肩外転装具装着時の胸腰部屈伸運動が肩甲骨位置と腱板筋の筋活動に与える影響

The purpose of this study was to accumulate basic data for planning rehabilitation programs in the early postoperative period after arthroscopic rotator cuff repair (ARCR). The subjects of our study were seven healthy adult males. We measured rotator cuff muscle activity and scapular position in a chair-sitting position wearing a shoulder abduction brace. Muscle activity for thoracolumbar extension, thoracolumbar flexion, scapular adduction, scapular abduction, and scapular elevation exercises was measured, as well as scapular position in the thoracolumbar neutral position and in the final range of thoracolumbar extension, thoracolumbar flexion, scapular abduction, and scapular elevation. In the result, muscle activity in the supraspinatus muscle was greater than 20% of maximal voluntary isometric contraction (MVC) in scapular adduction and scapular elevation. Although the scapula position with thoracolumbar motion changed less than with scapulothoracic joint motion, abduction of the scapula was observed with thoracolumbar flexion, and adduction of the scapula was also observed with thoracolumbar extension. Thoracolumbar flexion, extension and scapular abduction exercises performed in a chair-sitting position with a shoulder abduction brace may be safe and useful in preventing disuse syndrome and contractures in the early postoperative period after ARCR surgery.

本研究は、鏡視下腱板縫合術術後のリハビリテーションプログラムを立案するための基礎データを集積することを目的とした。健常成人男性７名を対象に、肩外転装具を装着した椅子座位における胸腰部伸展、胸腰部屈曲、肩甲骨内転、肩甲骨外転、肩甲骨挙上運動の際の腱板筋活動（%MVC）を測定した。また、胸腰部中間位と胸腰部伸展、胸腰部屈曲、肩甲骨内転、肩甲骨外転、肩甲骨挙上の最終域の肩甲骨位置を測定した。筋活動量は、20%MVC 以上を高活動量と定義して５つの運動間で比較し、肩甲骨位置は６肢位間で多重比較を行った。その結果、棘上筋の筋活動量は肩甲骨内転と挙上で20%MVC 以上であった。肩甲骨位置は、胸腰部屈曲で肩甲骨の外転、胸腰部伸展で肩甲骨の内転がみられた。肩外転装具を装着した椅子座位で行う胸腰部の屈伸と肩甲骨外転は、鏡視下腱板縫合術術後早期の廃用症候群や拘縮の予防に有用である可能性が考えられた。