Rören Alexandra, Ogiez Robin, Gajny Laurent, Blasco Aurore, Bouvier Fadila Mihoubi, Feydy Antoine, Rannou François, Lefèvre-Colau Marie-Martine, Roby-Brami Agnès
Faculté de Santé, Université Paris Cité, 75006, Paris, France.
UMR 1153, Centre de Recherche en Épidémiologie Et Statistique, Université Paris Cité, INSERM, Sorbonne Paris-Cité, 75004, Paris, France.
BMC Musculoskelet Disord. 2024 Dec 4;25(1):993. doi: 10.1186/s12891-024-08093-7.
Few studies have assessed the participation of the spine in arm elevation. The primary aim of this exploratory study was to specify spinal movements during unilateral arm elevation.
We used an EOS imaging system to assess 2D global posture (Sagittal Vertical Axis [SVA], T1 and T9 tilt and Central Sacral Line [CSL]) and segmental spine curves (C3-C7 in the sagittal plane only, and T1-T6, T7-T12 and L1-L5 in the sagittal and frontal planes) for four different left arm elevation levels: in the sagittal (Sa) plane (30°Sa: reference position, 140°Sa and 180°Sa), and in the scapular (Sc) plane (180°Sc), in ten right-handed asymptomatic participants (5 women; mean age 24.6 SD 3.0 years]. In addition, we estimated C1, head and pelvic orientation and head and pelvic linear displacement. We used Bayesian statistics (BF > 3 indicates a significant variation: moderate, strong, very strong or extreme evidence).
From 140°Sa to 180°Sa or Sc, the significant decrease in SVA and the T1-T9 tilt angles indicated a global backward spine bending (moderate to very strong evidence). The significant reversal of the C3-C7 lordosis at 30°Sa (-1.34 [2.53]°) to kyphosis at 180°Sa (13.88 [3.53]°, strong evidence) and 180°Sc (11.85 [2.75]°, extreme evidence) and the significant decrease in the T7-T12 kyphosis (26.58 [2.84]°at 30°Sa to 16.40 [2.65]° at 180°Sa and 17.60 [2.78]° at 180°Sc [all extreme evidence]) showed a global spine straightening. We found significant pelvic anteversion between 30°Sa and 140°Sa (moderate evidence) and persistent right spine bending and leftward head displacement (extreme evidence). The change in C1 orientation (extreme evidence) showed an atlanto-occipital extension.
Simple unconstrained movements of unilateral arm elevation involve the whole spine, pelvis and head, including significant backward spinal bending, a reduction in the low cervical spine lordosis and the thoracic kyphosis, and atlanto-occipital extension.
很少有研究评估脊柱在手臂抬高过程中的参与情况。这项探索性研究的主要目的是明确单侧手臂抬高时的脊柱运动。
我们使用EOS成像系统，对10名右利手无症状参与者（5名女性；平均年龄24.6岁，标准差3.0岁）在四种不同的左臂抬高角度下进行二维整体姿势评估（矢状面垂直轴[SVA]、T1和T9倾斜度以及骶骨中心线[CSL]）和节段性脊柱曲线评估（仅矢状面的C3 - C7，以及矢状面和额状面的T1 - T6、T7 - T12和L1 - L5）：在矢状面（Sa）（30°Sa：参考位置，140°Sa和180°Sa）以及肩胛面（Sc）（180°Sc）。此外，我们还估计了C1、头部和骨盆的方向以及头部和骨盆的线性位移。我们使用贝叶斯统计（BF＞3表示有显著变化：中等、强、非常强或极端证据）。
从140°Sa到180°Sa或Sc，SVA和T1 - T9倾斜角度的显著减小表明脊柱整体向后弯曲（中等至非常强的证据）。C3 - C7前凸在30°Sa时为-1.34[2.53]°，到180°Sa时变为后凸13.88[3.53]°（强证据）以及180°Sc时为11.85[2.75]°（极端证据），且T7 - T12后凸显著减小（30°Sa时为26.58[2.84]°，到180°Sa时为16.40[2.65]°，180°Sc时为17.60[2.78]°[均为极端证据]），这些都表明脊柱整体变直。我们发现在30°Sa和140°Sa之间存在显著的骨盆前倾（中等证据），以及持续的右侧脊柱弯曲和头部向左位移（极端证据）。C1方向的变化（极端证据）显示寰枕关节伸展。
单侧手臂简单无约束的抬高动作涉及整个脊柱、骨盆和头部，包括脊柱显著向后弯曲、下颈椎前凸和胸椎后凸减小以及寰枕关节伸展。
