The influence of handheld weight on the scapulohumeral rhythm

Scapulohumeral rhythm (SHR) provides insight to neuromuscular control and fundamental biomechanics of the shoulder. This rhythm often is disrupted in pathologic shoulders. As the first step, we sought to quantify SHR in healthy subjects for diagnostic assessment of shoulder function. Ten healthy shoulders were studied. Three-dimensional models of the humerus and scapula were created from computed tomography scans. Dynamic shoulder motion was recorded by use of single-plane fluoroscopy during arm abduction with 0-kg and 3-kg handheld loads. Shoulder kinematics were quantified by use of model-based 3-dimensional-to-2-dimensional registration techniques. SHR decreased (more scapular motion) with increasing abduction. With a 3-kg load, scapulothoracic motion was significantly reduced through the range of 35 degrees to 45 degrees of glenohumeral motion. Muscular stabilization of the scapula increased with external loading, as shown by decreased SHR during early lifting. Dynamic scapular stabilization provides a critical platform for upper extremity activity.     

Assessment of scapulohumeral rhythm for scapular plane shoulder elevation using a modified digital inclinometer

AIM: To develop a better understanding of scapulohumeral rhythm during scapular plane shoulder elevation.METHODS: Thirteen healthy, college-aged subjects participated in this study. Subjects were free from any upper extremity, neck or back pathology. A modified digital inclinometer was utilized to measure scapular upward rotation of the subject’s dominant shoulder. Upward rotation was measured statically as subjects performed clinically relevant amounts of shoulder elevation in the scapular plane. Testing order was randomized by arm position. Scapular upward rotation was assessed over the entire arc of motion and over a series of increments. The percent contributions to shoulder elevation for the scapula and glenohumeral joint were calculated. Scapulohumeral rhythm was assessed and represented the ratio of glenohumeral motion to scapulothoracic motion (glenohumeral elevation: scapular upward rotation). A one-way ANOVA was used to compare scapular upward rotation between elevation increments.RESULTS: Scapulohumeral rhythm for the entire arc of shoulder elevation was equal to a ratio of 2.34 :1 and ranged from 40.01:1 to 0.90:1 when assessed across the different increments of humeral elevation. Total scapular motion increased over the arc of shoulder elevation. The scapula contributed 2.53% of total motion for the first 30 degrees of shoulder elevation, between 20.87% and 37.53% for 30^o-90^o of shoulder elevation, and 52.73% for 90^o-120^o of shoulder elevation. Statistically significant differences in scapular upward rotation were identified across the shoulder elevation increments [F_(3,48) = 12.63, P = 0.0001].CONCLUSION: Clinically, we must recognize the usefulness of the inclinometer in documenting the variable nature of scapulohumeral rhythm in healthy and injured shoulders.     

Effect of shoulder tightness on glenohumeral translation, scapular kinematics, and scapulohumeral rhythm in subjects with stiff shoulders.

Shoulder tightness may cause altered kinematics and lead to development of subacromial impingement, tendinitis, and degenerative changes. In this investigation, the humeral head translations, scapular kinematics, and scapulohumeral rhythm were determined with a three-dimensional electromagnetic tracking device during arm elevations in six subjects with anterior shoulder tightness and in six subjects with posterior shoulder tightness to study the effects of anterior/posterior tightness on shoulder kinematics. Subjects with anterior tightness showed lower slopes in curves of glenohumeral elevation plotted against scapular upward rotation (scapulohumeral rhythm, 0.11 to 0.32; p = 0.021) and less posterior scapular tilt (2.9 to 7.5 degrees; p = 0.002) during arm elevations when compared to the group with posterior tightness. The humeral head was positioned less posteriorly (2.2 to 3.4 mm; p = 0.004) and more superiorly (3.8 to 7.0 mm; p < 0.0005) during arm elevation in subjects with posterior tightness. The alternations in shoulder kinematics between subjects with anterior and posterior shoulder tightness may be relevant to the development of subacromial impingement, tendinitis, and degenerative changes as seen in subjects with stiff shoulders.     

Analysis of the scapulo-humeral rhythm for periarthritis scapulohumeralis

To clarify the scapulo-humeral rhythm in twenty-five patients with periarthritis scapulo-humeralis, the movements of the scapula and the humerus during arm elevation were measured and analysed using a fluoroscope and a computer, and the rhythm of five patient with rotator cuff tear was compared with that of seven normal subjects. The ratio of scapular movement to humeral one in the patients with severe shoulder contracture due to periarthritis scapulohumeralis was greater than that of patients with mild contracture and that of normal subjects. In the patients with rotator cuff tear, wider range of scapular rotation was observed in the early phase of the motion. During the early phase of arm elevation, the humeral head moved to the upper direction by means of gliding in the patients with severely contracted shoulder and rotator cuff tear, and in the patients with mildly contracted shoulder the humeral head moved to the upper direction by means of ball rolling. In the normal subjects no such upward movement of the humeral head was observed. We believe that the restriction of the glenohumeral joint motion and dysfunction of the rotator cuff, which were caused by periarthritis scapulohumeralis, may break down the scapulohumeral rhythm.     

The scapulohumeral line revisited.

