Article

OBJECTIVE: To assess 3-dimensional scapulothoracic and glenohumeral kinematics
between subjects with spinal cord injury and disease (SCI/D) with and without
shoulder pain during a weight-relief raise and transfer task. DESIGN:
Case-control, repeated-measures analysis of variance. SETTING: Movement analysis
laboratory. PARTICIPANTS: Subjects (N=43; 23 with clinical signs of impingement
and 20 without) between 21 and 65 years of age, at least 1 year after SCI/D
(range, 1-43y) resulting in American Spinal Injury Association Impairment Scale
T2 motor neurologic level or below, and requiring the full-time use of a manual
wheelchair. INTERVENTIONS: Weight-relief raises and transfer tasks. MAIN OUTCOME
MEASURES: An electromagnetic tracking system acquired 3-dimensional position and
orientation of the thorax, scapula, and humerus. Dependent variables included
angular values for scapular upward and downward rotation, posterior and anterior
tilt, and internal and external rotation relative to the thorax,
and glenohumeral
internal and external rotation relative to the scapula. The mean of 3 trials was
collected, and angular values were compared at 3 distinct phases of the
weight-relief raise and transfer activity. Comparisons were also made between
transfer direction (lead vs trail arm) and across groups. RESULTS: Key findings
include significantly increased scapular upward rotation for the pain group
during transfer (P=.03). Significant group differences were found for the
trailing arm at the lift pivot (phase 2) of the transfer, with the pain group
having greater anterior tilt (mean difference +/- SE, 5.7 degrees +/-2.8 degrees
). The direction of transfer also influenced kinematics at the different phases
of the activity. CONCLUSIONS: Potentially detrimental magnitude and direction of
scapular and glenohumeral kinematics during weight-bearing tasks may pose
increased risk for shoulder pain or injury in persons with SCI/D. Consideration
should be given to rehabilitation strategies that promote favorable scapular
kinematics and glenohumeral external rotation.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS