Impact of Weight Relief Raise on Acromiohumeral Distance in Patients with Thoracolumbar Spinal Cord Injury / 中国康复理论与实践

Objective:To study the effect of weight relief raise on acromiohumeral distance in patients with thoracolumbar spinal cord injury. Methods:The acromiohumeral distance of 20 patients with thoracolumbar spinal cord injury was measured by ultrasonic diagnostic system, respectively in the resting position and the supporting decompression position. Results:The acromiohumeral distance was significantly larger in the resting position than in the supporting decompression position (t = 6.933, P < 0.001). Conclusion:Support could reduce the subacromial space in patients with spinal cord injury and become a potential factor for subacromial tissue injury.

Role of Magnetic Resonance Imaging in rotator cuff pathologies

Background: Stability to the shoulder joint which has great range of motility, is provided by the rotator cuff, the coraco-acromial arch and the glenoid labrum along with the capsule and glenohumeral ligaments. The common disorders involving the rotator cuff tendons include impingement, tendinopathies and tears. Magnetic Resonance Imaging (MRI) has good spatial resolution for identifying tendon edema and tears in the rotator cuff. Aim and objectives: To describe the MRI characteristics of rotator cuff pathologies. To describe the rotator cuff pathologies in terms of age, gender, symptomatology and predisposing factors among the study population. Materials and methods: The study was performed in the Department of Radiodiagnosis, NRI General Hospital, Chinakakani, Guntur from September 2015 to August 2017 and comprises of 100 patients with suspected rotator cuff pathologies who were referred for MRI shoulder. Results: The age distribution of patients with rotator cuff abnormalities was in the range of 21 and 74 years. The most commonly affected was supraspinatus tendon followed by subscapularis and infraspinatus tendons. Among the rotator cuff abnormalities the frequently encountered finding was tendinosis followed by partial tears. Conclusion: Magnetic Resonance Imaging is very useful in depicting rotator cuff disease in patients with painful, weak or stiff shoulder for prompt and accurate diagnosis.

Effect of a Specific Rehabilitation Program of Serratus Anterior and Lower Trapezius Muscles for Subacromial Impingement Syndrome on Subacromial Space and the Vascularity of Supraspinatus Tendon / 대한스포츠의학회지

PURPOSE: This study was designed to assess the effects of a rehabilitation program on clinical symptoms, subacromial space parameters and the supraspinatus vascularity in individuals with subacromial impingement syndrome (SIS). METHODS: Thirty-five participants (exercise group with SIS [EG]=11, non-exercise group with SIS [NEG]=10, control group [CG]=14) took part in this study. Only EG participated in 6-week rehabilitation program. Outcomes were evaluated at baseline, 6 weeks, and 10 weeks. Changes in symptoms and functional limitations were assessed using Shoulder Pain and Disability Index (SPADI) questionnaire. Changes in acromiohumeral distance (AHD) and supraspinatus tendon thickness (STT)/AHD were assessed using ultrasonographic measures. Quantitative analysis of tendon blood flow was performed by determining four regions of interest with power Doppler quantification and analysis software to normalize data for interpretation of the mean ratio of colored pixel to the region of interest (vascularization index [VI]) and the intensity per pixel (flow index [FI]). RESULTS: Following the rehabilitation program, the scores on SPADI were significantly improved (p < 0.05). However, AHD, STT/AHD, VI, and FI indicated no significant difference within groups or interactions of time and group in between groups. CONCLUSION: The rehabilitation program yielded improvements in symptoms, but not in subacromial parameters and the vascularity of supraspinatus in participants with SIS.

A Novel Method to Measure Superior Migration of the Humeral Head: Step-off of the C-line

BACKGROUND: Superior migration of humeral head has been conventionally determined by measuring the acromiohumeral distance (AHD), We sought to devise a novel measurement system more reliably and accurately than AHD. We described a structural landmark called 'C-line'. In this study, we investigated the clinical usefulness of 'step-off of the C-line (SOC)' compared to that of AHD. METHODS: The C-line formed from the medial margin of the proximal humeral head continuing up to the inferior margin of the articular glenoid and then to the lateral border of the scapula. The superior migration of the humeral head triggered by a rotator cuff tear introduces a discontinuity in this C-line. We measured the distance of this discontinuity. We enrolled 144 patients who underwent a rotator cuff repair. We selected 58 controls who didn't have any cuff lesions apparent on magnetic resonance imaging. Using radiographs derived from standardized true anteroposterior views of the shoulder, we measured the SOC and the AHD. We used t-tests for statistical analyses. RESULTS: A rotator cuff tear was associated with an increase in SOC and a decrease in AHD. In control group, the mean SOC was 1.29 ± 1.71 mm and AHD was 9.71 ± 2.65 mm. In cuff tear group, the mean SOC was 3.15 ± 3.41 mm and AHD was 8.28 ± 1.76 mm. The mean SOCs of the patient group in relation to the mean SOC of the control group according to tear size, the SOCs of medium tear and lager groups showed statistically significant increase (p<0.05). CONCLUSIONS: The SOC may be a similarly effective to diagnose cuff tears of medium size and larger compared with AHD.

A Novel Method to Measure Superior Migration of the Humeral Head: Step-off of the C-line

BACKGROUND: Superior migration of humeral head has been conventionally determined by measuring the acromiohumeral distance (AHD), We sought to devise a novel measurement system more reliably and accurately than AHD. We described a structural landmark called 'C-line'. In this study, we investigated the clinical usefulness of 'step-off of the C-line (SOC)' compared to that of AHD. METHODS: The C-line formed from the medial margin of the proximal humeral head continuing up to the inferior margin of the articular glenoid and then to the lateral border of the scapula. The superior migration of the humeral head triggered by a rotator cuff tear introduces a discontinuity in this C-line. We measured the distance of this discontinuity. We enrolled 144 patients who underwent a rotator cuff repair. We selected 58 controls who didn't have any cuff lesions apparent on magnetic resonance imaging. Using radiographs derived from standardized true anteroposterior views of the shoulder, we measured the SOC and the AHD. We used t-tests for statistical analyses. RESULTS: A rotator cuff tear was associated with an increase in SOC and a decrease in AHD. In control group, the mean SOC was 1.29 ± 1.71 mm and AHD was 9.71 ± 2.65 mm. In cuff tear group, the mean SOC was 3.15 ± 3.41 mm and AHD was 8.28 ± 1.76 mm. The mean SOCs of the patient group in relation to the mean SOC of the control group according to tear size, the SOCs of medium tear and lager groups showed statistically significant increase (p<0.05). CONCLUSIONS: The SOC may be a similarly effective to diagnose cuff tears of medium size and larger compared with AHD.