Individuals with rotator cuff tears unsuccessfully treated with exercise therapy have less inferiorly oriented net muscle forces during scapular plane abduction

被引：0

作者：

Mattar, Luke T. ^{[1
,4
]}

Mahboobin, Arash B. ^{[3
]}

Popchak, Adam J. ^{[5
]}

Anderst, William J. ^{[2
,4
]}

Musahl, Volker ^{[1
,3
,4
]}

Irrgang, James J. ^{[4
]}

Debski, Richard E. ^{[1
,3
,4
,6
]}

机构：

[1] Univ Pittsburgh, Orthopaed Robot Lab, Pittsburgh, PA USA

[2] Univ Pittsburgh, Biodynam Lab, Pittsburgh, PA USA

[3] Univ Pittsburgh, Swanson Sch Engn, Dept Bioengn, Pittsburgh, PA USA

[4] Univ Pittsburgh, UPMC Freddie Fu Sports Med Ctr, Dept Orthopaed Surg, Pittsburgh, PA USA

[5] Univ Pittsburgh, Dept Phys Therapy, Pittsburgh, PA USA

[6] 408 Ctr Bioengn,300 Technol Dr, Pittsburgh, PA 15219 USA

来源：

JOURNAL OF BIOMECHANICS | 2024年 / 162卷

基金：

美国国家卫生研究院;

关键词：

Rotator cuff; Kinematics; Computational modeling; Muscle force; Shoulder; MOMENT ARMS; ELECTROMYOGRAPHIC ANALYSIS; GLENOHUMERAL STABILITY; MUSCULOSKELETAL MODEL; TENDON REPAIR; OLDER-ADULTS; SHOULDER; SIMULATION; VALIDATION; DEFORMITY;

D O I：

10.1016/j.jbiomech.2023.111859

中图分类号：

Q6 [生物物理学];

学科分类号：

071011 ;

摘要：

Exercise therapy for individuals with rotator cuff tears fails in approximately 25.0 % of cases. One reason for failure of exercise therapy may be the inability to strengthen and balance the muscle forces crossing the glenohumeral joint that act to center the humeral head on the glenoid. The objective of the current study was to compare the magnitude and orientation of the net muscle force pre- and post-exercise therapy between subjects successfully and unsuccessfully (e.g. eventually underwent surgery) treated with a 12-week individualized exercise therapy program. Twelve computational musculoskeletal models (n = 6 successful, n = 6 unsuccessful) were developed in OpenSim (v4.0) that incorporated subject specific tear characteristics, muscle peak isometric force, in-vivo kinematics and bony morphology. The models were driven with experimental kinematics and the magnitude and orientation of the net muscle force was determined during scapular plane abduction at pre- and post-exercise therapy timepoints. Subjects unsuccessfully treated had less inferiorly oriented net muscle forces pre- and post-exercise therapy compared to subjects successfully treated (p = 0.039 & 0.045, respectively). No differences were observed in the magnitude of the net muscle force (p > 0.05). The current study developed novel computational musculoskeletal models with subject specific inputs capable of distinguishing between subjects successfully and unsuccessfully treated with exercise therapy. A less inferiorly oriented net muscle force in subjects unsuccessfully treated may increase the risk of superior migration leading to impingement. Adjustments to exercise therapy programs may be warranted to avoid surgery in subjects at risk of unsuccessful treatment.

引用

页数：9