The Alteration in Kinematics, sEMG, and Function of Shoulder Girdle in Adolescent Idiopathic Scoliosis
Date Issued
2008
Date
2008
Author(s)
Chen, Wei-Hsiu
Abstract
Eighty-five percent idiopathic scoliosis present in adolescent stage. Scoliosis is a side-to-side curvature of the spine in coronal plane. It usually happens with rotation of the vertebrae body. The effects of scoliosis are not only in the outside looking of the body, but also loss of both volume and function of the thorax. Severe scoliosis may result in the deformity of the rib cage and associated muscles. So, the convex side of spine in the scoliosis will make the scapula humping. It is supposed muscles’ tension around shoulder girdle is imbalanced because of asymmetric position of scapula. And that would result in abnormal muscle contraction and shoulder motion. There were few studies discussed about the relationship between the scoliosis and the motion of shoulder girdle. The purpose of the study was to compare the shoulder kinematics, surface electromyography(sEMG), and function of shoulder girdle between both sides of the adolescent idiopathic scoliosis(AIS) group and between the AIS group and normal subjects. The AIS group with Cobb angle more than 20 degree and the control group without scoliosis were recruited in this study. With FASTRAK motion system, they performed shoulder flexion in sagittal plane, abduction in scapular plane and coronal plane. At the same time, the muscular activities of upper trapezius, lower trapezius, serratus anterior and middle deltoid were detected by sEMG. Additionally, the shoulder function was evaluated by Flexilevel Scale of Shoulder Function. The collected data was analyzed by SPSS 11.0. Independent t-test was used to compare those outcomes between the AIS group and control group. Paired t-test was used to compare those outcomes of both shoulder girdles in AIS group. Pearson correlation was used to demonstrate the relationship between kinematics, sEMG and function of shoulder girdle in the AIS group. The results showed that 1.) the scapular movement during arm elevation was less in concave side than in convex side in AIS group. During tests, the onset of the muscles activities around shoulder in concave side was longer than that in convex side. And the higher muscular activities around shoulder in concave side compared to convex side. 2.) Comparison between the shoulders in AIS group and in the same side of normal group, there were some significant differences in sEMG, but not in kinematics. 3.) There was no relationship between shoulder function and kinematics in concave side in AIS. But, there was moderate to good relationship between shoulder function and sEMG finding of lower trapezius in concave side. Additionally, serratus anterior and middle deltoid have fair relationship with shoulder function in sEMG premotor time in abduction and scaption in concave side. Thus shoulder dysfunction was evident through our investigation. In clinical implication, we suggest that to increase the muscle power of serratus anterior on both sides and upper trapezius of concave side and to relax lower trapezius of concave side. It’s for improving the mal-alignment of scapula in convex side and re-education for the shoulder motion in concave side. In the future study, we should increase the sample size in AIS and consider the influence of muscle power in shoulder girdle. And also, the deep layer muscle group around shoulder may be the effective factors on function.
Subjects
adolescent idiopathic scoliosis
shoulder girdle
kinematics
sEMG
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