Modélisation musculosquelettique du complexe articulaire de l'épaule pour prévenir les troubles à la coiffe des rotateurs, prédire l'évolution des déchirures et concevoir des orthèses postopératoires personnalisées.
Shoulder musculoskeletal disorders affect over half a million Canadians. Rotator cuff tears are the most costly injuries, their treatment often consisting of surgery and immobilization by an orthosis. The shoulder joint consisting of a very complex structure, little evidence exists concerning risk factors and rehabilitation. Despite the evolution of surgical techniques, the rate of failure remains high amongst patients. Although clinical tests and imaging are used to establish diagnostics, they remain insufficient for the determination of the optimal immobilization position and even less effective when trying to identify high-risk patients of rapid injury aggravation who could benefit from urgent surgery. A shoulder musculoskeletal model could complete clinical analyses through muscle force estimation and allow numerous simulations to understand injury mechanisms. My objectives, through this model are to:
1) Identify handling conditions in a work setting that could lead to excessive use of the shoulder by varying the box weight and range of motion;
2) Design a dynamic orthotic device with a Quebec based company to give preferential treatment concerning shoulder rehabilitation by simulating the optimal position in which the shoulder should be immobilized and the appropriate range of motion to be allowed;
3) Determine musculoskeletal parameters associate with aggravation of rotator cuff injuries prior to operation through a series of tests performed by imaging as well as motion analysis in order to estimate for muscle forces.
This program will present recommendations for workers at risk of shoulder injury and lead to the conception of an orthosis and a musculoskeletal model to better understand the mechanisms associated with rotator cuff injuries. Patients should benefit from a quicker rehabilitation period leading to earlier return to their work setting. About ten students will receive a multidisciplinary training in the fields of kinesiology, bio-engineering and orthopedics.