The functional role of the supraspinatus and infraspinatus muscle subregions during forward flexion: a shear wave elastography study

Hoshikawa, Kyosuke; Yuri, Takuma; Giambini, Hugo; Mura, Nariyuki; Kiyoshige, Yoshiro

doi:10.1016/j.jseint.2022.05.011

Cited by 8 publications

(4 citation statements)

References 26 publications

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“…To comprehensively understand the compensation strategy, a prospective study throughout the different stages of rotator cuff tear and repair is essential. Third, whether the compensation strategy persists across various shoulder motions remains unknown because this study only focused on a single measurement posture and previous studies have demonstrated that depending upon the shoulder angle, the shear moduli of shoulder muscles vary during isometric contraction 31,49 . Finally, a rule of compensation strategy and its individual difference could not be referred to as we did not conduct a thorough investigation that all possible muscles were evaluated.…”

Section: Discussionmentioning

confidence: 99%

“…| 29 shoulder angle, the shear moduli of shoulder muscles vary during isometric contraction. 31,49 Finally, a rule of compensation strategy and its individual difference could not be referred to as we did not conduct a thorough investigation that all possible muscles were evaluated. However, this study could at least demonstrate that the compensation strategy of shoulder abductors is not stereotypical.…”

Section: F I G U R E 4 Individual Analysis For the Compensation Strat...mentioning

confidence: 99%

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Compensation strategy of shoulder synergist muscles is not stereotypical in patients with rotator cuff repair

Umehara

Yagi

Ueda

et al. 2023

Journal Orthopaedic Research

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Rotator cuff tear is a common shoulder injury that causes shoulder dysfunction and pain. Although surgical repair is the primary treatment for rotator cuff tear, it is well recognized that impaired force exertion of muscles connecting to the involved tendon and subsequent complemental change in the force exertion of synergist muscles persist even after repair. This study aimed to identify the compensation strategy of shoulder abductors by examining how synergist muscles respond to supraspinatus (SSP) muscle force deficit in patients with rotator cuff repair. Muscle shear modulus, an index of muscle force, was assessed for SSP, infraspinatus, upper trapezius, and middle deltoid muscles in repaired and contralateral control shoulders of 15 patients with unilateral tendon repair of the SSP muscle using ultrasound shear wave elastography while the patients passively or actively held their arm in shoulder abduction. In the repaired shoulder, the shear modulus of the SSP muscle declined, whereas that of other synergist muscles did not differ relative to that of the control. To find the association between the affected SSP and each of the synergist muscles, a regression analysis was used to assess the shear moduli at the population level. However, no association was observed between them. At the individual level, there was a tendency of variation among patients with regard to a specific muscle whose shear modulus complementarily increased. These results suggest that the compensation strategy for SSP muscle force deficit varies among individuals, being nonstereotypical in patients with rotator cuff injury.

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Section: Discussionmentioning

confidence: 99%

Section: F I G U R E 4 Individual Analysis For the Compensation Strat...mentioning

confidence: 99%

Compensation strategy of shoulder synergist muscles is not stereotypical in patients with rotator cuff repair

Umehara

Yagi

Ueda

et al. 2023

Journal Orthopaedic Research

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“…Multiple imaging techniques, such as plain X-ray, MRS, computed tomography, and shoulder ultrasonography, are available. [15][16][17][18] However, it is difficult to evaluate SNE syndrome by means of imaging modalities, because of the lack of a reliable objective imaging parameter. And, atrophied infraspinatus muscle has been considered to be a major morphologic parameter of SNE syndrome.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of suprascapular nerve entrapment syndrome based on the infraspinatus muscle cross-sectional area on shoulder MRI

