Purpose: To investigate whether scapular movement training (SMT) is superior to standardized exercises in improving scapular biomechanics, behavioral, and clinical aspects of individuals with shoulder pain.
Methods And Methods: A total of 64 individuals with chronic shoulder pain were randomly assigned to receive 16 sessions of SMT or SE over 8 weeks. Outcome measures included three-dimensional scapular kinematics, muscle activity of scapulothoracic muscles, pain, disability, fear-avoidance, kinesiophobia, and self-perceived changes. Kinematics and muscle activity were assessed at baseline and after treatment, and self-reported measurements at baseline, 4, 8, and 12 weeks.
Results: SMT significantly ( < 0.05) decreased scapular internal rotation during arm elevation and lowering at sagittal and scapular planes (mean difference [MD]: ranged from 2.8 to 4.1°), and at lower angles of arm elevation and lowering at the frontal plane (MD: 3.4° and 2.4°, respectively), increased upper trapezius (UT) activity (MD: 10.3%) and decreased middle trapezius (MT) (MD: 60.4%) and serratus anterior (MD: 9.9%) activity during arm lowering compared to SE. Both groups significantly improved pain, disability, fear-avoidance, kinesiophobia, and self-perceived changes over 4 weeks, which was sustained over the remaining 8 weeks.
Conclusions: SMT is not superior to standardized exercises in improving scapular biomechanics, behavioral, and clinical aspects of individuals with shoulder pain.
Clinical Trial Registration Number: NCT03528499Implications for rehabilitationScapular movement training (SMT) showed small and likely not clinically relevant changes in scapular kinematics and muscle activity compared to standardized exercises.SMT and standardized exercises presented similar improvements in pain, disability, fear-avoidance beliefs, kinesiophobia, and self-perceived change in health condition immediately following 4-weeks of treatment, which was sustained over the following 8 weeks.The changes in patient-reported outcome measures are unlikely to be associated with changes in scapular kinematics and electromyographic activity.Clinicians should consider other factors than scapular movement during the treatment of patients with shoulder pain.
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http://dx.doi.org/10.1080/09638288.2022.2114552 | DOI Listing |
Cureus
December 2024
Medical Research, Universidad Francisco Marroquín, Guatemala, GTM.
Scapular fractures are rare, typically resulting from high-energy trauma. These injuries frequently present alongside other thoracic or shoulder injuries. Patients often exhibit posterior shoulder pain, swelling, and limited range of motion, which can suggest a variety of shoulder pathologies.
View Article and Find Full Text PDFInt J Sports Med
January 2025
Physical Therapy, Catholic University of Pusan, Busan, Korea (the Republic of).
The effects of the two popular strategies, scapular adduction and depression and scapular posterior tilt, on muscle activity of the trapezius and serratus anterior muscles have not been compared. This study demonstrates the effects of additional scapular adduction and depression or scapular posterior tilt movements on the activation of trapezius and serratus anterior muscles and scapular kinematics during arm raising. Eighteen asymptomatic men performed arm raising tasks with and without additional scapular movements, including scapular adduction and depression or scapular posterior tilt.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
January 2025
Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Campus UZ Gent, Ghent, Belgium.
Background: Reversed shoulder arthroplasty (rTSA) is often used to restore functionality in patients with joint arthropathy and dysfunctional rotator cuff. As rTSA changes the biomechanical properties of the shoulder, an altered movement pattern of arm and scapula is to be expected. Previous studies focused on changes of the scapulohumeral rhythm during functional elevation tasks.
View Article and Find Full Text PDFClin Biomech (Bristol)
January 2025
Health Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Brazil.
Background: Upper limb fractures significantly alter movement, impacting function and recovery. Three-dimensional motion analysis allows precise assessment of these changes.
Methods: Sixty patients were divided into four groups: shoulder, elbow, wrist fractures, and controls.
J Hand Ther
January 2025
Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
Background: Usually, patients with hand, wrist/forearm disorders report musculoskeletal complaints in the shoulder. Although, role of scapula is fundamental for movement and functional stability across the upper limb kinetic chain; however, there are no systematic reviews and meta-analyses that have analyzed the effect of scapular exercises in these patients.
Purpose: This study aimed to determine the effectiveness of a scapular exercise program on functional outcomes in patients with hand, wrist or elbow disorders.
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