- 期刊
伸展胸小肌對於肩胛骨運動學和肌肉長度的效果：系統性回顧與統合分析
The Effects of Pectoralis Minor Stretches on Scapular Kinematics and Muscle Length: A Systematic Review and Meta-Analysis
摘要
背景與目的：過短的胸小肌與肩胛骨失能有關，也是造成肩痛的危險因子之一。臨床上常使用伸展來增加胸小肌的長度。過去的統合分析曾指出短期的神經肌肉誘發技術可以增加胸小肌的長度，然而，未有統合分析探討伸展對於肩胛骨運動學的效果為何。因此，本研究主要欲探討胸小肌伸展運動對於舉手過程的肩胛骨運動學和胸小肌長度的效果。方法：使用胸小肌、伸展運動、肩胛骨運動學和肌肉長度作為關鍵字於PubMed、Ovid MEDLINE、CINAHL、Cochrane Library等醫學資料庫搜尋文獻至2022年一月。主要測量參數為舉手時的肩胛骨運動學，次要結果為胸小肌長度與胸小肌指數。各篇的研究結果會依據牽拉前後的平均值與標準差進行統合分析。結果：共有七篇研究中的健康受測者資料納入統合分析，伸展運動並沒有顯著改變舉手活動時肩胛骨向上旋轉、外轉與後傾的角度。胸小肌指數與胸小肌長度在介入後皆有顯著增加。結論：伸展運動能使胸小肌的肌肉長度增加，但是無肩痛者接受胸小肌伸展後肩胛骨運動學並沒有顯著改變。
並列摘要
Background and Purpose: A shortened pectoralis minor has been associated with scapular dyskinesis, which is a risk factor of shoulder pain. To restore the normal length of pectoralis minor, stretch is a common approach in clinical practice. A previous systematic review and meta-analysis has found that a short-term PNF protocol could increase the pectoralis minor length. However, the effects of pectoralis minor stretches on scapular kinematics were still inconclusive. Therefore, the main purpose of the study was to examine the changes in the scapular kinematics and length of pectoralis minor following stretch exercises. Methods: We searched for studies in PubMed, Ovid MEDLINE, CINAHL, Cochrane Library, and until January 2022, with keywords related to pectoralis minor muscle, stretch exercises, scapular kinematics, and muscle length. The primary outcomes were 3-dimentional scapular kinematics during arm elevation. The secondary outcomes were pectoralis minor length (PML) and pectoralis minor index (PMI). Data from both randomized controlled trials (RCTs) and pretest-posttest studies were pooled for meta-analysis, only including pretest-posttest data in the RCTs. Results: In total, data from healthy subjects in seven studies were included in the meta-analysis. Following stretch exercise, no change was found in all parameters of scapular kinematics at 30, 60, 90, and 120 degrees of arm elevation, including scapular upper rotation, posterior tilt, and external rotation. In addition, there was a significant increase in PMI and PML following stretch exercises. Conclusion: Although there is an effect of pectoralis minor stretch on the muscle length, scapular kinematics does not change following stretch exercise in asymptomatic individuals.