Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.
Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Australia.
Gait Posture. 2022 Sep;97:48-55. doi: 10.1016/j.gaitpost.2022.07.236. Epub 2022 Jul 19.
Scapular dyskinesis is often observed in patients with neck pain. However, it is unknown whether clavicular, scapular and spinal kinematics vary with different types of scapular dyskinesis during arm movement.
Are there differences in clavicular, scapular and spinal kinematics during unilateral arm elevation and lowering among neck pain patients presenting with (i) scapular winging, (ii) with dysrhythmia, (iii) with no scapular abnormality and (iv) healthy controls?
Sixty participants with neck pain (20 in each group) and 20 asymptomatic controls were recruited. The 3D kinematic data were measured during unilateral arm elevation and lowering at 30°, 60°, 90°, and 120° in the scapular plane. A three-way mixed-effects ANOVA was used to determine the main effects (group, phase and angle) and the interactions between three independent variables on the kinematic data.
The neck pain group with scapular winging had decreased clavicular retraction and increased scapular internal rotation and anterior tilt compared to the other neck pain and control groups at all angles during both phases of arm movement (p < 0.01). The neck pain group with scapular dysrhythmia had decreased scapular upward rotation compared to all other groups (p < 0.01). Some alterations in the kinematics existed during the lowering phase compared to the raising phase for all groups (p < 0.05). Spinal kinematics were similar across all groups (p > 0.05).
Specific patterns of clavicular and scapular kinematics were identified during arm movement relevant to the type of observed scapular dyskinesis in patients with neck pain. Such findings stand to inform more precise and relevant motor training in rehabilitation and improve understanding of the association between altered scapular kinematics and neck pain.
肩胛运动障碍在颈痛患者中经常观察到。然而，在手臂运动期间，不同类型的肩胛运动障碍是否会导致锁骨、肩胛和脊柱运动学发生变化尚不清楚。
在进行单侧手臂抬高和降低运动时，患有颈痛的患者中出现（i）肩胛翼状，（ii）节律异常，（iii）无肩胛异常和（iv）健康对照组，锁骨、肩胛和脊柱运动学是否存在差异？
招募了 60 名颈痛患者（每组 20 名）和 20 名无症状对照者。在肩胛平面上，在 30°、60°、90°和 120°处，测量 3D 运动学数据。采用三向混合效应方差分析确定主要效应（组、阶段和角度）以及三个独立变量之间的相互作用对运动学数据的影响。
与其他颈痛和对照组相比，在手臂运动的两个阶段的所有角度，患有肩胛翼状的颈痛组的锁骨回缩减少，肩胛内旋和前倾斜增加（p<0.01）。与所有其他组相比，患有肩胛节律异常的颈痛组的肩胛上旋减少（p<0.01）。与手臂抬高阶段相比，所有组在手臂降低阶段的运动学都存在一些变化（p<0.05）。所有组的脊柱运动学相似（p>0.05）。
在手臂运动过程中，针对观察到的肩胛运动障碍的类型，确定了特定的锁骨和肩胛运动学模式。这些发现有助于在康复中提供更精确和相关的运动训练，并提高对改变的肩胛运动学与颈痛之间关联的理解。
