Is there a relationship between subacromial impingement syndrome and scapular orientation? A systematic review (original) (raw)
Related papers
Scapular kinematics and subacromial-impingement syndrome: a meta-analysis
Journal of sport rehabilitation, 2012
The literature does not present a consistent pattern of altered scapular kinematics in patients with shoulder-impingement syndrome (SIS). To perform meta-analyses of published comparative studies to determine the consistent differences in scapular kinematics between subjects with SIS and controls. In addition, the purpose was to analyze factors of the data-collection methods to explain the inconsistencies in reported kinematics. The results of this study will help guide future research and enable our understanding of the relationship between scapular kinematics and SIS. A search identified 65 studies; 9 papers met inclusion criteria. Sample sizes, means, and SDs of 5 scapular-kinematic variables were extracted or obtained from each paper's lead author. Standard difference in the mean between SIS and controls was calculated. Moderator variables were plane of arm elevation, level of arm elevation (ARM) and population (POP). Overall, the SIS group had less scapular upward rotation ...
Manual Therapy, 2011
Introduction: The scapular muscular system is the major determinant of scapular positioning. In addition, strength and muscular endurance develops from childhood through adolescence. It is not known whether differences in scapular positioning and motor control between adults and children may exist. Methods: Ninety-two shoulders of 46 adults (mean ¼ 39.4; 18e86 years; SD ¼ 22.5), and 116 shoulders of 59 children (mean ¼ 11.6; 6e17 years; SD ¼ 3.5), were included in the study. Scapular positioning data were collected using a clinical assessment protocol including visual observation of titling and winging, measurement of forward shoulder posture, measurement of scapular upward rotation, and the Kinetic Medial Rotation Test (KMRT). Results: The observation protocol for scapular winging and tilting did not show significant differences between adults and children. After controlling for height, forward shoulder posture (relaxed (0.28 cm/cm (0.06) vs. 0.31 cm/cm (0.07) and retracted (0.15 cm/cm (0.05) vs. 0.20 cm/cm (0.06)) were significantly smaller in children than in adults (P < 0.01). In addition, children showed greater scapular upward rotation (18.6 ; SD 9.6 ) than adults (14.5 ; SD 10.9 ) at 90 shoulder abduction. No significant differences were seen between children (19% positive test) and adults (24% positive test) using the KMRT. Conclusion: Children and adults show significant but small differences in scapular upward rotation and forward shoulder posture. These data provide useful reference values using a clinical protocol.
Scapular positioning in overhead athletes with and without shoulder pain: a case-control study
Scandinavian journal of medicine & science in sports, 2011
Abnormalities of scapular positioning are considered important risk factors for developing shoulder disorders. This study analyses the scapular positioning pattern in a group of overhead athletes with and without shoulder pain. In a multi-center blinded case-control study, 36 shoulder pain athletes (19 men, 17 women), were compared with 36 unimpaired athletes free of shoulder pain, matched for gender, age, hand dominance and body mass index. The blinded assessor performed visual observation, the measurement of the distance between the acromion and the table, inclinometry and the kinetic medial rotation test for dynamic scapular control in random order. Athletes with shoulder pain demonstrate scapular asymmetry in the sagittal plane, observed visually as anterior tilting on the painful side. Athletes with shoulder pain show a lack of scapular motor control on their painful side in contrast to their pain-free side. No scapular positioning or motor control differences were found in ath...
Journal of Athletic Training
Context Impaired scapular kinematics are commonly reported in patients with subacromial impingement syndrome (SIS). Various therapeutic interventions designed to improve scapular kinematics and minimize pain and disability have been described in the literature. However, the short- and long-term benefits of these interventions are unclear. Objective To determine the effects of specific short- and long-term therapeutic interventions on scapular kinematics and disability in patients with SIS. Data Sources We searched PubMed, CINAHL, and SPORTDiscus databases from their origins to January 2018 using a combination of the key words scapular kinematics AND (shoulder dysfunction OR subacromial impingement) and conducted a manual search by reviewing the references of the identified papers. Study Selection Studies were included if (1) preintervention and postintervention measures were available; (2) patient-reported outcomes were reported; (3) scapular kinematics measures at 90° of ascending ...
