RESUMO
Background@#Massive rotator cuff tears (MRCTs) with subscapularis (SSC) tears cause severe shoulder dysfunction. In the present study, the influence of SSC tears on three-dimensional (3D) shoulder kinematics during scapular plane abduction in patients with MRCTs was examined. @*Methods@#This study included 15 patients who were divided into two groups: supraspinatus (SSP) and infraspinatus (ISP) tears with SSC tear (torn SSC group: 10 shoulders) or without SSC tear (intact SSC group: 5 shoulders). Single-plane fluoroscopic images during scapular plane elevation and computed tomography (CT)-derived 3D bone models were matched to the fluoroscopic images using two-dimensional (2D)/3D registration techniques. Changes in 3D kinematic results were compared. @*Results@#The humeral head center at the beginning of arm elevation was significantly higher in the torn SSC group than in the intact SSC group (1.8±3.4 mm vs. −1.1±1.6 mm, p<0.05). In the torn SSC group, the center of the humeral head migrated superiorly, then significantly downward at 60° arm elevation (p<0.05). In the intact SSC group, significant difference was not observed in the superior-inferior translation of the humeral head between the elevation angles. @*Conclusions@#In cases of MRCTs with a torn SSC, the center of the humeral head showed a superior translation at the initial phase of scapular plane abduction followed by inferior translation. These findings indicate the SSC muscle plays an important role in determining the dynamic stability of the glenohumeral joint in a superior-inferior direction in patients with MRCTs.
RESUMO
Trunk motion and the mechanisms of postural control during pedaling was investigated by analyzing the lower trunk muscle activity and spinal motion.<BR>Eight healthy adult men were assigned to pedal at the rate of 60 cycles per min. with the load of 100 W, 150 W and 200 W. Muscle activity was recorded with the surface electrodes from the m. multifidus, m, iliocostalis, m. obliquus externus, m; rectus abdominis, m. rectus lemons, m. adductor longus and m. semitendinosus. Spinal motion was filmed with 8 mm video camera located 5 m behind the subject and 1 m above the floor, and five markers were attached on the midline of the spine (C 7, Th 6, Th 12, S 1, Co) .<BR>Muscle activity (iEMG) was quantified by integrating one cycle of recorded electromyogram, and significant increase was recognized in the trunk muscles and m. rectus femoris as the load increased. The angles between each segments were calculated and the largest deviation was observed in the lumbo-sacral portion. Focussing on the activity of the m. obliquus externus, four patterns of controling the trunk posture were observed, and as the load increased, the activity patterns changed in four subjects and the other four showed tremendous increase in iEMG without changing the pattern.<BR>The results sugest that the pedaling may cause relatively large motion at lambo-sacral portion of the spine, and either the change in the activity pattern or the increase in the activity level of the trunk muscles, such as m, obliquus externus, should contribute to reduce the stress on the lambo-sacral portion.
