Портал освітньо-інформаційних послуг «Студентська консультація»

  
Телефон +3 8(066) 185-39-18
Телефон +3 8(093) 202-63-01
 (066) 185-39-18
Вконтакте Студентська консультація
 studscon@gmail.com
 facebook.com/studcons

<script>

  (function(i,s,o,g,r,a,m){i['GoogleAnalyticsObject']=r;i[r]=i[r]||function(){

  (i[r].q=i[r].q||[]).push(arguments)},i[r].l=1*new Date();a=s.createElement(o),

  m=s.getElementsByTagName(o)[0];a.async=1;a.src=g;m.parentNode.insertBefore(a,m)

  })(window,document,'script','//www.google-analytics.com/analytics.js','ga');

 

  ga('create', 'UA-53007750-1', 'auto');

  ga('send', 'pageview');

 

</script>

Особливості розташування лопатки у пацієнтів із болями в ділянці плеча: достовірність досліджень та важливість клінічних тестів

Предмет: 
Тип роботи: 
Стаття
К-сть сторінок: 
17
Мова: 
Українська
Оцінка: 
ОСОБЛИВОСТІ РОЗТАШУВАННЯ ЛОПАТКИ У ПАЦІЄНТІВ ІЗ БОЛЯМИ В ДІЛЯНЦІ ПЛЕЧА: ДОСТОВІРНІСТЬ ДОСЛІДЖЕНЬ ТА ВАЖЛИВІСТЬ КЛІНІЧНИХ ТЕСТІВ
 
SCAPULAR POSITIONING IN PATIENTS WITH SHOULDER PAIN: A STUDY EXAMINING THE RELIABILITY AND CLINICAL IMPORTANCE OF 3 CLINICAL TESTS
 
Jo Nijs, Nathalie Roussel,
Kim Vermeulen, Greet Souvereyns
Department of Human Physiology, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brüssel, Belgium
 
Анотація. Джо Нійс, Наталі Руссел і ін. Особливості розташування лопатки у пацієнтів із болями в ділянці плеча: достовірність досліджень та важливість клінічних тестів. Наводяться дослідження достовірності надійності та важливості трьох клінічних тестів для оцінки розташування лопатки у пацієнтів з болями у плечовій ділянці.
Ключові слова: реабілітація, достовірність, надійність, лопатка.
Аннотация. Джо Нийс, Наталия Руссел и др. Особенности расположения лопатки у пациентов, которые жалуются на боли в плече: достоверность исследований та важность клинических тестов. Описываются исследования достоверности и важности трех клинических тестов для оценивания расположения лопатки у пациентов, которые жалуются на боль в плече.
Ключевые слова: реабилитация, достоверность, надёжность, лопатка.
Abstract. Nijs J, Roussel N, Vermuelen K, Souvereyns G. Scapular positioning in patients with shoulder pain: a study examining the reliability and clinical importance of 3 clinical tests. These data provide evidence favoring the interobserver reliability of 2 of 3 tests for the assessment of scapular positioning in patients with shoulder pain. The clinical importance of the tests' outcomes, however, is questionable.
Key words: Rehabilitation; Reliability and validity; Scapula.
IT IS WIDELY RECOGNIZED that the ability to position the scapula at rest and during movements and tasks (scapular positioning) is essential for optimal upper-limb function. 1, 2 Scapular positioning should be optimal in relation to both the thorax and the humerus. In relation to the humerus, optimal positioning is essential for appropriate positioning of the glenoid, which in turn guarantees maximal mobility and stability of the glenohumeral joint. From basic sciences like anatomy and movement analysis it can be concluded that the muscular system is the major contributor to scapular positioning both at rest and during functional tasks. In the case of altered muscle activity (delayed firing or increased tension and consequent shortening) of scapular muscles, however, scapular positioning is likely to become abnormal. Inappropriate control of scapular positioning has frequently been linked to the development of shoulder impingement syndrome, 2, 6 and Ackermann et al7 suggested a link with shoulder and neck problems in violinists.
From a clinical perspective, however, guidelines for a reliable and valid assessment of faulty scapular positioning in patients with shoulder pain are currently unavailable. Hebert et al2 concluded that simple clinical indicators should be developed to allow clinicians to assess scapular kinematic behavior accurately. The measurement of scapular protraction (intraclass correlation coefficient [ICC]=. 97 [intrarater reliability]; ICC=. 96 [interrater reliability]) and scapular rotation (ICC=. 97 [intrarater and interrater reliability]) has good reliability and validity (statistically related to radiographic measurements) in 8 healthy subjects. 8 Host3 described how scapular taping was able to improve the resting position of the scapula and the scapulothoracic joint movement in a patient with chronic shoulder pain. To quantify the resting scapular position, she used 2 clinical tests: measurement of the distance from the medial scapular border to the fourth thoracic spinous processes and measurement of the distance between the posterior border of the acromion and the table. No data addressing either the reliability or the validity of these tests are currently available. Host herself indicated that «the normal distance from the medial scapular border to the thoracic spinous processes is believed to be 5. 08 cm, « but this value «is not based on data or research findings. 3, 8 It has been suggested that the measurement of the distance between the posterior border of the acromion and the table is indicative of the length of the pectoralis minor muscle. 3 A short or overactive pectoralis minor muscle can maintain the scapula in an excessive protracted or downwardly rotated position (ie, pseudowinging, a frequently observed type of abnormal scapular positioning). 1 Likewise, the lateral scapular slide test (LSST) was designed by Kibler9 to assess scapular asymmetry under varying loads (measurement of the distance between the inferior angle of the scapula and the closest spinous process in 0°, 45°, and 90° of abduction in the coronal plane). It was originally proposed that a side-to-side difference (asymmetry) greater than 1. 5cm was indicative of shoulder dysfunction. 9 Experimental data, however, showed that asymmetric scapular position is commonly seen in asymptomatic subjects and that the cutoff value of 1. 5cm has a low specificity. Thus, further studying of the reliability and validity of these 3 clinical tests for the assessment of scapular positioning (LSST, measurement of the distance from the medial scapular border to the fourth thoracic spinous processes, measurement of the distance between the posterior
Фото Капча