Proprioceptive Neuromuscular Facilitation Training Improves Scapular Muscle Strength and Pectoralis Minor Length in Individuals with Scapular Dyskinesis

Abstract

Purpose: Scapular dyskinesis is defined as alteration in scapular movements due to the loss of strength in scapular muscles; tightness of the soft tissues around shoulder and postural problems. Proprioceptive neuromuscular facilitation (PNF) is one of the therapeutic exercises to improve muscles weakness and pain levels. The aim of this study was to investigate the effects of a six-week PNF application on scapular muscle strength, scapular asymmetry, and pectoralis minor (PM) muscle tightness in participants with asymptomatic scapular dyskinesis.
 Methods: Twenty-five asymptomatic participants were evaluated using the video analysis method to determine the scapular dyskinesis. Eleven of them diagnosed with scapular dyskinesis and recruited for the PNF application. Lateral scapular slide test (LSST); tightness of PM; the muscle strength of serratus anterior (SA); lower trapezius (LT) and upper trapezius (UT) were evaluated. Anterior elevation-posterior depression; posterior elevation-anterior depression of PNF patterns were applied as repeated contractions technique by 2 times a week during 6 weeks. 
 Results: The LT (p=0.012) and SA (p=0.035) muscle strength increased following PNF training, while UT muscle strength was similar (p>0,05). The UT/SA (p=0.035) and UT/LT (p=0.012) strength ratios decreased following PNF application. The mean differences of PM tightness and LSST did not exceed the established MDC%95. 
 Conclusion: Scapular muscle balance improved following scapular PNF training. Therefore, scapular PNF patterns would be considered as an alternative treatment option to provide scapular stabilization and increase muscle strength.