Department of Rehabilitation, Hitsujigaoka Hospital, 3-1-10 Aoba-cho, Atsubetsu-ku, Sapporo, Hokkaido, 004-0021, Japan.
Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, West 17, South 1, Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan.
J Med Ultrason (2001). 2022 Jan;49(1):77-84. doi: 10.1007/s10396-021-01168-1. Epub 2021 Nov 19.
This study aimed to investigate the time-course changes in the active stiffness of the supraspinatus muscle after arthroscopic rotator cuff repair.
Eight male patients (mean age 61.5 ± 9.4 years) who underwent arthroscopic rotator cuff repair for small to medium tears were recruited for this study. Movement tasks included 30° shoulder isometric abduction and maximal voluntary isometric contraction of shoulder abduction in the scapular plane. The stiffness of the supraspinatus (anterior superficial, anterior deep, posterior superficial, and posterior deep regions), upper trapezius, and middle deltoid muscles in bilateral shoulders was recorded using ultrasound shear wave elastography. For each subject, the measurement was performed preoperatively and 3, 6, and 12 months postoperatively.
The stiffness of the affected anterior superficial region of the supraspinatus muscle 12 months postoperatively was significantly higher than that measured preoperatively and 3 months postoperatively (p < 0.05); it was significantly higher at 6 months postoperatively than at 3 months postoperatively (p < 0.05). Further, the maximal voluntary isometric contraction had significantly improved 12 months postoperatively compared to that measured preoperatively and 3 months postoperatively (p < 0.05). The stiffness of the affected upper trapezius and middle deltoid muscles 12 months postoperatively was significantly lower than that preoperatively (p < 0.05).
The maximal voluntary isometric contraction 12 months postoperatively possibly increased because of improvement in the active stiffness of the anterior superficial region. Active stiffness of the anterior superficial region may improve 6 months rather than 3 months postoperatively because of the different stages of muscle force, structural repair tendon strength, and remodeling.
本研究旨在探讨关节镜下肩袖修补术后冈上肌主动刚度的时程变化。
本研究纳入了 8 名男性患者(平均年龄 61.5±9.4 岁),这些患者因小至中等大小的肩袖撕裂而行关节镜下肩袖修补术。运动任务包括 30°肩等长外展和肩胛平面最大自主等长肩外展。使用超声剪切波弹性成像记录双侧肩冈上肌(前浅层、前深层、后浅层和后深层区域)、上斜方肌和中三角肌的刚度。对于每个受试者,在术前和术后 3、6 和 12 个月进行测量。
术后 12 个月,患侧冈上肌前浅层的刚度明显高于术前和术后 3 个月(p<0.05);术后 6 个月明显高于术后 3 个月(p<0.05)。此外,术后 12 个月的最大自主等长收缩明显优于术前和术后 3 个月(p<0.05)。术后 12 个月,患侧上斜方肌和中三角肌的刚度明显低于术前(p<0.05)。
术后 12 个月最大自主等长收缩可能因前浅层主动刚度的改善而增加。前浅层主动刚度可能在术后 6 个月而不是 3 个月改善,这可能与肌肉力量、结构修复肌腱强度和重塑的不同阶段有关。