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系統識別號 U0026-0812200914062373
論文名稱(中文) 肩峰下注射與肌肉鬆動術對於肩峰下夾擊症候群患者於肩胛控制之立即效應
論文名稱(英文) The Immediate Effect of Subacromial Injection and Soft Tissue Mobilization: An Analysis of Scapular Control in Patients with Subacromial Impingement Syndrome
校院名稱 成功大學
系所名稱(中) 物理治療研究所
系所名稱(英) Department of Physical Therapy
學年度 96
學期 1
出版年 97
研究生(中文) 陳柏村
研究生(英文) Po-Tsun Chen
電子信箱 t6694104@mail.ncku.edu.tw
學號 t6694104
學位類別 碩士
語文別 中文
論文頁數 88頁
口試委員 指導教授-陳文玲
口試委員-徐阿田
指導教授-周一鳴
中文關鍵字 肌肉鬆動術  上斜方肌  肩峰下玻尿酸注射  肩峰下夾擊症候群 
英文關鍵字 subacromial impingement syndrome  sodium hyaluronate  soft tissue mobilization  subacromial injection  upper trapezius 
學科別分類
中文摘要 研究背景:肩峰下夾擊症候群患者於手臂抬舉動作時,常伴隨著過度活動的上斜方肌與活動不足的前鉅肌而呈現異常肩胛控制。臨床上常藉由肩峰下玻尿酸注射治療迅減少疼痛,或利用肌肉鬆動術可有效降低局部肌肉痙攣與高張。但至今仍未有研究分析夾擊症患者在接受肩峰下注射後或在針對之上斜方肌施以鬆動術治療後於抬舉時肩胛控制策略之改變。目的:針對肩峰下夾擊症候群患者檢定肩峰下玻尿酸注射與上斜方肌鬆動術於抬舉時肩胛控制策略與相關臨床症狀之療效。方法:本研究徵召17位夾擊症患者接受肩峰下玻尿酸注射,並於注射前、後(n=17)及注射後一週(n=9)進行疼痛狀態、肩關節活動度(外展、外轉與內轉)、旋轉肌力測試(內外旋轉肌)、與進行肩胛面抬舉時肩胛肌(上斜方肌、前鉅肌、三角肌中枝與下斜方肌)肌電訊號評估。此外於注射前評估肩痛失能指數並於一週後再度追蹤。另外安排一週後再度追蹤的患者(n=10)及個別徵召5位未曾接受肩峰下注射之夾擊症患者進行上斜方肌鬆動術治療並於治療前後進行上斜方肌柔軟度與肩胛面抬舉時肩胛肌肌電訊號評估。結果:患者在注射後不但疼痛強度顯著降低外,於關節活動度、肩外轉肌力方面均有顯著性立即療效(n=17, p<0.05)。在肩胛肌活動方面,發現在抬舉期間,前鋸肌與三角肌中枝於注射後之平均活動量均顯著高於注射前(n=17,p<0.05)。經過一週後發現,疼痛強度雖未繼續減少但仍顯著低於注射前(n=9,p<0.05),而肩痛失能指數亦顯著低於一週前(n=9,p<0.05)。關節活動度與肩旋轉肌力之注射後立即療效亦繼續維持,然未呈現顯著差異(n=9,p=0.44~0.96)。此處注射後一週之肩胛肌肉活動量反而普遍降低,且部分肌肉於抬舉前期與末期呈現顯著降低的現象(0°-30°,上斜方肌;90°-120°,上斜方肌與下斜方肌,p<0.05)。有關上斜方肌鬆動術之立即性療效分析,結果顯示患者於治療後呈現上斜方肌柔軟度增加(p<0.05)。在肩胛肌活動方面,在抬舉初期前鉅肌與下斜方肌之平均活動量均顯著高於治療前(0°-30°,前鉅肌與下斜方肌;30°-60°,前鉅肌,p<0.05)。結論:本研究結果除了驗證肩峰下玻尿酸注射於止痛或改善肌力關節活動度以及肩部功能等已知的立即療效外,更針對促進抬舉過程之肩胛控制策略提供直接證據,顯示在剛注射完肩胛肌群之肌肉活動量顯著增加。然此現象可能無法維持一週,應積極介入相關肩胛肌之肌力訓練。過去鮮少有關上斜方肌鬆動術之實證,此乃首次提出直接證據支持此治療手法於抬舉時肩胛肌活動模式之研究。雖未如預期有效降低上斜方肌之活動量,但上斜方肌之柔軟度於療後顯著增加且前鉅肌亦於療後立即呈現活動量增加現象。
英文摘要 Background: Patients with subacromial impingement syndrome(SAIS) have been reported to demonstrate increased upper trapezius(UT) and reduced serratus anterior(SA) muscle activities during arm elevation. While subacromial injection is commonly used in clinical orthopedics for the reduction of pain and inflammation and soft tissue mobilization were recommended to decrease local muscle spasm and hypertonicity, no studies have investigated the effect of subacromial injection or UT soft tissue mobilization on scapular control in patients with SAIS. Purpose: The study aimed to examine the immediate effect of subacromial injection or UT soft tissue mobilization on scapular control and related symptoms in patients with SAIS. Methods: 17 subjects with SAIS were included to take subacromial injection. Pain status, range of motion(ROM) of shoulder, strength of shoulder rotators, and scapular muscles activities including UT, SA, middle deltoid(MD), and loer trapezius(LT) were measured during scaption before and after injection. The assessment of shoulder pain and disability index(SPADI) was finished before and follow-up 1 week after injection(n=9). 