Effect of Plane of Arm Elevation on Glenohumeral Kinematics

Authors:
  • JBJohn P. Brunkhorst
    John P. Brunkhorst
  • NHNils H. Horn
    Nils H. Horn
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Abstract
-dimensional glenohumeral translations and rotations during arm elevation in healthy subjects. Methods: Eight male subjects performed scaption and forward flexion, and five subjects (three men and two women) performed abduction, inside a dynamic biplane fluoroscopy system. Bone geometries were extracted from computed tomography images and used to determine the three-dimensional position and orientation of the humerus and scapula in individual frames. Descriptive statistics were determined for glenohumeral joint rotations and translations, and linear regressions were performed to calculate the scapulohumeral rhythm ratio. Results: The scapulohumeral rhythm ratio was 2.0 ± 0.4:1 for abduction, 1.6 ± 0.5:1 for scaption, and 1.1 ± 0.3:1 for forward flexion, with the ratio for forward flexion being significantly lower than that for abduction (p = 0.002). Humeral head excursion was largest in abduction (5.1 ± 1.1 mm) and smallest in scaption (2.4 ± 0.6 mm) (p < 0.001). The direction of translation, as determined by the linear regression slope, was more inferior during abduction (−2.1 ± 1.8 mm/90°) compared with forward flexion (0.1 ± 10.9 mm/90°) (p = 0.024). Conclusions: Scapulohumeral rhythm significantly decreased as the plane of arm elevation moved in an anterior arc from abduction to forward flexion. The amount of physiologic glenohumeral excursion varied significantly with the plane of elevation, was smallest for scaption, and showed inconsistent patterns across subjects with the exception of consistent inferior translation during abduction. Clinical Relevance: When evaluating scapulohumeral kinematics during clinical assessment or for rehabilitation protocols, it is important to take into account and control the plane of arm elevation. Abnormalities in scapular motion may be better evaluated during forward flexion of the arm because greater scapular motion is required for this arm motion....

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