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Freehand Three-Dimensional Ultrasound to Evaluate Scapular Movement

Worobey, Lynn A (2013) Freehand Three-Dimensional Ultrasound to Evaluate Scapular Movement. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Altered scapular kinematics have been linked to increases in shoulder pain and pathology. As such, identifying normal scapular movement is integral to preventing pathology and maintaining health of the joint. Existing methods to evaluate scapular movement are invasive, expensive, require exposure to radiation, suffer skin based motion artifacts, or allow for examination only in static postures. Freehand three-dimensional ultrasound offers the unique ability to image bone while being non-invasive, relatively low cost, and free of radiation. This is a novel application of a technology that in the past has been used for needle guided injections and determining changes in organ volumes, but never for evaluating bone movement. We have developed a custom freehand-ultrasound system that shows high repeatability across trials (SEM < 2°) in evaluating scapular kinematics in static postures with the arm at rest and elevated in the sagittal, frontal and scapular planes. Among manual wheelchair users and able-bodied controls we found scapular kinematics with the arm in an elevated position were predicted by scapular and trunk position at rest. We also found BMI ≥ 25, presence of pathology on a physical exam, shoulder abnormalities on a clinical ultrasound exam, and greater than 10 years of wheelchair use resulted in scapular postures associated with shoulder pathology in previous studies. We found no significant differences between wheelchair users and age-matched controls but attribute this to a lack of difference in pathology between the groups. A learning curve was identified over time for capturing quality ultrasound images and it is suggested future studies incorporate ample training time and require raters to meet minimum performance measures set forth by this study. In a subsample of subjects we found increases in external rotation, upward rotation and posterior tilting at incremental angles of humeral elevation during dynamic trials indicating that it is feasible to apply our methods to evaluate dynamic scapular movement. Application of these methods may help to identify shoulder pathology and evaluate the efficacy of interventions to correct altered scapular kinematics.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Worobey, Lynn Alaw93@pitt.eduLAW93
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairBoninger, Michael Lboninger@upmc.eduBONINGER
Committee MemberCollinger, Jennifer L.collingr@pitt.eduCOLLINGR
Committee MemberDelitto, Anthonydelitto@pitt.eduDELITTO
Committee MemberFarrokhi, Shawnfarrokhi@pitt.eduFARROKHI
Committee MemberKoontz, Alicia Makoontz@pitt.eduAKOONTZ
Date: 25 September 2013
Date Type: Publication
Defense Date: 7 May 2013
Approval Date: 25 September 2013
Submission Date: 2 July 2013
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Number of Pages: 203
Institution: University of Pittsburgh
Schools and Programs: Swanson School of Engineering > Bioengineering
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Ultrasound, scapula, wheelchair
Date Deposited: 25 Sep 2013 13:07
Last Modified: 25 Sep 2018 05:15


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