Effects of Passive Scapular Stabilization on Upper Extremity Muscle Strength in Patients With Rotator Cuff Repair
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Scapular dyskinesis may cause not only rotator cuff (RC) tear but also weak-ness of the upper extremity, studies on scapular dyskinesis that may occur after RC repair is still lacking. Objects: To determine whether scapular dsykinesis was present in patients after arthroscopic RC repair and to investigate the influence of passive scapular stabilization on upper extremity strength. Methods: A total of 30 patients after RC repair participated in this study. To compare the scapula of the arthroscopic RC repair shoulder and the contralateral shoulder, the winged scapula (WS) was measured using a scapulometer and scapular dyskinesis was also classified by type. Fixed instruments for muscle strength measurements were used to measure upper extremity muscle strength differences depending on passive scapular stabilization position or natural scapular position. A chi-square test, an independent t-test and a 2-way mixed mea-sures analysis of variance (ANOVA) was used as statistical analysis. In analyses, p < 0.05 was deemed to be statistically significant. Results: Postoperative shoulder had a significant association with scapular dyskinesis and the WS compared to the contralateral shoulder (F = 0.052, p < 0.01). Postoperative shoulder, muscle strength in the shoulder abduction (p < 0.01), elbow flexion (p < 0.01) and forearm supination (p < 0.05) were significantly greater in the scapular stabilization position than in the scapular natural position. Conclusion: Patients underwent arthroscopic RC repair had a significant association with scapular dyskinesis and muscle strength was improved by a passive scapular stabilization posi-tion, therefore scapular stabilization is important in rehabilitation program.
Abstract
Background: Scapular dyskinesis may cause not only rotator cuff (RC) tear but also weak-ness of the upper extremity, studies on scapular dyskinesis that may occur after RC repair is still lacking. Objects: To determine whether scapular dsykinesis was present in patients after arthroscopic RC repair and to investigate the influence of passive scapular stabilization on upper extremity strength. Methods: A total of 30 patients after RC repair participated in this study. To compare the scapula of the arthroscopic RC repair shoulder and the contralateral shoulder, the winged scapula (WS) was measured using a scapulometer and scapular dyskinesis was also classified by type. Fixed instruments for muscle strength measurements were used to measure upper extremity muscle strength differences depending on passive scapular stabilization position or natural scapular position. A chi-square test, an independent t-test and a 2-way mixed mea-sures analysis of variance (ANOVA) was used as statistical analysis. In analyses, p < 0.05 was deemed to be statistically significant. Results: Postoperative shoulder had a significant association with scapular dyskinesis and the WS compared to the contralateral shoulder (F = 0.052, p < 0.01). Postoperative shoulder, muscle strength in the shoulder abduction (p < 0.01), elbow flexion (p < 0.01) and forearm supination (p < 0.05) were significantly greater in the scapular stabilization position than in the scapular natural position. Conclusion: Patients underwent arthroscopic RC repair had a significant association with scapular dyskinesis and muscle strength was improved by a passive scapular stabilization posi-tion, therefore scapular stabilization is important in rehabilitation program.
