手臂伸展/外展(100%)进行三维运动学分析。SSP 组躯干前屈更多(0-100%,p<0.001),肩胛骨内旋更多(0-20%,p<0.001 和 75-100%,p<0.001);肩胛骨上旋(17-32%,p<0.005 和 58-87%,p<0.003)和后倾(28-79%,p<0.001 和 81-95%,p<0.006)较 CG 组少。通过手臂屈伸,SSP 组躯干前屈(38-82%,p<0.009)更少,肩胛骨上旋(5-10%,p=0.021)更少,肩胛骨后倾(0-100%,p<0.001)更多。结合传统的变量用于描述 SSP 患者的运动,如最小和最大值、运动范围和 SPM 提供的结果,可以详细描述患者的代偿和限制,更好地理解肩胛骨带的功能,并改善评估过程和临床决策。