Clarification of kinematic factors related to shoulder pain in patients with rotator cuff pathology and their application to rehabilitation

2023 Fiscal Year Final Research Report

• Project/Area Number: 19K19786
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 59010:Rehabilitation science-related
• Research Institution: Tohoku University
• Principal Investigator: Ishikawa Hiroaki 東北大学, 大学病院, 理学療法士 (30597828)
• Project Period (FY): 2019-04-01 – 2024-03-31
• Keywords: 腱板断裂 / 三次元動作解析 / 筋活動 / 肩関節 / テーピング

Outline of Final Research Achievements

The purpose of this study was to (1) compare scapular kinematics between symptomatic and asymptomatic patients in rotator cuff pathology and (2) investigate the effectiveness of taping to correct scapular movement. Thirty five (67 shoulders) patients with rotator cuff tears were recruited in this study. The shoulders were classified as presence or absence of pain during arm elevation: 23 symptomatic and 15 asymptomatic shoulders. In most of the symptomatic shoulders, pain during arm elevation occurred after the greater tuberosity has passed beneath the acromion. There was no significant difference in three-dimensional scapular movement between the symptomatic and asymptomatic shoulders, but the symptomatic shoulders showed an increasing trend in scapular posterior tilt after 60° of arm elevation. In addition, scapular upward rotation, posterior tilt, and internal rotation were increased after taping, and pain was improved in approximately half of the shoulders.

Free Research Field

総合領域

Academic Significance and Societal Importance of the Research Achievements

腱板断裂患者の多くは、大結節が肩峰を通過した後に痛みが生じていたことから、腱板断裂患者の上肢挙上運動中の痛みは肩峰下インピンジメントとは異なる機械的ストレス（関節内インピンジメントなど）が原因である可能性が考えられる。また、テーピング後に肩甲骨上方回旋、後傾、内旋角度の増加を認めた。特に、肩甲骨後傾は実際に痛みが生じる挙上中期で増加を認めたことから、後傾方向に肩甲骨運動を修正する治療は痛みを軽減させるために有効であるかもしれない。今後は、本研究で得られた知見をもとにして肩甲骨運動の修正に着目した治療プログラムを立案し、最終的には早期の社会復帰の実現や医療コストの削減に繋げる。