참고문헌 (30)
- Henn RF 3rd, "Patients’ preoperative expectations predict the outcome of rotator cuff repair", J Bone Joint Surg Am, 89(9), pp.1913~1919 (2007)
- Halder AM, "Dynamic contributions to superior shoulder stability", J Orthop Res, 19(2), pp.206~212 (2001)
- Speer KP, "The shoulder: a balance of mobility and stability", pp.159~173 (1993), Academy of Orthopaedic Surgeons
- Kibler WB, "Scapular dyskinesis and its relation to shoulder injury", J Am Acad Orthop Surg, 20(6), pp.364~372 (2012)
- Ludewig PM, "The association of scapular kinematics and glenohumeral joint pathologies", J Orthop Sports Phys Ther, 39(2), pp.90~104 (2009)
- Solem-Bertoft E, "The influence of scapular retraction and protraction on the width of the subacromial space. An MRI study", Clin Orthop Relat Res, (296), pp.99~103 (1993)[DOI]
- Kibler WB, "Current concepts : scapular dyskinesis", Br J Sports Med, 44(5), pp.300~305 (2010)
- Kikukawa K, "Hypertrophic changes of the teres minor muscle in rotator cuff tears : quantitative evaluation by magnetic resonance imaging", J Shoulder Elbow Surg, 23(12), pp.1800~1805 (2014)
- Kebaetse M, "Thoracic position effect on shoulder range of motion, strength, and three-dimensional scapular kinematics", Arch Phys Med Rehabil, 80(8), pp.945~950 (1999)
- Smith J, "Effect of scapular protraction and retraction on isometric shoulder elevation strength", Arch Phys Med Rehabil, 83(3), pp.367~370 (2002)
- Kibler WB, "Evaluation of apparent and absolute supraspinatus strength in patients with shoulder injury using the scapular retraction test", Am J Sports Med, 34(10), pp.1643~1647 (2006)
- Van De Graaff KM, "Human anatomy", pp.93~113 (2002), McGraw-Hill
- Tortora GJ, "Principles of human anatomy" (2002), Wiley
- 최슬아, "Relationships Between Rounded Shoulder Posture and Biceps Brachii Muscle Length, Elbow Joint Angle, Pectoralis Muscle Length, Humeral Head Anterior Translation, and Glenohumeral Range of Motion", 한국전문물리치료학회지, 24(2), pp.48~57 (2017), 한국전문물리치료학회[DOI]
- McCormick F, "Postoperative rotator cuff repair rehabilitation and complication management", Oper Tech Orthop, 25(1), pp.76~82 (2015)
- Sgroi TA, "Rotator cuff repair : post-operative rehabilitation concepts", Curr Rev Musculoskelet Med, 11(1), pp.86~91 (2018)
- Shin SJ, "Recovery of muscle strength after intact arthroscopic rotator cuff repair according to preoperative rotator cuff tear size", Am J Sports Med, 44(4), pp.972~980 (2016)
- Weon JH, "Realtime visual feedback can be used to activate scapular upward rotators in people with scapular winging : an experimental study", J Physiother, 57(2), pp.101~107 (2011)
- Kibler WB, "Qualitative clinical evaluation of scapular dysfunction : a reliability study", J Shoulder Elbow Surg, 11(6), pp.550~556 (2002)
- Karduna AR, "Dynamic measurements of three-dimensional scapular kinematics : a validation study", J Biomech Eng, 123(2), pp.184~190 (2001)
- McClure PW, "Direct 3-dimensional measurement of scapular kinematics during dynamic movements in vivo", J Shoulder Elbow Surg, 10(3), pp.269~277 (2001)
- Oh JS, "Reproducibility of isometric shoulder protraction and retraction strength measurements in normal subjects and individuals with winged scapula", J Shoulder Elbow Surg, 25(11), pp.1816~1823 (2016)
- Kerschbaum M, "Arthroscopic knotless suprapectoral tenodesis of the long head of biceps : clinical and structural results", Arch Orthop Trauma Surg, 136(8), pp.1135~1142 (2016)
- O’Sullivan LW, "Upper-limb surface electro-myography at maximum supination and pronation torques : the effect of elbow and forearm angle", J Electromyogr Kinesiol, 12(4), pp.275~285 (2002)
- Longo UG, "Scapular dyskinesis: from basic science to ultimate treatment", Int J Environ Res Public Health, 17(11), pp.3810~ (2020)
- Panagiotopoulos AC, "Scapular dyskinesia, the forgotten culprit of shoulder pain and how to rehabilitate", SICOT J, 5, pp.29~ (2019)
- Barcia AM, "Scapular motion in the presence of rotator cuff tears : a systematic review", J Shoulder Elbow Surg, 30(7), pp.1679~1692 (2021)
- Kim HM, "Shoulder strength in asymptomatic individuals with intact compared with torn rotator cuffs", J Bone Joint Surg Am, 91(2), pp.289~296 (2009)
- Lukasiewicz AC, "Comparison of 3-dimensional scapular position and orientation between subjects with and without shoulder impingement", J Orthop Sports Phys Ther, 29(10), pp.574~583 (1999)
- Moore KL, "Clinically oriented anatomy" (2018), Wolters Kluwer