Routine observation of the scapulohumeral line in the true anteroposterior radiographic view of the shoulder will allow a higher level of confidence in ruling out posterior dislocation of the glenohumeral joint. It will also facilitate evaluation of the relationship between the proximal humerus and the scapula (especially the acromion and the glenoid fossa) in (1) abnormal conditions of the subacromial space; (2) fractures and dislocations of the proximal humerus; and (3) proximal humerus prosthesis insertion and assessment.     

体外冲击波治疗肩周炎临床效果观察

目的观察体外冲击波疗法对肩周炎的治疗作用。方法将2013年1月至2014年12月厦门大学附属第一医院收治的168例肩周炎患者随机分为观察组和对照组,每组各84例。观察组以患者疼痛点为中心施行体外冲击波疗法,对照组口服西乐葆并配合功能锻炼治疗。评估两组治疗前后视觉模拟量表(VAS)评分并进行疗效判定,观察两组不良反应发生情况。结果两组治疗前VAS评分比较,差异无统计学意义(P0.05)。两组治疗后VAS评分较治疗前明显改善(P0.05);治疗后观察组VAS评分明显低于对照组,疗效评定结果显著优于对照组,肩关节外展、后伸和内旋活动度较对照组明显改善(P0.05)。两组均未出现严重不良反应。结论体外冲击波是治疗肩周炎患者的有效方法,可显著缓解患者疼痛症状,改善肩关节活动度,近期疗效满意。     

液压扩张结合小针刀疗法治疗肩周炎的临床观察

2000年2月-2006年1月采用液压扩张配合小针刀疗法治疗肩周炎187例,疗效满意,现报告如下.     

Scapulohumeral rhythm: relationship between motion velocity and rhythm

The relative contributions of scapulothoracic and glenohumeral motion at different rates of shoulder motion were studied through adduction to abduction in the scapular plane. Nineteen shoulders of 10 healthy individuals (all men, 24-30 years of age) were analyzed using an image intensifier and a high-resolution digital video system. High- and low-speed motion consisted of 2 and 4 seconds per one cycle, respectively, from abduction to adduction in the scapular plane. Glenohumeral and scapulothoracic ratios were fixed at low speed and these results agree with the finding of other researchers. Ratios at high speed were not fixed and differed significantly from those at low speed. Ratios were high at the beginning of abduction or adduction and at angles beyond 40 degrees abduction, then decreased according to the arm movement. Glenohumeral motion at high speed was more dominant at the beginning of abduction or adduction beyond the setting phase, then became less dominant according to the arm movement, compared with the motion at low speed.     

液压扩张结合小针刀疗法治疗肩周炎的临床观察

2000年2月-2006年1月采用液压扩张配合小针刀疗法治疗肩周炎187例,疗效满意,现报告如下。1资料与方法1·1一般资料本组187例（197肩）,男81例,女106例;年龄34⁷8岁,平均46·7岁。左肩79例,右肩98例,双肩10例。病程2周³年,平均7·4个月。1·2诊断标准①肩部疼痛,夜间尤甚,甚则痛醒;②肩关节活动受限,以外展、旋转、后伸为著,被动增大活动范围则有剧痛;③肩关节周围有广泛压痛点;④X线片多为正常,部分患者可见肩部骨质疏松、囊性变或肩峰下钙化影。     

体外冲击波联合常规康复治疗肩关节周围炎

目的 观察体外冲击波(extracorporeal shockwave therapy,ESWT)联合常规康复治疗和单纯常规康复治疗对肩关节周围炎患者的疗效.方法 回顾性分析2016年7月～2021年1月就诊于本科室的200例肩关节周围炎患者.其中对照组94例予以常规康复治疗,治疗组106例予以体外冲击波联合常规康复治疗.评估患者治疗前、治疗后和随访时的VAS评分、Constant Murley肩关节评分(Constant Murley shoulder score,CMS)和疗效.结果 在治疗后及随访时,两组患者在VAS评分、关节活动度、CMS评分方面均较治疗前明显改善(P<0.05),对照组临床治疗总有效率达81.91％,治疗组总有效率达94.34％,均取得了较满意的治疗效果.其中治疗组在各项评定中的改善效果更优于对照组(P<0.05).结论 体外冲击波联合常规康复治疗肩关节周围炎能缓解患者肩关节疼痛,改善肩关节综合功能,疗效优于单纯常规康复治疗.     

运动疗法联合微波治疗肩周炎的疗效观察

目的：观察运动疗法联合微波治疗肩周炎的临床疗效。方法选取在我科就诊的中老年肩周炎患者50例,随机分为治疗组和对照组,每组25例,对照组患者单纯给予微波治疗,治疗组患者在微波治疗结束后,给予运动疗法治疗,2组患者均在治疗前后进行康复评估,包括疼痛、关节活动度和日常生活活动能力3个方面的评估。结果治疗组临床总有效率明显优于对照组,组间差异均有统计学意义（P〈0.05）。结论单纯微波治疗肩周炎治疗效果很难令人满意,而运动疗法联合微波治疗肩周炎综合疗法能够很好的改善患者的功能障碍,提高患者的日常生活质量,减轻患者的疼痛。