@article{oai:ryotokuji-u.repo.nii.ac.jp:00000086, author = {橋本, 俊彦 and 岡田, 尚之}, issue = {4}, journal = {了德寺大学研究紀要, The Bulletin of Ryotokuji University}, month = {}, note = {肩関節外転位における肩関節可動時の肩甲骨周囲筋群の変化について,超音波断層法および磁気共鳴画像法(MRI)を用いて定量的に計測し評価することを目的とした.対象は健常男子大学生(CG)8例(20.6±1.7yrs,172.3±4.2cm,69.4±6.1kg),オーバーヘッドスポーツを行っている大学アスリート(OG)8例(21.3±1.8yrs,174.0±5.3cm,70.0±5.3kg)であった.方法1では,超音波診断装置を用いて肩関節外転角度の変化における肩甲骨周囲筋の筋厚値を測定し,筋の動態変化について検討した.肩関節外転角度の上昇に伴い僧帽筋上部は短縮性収縮により筋厚値が変化し,繰り返される外転動作に貢献度が高いことが示唆された.方法2では,生体内組織の硬度を画像化する弾性組織計測システム(Real-Time Tissue Elastography: RTE)を用いて筋硬度の定量化を試みた.OGはCGと比較して僧帽筋中部/大菱形筋では低値を,僧帽筋上部/棘上筋では高値を示す傾向がみられた.また,OGでは肩関節外転90°肘関節90°屈曲位での肩甲骨内外転運動に伴う棘上筋の反応性が高いことから,肩甲骨の内外転運動によって僧帽筋上部の筋弾性が低下すると考えられ,OGの肩甲骨内側の弾性と肩甲胸郭関節の機能との関連性が示唆された.方法3では,MRによるT2緩和時間の変化を用いて肩関節90°外転位で肩関節内旋運動での肩甲骨周囲筋の活動性を検討した.座位での肩関節外転90°における内旋運動直後に大胸筋,僧帽筋,菱形筋,棘下筋でT2値が上昇し,僧帽筋中部および大菱形筋においてT2緩和時間の有意な延長がみられた.これは,肩関節外転位で回旋運動が繰り返される中での肩甲骨周囲筋の重要性が示唆された.総じて,肩関節90°外転位での肩関節回旋運動では肩甲骨周囲筋の活動性は肩甲胸郭関節機能に影響することが示唆され,肩甲骨周囲筋の機能不全はオーバーヘッドスポーツにおける肩甲上腕関節の障害の一因になると考えられた., The purpose of this study is to quantitatively and evaluate the changes of the scapular muscles by ultrasonic tomography and MRI at the shoulder rotation in shoulder abduction. The subjects were 8 each of university students and overhead sports players. (1) In the scapula plane, we measured the change in from of the trapezius muscle (upper, middle, lower : TU, TM, TL), rhomboid muscle (major, minor:RMJ, RMN) and the serratus anterior muscle using ultrasonic tomography at shoulder abduction. (2) To evaluate the tissue elasticity about TU / SUS and TM / RMJ by real - time tissue elastography the subjects performed scapular horizontal flexion and extension exercises (10 reps* 5 sets). (3) They performed shoulder incycloduction movement of 15, 30 deg / sec in abduction in Biodex, and used MRI, and calculated T2 relaxation time about the exercises of the rotator cuff and scapular muscles. The muscle thickness value changed in TU and TL, especially TL revealed a change in higher than 90 degrees shoulder abduction. And the elastic value of the overhead group, TU / SUS revealed a tendency to show a high level for the control. As for the overhead sports, the activity in more than 45 degrees shoulder abduction is important and scapular muscle functions as a scapular stabilizer at the time of repeated shoulder rotation Also, it was suggested as for the rhomboid muscle that we respond as scapular stabilizer at the time of shoulder rotation. The pectoralis major, trapezius, rhomboid, infraspinatus muscles revealed elevation of T2 value and extension for T2 relaxation time after the exercises by MRI. It was suggested that the shoulder rotation in abduction is influenced by muscle activity of the scapular muscles and dysfunction of scapular muscles was caused by disorder of the glenohumeral joint in the overhead sports.}, pages = {93--99}, title = {肩関節外転位における肩甲骨周囲筋群の動態変化}, year = {2010}, yomi = {ハシモト, トシヒコ and オカダ, ナオユキ} }