Purpose: Altered kinematics of the scapula or scapular dyskinesis (downward rotation, anterior tilt, and protraction) contribute to impingement syndrome by decreasing the subacromial space. Given the critical role of scapular position and movement in the function of the shoulder, the aim of this study was to compare scapular position and dyskinesis in individuals with and without rounded shoulder posture. Methods: By employing the convenience sampling method, 21 individuals with rounded shoulder posture (11 females and 10 males; average age: 22.95 years) and 23 individuals without rounded shoulder posture (13 females and 10 males; average age: 22.43 years) were enrolled in this study through a case-control design.The scapular dyskinesis test was used to observe alterations in scapulohumeral rhythm in the sagittal and frontal planes of the arm. Also, the scapular position was examined according to the Kibler test. Data were analyzed using SPSS 21. We used the Independent t-test and Mann-Whitney test to compare the differences between the two groups. Results: There were no differences in scapular dyskinesis between the two groups (P>0.05). The prevalence of subtle or obvious scapular dyskinesis in individuals with rounded shoulder posture was greater than those without rounded shoulder posture, but the difference was not statistically significant. Furthermore, no significant difference was found in static scapular position (Kibler test) of the dominant and non-dominant sides between the two groups (P>0.05). Conclusion: There were no significant differences in scapular position and scapular movement pattern between the individuals with and without rounded shoulder posture.
Clinical assessment of the scapula: a review of the literature
British Journal of Sports Medicine, 2012
Scientific evidence supporting a role for faulty scapular positioning in patients with various shoulder disorders is cumulating. Clinicians who manage patients with shoulder pain and athletes at risk of developing shoulder pain need to have the skills to assess static and dynamic scapular positioning and dynamic control. Several methods for the assessment of scapular positioning are described in scientific literature. However, the majority uses expensive and specialised equipment (laboratory methods), making their use in clinical practice nearly impossible. On the basis of biometric and kinematic studies, guidelines for interpreting the observation of static and dynamic scapular positioning pattern in patients with shoulder pain are provided. At this point, clinicians can use reliable clinical tests for the assessment of both static and dynamic scapular positioning in patients with shoulder pain. However, this review also provides clinicians several possible pitfalls when performing clinical scapular evaluation. On the basis of its clinical relevance, its proven reliability, its relation to body length and its applicability in a clinical setting, this review recommends to assess the scapula both static (visual observation and acromial distance or Baylor/double square method for shoulder protraction) and semidynamic (visual observation and inclinometry for scapular upward rotation). In addition, when the patient demonstrates with shoulder impingement symptoms, the scapular repositioning test and scapular assistant test are recommended for relating the patients' symptoms to the position or movement of the scapula.
Medical Journal of the Islamic Republic of Iran, 2014
Background: Dysfunction in the kinetic chain caused by poor scapula stabilization can contribute to shoulder injuries and Shoulder Impingement Syndrome (SIS). The purpose of this study was to compare the effectiveness of two treatment approaches scapular stabilization based exercise therapy and physical therapy in patients with SIS. Methods: The study is a randomized clinical trial in which 68 patients with SIS were randomly assigned in two groups of exercise therapy (ET) and physical therapy (PT) and received 18 sessions of treatment. Pain, shoulders' range of abduction and external rotation, shoulder protraction, scapular rotation and symmetry as well as postural assessment and Pectoralis minor length were evaluated pre and post intervention. The paired-sample t test and the independent sample t test were applied respectively to determine the differences in each group and between two groups. Results: Our findings indicated significant differences in abduction and external rotation range, improvement of forward shoulder translation and increase in the flexibility of the involved shoulder between the two groups (respectively ; p=0.024, p=0.001, p<0/0001, p<0/0001). No significant difference was detected in pain reduction between the groups (p=0.576). Protraction of the shoulder (p<0.0001), forward head posture (p<0/0001) and mid thoracic curvature (p<0.0001) revealed a significant improvement in the ET group. Apparent changes occurred in scapular rotation and symmetry in both groups but no significant differences were observed between the two groups (respectively; p=0.183, p=0.578). Conclusion: The scapular stabilization based exercise intervention was successful in increasing shoulder range, decreasing forward head and shoulder postures and Pectoralis minor flexibility.
Journal of Orthopaedic & Sports Physical Therapy, 2020
T he etiology of shoulder complaints is multifactorial. 56 Scapular dyskinesis is one factor frequently suggested to mechanically contribute to the onset and persistence of shoulder complaints. 3,16 Although debated, scapular dyskinesis generally encompasses a concept of scapular dysfunction that is reflected by aberrant scapular posture and movement patterns, such as scapular winging and asymmetry. 22 Such scapular movement and posture are believed to evoke circumstances where soft tissue structures in and around the shoulder joint are exposed to detrimental mechanical stress. 26,53 Assessing scapular movement and posture is therefore often part of the clinical-reasoning process of clinicians who manage shoulder pain. Assessments of scapular upward rotation and visual evaluation systems to assess scapular dyskinesis have been advocated as reliable and valid for clinical use. 12,24 However, we recently studied the reliability of these measures and found that the evidence was insufficient to recommend their use. 8 There is also growing evidence that common treatment programs that target scapular dyskinesis may have limited clinical U OBJECTIVE: To determine the construct validity, criterion validity, and responsiveness of measurement instruments evaluating scapular function. U DESIGN: Systematic review of measurement properties.