Relationships Between Rounded Shoulder Posture and Biceps Brachii Muscle Length, Elbow Joint Angle, Pectoralis Muscle Length, Humeral Head Anterior Translation, and Glenohumeral Range of Motion원문보기
Background: Rounded shoulder posture (RSP), a postural abnormality, might cause shoulder pain and pathologic conditions. Although most previous research has investigated RSP focusing on the proximal structures of the shoulder, such as the scapula and pectoralis muscles, the relationship between RSP ...
Background: Rounded shoulder posture (RSP), a postural abnormality, might cause shoulder pain and pathologic conditions. Although most previous research has investigated RSP focusing on the proximal structures of the shoulder, such as the scapula and pectoralis muscles, the relationship between RSP and anterior distal structures of the upper extremity, such as the biceps brachii muscle and elbow joint, is not clearly understood. Objects: This study aimed to investigate the correlations between RSP and the biceps brachii length, elbow joint angle (EJA), pectoralis minor length, general pectoralis major length, humeral head anterior translation (HHAT), glenohumeral internal rotation (IR), external rotation (ER), and horizontal adduction (HAD). Methods: Twelve subjects with RSP (6 male, 6 female) were recruited. All subjects fulfilled the RSP criteria indicated by a distance ${\geq}2.5cm$ from the posterior aspect of the acromion to the table in the supine position. The examiner measured each of the following parameters twice: RSP, biceps brachii length, EJA, pectoralis minor length, pectoralis major length, HHAT, glenohumeral IR, ER, and HAD. Pearson's correlation coefficient(r) was used to assess the correlation between RSP and all the variables. Results: There was a significant moderate positive correlation between RSP and biceps brachii length (r=.55, p=.032), moderate negative correlation between RSP and pectoralis minor length (r=-.62, p=.015), and moderate positive correlation between RSP and HHAT (r=.53, p=.038). Conclusion: The biceps brachii length, pectoralis minor length, and HHAT could be used to evaluate patients with RSP. Better understanding of the correlation between these factors and RSP could help in the development of effective methods to treat patients with this condition in clinical management.
Background: Rounded shoulder posture (RSP), a postural abnormality, might cause shoulder pain and pathologic conditions. Although most previous research has investigated RSP focusing on the proximal structures of the shoulder, such as the scapula and pectoralis muscles, the relationship between RSP and anterior distal structures of the upper extremity, such as the biceps brachii muscle and elbow joint, is not clearly understood. Objects: This study aimed to investigate the correlations between RSP and the biceps brachii length, elbow joint angle (EJA), pectoralis minor length, general pectoralis major length, humeral head anterior translation (HHAT), glenohumeral internal rotation (IR), external rotation (ER), and horizontal adduction (HAD). Methods: Twelve subjects with RSP (6 male, 6 female) were recruited. All subjects fulfilled the RSP criteria indicated by a distance ${\geq}2.5cm$ from the posterior aspect of the acromion to the table in the supine position. The examiner measured each of the following parameters twice: RSP, biceps brachii length, EJA, pectoralis minor length, pectoralis major length, HHAT, glenohumeral IR, ER, and HAD. Pearson's correlation coefficient(r) was used to assess the correlation between RSP and all the variables. Results: There was a significant moderate positive correlation between RSP and biceps brachii length (r=.55, p=.032), moderate negative correlation between RSP and pectoralis minor length (r=-.62, p=.015), and moderate positive correlation between RSP and HHAT (r=.53, p=.038). Conclusion: The biceps brachii length, pectoralis minor length, and HHAT could be used to evaluate patients with RSP. Better understanding of the correlation between these factors and RSP could help in the development of effective methods to treat patients with this condition in clinical management.
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문제 정의
This study found a significant moderate negative correlation between RSP and pectoralis minor muscle length, supporting the research hypothesis. This finding is consistent with many previous studies (Burkhart et al, 2000; Escamilla et al, 2009; Hebert et al, 2002; Ludewig and Cook, 2000).
This study found a significant moderate positive correlation between the RSP and HHAT, supporting the research hypothesis. RSP is associated with upper crossed syndrome (USC) (Page et al, 2009).
제안 방법
Discussion
To our knowledge, this study is the first to analyze the correlation between RSP and not only proximal structures of the shoulder girdle such as the humeral head position, the glenohumeral ROM, and pectoralis major, and minor muscles length, but also distal structures of the upper extremity such as the biceps brachii muscle length and EJA. The results partially supported the research hypothesis.
This study has several limitations. First, our findings could not be generalized to the general patient population because healthy young subjects with only specific RSP criteria participated in this study. Therefore, young as well as older subjects with various clinical assessments for RSP should be investigated in future studies.
