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我是否应该给肩部固定的患者开运动处方?一项针对单侧肩部疼痛患者和健康志愿者的肌电图研究。

Should I prescribe exercise to a patient with an immobilized shoulder? An electromyographic study in patients with unilateral shoulder pain and healthy volunteers.

作者信息

Intelangelo Leonardo, Ignacio Lassaga, Mendoza Cristian, Roulet Iván, Jerez-Mayorga Daniel, Barbosa Alexandre Carvalho

机构信息

Musculoskeletal Research Unit, University Center for Assistance, Teaching and Research, University of Gran Rosario, Rosario, Argentina.

Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago de Chile, Chile.

出版信息

Shoulder Elbow. 2024 Aug 20:17585732241269145. doi: 10.1177/17585732241269145.

DOI:10.1177/17585732241269145
PMID:39552658
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11562157/
Abstract

BACKGROUND

There is limited evidence about exercise performance during postoperative immobilization. This study aimed to quantify the muscle activity in the immobilized shoulder girdle in an abduction and neutral rotation position during a battery of contralateral activities and ipsilateral exercises of the upper limb in healthy volunteers and patients with unilateral shoulder pain (USP).

METHODS

Thirty participants were included and grouped as without ( = 17) or with USP ( = 13). Muscle activity (percentage of maximum voluntary isometric contraction (%MVIC)) of the serratus anterior (SA), upper trapezius (UT), lower trapezius (LT) and infraspinatus muscles was assessed during five contralateral activities (during comfortable speed, fast speed and comfortable speed with additional load) and seven ipsilateral exercises.

RESULTS

No differences in % MVIC were found between healthy volunteers and patients with USP on immobilized upper limb exercises and with the contralateral shoulder girdle. General muscle activity was low (<15% MVIC) to moderate (21-40% MVIC). This similarity was maintained at different speeds and with additional load. Adapted lawnmower exercise showed a favorable UT/LT activation ratio.

CONCLUSION

The study results support the use of all evaluated shoulder exercises, as they have shown low muscle activity, which is important for early rehabilitation phases.

摘要

背景

关于术后固定期间运动表现的证据有限。本研究旨在量化健康志愿者和单侧肩部疼痛(USP)患者在一系列对侧活动和上肢同侧运动过程中,处于外展和中立旋转位的固定肩胛带的肌肉活动。

方法

纳入30名参与者,分为无USP组(n = 17)和有USP组(n = 13)。在五项对侧活动(舒适速度、快速以及附加负荷下的舒适速度)和七项同侧运动过程中,评估前锯肌(SA)、上斜方肌(UT)、下斜方肌(LT)和冈下肌的肌肉活动(最大自主等长收缩百分比,%MVIC)。

结果

在固定上肢运动和对侧肩胛带方面,健康志愿者和USP患者之间的%MVIC没有差异。总体肌肉活动为低水平(<15%MVIC)至中等水平(21 - 40%MVIC)。在不同速度和附加负荷下,这种相似性得以保持。改良割草机运动显示出良好的UT/LT激活比率。

结论

研究结果支持使用所有评估的肩部运动,因为它们显示出较低的肌肉活动,这对早期康复阶段很重要。

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Biology (Basel). 2023 Feb 11;12(2):291. doi: 10.3390/biology12020291.
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Assessment of several postoperative protocols after rotator cuff repair: A network meta-analysis.评估几种肩袖修复术后方案:网络荟萃分析。
Orthop Traumatol Surg Res. 2022 Dec;108(8S):103418. doi: 10.1016/j.otsr.2022.103418. Epub 2022 Sep 22.
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Effect of Abduction Brace Wearing Compliance on the Results of Arthroscopic Rotator Cuff Repair.佩戴外展支具的依从性对关节镜下肩袖修复结果的影响。
JB JS Open Access. 2022 May 5;7(2). doi: 10.2106/JBJS.OA.21.00148. eCollection 2022 Apr-Jun.
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Supine scapular punch: An exercise for early phases of shoulder rehabilitation?仰卧位肩胛冲压:一种用于肩部康复早期阶段的锻炼方法?
Clin Biomech (Bristol). 2022 Feb;92:105583. doi: 10.1016/j.clinbiomech.2022.105583. Epub 2022 Jan 21.
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Scapular Retraction under Adduction Load: An Alternative to Overhead Exercises to Activate Infraspinatus, Upper, and Lower Trapezius in Subjects with and without Shoulder Pain.肩胛骨内收在肩内收负荷下:一种替代过头运动的方法,用于激活有和无肩痛受试者的冈下肌、上斜方肌和下斜方肌。
Int J Environ Res Public Health. 2021 Sep 2;18(17):9251. doi: 10.3390/ijerph18179251.
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Effectiveness of early versus delayed rehabilitation following rotator cuff repair: Systematic review and meta-analyses.肩袖修复术后早期与延迟康复的效果比较:系统评价和荟萃分析。
PLoS One. 2021 May 28;16(5):e0252137. doi: 10.1371/journal.pone.0252137. eCollection 2021.
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J Shoulder Elbow Surg. 2021 Jun;30(6):e322-e333. doi: 10.1016/j.jse.2020.11.016. Epub 2021 Jan 5.
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