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用于评估肩袖力量的徒手肌力检查:一项肌电图研究。

The manual muscle examination for rotator cuff strength. An electromyographic investigation.

作者信息

Kelly B T, Kadrmas W R, Speer K P

机构信息

Division Of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.

出版信息

Am J Sports Med. 1996 Sep-Oct;24(5):581-8. doi: 10.1177/036354659602400504.

Abstract

The electromyographic activity of eight muscles of the rotator cuff and shoulder girdle (supraspinatus, infraspinatus, subscapularis, pectoralis, latissimus dorsi, and the anterior, middle, and posterior deltoid) was measured from the nondominant shoulders of 11 subjects during a series of 29 isometric contractions. The contractions simulated different positions used for strength testing of the rotator cuff and involved elevation, external rotation, and internal rotation at three degrees of initial humeral rotation (-45 degrees of internal rotation, 0 degree, +45 degrees of external rotation) and scapular elevation (0 degree, 45 degrees, 90 degrees). Isolation of the supraspinatus muscle was best achieved with the test position of elevation at 90 degrees of scapular elevation and +45 degrees (external rotation) of humeral rotation. Isolation of the infraspinatus muscle was best achieved with external rotation at 0 degree of scapular elevation and -45 degrees (internal rotation) of humeral rotation. Isolation of the subscapularis muscle was best achieved with the Gerber push-off test. This study used four criteria for identifying the optimal manual muscle test for each rotator cuff muscle: 1) maximal activation of the cuff muscle, 2) minimal contribution from involved shoulder synergists, 3) minimal provocation of pain, and 4) good test-retest reliability. Based on the results of this study and known painful arcs of motion, an objective identification of the optimal tests for the manual muscle testing of the cuff was elucidated.

摘要

在29次等长收缩过程中,测量了11名受试者非优势肩的肩袖和肩胛带八块肌肉(冈上肌、冈下肌、肩胛下肌、胸大肌、背阔肌以及三角肌前束、中束和后束)的肌电活动。这些收缩模拟了用于肩袖力量测试的不同姿势,包括在肱骨初始旋转的三个角度(内旋45度、0度、外旋45度)和肩胛抬高(0度、45度、90度)时的抬高、外旋和内旋。在肩胛抬高90度且肱骨旋转45度(外旋)的测试姿势下,最能分离冈上肌。在肩胛抬高0度且肱骨旋转45度(内旋)的外旋测试姿势下,最能分离冈下肌。肩胛下肌的分离最好通过格伯推离试验实现。本研究采用了四个标准来确定针对每块肩袖肌肉的最佳徒手肌力测试:1)肩袖肌肉的最大激活,2)受累肩部协同肌的最小贡献,3)最小的疼痛激发,4)良好的重测信度。基于本研究结果和已知的疼痛运动弧,阐明了肩袖徒手肌力测试最佳测试的客观识别方法。

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