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How Do Scapulothoracic Kinematics During Shoulder Elevation Differ Between Adults With and Without Rotator Cuff
Vilijam Zdravkovic1, Nathalie Alexander2, Regina Wegener2
1V. Zdravkovic, C. Spross, B. Jost, Department of Orthopaedics and Traumatology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Clinical Orthopaedics and Related Research
|July 23, 2020
Summary
Patients with rotator cuff arthropathy exhibit altered scapular motion during arm elevation, with distinct patterns observed before and during visible movement. This study reveals complex scapulothoracic kinematics in these patients.
Area of Science:
- Orthopedics
- Biomechanics
- Human Movement Science
Background:
- Rotator cuff arthropathy significantly impairs active arm elevation, often treated with reverse total shoulder arthroplasty.
- Current kinematic models primarily focus on glenohumeral motion, often overlooking the crucial role of scapular motion.
- Scapular kinematics are poorly understood due to assessment challenges, leading to simplified glenohumeral-centric models.
Purpose of the Study:
- To investigate changes in scapulohumeral rhythm during arm elevation.
- To determine if scapular motion precedes clinically observable arm elevation.
- To compare scapulothoracic kinematics during shoulder elevation between healthy adults and those with rotator cuff arthropathy.
Main Methods:
- Comparative kinematics study involving 20 healthy adults and 20 patients with rotator cuff arthropathy.
- Utilized a 3-D motion analysis system with infrared cameras and skin markers.
- Employed the Upper Limb Evaluation in Movement Analysis (ULEMA) model to analyze scapulothoracic and glenohumeral movements during active arm elevation.
Main Results:
- Scapular rhythm dynamically changes throughout arm elevation, deviating from a homogenous pattern in patients with rotator cuff arthropathy.
- Medial scapular rotation was observed before visible arm elevation, followed by limited rotation during initial elevation.
- Patients with rotator cuff arthropathy demonstrated increased scapulothoracic motion between 50° and 93° of elevation compared to the control group.
Conclusions:
- Scapulothoracic motion is more complex than previously understood, particularly in rotator cuff arthropathy patients.
- The study introduces a novel, noninvasive method for simultaneous glenohumeral and scapular kinematic analysis.
- Findings highlight distinct scapular motion patterns in rotator cuff arthropathy, crucial for understanding treatment outcomes and restoring function.
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