10 patients with injection 1 week ago and another 5 SAIS patients without subacromial injection were recruited. They received soft tissue mobilization treatment on UT(n=15). The flexibility of UT and scapular muscles activities during scaption were measured before and after soft tissue mobilization. Results: Significantly reduced pain scale, increased shoulder ROM, increased strength were found after injection(n=17, p<0.05). During scaption 30°-60°, the activities of SA and MD were increased significantly after injection. Significant pain reduction 1 week after injection was found, compared to the status before injection(n=9, p<0.05), and SPADI showed significant improvement 1 week after injection. Shoulder ROM and rotators strength were improved 1 week after injection, but no significant changes found(n=9, p=0.44~0.96 ). The activities of scapular muscles during scaption were generally decreased, especially during initial and late scaption phase. The flexibility of UT was increased significantly after UT mobilization. In the initial phase of scaption, significant increased activities of SA and LT were found. Conclusion: This study not only examine the immediately effect of subacromial injection on pain reduction and strength and ROM improvement, but provided the evidence of scapular muscles contributions during scaption after pain reduction. The scapular muscle strengthening should be followed after injection, since the effect of injection may not be maintained about 1 week. This study was the first research about soft tissue mobilization on UT and demonstrated the changed scapular muscle activities after UT soft tissue mobilization. The significantly increased flexibility of UT and activities of SA was found after UT soft tissue mobilization.
論文目次 中文摘要 --------------------------------- 3
英文摘要 --------------------------------- 5
誌謝 ------------------------------------- 7
目錄 ------------------------------------- 8
表目錄 ----------------------------------- 12
圖目錄 ----------------------------------- 13
第一章 文獻回顧
1.1肩峰下夾擊症候群之盛行率 -- --- 14
1.2肩峰下夾擊症候群之定義 -------- 14
1.3 致病機轉 --------------------- 14
1.4 臨床症狀 --------------------- 15
1.5 肩胛肱骨節律 ----------------- 16
1.6 肩胛之動作學 ----------------- 17
1.7 肩胛肌之解剖位置與功能 ------- 19
1.8 肩胛肌於手臂抬舉時之肌電訊號
1.8.1肩部損傷對於肩胛肌活動之影響 - 20
1.8.2 上下斜方肌活動量比值之驗證 - 21
1.9 肩峰下夾擊症候群之非手術治療
1.9.1肩部注射治療 ---------------- 22
