肩関節屈曲初期時の代償動作への運動療法と肩甲骨アラインメントの重要性

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  • Importance of Therapeutic Exercise for Compensation Movements during Primary Flexion of Shoulder Joint and Alignment of Scapula
  • 症例報告 肩関節屈曲初期時の代償動作への運動療法と肩甲骨アラインメントの重要性
  • ショウレイ ホウコク カタカンセツ クッキョク ショキジ ノ ダイショウ ドウサ エノ ウンドウ リョウホウ ト ケンコウコツ アラインメント ノ ジュウヨウセイ

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説明

In this article, we describe physical therapy for a case of decline in muscular strength caused by axillary nervous paralysis with a dislocation of the shoulder joint. This case was characterized by difficulty in flexional movement in the scapulothoracic joint in primary flexion of the shoulder joint because of the adduction and lift of the scapula. We defined the alignment on the several phases that the specific movement of scapula appears. We practiced scapula alignment and performed electromyographic assessment. In this case, in addition to a decline of muscular activity in the deltoid muscle, the upper, middle and lower fibers of the trapezius muscle started to move before the anterior fibers of the deltoid muscle. So, we supposed that this phenomenon caused the disorder, the specific movement of the scapula. We observed the start of activity of the deltoid and trapezius muscles and administered a pendular movement as a therapeutic exercise. Improvement in both excursion of flexion and in patterns of muscular activity in the deltoid and trapezius muscles were confirmed. Furthermore, with repetition of kinesiatrics in the sitting position on the edge of a bed following results was acquired; an increase in muscular activation in the anterior fibers of the deltoid muscle and a muscle activation with same order. This lead to improvement of stability of the scapula because of a decrease in adduction and lift of the scapula in the start position. From the above, we suggest that choice of the method of kinesic therapy, paying attention to the posture of patients and paying attention to the stability of scapulothoracic joint is important.<br>

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