Cho,

Yi,

Kim

et al. 2024

Medicine

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Suprascapular nerve entrapment (SNE) syndrome is a commonly overlooked cause of shoulder weakness and pain. It frequently causes weakness over the posterior and lateral and posterior aspects of the shoulder, as well as pain of infraspinatus muscles. Therefore, we considered that the infraspinatus muscle cross-sectional area (IMCSA) might be a new morphological parameter to analyze SNE syndrome. We assumed that the IMCSA is an important morphologic parameter in SNE syndrome diagnosis. We acquired infraspinatus muscle data from 10 patients with SNE syndrome and from 10 healthy subjects who had undergone magnetic resonance imaging of the shoulder and who revealed no evidence of SNE syndrome. We analyzed the infraspinatus muscle thickness (IMT) and IMCSA at the shoulder on the imaging of the shoulder using our image analysis program. The IMCSA was measured as the whole infraspinatus muscle cross-sectional area that was most atrophied in the sagittal S-MR images. The IMT was measured as the thickest level of infraspinatus muscle. The mean IMT was 29.17 ± 2.81 mm in the healthy subjects and 25.22 ± 3.19 mm in the SNE syndrome group. The mean IMCSA was 1321.95 ± 175.91 mm2 in the healthy group and 1048.38 ± 259.94 mm2 in the SNE syndrome group. SNE syndrome patients had significantly lower IMT (P < .001) and IMCSA (P < .001) than the healthy group. The ROC curve shows that the optimal cutoff point of the IMT was 26.74 mm, with 70.0% sensitivity, 70.0% specificity, and an AUC of 0.83 (95% CI, 0.65–1.00). The best cutoff value of the IMCSA was 1151.02 mm2, with 80.0% sensitivity, 80.0% specificity, and AUC of 0.87 (95% CI, 0.69–1.00). The IMT and IMCSA were both significantly associated with SNE syndrome. And the IMCSA was a highly sensitive diagnostic tool.

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“…This indicates that tensions from the individual regions combine synergistically and are unequally distributed to the rotator cable and crescent region, merging their mechanical behaviors. Importantly, prior studies have delineated distinct biomechanics and degenerative properties within individual anatomical rotator cuff regions [21][22][23][24][25] . These differences in function and pathophysiology among regions might contribute to dysfunctional synergies and tension distribution in patients with rotator cuff tears.…”

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confidence: 99%

Tension Distribution in Articular Surfaces of the Rotator Cable and Crescent

Yuri,

Prado,

Hoshikawa

et al. 2024

Journal of Bone and Joint Surgery

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Background: The rotator cable functions as a stress and/or load transfer structure. Some studies suggested that a disruption of the cable negatively affects shoulder function and tendon integrity in patients with rotator cuff tears, while others found no functional impairment regardless of rotator cable tear severity. Although anatomical studies have identified distinct regions within the rotator cuff muscles, the strain distribution within the articular sides of the rotator cuff tendons that results from the tension in each region remains unknown. We hypothesized that the posterior region of the supraspinatus (SSP) muscle and the middle region of the infraspinatus (ISP) muscle, with their firm capsular attachments to the cable, transmit 3D strains, and thus tension, to the whole cable, leading to differences in tension within the cable. Methods: The 3D strain distributions in the articular sides of the SSP and ISP tendons of 8 fresh-frozen cadaveric intact shoulders were determined when tension was applied to the various SSP and ISP muscle regions. Results: Loading the anterior SSP muscle region yielded significantly higher strains in the anterior third of the cable compared with the posterior third (p < 0.05). Loading the posterior SSP muscle region yielded no significant differences among the cable and crescent regions. Loading the middle ISP muscle region yielded higher strains in the anterior and posterior thirds of the cable compared with the middle third (p < 0.01). Loading the superior ISP muscle region yielded no significant differences among the cable and crescent regions (p > 0.05). Conclusions: Tension generated from the posterior region of the SSP muscle and middle region of the ISP muscle was evenly distributed to the anterior and posterior attachments of the rotator cable, while the tension generated from other SSP and ISP muscle regions was locally transmitted to the respective attachment area. Clinical Relevance: The rotator cable and crescent serve pivotal roles in transmitting tension generated from the deep regions of the rotator cuff muscles, i.e., the posterior SSP and middle ISP. These findings indicate that both the rotator cable and the rotator crescent play crucial roles as tension transmitters for the deep regions of the rotator cuff muscles. This information could have important implications for developing anatomically relevant repair techniques and enhancing rehabilitation protocols.

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The functional role of the supraspinatus and infraspinatus muscle subregions during forward flexion: a shear wave elastography study

Cited by 8 publications

References 26 publications

Compensation strategy of shoulder synergist muscles is not stereotypical in patients with rotator cuff repair

Compensation strategy of shoulder synergist muscles is not stereotypical in patients with rotator cuff repair

Diagnosis of suprascapular nerve entrapment syndrome based on the infraspinatus muscle cross-sectional area on shoulder MRI

Tension Distribution in Articular Surfaces of the Rotator Cable and Crescent

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