1.9.2物理治療 -------------------- 23
1.9.3上斜方肌鬆動術 -------------- 24
1.10總結 ------------------------- 25
1.11研究動機 --------------------- 25
1.12研究問題 ---------------------- 26
1.13研究目的 --------------------- 27
第二章 研究方法
2.1研究對象 -------------------- 28
2.2研究儀器與設備 -------------- 28
2.3研究流程 -------------------- 31
2.4評估項目
2.4.1疼痛狀態評估 -------------- 33
2.4.2肩功能問卷 ---------------- 33
2.4.3相關肌力測試 -------------- 34
2.4.4上斜方肌柔軟度測量 -------- 37
2.4.5肩胛面抬舉動作測量 --------- 37
2.4.6相關肌肉於肩胛面抬舉時之肌電訊號測量 --- 40
2.5上斜方肌鬆動術 ------------------------- 41
2.6資料處理與分析
2.6.1肩胛面抬舉動作分析 ----------------- 42
2.6.2肌電訊號分析 ----------------------- 43
2.7資料統計與分析 ------------------------ 44
第三章 研究結果
3.1肩峰下玻尿酸注射之立即效應
3.1.1受試者基本資料 ---------------------- 46
3.1.2肩峰下注射於疼痛狀態、關節活動角度及肌力方面
之立即效應--- 46
3.1.3肩峰下注射對於抬舉過程肩胛肌活動之立即效應-47
3.2肩峰下注射後ㄧ週之縱向療效分析
3.2.1疼痛狀態、關節活動角度、肌力、及SPADI量表評
估---- 48
3.2.2注射前後、及注射後一週之抬舉時肩胛肌活動變
化---------- 50
3.2.3注射後當天與注射一週後之最大自主收縮肌電訊
號 ------ 51
3.3上斜方肌鬆動術治療之療效
3.3.1受試者基本資料--------------------- 52
3.3.2鬆動術前後之疼痛狀態與上斜方肌柔軟度---- 53
3.3.3上斜方肌鬆動術對於肩部肌肉活動之影響---- 54
第四章 討論
4.1肩峰下注射受試者之超音波影像檢查 ---------- 56
4.2.肩峰下注射於疼痛狀態、關節活動度、肌力、與肩功
能量表之療效
4.2.1立即性療效 -------------------- 57
4.2.2注射後一週之療效 -----------------59
4.3肩峰下注射對於手臂抬舉過程肩胛肌肉活動之影響
4.3.1立即性療效 ------------------------ 59
4.3.2注射後一週之療效 ------------------- 61
4.4上斜方肌鬆動術之療效
4.4.1受試者基本資料 ------------------ 63
4.4.2上斜方肌鬆動術之療效 -------------- 64
第五章 結論 ------------------------------------ 68
第六章 參考文獻 -------------------------------- 69
附錄一 人體試驗同意書 ----------------------- 85
附錄二 肩疼痛與失能指數 ---------------------- 87
參考文獻 1. Picavet HS, Schouten JS. Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC(3)-study. Pain. Mar 2003;102(1-2):167-178.
2. van der Windt DA, Koes BW, de Jong BA, Bouter LM. Shoulder disorders in general practice: incidence, patient characteristics, and management. Ann Rheum Dis. Dec 1995;54(12):959-964.
3. Vecchio P, Kavanagh R, Hazleman BL, King RH. Shoulder pain in a community-based rheumatology clinic. Br J Rheumatol. May 1995;34(5):440-442.
4. Chipchase LS, O'Connor DA, Costi JJ, Krishnan J. Shoulder impingement syndrome: preoperative health status. J Shoulder Elbow Surg. Jan-Feb 2000;9(1):12-15.
5. Neer CS, 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am. Jan 1972;54(1):41-50.
6. Bigliani LU, Levine WN. Subacromial impingement syndrome. J Bone Joint Surg Am. Dec 1997;79(12):1854-1868.
7. Fu FH, Harner CD, Klein AH. Shoulder impingement syndrome. A critical review. Clin Orthop Relat Res. Aug 1991(269):162-173.
8. Michener LA, McClure PW, Karduna AR. Anatomical and biomechanical mechanisms of subacromial impingement syndrome. Clin Biomech (Bristol, Avon). Jun 2003;18(5):369-379.
