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30°肩部外展试验中负荷诱导的盂肱关节平移的透视评估的可靠性

Reliability of the Fluoroscopic Assessment of Load-Induced Glenohumeral Translation during a 30° Shoulder Abduction Test.

作者信息

Croci Eleonora, Künzler Marina, Börlin Sean, Eckers Franziska, Nüesch Corina, Baumgartner Daniel, Müller Andreas Marc, Mündermann Annegret

机构信息

Department of Biomedical Engineering, University of Basel, 4001 Basel, Switzerland.

Department of Orthopaedics and Traumatology, University Hospital Basel, 4031 Basel, Switzerland.

出版信息

Biomechanics (Basel). 2022 May 19;2(2):255-263. doi: 10.3390/biomechanics2020020.

Abstract

Rotator cuff tears are often linked to superior translational instability, but a thorough understanding of glenohumeral motion is lacking. This study aimed to assess the reliability of fluoroscopically measured glenohumeral translation during a shoulder abduction test. Ten patients with rotator cuff tears participated in this study. Fluoroscopic images were acquired during 30° abduction and adduction in the scapular plane with and without handheld weights of 2 kg and 4 kg. Images were labelled by two raters, and inferior-superior glenohumeral translation was calculated. During abduction, glenohumeral translation (mean (standard deviation)) ranged from 3.3 (2.2) mm for 0 kg to 4.1 (1.8) mm for 4 kg, and from 2.3 (1.5) mm for 0 kg to 3.8 (2.2) mm for 4 kg for the asymptomatic and symptomatic sides, respectively. For the translation range, moderate to good interrater (intra-class correlation coefficient ICC [95% confidence interval (CI)]; abduction: 0.803 [0.691; 0.877]; adduction: 0.705 [0.551; 0.813]) and intrarater reliabilities (ICC [95% CI]; abduction: 0.817 [0.712; 0.887]; adduction: 0.688 [0.529; 0.801]) were found. Differences in the translation range between the repeated measurements were not statistically significant (mean difference, interrater: abduction, -0.1 mm, = 0.686; adduction, -0.1 mm, = 0.466; intrarater: abduction 0.0 mm, = 0.888; adduction, 0.2 mm, = 0.275). This method is suitable for measuring inferior-superior glenohumeral translation in the scapular plane.

摘要

肩袖撕裂常与上向平移不稳定相关,但对盂肱关节运动的全面了解尚缺。本研究旨在评估在肩部外展试验中通过荧光透视测量盂肱关节平移的可靠性。10例肩袖撕裂患者参与了本研究。在肩胛平面30°外展和内收过程中,分别在有和没有2千克及4千克手持重物的情况下采集荧光透视图像。图像由两名评估者标记,并计算盂肱关节下-上平移。在外展过程中,盂肱关节平移(均值(标准差))在无重物时为3.3(2.2)毫米,在4千克重物时为4.1(1.8)毫米;无症状侧和有症状侧在无重物时分别为2.3(1.5)毫米,在4千克重物时分别为3.8(2.2)毫米。对于平移范围,评估者间(组内相关系数ICC [95%置信区间(CI)];外展:0.803 [0.691;0.877];内收:0.705 [0.551;0.813])和评估者内信度(ICC [95% CI];外展:0.817 [0.712;0.887];内收:0.688 [0.529;0.801])为中度至良好。重复测量之间平移范围的差异无统计学意义(均值差异,评估者间:外展,-0.1毫米,P = 0.686;内收,-0.1毫米,P = 0.466;评估者内:外展0.0毫米,P = 0.888;内收,0.2毫米,P = 0.275)。该方法适用于测量肩胛平面内盂肱关节下-上平移。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bafe/7612827/9db8c3e77170/EMS145312-f001.jpg

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