肩峰下夾擠症候群和頸胸椎理學檢查之關聯性探討

Examination of the Cervico-thoracic Spine and Its Association with the Subacromial Impingement Syndrome

許其揚(Chi-Yang Hsu) ； 蔡永裕(Yung-Yuh Tsai) ； 王子娟(Wendy TJ Wang) ； 阮雅莉(Ya-Li Ruan) ； 陳文英(Wen-Yin Chen)

《物理治療》 35卷3期 (2010/09) Pp. 233-242

摘要

Background and Purpose: Subacromial impingement syndrome (SIS) is resulted from a variety of factors, Evidence shows that poor posture of the cervical and thoracic spine may contribute to the problem because it leads to inadequate scapulothoracic and glenohumeral kinematics. The purpose of this study was to investigate whether cervico-thoracic spinal posture, intervertebral joint mobility test and upper limb neural tests were associated with subacromial impingement syndrome. Methods: This was a cross-sectional, case-control design. Twenty-seven individuals with subacromial impingement syndrome and 28 asymptomatic subjects were recruited. We examined two posture variables (forward head and thoracic kyphosis angles), tested intervertebral joint mobility on four vertebral levels (C5/6, C6/7, C7/T1, T1/T2), and performed upper limb nerve (median, radial, and ulnar nerves) tension tests on all subjects. Results: The posture, intervertebral joint mobility, and upper limb tension variables showed significant differences between the two groups (p＜.05). Significant association was observed between positive radial nerve tension test, positive ulnar tension test, restricted C5/6, C617 intervertebral joint mobility and the presence of the subacromial impingement syndrome. Conclusion and Clinical Relevance: The association between variables of the cervico-thoracic spine and presence of the subacromial impingement syndrome was confirmed, with positive radial nerve tension test, positive ulnar tension test, and restricted C5/6 and C6/7 intervertebral joint mobilily showing the strongest association. Clinicians need to thoroughly examine the cervico-thoracic spine when assessing the patient with subacromial impingement syndrome.

關鍵字

肩峰下夾擠症候群 ； 頸胸姿勢 ； 椎間關節活動度 ； 上肢神經張力

並列摘要

Background and Purpose: Subacromial impingement syndrome (SIS) is resulted from a variety of factors, Evidence shows that poor posture of the cervical and thoracic spine may contribute to the problem because it leads to inadequate scapulothoracic and glenohumeral kinematics. The purpose of this study was to investigate whether cervico-thoracic spinal posture, intervertebral joint mobility test and upper limb neural tests were associated with subacromial impingement syndrome. Methods: This was a cross-sectional, case-control design. Twenty-seven individuals with subacromial impingement syndrome and 28 asymptomatic subjects were recruited. We examined two posture variables (forward head and thoracic kyphosis angles), tested intervertebral joint mobility on four vertebral levels (C5/6, C6/7, C7/T1, T1/T2), and performed upper limb nerve (median, radial, and ulnar nerves) tension tests on all subjects. Results: The posture, intervertebral joint mobility, and upper limb tension variables showed significant differences between the two groups (p＜.05). Significant association was observed between positive radial nerve tension test, positive ulnar tension test, restricted C5/6, C617 intervertebral joint mobility and the presence of the subacromial impingement syndrome. Conclusion and Clinical Relevance: The association between variables of the cervico-thoracic spine and presence of the subacromial impingement syndrome was confirmed, with positive radial nerve tension test, positive ulnar tension test, and restricted C5/6 and C6/7 intervertebral joint mobilily showing the strongest association. Clinicians need to thoroughly examine the cervico-thoracic spine when assessing the patient with subacromial impingement syndrome.

並列關鍵字

Subacromial impingement syndrome ； Cervicothoracic posture ； Intervertebral joint mobility ； Upper limb tension test