9. Herring SA, Nilson KL. Introduction to overuse injuries. Clin Sports Med. Apr 1987;6(2):225-239.
10. Rathbun JB, Macnab I. The microvascular pattern of the rotator cuff. J Bone Joint Surg Br. Aug 1970;52(3):540-553.
11. Uhthoff HK, Sano H. Pathology of failure of the rotator cuff tendon. Orthop Clin North Am. Jan 1997;28(1):31-41.
12. Bigliani LU, Ticker JB, Flatow EL, Soslowsky LJ, Mow VC. The relationship of acromial architecture to rotator cuff disease. Clin Sports Med. Oct 1991;10(4):823-838.
13. Belling Sorensen AK, Jorgensen U. Secondary impingement in the shoulder. An improved terminology in impingement. Scand J Med Sci Sports. Oct 2000;10(5):266-278.
14. Payne LZ, Deng XH, Craig EV, Torzilli PA, Warren RF. The combined dynamic and static contributions to subacromial impingement. A biomechanical analysis. Am J Sports Med. Nov-Dec 1997;25(6):801-808.
15. Jobe FW, Kvitne RS, Giangarra CE. Shoulder pain in the overhand or throwing athlete. The relationship of anterior instability and rotator cuff impingement. Orthop Rev. Sep 1989;18(9):963-975.
16. Magee DJ. Orthopedic Physical Assessment. 3rd ed. ed. Philadelphia, Pennsylvania: W.B. Saunders Company; 1997.
17. Warner JJ, Micheli LJ, Arslanian LE, Kennedy J, Kennedy R. Patterns of flexibility, laxity, and strength in normal shoulders and shoulders with instability and impingement. Am J Sports Med. Jul-Aug 1990;18(4):366-375.
18. Lin JJ, Yang JL. Reliability and validity of shoulder tightness measurement in patients with stiff shoulders. Man Ther. May 2006;11(2):146-152.
19. Tyler TF, Nicholas SJ, Roy T, Gleim GW. Quantification of posterior capsule tightness and motion loss in patients with shoulder impingement. Am J Sports Med. Sep-Oct 2000;28(5):668-673.
20. Osbahr DC, Murrell GA. The rotator cuff functional index. Am J Sports Med. Jun 2006;34(6):956-960.
21. Tyler TF, Nahow RC, Nicholas SJ, McHugh MP. Quantifying shoulder rotation weakness in patients with shoulder impingement. J Shoulder Elbow Surg. Nov-Dec 2005;14(6):570-574.
22. Cathcart CW. Movements of the Shoulder Girdle involved in those of the Arm on the Trunk. J Anat Physiol. Jan 1884;18(Pt 2):211-218.
23. Codman EA. Rupture of the supraspinatus tendon. 1911. Clin Orthop Relat Res. May 1990(254):3-26.
24. Lin JJ, Lim HK, Yang JL. Effect of shoulder tightness on glenohumeral translation, scapular kinematics, and scapulohumeral rhythm in subjects with stiff shoulders. J Orthop Res. May 2006;24(5):1044-1051.
25. McQuade KJ, Dawson J, Smidt GL. Scapulothoracic muscle fatigue associated with alterations in scapulohumeral rhythm kinematics during maximum resistive shoulder elevation. J Orthop Sports Phys Ther. Aug 1998;28(2):74-80.
26. McQuade KJ, Smidt GL. Dynamic scapulohumeral rhythm: the effects of external resistance during elevation of the arm in the scapular plane. J Orthop Sports Phys Ther. Feb 1998;27(2):125-133.
27. Mell AG, LaScalza S, Guffey P, et al. Effect of rotator cuff pathology on shoulder rhythm. J Shoulder Elbow Surg. Jan-Feb 2005;14(1 Suppl S):58S-64S.
28. Vermeulen HM, Stokdijk M, Eilers PH, Meskers CG, Rozing PM, Vliet Vlieland TP. Measurement of three dimensional shoulder movement patterns with an electromagnetic tracking device in patients with a frozen shoulder. Ann Rheum Dis. Feb 2002;61(2):115-120.
29. van der Helm FC, Pronk GM. Three-dimensional recording and description of motions of the shoulder mechanism. J Biomech Eng. Feb 1995;117(1):27-40.
