The effect of pathological shoulder rhythm on muscle and joint forces after reverse shoulder arthroplasty, a numerical analysis.
Musculoskeletal modelling
Numerical biomechanics
Patient-specific simulations
Reverse shoulder arthroplasty
Shoulder rhythm
Journal
Clinical biomechanics (Bristol, Avon)
ISSN: 1879-1271
Titre abrégé: Clin Biomech (Bristol, Avon)
Pays: England
ID NLM: 8611877
Informations de publication
Date de publication:
07 2023
07 2023
Historique:
received:
11
01
2023
revised:
09
05
2023
accepted:
12
06
2023
medline:
21
7
2023
pubmed:
7
7
2023
entrez:
6
7
2023
Statut:
ppublish
Résumé
Compromised abduction ability after reverse shoulder arthroplasty is primarily linked to limited glenohumeral range of motion while scapulothoracic mobility can typically be maintained. Glenohumeral joint forces strongly depend on the resulting scapulohumeral rhythm, however, an association between the acting muscle and joint forces and the subject-specific scapulohumeral rhythm after reverse shoulder arthroplasty has not been established. Eleven reverse shoulder arthroplasty patients were divided into groups of poor and excellent abduction ability. Subject-specific models were developed and scaled for each patient using existing motion capture data in AnyBody™. Shoulder muscle and joint forces were obtained using inverse dynamics calculations during shoulder abduction to 100° in the scapula plane. The scapulohumeral rhythm, the resting abduction angle and internal body forces between the outcome groups were compared using a Mann Whitney U test. The mean glenohumeral and scapulothoracic contribution to overall shoulder abduction for the excellent group was on average 9.7% higher and 21.4% lower, respectively, compared to the mean of the poor group. For shoulder abduction angles between 30° and 60°, the excellent group demonstrated on average 25% higher muscle forces in the anterior deltoid which was significantly higher compared to the poor outcome patients. Scapulothoracic muscle activity did not differ significantly between the two functional groups. Accordingly, rehabilitation strategies focusing on strengthening the anterior part of the deltoid in particular may improve clinical outcomes.
Sections du résumé
BACKGROUND
Compromised abduction ability after reverse shoulder arthroplasty is primarily linked to limited glenohumeral range of motion while scapulothoracic mobility can typically be maintained. Glenohumeral joint forces strongly depend on the resulting scapulohumeral rhythm, however, an association between the acting muscle and joint forces and the subject-specific scapulohumeral rhythm after reverse shoulder arthroplasty has not been established.
METHODS
Eleven reverse shoulder arthroplasty patients were divided into groups of poor and excellent abduction ability. Subject-specific models were developed and scaled for each patient using existing motion capture data in AnyBody™. Shoulder muscle and joint forces were obtained using inverse dynamics calculations during shoulder abduction to 100° in the scapula plane. The scapulohumeral rhythm, the resting abduction angle and internal body forces between the outcome groups were compared using a Mann Whitney U test.
FINDINGS
The mean glenohumeral and scapulothoracic contribution to overall shoulder abduction for the excellent group was on average 9.7% higher and 21.4% lower, respectively, compared to the mean of the poor group. For shoulder abduction angles between 30° and 60°, the excellent group demonstrated on average 25% higher muscle forces in the anterior deltoid which was significantly higher compared to the poor outcome patients. Scapulothoracic muscle activity did not differ significantly between the two functional groups.
INTERPRETATION
Accordingly, rehabilitation strategies focusing on strengthening the anterior part of the deltoid in particular may improve clinical outcomes.
Identifiants
pubmed: 37413811
pii: S0268-0033(23)00161-4
doi: 10.1016/j.clinbiomech.2023.106030
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
106030Informations de copyright
Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest This research was funded by Innosuisse—Swiss Innovation Agency (grant agreement no.: 35656.1 IP-LS).