Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2009
Central neuromuscular dysfunction of the deltoid muscle in patients with chronic rotator cuff tears.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Berth Alexander, Pap Géza, Neuman Wolfram, Awiszus Friedemann
Аннотация
BACKGROUND: Previous surface electromyogram (EMG) studies have shown that chronic rotator cuff tears (RCT) may be associated with a altered activation of adjacent shoulder muscles. The effect of RCT on central neuromuscular control mechanisms of the shoulder girdle muscles such as the deltoideus muscle (DM), a key muscle of shoulder function, has as not yet been studied in detail.
MATERIALS AND METHODS: This study investigated the corticospinal excitability of the DM to assess the effects of RCT on the central neuromuscular function of proximal upper limb muscles. The motor-evoked potentials (MEP) in response to transcranial magnetic stimulation of DM on both sides were obtained from patients with unilateral RCT and compared with healthy control subjects.
RESULTS: In patients, stimulus response curves of DM demonstrated a bilateral hyperexcitability at rest and a hypoexcitability during voluntary activation (F = 3.82, P = 0.007).
CONCLUSIONS: The DM hyperexcitability may be related to alterations in the sensory output from the shoulder. The insufficient facilitation of the DM points toward a bilateral central activation deficit. These findings seem to be assigned to adaptive changes in the motor cortex as a consequence of chronic RCT, and the neuromuscular alteration of the DM should be considered when treating patients with RCT.
MATERIALS AND METHODS: This study investigated the corticospinal excitability of the DM to assess the effects of RCT on the central neuromuscular function of proximal upper limb muscles. The motor-evoked potentials (MEP) in response to transcranial magnetic stimulation of DM on both sides were obtained from patients with unilateral RCT and compared with healthy control subjects.
RESULTS: In patients, stimulus response curves of DM demonstrated a bilateral hyperexcitability at rest and a hypoexcitability during voluntary activation (F = 3.82, P = 0.007).
CONCLUSIONS: The DM hyperexcitability may be related to alterations in the sensory output from the shoulder. The insufficient facilitation of the DM points toward a bilateral central activation deficit. These findings seem to be assigned to adaptive changes in the motor cortex as a consequence of chronic RCT, and the neuromuscular alteration of the DM should be considered when treating patients with RCT.