30. Ludewig PM, Cook TM, Nawoczenski DA. Three-dimensional scapular orientation and muscle activity at selected positions of humeral elevation. J Orthop Sports Phys Ther. Aug 1996;24(2):57-65.
31. Flatow EL, Soslowsky LJ, Ticker JB, et al. Excursion of the rotator cuff under the acromion. Patterns of subacromial contact. Am J Sports Med. Nov-Dec 1994;22(6):779-788.
32. Graichen H, Bonel H, Stammberger T, Englmeier KH, Reiser M, Eckstein F. Subacromial space width changes during abduction and rotation--a 3-D MR imaging study. Surg Radiol Anat. 1999;21(1):59-64.
33. McClure PW, Michener LA, Sennett BJ, Karduna AR. Direct 3-dimensional measurement of scapular kinematics during dynamic movements in vivo. J Shoulder Elbow Surg. May-Jun 2001;10(3):269-277.
34. McQuade KJ, Hwa Wei S, Smidt GL. Effects of local muscle fatigue on three-dimensional scapulohumeral rhythm. Clin Biomech (Bristol, Avon). Apr 1995;10(3):144-148.
35. Culham E, Peat M. Functional anatomy of the shoulder complex. J Orthop Sports Phys Ther. Jul 1993;18(1):342-350.
36. Kebaetse M, McClure P, Pratt NA. Thoracic position effect on shoulder range of motion, strength, and three-dimensional scapular kinematics. Arch Phys Med Rehabil. Aug 1999;80(8):945-950.
37. Solem-Bertoft E, Thuomas KA, Westerberg CE. The influence of scapular retraction and protraction on the width of the subacromial space. An MRI study. Clin Orthop Relat Res. Nov 1993(296):99-103.
38. Lukasiewicz AC, McClure P, Michener L, Pratt N, Sennett B. Comparison of 3-dimensional scapular position and orientation between subjects with and without shoulder impingement. J Orthop Sports Phys Ther. Oct 1999;29(10):574-583; discussion 584-576.
39. Endo K, Ikata T, Katoh S, Takeda Y. Radiographic assessment of scapular rotational tilt in chronic shoulder impingement syndrome. J Orthop Sci. 2001;6(1):3-10.
40. Hebert LJ, Moffet H, McFadyen BJ, Dionne CE. Scapular behavior in shoulder impingement syndrome. Arch Phys Med Rehabil. Jan 2002;83(1):60-69.
41. Ludewig PM, Cook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Phys Ther. Mar 2000;80(3):276-291.
42. McClure PW, Michener LA, Karduna AR. Shoulder function and 3-dimensional scapular kinematics in people with and without shoulder impingement syndrome. Phys Ther. Aug 2006;86(8):1075-1090.
43. Johnson G, Bogduk N, Nowitzke A, House D. Anatomy and actions of the trapezius muscle. Clinical Biomechanics. 1994;9:44-50.
44. Bagg SD, Forrest WJ. Electromyographic study of the scapular rotators during arm abduction in the scapular plane. Am J Phys Med. Jun 1986;65(3):111-124.
45. Peat M, Grahame RE. Electromyographic analysis of soft tissue lesions affecting shoulder function. Am J Phys Med. Oct 1977;56(5):223-240.
46. Kelly BT, Williams RJ, Cordasco FA, et al. Differential patterns of muscle activation in patients with symptomatic and asymptomatic rotator cuff tears. J Shoulder Elbow Surg. Mar-Apr 2005;14(2):165-171.
47. Lin JJ, Hanten WP, Olson SL, et al. Functional activity characteristics of individuals with shoulder dysfunctions. J Electromyogr Kinesiol. Dec 2005;15(6):576-586.
48. Cools AM, Declercq GA, Cambier DC, Mahieu NN, Witvrouw EE. Trapezius activity and intramuscular balance during isokinetic exercise in overhead athletes with impingement symptoms. Scand J Med Sci Sports. Feb 2007;17(1):25-33.