In this study, there was no significant correlation between RSP and the glenohumeral ROM such as IR, ER, and HAD. The reason for this unexpected result is that this study did not focus on tight or stiff posterior shoulder muscles or capsule regardless of recruiting subjects with RSP. Many previous studies reported that posterior shoulder tightness leads to approximation of the humeral head to the acromion causing shoulder impingement (Choi et al, 2012; Tyler et al, 2000; Yang et al, 2012), related to altered acromioclavicular and sternoclavicular joint motion (Wong et al, 2010), and change in glenohumeral flexion, IR, and HAD (Kibler and McMullen, 2003; Laudner et al, 2006; Tyler et al, 2000).
The subject was positioned in the supine position with the shoulder abducted 90° and the elbow flexed 90° to ensure a neutral horizontal position.
Therefore, the purpose of this study was to investigate the correlations between RSP and the biceps brachii length, EJA, pectoralis minor length, general pectoralis major length, humeral head anterior translation (HHAT), glenohumeral internal rotation (IR), external rotation (ER), and horizontal adduction (HAD). It was hypothesized that there would be a moderate to strong correlation between RSP and the biceps brachii muscle length, EJA, pectoralis minor muscle length, pectoralis major muscle length, HHAT, glenohumeral IR, ER, and HAD
This study examined the relationship between RSP and the biceps brachii length, EJA, pectoralis minor length, pectoralis major length, HHAT, glenohumeral IR, ER, and HAD. There was a significant positive correlation between RSP and biceps brachii muscle length, negative correlation between RSP and pectoralis minor muscle length, and positive correlation between RSP and HHAT.
To achieve a natural resting posture, subjects were instructed to march in place 5 times, moving both the upper and lower extremities. Next, subjects stood in a relaxed position looking straight ahead with their feet shoulder width apart.
To our knowledge, this study is the first to analyze the correlation between RSP and not only proximal structures of the shoulder girdle such as the humeral head position, the glenohumeral ROM, and pectoralis major, and minor muscles length, but also distal structures of the upper extremity such as the biceps brachii muscle length and EJA. The results partially supported the research hypothesis.
대상 데이터
Next, subjects stood in a relaxed position looking straight ahead with their feet shoulder width apart. Three reflective markers were placed over the acromion, humerus lateral epicondyle, and middle point of the radial styloid process and the ulnar head. The EJA was measured as the angle between the line connecting the acromion and the humerus lateral epicondyle and the line connecting humerus lateral epicondyle and the middle point of the radial styloid process and the ulnar head.
데이터처리
Pearson’s correlation coefficient (r) was used to assess the correlation between RSP and the biceps brachii length, EJA, pectoralis minor length, general pectoralis major length, humeral head anterior translation (HHAT), glenohumeral internal rotation (IR), external rotation (ER), and horizontal adduction (HAD).
이론/모형
The Kolmogorov-Smirnov Z-test was used to assess normal data distribution. Pearson’s correlation coefficient (r) was used to assess the correlation between RSP and the biceps brachii length, EJA, pectoralis minor length, general pectoralis major length, humeral head anterior translation (HHAT), glenohumeral internal rotation (IR), external rotation (ER), and horizontal adduction (HAD).
성능/효과
The measured values of RSP, biceps brachii length, EJA, pectoralis minor length, pectoralis major length, HHAT, glenohumeral IR, ER, and HAD are presented in Table 1. There was a significant moderate positive correlation between RSP and biceps brachii length (r=.55, p=.032), moderate negative correlation between RSP and pectoralis minor length (r=-.62, p=.015), and moderate positive correlation between RSP and HHAT (r=.53, p=.038) (Table 2).
This study found a significant moderate positive correlation between RSP and biceps brachii length (r=.55, p=.032), moderate negative correlation between RSP and pectoralis minor length (r=-.62, p=.015), and moderate positive correlation between RSP and HHAT (r=.53, p=.038) (Table 2). Discussion To our knowledge, this study is the first to analyze the correlation between RSP and not only proximal structures of the shoulder girdle such as the humeral head position, the glenohumeral ROM, and pectoralis major, and minor muscles length, but also distal structures of the upper extremity such as the biceps brachii muscle length and EJA.
The results partially supported the research hypothesis. This study found a significant moderate positive correlation between RSP and biceps brachii muscle length. RSP is related to the dominant or tight pectoralis major muscle, which pulls the humeral head anteriorly (Konrad et al, 2006; Page et al, 2009; Labriola et al, 2005), i.
후속연구
As mentioned above, RSP was related to the pectoralis minor, and so we expected that the dominant pectoralis minor would tighten the biceps brachii and coracobrachialis, inducing excessive elbow flexion. Despite these possible reasons, our study did not confirm a significant correlation between RSP and the EJA; therefore, future study with a greater number of patients with RSP, chronic pain, or pathologic symptoms from RSP is needed clarify the relationship between RSP and the EJA.
Second, because this study only examined the relationship between RSP and independents variables, it could not explain the cause and effect for RSP by other independents variables. Further research about the long-term effect of therapeutic intervention or a randomized controlled trial is warranted to validate the results of our study.
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