Sasaki M, Torisu T, Nakayama A, Tagawa Y
Nihon Seikeigeka Gakkai Zasshi. 1980 May;54(5):431-47.
The relationship between glenohumeral and scapular movements during abduction and adduction of the limb in the scapular plane were studied in twenty normal subjects and nine quadriplegic patients by analysis of roentgenograms and enveloped electromyograms with electrogoniometer. In normal subjects the ratio of glenohumeral to scapulothoracic movement was 4.2 : 1 for the range 0-30 degrees and 1.7 : 1 for the range 30-150 degrees for abduction, and 1.9 : 1 for the range 150-30 degrees and 1.7 : 1 for the range 30-0 degrees for adduction. In comparing quadriplegic patients with normal subjects, outstanding medial shift of the scapula was observed in early phase of abduction, elevation, and upward rotation of the scapula which were limited through whole abduction. Distances of the shift of the scapula in quadriplegic patients were the same as those in normal subjects in the final phase of adduction. In enveloped electromyograms of normal subjects, each activity of the six sampled muscles, increased or decreased gradually during abduction and adduction in similar relationships. The upper fiber of the trapezius demonstrated the highest activity through abduction and adduction. During abduction and adduction the supraspinatus showed undulated wave patterns and had the plateau at 80-140 degrees. The activity of the supraspinatus was higher than that of the deltoideus statistically for the range 0-40 degrees for abduction. In each quadriplegic patient the patterns of muscle activities during abduction and adduction were characteristically peculiar and did not indicate any constant relationship findings in normal subjects, irrespective of the functional level.
通过X线片分析以及使用电子测角器记录的表面肌电图,对20名正常受试者和9名四肢瘫痪患者在肩胛平面内上肢外展和内收过程中盂肱关节与肩胛运动之间的关系进行了研究。在正常受试者中,外展时0 - 30度范围内盂肱关节与肩胛胸壁运动的比例为4.2 : 1,30 - 150度范围内为1.7 : 1;内收时150 - 30度范围内为1.9 : 1,30 - 0度范围内为1.7 : 1。将四肢瘫痪患者与正常受试者进行比较时,观察到在肩胛外展、抬高和向上旋转的早期阶段,肩胛明显向内侧移位,且整个外展过程中这种移位均受限。在四肢瘫痪患者中,肩胛移位的距离在内收的最后阶段与正常受试者相同。在正常受试者的表面肌电图中,所采样的6块肌肉的每项活动在内外展过程中以相似的关系逐渐增加或减少。斜方肌上束在内外展过程中表现出最高的活性。在内外展过程中,冈上肌呈现出波动的波形,在80 - 140度处有一个平台期。在外展0 - 40度范围内,冈上肌的活性在统计学上高于三角肌。在每例四肢瘫痪患者中,内外展过程中的肌肉活动模式具有独特的特征,且与正常受试者的任何恒定关系均不相符,无论其功能水平如何。