49. Lin JJ, Wu YT, Wang SF, Chen SY. Trapezius muscle imbalance in individuals suffering from frozen shoulder syndrome. Clin Rheumatol. Nov 2005;24(6):569-575.
50. Babyar SR. Excessive scapular motion in individuals recovering from painful and stiff shoulders: causes and treatment strategies. Phys Ther. Mar 1996;76(3):226-238; discussion 239-247.
51. Andrews JR. Diagnosis and treatment of chronic painful shoulder: review of nonsurgical interventions. Arthroscopy. Mar 2005;21(3):333-347.
52. Itokazu M, Matsunaga T, Itokazu M, Matsunaga T. Clinical evaluation of high-molecular-weight sodium hyaluronate for the treatment of patients with periarthritis of the shoulder. Clinical Therapeutics. Sep-Oct 1995;17(5):946-955.
53. Rovetta G, Monteforte P, Rovetta G, Monteforte P. Intraarticular injection of sodium hyaluronate plus steroid versus steroid in adhesive capsulitis of the shoulder. International Journal of Tissue Reactions. 1998;20(4):125-130.
54. Shibata Y, Midorikawa K, Emoto G, et al. Clinical evaluation of sodium hyaluronate for the treatment of patients with rotator cuff tear. Journal of Shoulder & Elbow Surgery. May-Jun 2001;10(3):209-216.
55. Vangsness CT, Jr., Ennis M, Taylor JG, Atkinson R. Neural anatomy of the glenohumeral ligaments, labrum, and subacromial bursa. Arthroscopy. Apr 1995;11(2):180-184.
56. Adebajo AO, Nash P, Hazleman BL. A prospective double blind dummy placebo controlled study comparing triamcinolone hexacetonide injection with oral diclofenac 50 mg TDS in patients with rotator cuff tendinitis. J Rheumatol. Sep 1990;17(9):1207-1210.
57. Petri M, Dobrow R, Neiman R, Whiting-O'Keefe Q, Seaman WE. Randomized, double-blind, placebo-controlled study of the treatment of the painful shoulder. Arthritis Rheum. Sep 1987;30(9):1040-1045.
58. Anderson B, Kaye S, Anderson B, Kaye S. Treatment of flexor tenosynovitis of the hand ('trigger finger') with corticosteroids. A prospective study of the response to local injection. Archives of Internal Medicine. Jan 1991;151(1):153-156.
59. Galloway MT, Jokl P, Dayton OW, Galloway MT, Jokl P, Dayton OW. Achilles tendon overuse injuries. Clinics in Sports Medicine. Oct 1992;11(4):771-782.
60. Halpern AA, Horowitz BG, Nagel DA, Halpern AA, Horowitz BG, Nagel DA. Tendon ruptures associated with corticosteroid therapy. Western Journal of Medicine. Nov 1977;127(5):378-382.
61. Stannard JP, Bucknell AL, Stannard JP, Bucknell AL. Rupture of the triceps tendon associated with steroid injections.[see comment]. American Journal of Sports Medicine. May-Jun 1993;21(3):482-485.
62. Iwata H, Iwata H. Pharmacologic and clinical aspects of intraarticular injection of hyaluronate. Clinical Orthopaedics & Related Research. Apr 1993(289):285-291.
63. Leardini G, Perbellini A, Franceschini M, Mattara L. Intra-articular injections of hyaluronic acid in the treatment of painful shoulder. Clin Ther. 1988;10(5):521-526.
64. Calis M, Demir H, Ulker S, Kirnap M, Duygulu F, Calis HT. Is intraarticular sodium hyaluronate injection an alternative treatment in patients with adhesive capsulitis? Rheumatol Int. Apr 2006;26(6):536-540.
65. Bang MD, Deyle GD. Comparison of supervised exercise with and without manual physical therapy for patients with shoulder impingement syndrome. J Orthop Sports Phys Ther. Mar 2000;30(3):126-137.
66. Brox JI, Gjengedal E, Uppheim G, et al. Arthroscopic surgery versus supervised exercises in patients with rotator cuff disease (stage II impingement syndrome): a prospective, randomized, controlled study in 125 patients with a 2 1/2-year follow-up. J Shoulder Elbow Surg. Mar-Apr 1999;8(2):102-111.
