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Muscle compensation strategies to maintain glenohumeral joint stability with increased rotator cuff tear severity: A simulation study
Institution:1. Biomedical Engineering, Pennsylvania State University, University Park, PA, USA;2. College of Health Solutions, Arizona State University, Phoenix, AZ, USA;3. Physical Medicine & Rehabilitation, Penn State College of Medicine, Hershey, PA, USA;1. Laboratory for Biomechanics, Ostbayerische Technische Hochschule (OTH) Regensburg, Regensburg, Germany;2. Man-Machine Interaction Department, New Technologies - Research Center, University of West Bohemia in Pilsen, Univerzitní 8, 301 00 Pilsen, Czech Republic;3. Faculty of Applied Sciences, University of West Bohemia in Pilsen, Univerzitní 8, 301 00 Pilsen, Czech Republic;4. Regensburg Center for Biomedical Engineering, University and OTH Regensburg, Germany;1. Biomedical Engineering, Pennsylvania State University, University Park, PA, USA;2. Graduate Program in Acoustics, Pennsylvania State University, University Park, PA, USA;3. Physical Medicine & Rehabilitation, Penn State College of Medicine, Hershey, PA, USA;1. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, United States;2. Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, United States;3. Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN, United States;1. University of Southern California, United States;2. Rancho Los Amigos National Rehabilitation Center, United States;1. Department of Physical Therapy, Universidade Federal de São Carlos, Rodovia Washington Luis km 235, São Carlos, SP 13565-905, Brazil;2. Department of Clinical Research, Indian Spinal Injuries Center, Vasant Kunj, New Delhi 110070, India;1. Biomedical Engineering, Pennsylvania State University, University Park, PA, USA;2. Graduate Program in Acoustics, Pennsylvania State University, University Park, PA, USA;3. Physical Medicine & Rehabilitation, Penn State College of Medicine, Hershey, PA, USA
Abstract:Rotator cuff tear (RCT) in older adults may cause decreased muscle forces and disrupt the force balance at the glenohumeral joint, compromising joint stability. Our objective was to identify how increased RCT severity affects glenohumeral joint loading and muscle activation patterns using a computational model. Muscle volume measurements were used to scale a nominal upper limb model’s peak isometric muscle forces to represent force-generating characteristics of an average older adult male. Increased RCT severity was represented by systematically decreasing peak isometric muscle forces of supraspinatus, infraspinatus, and subscapularis. Five static postures in both scapular and frontal planes were evaluated. Results revealed that in both scapular and frontal planes, the peak glenohumeral joint contact force magnitude remained relatively consistent across increased RCT severity (average 1.5% and −4.2% change, respectively), and a relative balance of the transverse force couple is maintained even in massive RCT models. Predicted muscle activations of intact muscles, like teres minor, increased (average 5–30% and 4–17% in scapular and frontal planes, respectively) with greater RCT severity. This suggests that the system is prioritizing glenohumeral joint stability, even with severe RCT, and that unaffected muscles play a compensatory role to help stabilize the joint.
Keywords:Rotator cuff  Computational model  Glenohumeral joint  Muscle activation  Force couple  Tear severity
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