論文

査読有り 国際誌
2020年9月9日

Effective stretching positions for the posterior shoulder capsule as determined by shear wave elastography.

Journal of shoulder and elbow surgery
  • Naoya Iida
  • ,
  • Keigo Taniguchi
  • ,
  • Kota Watanabe
  • ,
  • Hiroki Miyamoto
  • ,
  • Tatsuya Taniguchi
  • ,
  • Atsushi Teramoto
  • ,
  • Masaki Katayose

30
5
開始ページ
1186
終了ページ
1195
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.jse.2020.08.021

BACKGROUND: Stretching is often used to prevent and treat posterior shoulder capsule tightness; however, the most effective stretching positions are not clearly defined. The purpose of this study was to identify the stretching positions that specifically applied the greatest passive tension on the posterior shoulder capsule by evaluating the elastic characteristics of posterior capsules and muscles in various stretching positions using ultrasound shear wave elastography (SWE). METHODS: We evaluated 9 fresh-frozen shoulders (mean age 86.6 ± 7.7 years) without osteoarthritis or rotator cuff tears. All posterior shoulder tissues were preserved intact. Shear moduli of the middle and inferior posterior shoulder capsules and the posterior shoulder muscles were evaluated using SWE. We obtained shear modulus measurements in 9 stretching positions using a combination of glenohumeral elevation planes and angles (frontal, sagittal, scapular; -30°, 0°, 30°, 60°, respectively). A 4-Nm torque for shoulder internal rotation or horizontal adduction was applied in each position. We also measured shear moduli in the resting position (0° elevation with neutral shoulder internal/external rotation). We compared the shear moduli of all stretching and resting positions using 1-way repeated measures analysis of variance (P < .05). In addition, we compared the shear modulus in 2 positions (ie, resting and each stretching) among tissues (ie, capsules and muscles) with repeated measures using 2-way analysis of variance (P < .05). RESULTS: Shear modulus values for the middle posterior capsules in "internal rotation at 30° in scapular plane elevation" (28.7 ± 14.3 kPa, P = .01) and in "horizontal adduction at 60° of elevation" (31.1 ± 13.1 kPa, P < .001) were significantly higher than that of the resting position (11.0 ± 7.3 kPa). The shear modulus value for the inferior posterior capsule in "internal rotation at 30° of flexion" was significantly higher than that of the resting position (39.0 ± 17.3 vs. 15.4 ± 13.9 kPa, respectively; P = .004). Additionally, the shear modulus values for the posterior capsules in "internal rotation at 30° in scapular plane elevation and flexion" were significantly higher than that of the posterior shoulder muscles. CONCLUSION: Effective middle posterior shoulder capsule stretching positions were shoulder "internal rotation at 30° of scapular plane elevation" and "horizontal adduction at 60° of elevation." Shoulder "internal rotation at 30° of flexion" was the most effective position for the inferior posterior shoulder capsule. Stretching in these positions could relieve posterior shoulder capsule tightness and contribute to the prevention and treatment of throwing injuries of the shoulder.

リンク情報
DOI
https://doi.org/10.1016/j.jse.2020.08.021
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32919046
ID情報
  • DOI : 10.1016/j.jse.2020.08.021
  • PubMed ID : 32919046

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