67. Brox JI, Staff PH, Ljunggren AE, Brevik JI. Arthroscopic surgery compared with supervised exercises in patients with rotator cuff disease (stage II impingement syndrome). BMJ. Oct 9 1993;307(6909):899-903.
68. Conroy DE, Hayes KW. The effect of joint mobilization as a component of comprehensive treatment for primary shoulder impingement syndrome. J Orthop Sports Phys Ther. Jul 1998;28(1):3-14.
69. Ludewig PM, Borstad JD. Effects of a home exercise programme on shoulder pain and functional status in construction workers. Occup Environ Med. Nov 2003;60(11):841-849.
70. Rahme H, Solem-Bertoft E, Westerberg CE, Lundberg E, Sorensen S, Hilding S. The subacromial impingement syndrome. A study of results of treatment with special emphasis on predictive factors and pain-generating mechanisms. Scand J Rehabil Med. Dec 1998;30(4):253-262.
71. Holte KA, Westgaard RH. Further studies of shoulder and neck pain and exposures in customer service work with low biomechanical demands. Ergonomics. Oct 20 2002;45(13):887-909.
72. Mork PJ, Westgaard RH. The association between nocturnal trapezius muscle activity and shoulder and neck pain. Eur J Appl Physiol. Jun 2004;92(1-2):18-25.
73. Westgaard RH. Muscle activity as a releasing factor for pain in the shoulder and neck. Cephalalgia. Dec 1999;19 Suppl 25:1-8.
74. Westgaard RH, Vasseljen O, Holte KA. Trapezius muscle activity as a risk indicator for shoulder and neck pain in female service workers with low biomechanical exposure. Ergonomics. Feb 20 2001;44(3):339-353.
75. Godges JJ, Mattson-Bell M, Thorpe D, Shah D. The immediate effects of soft tissue mobilization with proprioceptive neuromuscular facilitation on glenohumeral external rotation and overhead reach. J Orthop Sports Phys Ther. Dec 2003;33(12):713-718.
76. Jones L. Strain and counterstrain. Paper presented at: Academy of Applied Osteopathy, 1981; Colorado Springs.
77. Chaitow L. Positional Release Technique: Churchill Livingstone; 1998.
78. Lin JJ, Hanten WP, Olson SL, et al. Functional activities characteristics of shoulder complex movements: Exploration with a 3-D electromagnetic measurement system. J Rehabil Res Dev. Mar-Apr 2005;42(2):199-210.
79. Park HB, Yokota A, Gill HS, El Rassi G, McFarland EG. Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am. Jul 2005;87(7):1446-1455.
80. Roach KE, Budiman-Mak E, Songsiridej N, Lertratanakul Y. Development of a shoulder pain and disability index. Arthritis Care Res. Dec 1991;4(4):143-149.
81. Heald SL, Riddle DL, Lamb RL. The shoulder pain and disability index: the construct validity and responsiveness of a region-specific disability measure. Phys Ther. Oct 1997;77(10):1079-1089.
82. Macdermid JC, Solomon P, Prkachin K. The Shoulder Pain and Disability Index demonstrates factor, construct and longitudinal validity. BMC Musculoskelet Disord. Feb 10 2006;7(1):12.
83. Michener LA, Boardman ND, Pidcoe PE, Frith AM. Scapular muscle tests in subjects with shoulder pain and functional loss: reliability and construct validity. Phys Ther. Nov 2005;85(11):1128-1138.
84. Kendall FP. Muscles, Testing and Function with Posture and Pain. 5th Edition ed. Baltimore: Lippincott Williams & Wilkins; 2005.
85. Ekstrom RA, Soderberg GL, Donatelli RA. Normalization procedures using maximum voluntary isometric contractions for the serratus anterior and trapezius muscles during surface EMG analysis. J Electromyogr Kinesiol. Aug 2005;15(4):418-428.
86. Johnson EG, Godges JJ, Lohman EB, Stephens JA, Zimmerman GJ, Anderson SP. Disability self-assessment and upper quarter muscle balance between female dental hygienists and non-dental hygienists. J Dent Hyg. Fall 2003;77(4):217-223.
