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首页> 外文期刊>Journal of shoulder and elbow surgery >Differential patterns of muscle activation in patients with symptomatic and asymptomatic rotator cuff tears.
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Differential patterns of muscle activation in patients with symptomatic and asymptomatic rotator cuff tears.

机译：有症状和无症状肩袖撕裂患者的肌肉激活差异模式。

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摘要

Patients with rotator cuff tears have varying degrees of symptom expression. Our purpose was to evaluate the differential firing patterns of the rotator cuff, deltoid, and scapular stabilizer muscle groups in normal control subjects and in patients with symptomatic and asymptomatic 2-tendon rotator cuff tears. Eighteen subjects were evaluated: six normal subjects and twelve with 2-tendon cuff tears (six asymptomatic and six symptomatic). All cuff tear patients had magnetic resonance imaging (MRI) scans documenting superoposterior tear configurations involving the supraspinatus and infraspinatus tendons; all normal subjects had an ultrasound examination confirming the absence of cuff pathology. Subjects were grouped based on shoulder examination and outcomes questionnaires. Asymptomatic patients had minimal pain (<3 on the visual analog scale and no loss of active range of motion compared with the contralateral side); symptomatic patients had pain greater than 3 on the visual analog scale and decreased range of motion compared with the contralateral side (>10 degrees of motion loss). Electromyographic activity from 12 muscles and kinematic data were collected simultaneously during 10 functional tasks. Both symptomatic and asymptomatic cuff subjects demonstrated a trend toward increased muscle activation during all tasks compared with normal subjects. During the internal rotation tasks, asymptomatic patients had significantly greater (P<.05) subscapularis activity than symptomatic patients (65% maximal voluntary contraction [MVC] vs 42% MVC). During the carrying task, asymptomatic patients demonstrated significantly less (P<.03) upper trapezius muscle activation than symptomatic patients (16% MVC vs 50% MVC). During shoulder elevation tasks, symptomatic patients had significantly greater supraspinatus (52% MVC vs 28% MVC, P<.03), infraspinatus (32% MVC vs 16% MVC, P<.05), and upper trapezius (39% MVC vs 20% MVC, P<.04) muscle activation compared with asymptomatic patients. During heavy elevation (8 lb), asymptomatic patients showed a trend toward increased activation (P<.06) of the subscapularis compared with symptomatic patients (34% MVC vs 21% MVC). Differential shoulder muscle firing patterns in patients with rotator cuff pathology may play a role in the presence or absence of symptoms. Asymptomatic subjects demonstrated increased firing of the intact subscapularis, whereas symptomatic subjects continued to rely on torn rotator cuff tendons and periscapular muscle substitution, resulting in compromised function.
机译：肩袖撕裂的患者有不同程度的症状表达。我们的目的是评估正常对照受试者以及有症状和无症状的2肌腱肩袖撕裂患者的肩袖，三角肌和肩cap稳定肌群的不同放电模式。评价了18名受试者：6名正常受试者和12名2肌腱袖口撕裂（6名无症状和6名有症状）。所有袖带撕裂患者均进行了磁共振成像（MRI）扫描，记录了涉及棘上肌和脊柱下肌腱的后上泪形态。所有正常受试者均接受超声检查，确认没有袖带病理。根据肩膀检查和结果调查表对受试者进行分组。无症状患者的疼痛极小（在视觉模拟量表上<3，与对侧相比，活动范围没有损失）;有症状的患者在视觉模拟量表上的疼痛大于3，并且与对侧相比，运动范围减小（运动损失> 10度）。在10个功能性任务期间，同时收集了12条肌肉的肌电活动和运动学数据。有症状和无症状的袖带受试者均显示出与正常受试者相比在所有任务中肌肉激活增加的趋势。在内部旋转任务期间，无症状患者的肩sub下肌活动明显大于有症状患者（P <.05）（最大自愿收缩[MVC]为65％，MVC为42％）。在携带任务期间，无症状患者的斜方肌上斜肌激活明显少于有症状患者（MVC为16％，MVC为50％）（P <.03）。在肩部抬高任务期间，有症状的患者具有明显较高的上棘（52％MVC vs 28％MVC，P <.03），鼻下肌（32％MVC vs 16％MVC，P <.05）和上斜方肌（39％MVCvs。与无症状患者相比，有20％的MVC，P <.04）肌肉激活。在重度抬高（8磅）期间，与有症状的患者（34％的MVC对21％的MVC）相比，无症状的患者表现出肩activation下肌激活增加的趋势（P <.06）。肩袖病理学患者的肩部肌肉不同的射击方式可能在出现或不出现症状时起作用。无症状的受试者表现出完整的肩sub下肌射击增加，而有症状的受试者继续依靠撕裂的肩袖肌腱和肩cap骨周围肌肉替代，导致功能受损。

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