Abstract
Background
We often clinically observe individual differences in arm elevation angles, but the
motion producing these differences remains unclear, partly because of the difficulty
of accurately measuring scapular motion. The aim of this study was to determine whether
the scapular or glenohumeral (GH) motion has more influence on differences in the
arm elevation angles by capturing not only the humerus and scapula but also the trunk
using two- (2D) and three-dimensional (3D) shape-matching registration techniques.
Methods
Fifteen healthy subjects (13 male and 2 female; mean age: 27.7 years) were instructed
to elevate their arms in the sagittal, scapular, and coronal planes. They were divided
into high and low groups based on the average of arm elevation angle measured by a
goniometer. The 3D scapular, thoracohumeral, and glenohumeral motions were evaluated
using 2D/3D single-plane registration. To compare 3D motions between groups, we performed
a two-way repeated measures analysis of variance.
Results
Eight subjects were assigned to the high group, while seven subjects were assigned
to the low groups based on an average elevation angle of 172°. The low group demonstrated
a significant larger scapular protraction during elevation in all planes (P = 0.0002
for flexion; P = 0.0047 for scaption; P = 0.0314 for abduction), and smaller posterior
tilting only during flexion (P = 0.0157). No significant differences occurred in scapular
upward rotations or the glenohumeral positions and rotations.
Conclusions
This study revealed that insufficient scapular retraction and posterior tilting results
in lower arm elevation angles, suggesting that improving the flexibility and activation
of muscles surrounding the scapula may be important to achieve complete arm elevation.
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Article info
Publication history
Accepted:
December 26,
2021
Received in revised form:
December 13,
2021
Received:
May 31,
2021
Identification
Copyright
© 2022 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