87. Cram JR, Kasman GS. Introduction to Surface Electromyography. Maryland: Aspen Publishers,Inc.; 1998.
88. Korr IM. Proprioceptors and somatic dysfunction. J Am Osteopath Assoc. Mar 1975;74(7):638-650.
89. Meskers CG, Vermeulen HM, de Groot JH, van Der Helm FC, Rozing PM. 3D shoulder position measurements using a six-degree-of-freedom electromagnetic tracking device. Clin Biomech (Bristol, Avon). Jun 1998;13(4-5):280-292.
90. Meskers CG, van der Helm FC, Rozendaal LA, Rozing PM. In vivo estimation of the glenohumeral joint rotation center from scapular bony landmarks by linear regression. J Biomech. Jan 1998;31(1):93-96.
91. Desmeules F, Minville L, Riederer B, Cote CH, Fremont P. Acromio-humeral distance variation measured by ultrasonography and its association with the outcome of rehabilitation for shoulder impingement syndrome. Clin J Sport Med. Jul 2004;14(4):197-205.
92. Azzoni R, Cabitza P, Parrini M. Sonographic evaluation of subacromial space. Ultrasonics. Apr 2004;42(1-9):683-687.
93. Ben-Yishay A, Zuckerman JD, Gallagher M, Cuomo F. Pain inhibition of shoulder strength in patients with impingement syndrome. Orthopedics. Aug 1994;17(8):685-688.
94. Brox JI, Roe C, Saugen E, et al. Isometric abduction muscle activation in patients with rotator tendinosis of the shoulder. Archives of Physical Medicine & Rehabilitation. Nov 1997;78(11):1260-1267.
95. MacDermid JC, Ramos J, Drosdowech D, Faber K, Patterson S. The impact of rotator cuff pathology on isometric and isokinetic strength, function, and quality of life. J Shoulder Elbow Surg. Nov-Dec 2004;13(6):593-598.
96. Reddy AS, Mohr KJ, Pink MM, Jobe FW. Electromyographic analysis of the deltoid and rotator cuff muscles in persons with subacromial impingement. J Shoulder Elbow Surg. Nov-Dec 2000;9(6):519-523.
97. Michaud M, Arsenault AB, Gravel D, Tremblay G, Simard TG. Muscular compensatory mechanism in the presence of a tendinitis of the supraspinatus. Am J Phys Med. Jun 1987;66(3):109-120.
98. Brox JI, Roe C, Saugen E, Vollestad NK. Isometric abduction muscle activation in patients with rotator tendinosis of the shoulder. Arch Phys Med Rehabil. Nov 1997;78(11):1260-1267.
99. Kibler WB. The role of the scapula in athletic shoulder function. Am J Sports Med. Mar-Apr 1998;26(2):325-337.
100. On AY, Uludag B, Taskiran E, Ertekin C. Differential corticomotor control of a muscle adjacent to a painful joint. Neurorehabil Neural Repair. Sep 2004;18(3):127-133.
101. Simons DG, Mense S. Understanding and measurement of muscle tone as related to clinical muscle pain. Pain. Mar 1998;75(1):1-17.
102. Howell JN, Cabell KS, Chila AG, Eland DC. Stretch reflex and Hoffmann reflex responses to osteopathic manipulative treatment in subjects with Achilles tendinitis. J Am Osteopath Assoc. Sep 2006;106(9):537-545.
103. Decker MJ, Hintermeister RA, Faber KJ, Hawkins RJ. Serratus anterior muscle activity during selected rehabilitation exercises. Am J Sports Med. Nov-Dec 1999;27(6):784-791.
104. Ekstrom RA, Donatelli RA, Soderberg GL. Surface electromyographic analysis of exercises for the trapezius and serratus anterior muscles. J Orthop Sports Phys Ther. May 2003;33(5):247-258.
105. Lear LJ, Gross MT. An electromyographical analysis of the scapular stabilizing synergists during a push-up progression. J Orthop Sports Phys Ther. Sep 1998;28(3):146-157.
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