Lateral Slide Research Articles

Evaluation of Neck Pain and Scapular Stability in Graduate Dental Students

Background: There is a high prevalence of work-related musculoskeletal disorders in dentists. The most commonly affected areas are the neck, low back, wrist, and hand. The symptoms of the musculoskeletal disorder occur during the educational and training course in dental students. Aim: The aim of this study was to assess neck pain and the scapular stability in graduate dental students. Study Design: This was an observational, cross-sectional study. Study Setting: This study was conducted at a dental college attached to a tertiary care hospital. Methods: The site of pain over the neck region (in subjects with pain) was assessed using body diagrams. Assessment of intensity of pain (if present) was done using Numerical Rating Scale, scapular posture using the pectoralis minor (PM) length test and resting scapular upward rotation using Baseline Bubble Inclinometer, dynamic scapular positioning using Lateral Scapular Slide Test, and muscle strength of scapular stabilizers using Lafayette Manual Muscle Tester. The outcome measures were compared between 1st-year undergraduate dental students (Group A) and dental interns (Group B). Results: Sixty-three female dental students (Group A, n = 32; Group B, n = 31) were included. There was a significant difference in the PM length test of left side (P = 0.02) and intensity of pain (right side P = 0.008, left side P = 0.003) in Groups A and B. The site of pain was over the lateral aspect of the neck and the character of pain was aching. We found no significant difference in other outcome measures. Conclusion: Dental students suffer from neck pain. Static scapular posture was affected, whereas the dynamic scapular stability was not affected.

English

BACKGROUND Poor posture like hunching forward is one of the most commonly practiced postures by women during breastfeeding. The maintenance of such postures for prolonged period can result in progressive weakness of the scapular muscles and subsequent increase in the kyphotic curve. Both lordosis and kyphosis increase during pregnancy and are observed to be maintained for up to 2 months postnatally. The thoracic spine position and slouched position significantly affects the scapular dynamics during scapular abduction resulting in decreased muscle forces. Thus, scapular dyskinesis, defined as an alteration of normal position or motion of the scapula during coupled scapulohumeral movements can occur as a result of decreased muscle forces. Thus, this gives rise to the need for evaluating scapular dyskinesis and its prevalence in postnatal women. The purpose of the study was to find the prevalence of scapular dyskinesis in breastfeeding postnatal women. METHODS An observational analytical study was undertaken at Krishna Institute of Medical Sciences, including a total of 40 subjects within the age group of (15 - 40) yrs. who had been breastfeeding for 6 months or more. These subjects were assessed for scapular dyskinesis using Yes / No test and the lateral scapular slide test (LSST). Kyphosis was assessed on observational basis through postural assessment in these individuals. Statistical analysis was done using the InStat app. RESULTS 67 % and 75 % of the subjects were found to be positive for scapular dyskinesis through Yes / No Test and LSST test respectively. Observational assessment showed that 55 % of the subjects were positive for kyphosis. Subjects demonstrated significant prevalence of scapular dyskinesis and subsequent kyphosis in postnatal females due to wrong ergonomic practice of breastfeeding. CONCLUSIONS The study shows that women lack proper knowledge about the breastfeeding ergonomics leading to weakness of scapular muscles. Thus, a significant prevalence of scapular dyskinesis was seen in breastfeeding postnatal women. KEY WORDS Breastfeeding, Scapular Muscle Weakness, Kyphosis, Ergonomics, Scapular Dyskinesis

Scapular Dyskinesis, Shoulder Joint Position Sense, and Functional Level After Arthroscopic Bankart Repair.

Background:Scapular kinesia is an important component of glenohumeral rhythm and shoulder stability. No studies have evaluated scapular dyskinesis and its relationship to shoulder proprioception in patients who have undergone arthroscopic Bankart repair (ABR).Purpose:To investigate scapular dyskinesis, proprioception, and functional level after ABR.Study Design:Cohort study; Level of evidence, 3.Methods:This study included 13 male patients who underwent ABR (ABR group; mean age, 30 years; range, 24-36 years) and 13 sex- and age-matched healthy individuals (control group). The age, height, weight, and dominant side of all participants were collected. Scapular dyskinesis was evaluated using the lateral scapular slide test and the scapular dyskinesis test; proprioception was measured by the active angle reproduction test using a smartphone goniometer application, and functional level was assessed using the upper-quarter Y-balance test for dynamic stability as well as the Rowe score and Walch-Duplay score for quality of life and return to activities of daily living.Results:The presence of static scapular dyskinesis in the neutral position, at 45° of abduction, and at 90° of abduction as well as the presence of dynamic scapular dyskinesis was higher in the ABR group compared with the control group (P ≤ .04 for all). Shoulder joint position sense (absolute error) at 40° and 100° of shoulder elevation and shoulder functional level according to the Rowe score were worse in the ABR patients compared with the healthy controls (P ≤ .02 for all). Dynamic scapular dyskinesis was negatively related to shoulder joint position sense at 40° of shoulder elevation (r = –0.64; P = .01). Static scapular movement as measured on the lateral scapular slide test was moderately related to the Rowe score (r = 0.58; P = .03).Conclusion:Scapular kinematics and proprioception should be evaluated after ABR. Treatment approaches to improve scapular control and proprioceptive sense should be included in the rehabilitation program for patients after ABR.

Contributions of Muscle Elasticity and Lateral Slide of the Transversus Abdominis to Lumbar Stability.

Lumbar instability can cause lumbar spondylolisthesis and chronic low-back pain in sports situation. Abdominal hollowing is commonly used in clinical practice to preferentially target the transversus abdominis (TrA) to stabilize the lumbar vertebrae; however, the contribution of muscle elasticity and lateral slide of the TrA to lumbar stability has not yet been clarified. To clarify the contribution of elasticity and lateral slide of the TrA to lumbar stability and to identify an effective exercise to stabilize the lumbar vertebrae. Experimental study. Laboratory. A total of 29 healthy males participated in this study. The participants performed hollowing during measurement of muscle elasticity of TrA and both knees extension from crook lying position for pelvic stability measurement. Lumbar stability, muscle elasticity change ratio, and lateral slide amount of TrA. There was a significant correlation between elasticity of the TrA and lumbar stability; however, no relationship was observed between lateral slide and lumbar stability or elasticity of the TrA. Elasticity of the TrA and lumbar stability was significantly correlated; therefore, improving the tonicity of the TrA may stabilize the lumbar vertebrae in healthy individuals. Moreover, hollowing with maximum effort may be effective as training aimed to stabilize the lumbar vertebrae for physical dysfunction due to lumbar instability.

Scapula dyskinesia in hospital housekeepers: A prevalence study

Background: Hospital Housekeeping staff perform repetitive and forceful upper limb motion which gives rise to scapula muscle fatigue which lead to muscle weakness and alters the position and motion of the scapula. These alterations in the scapula predispose the housekeepers to various work related disorders and injuries.Objective: To determine the prevalence of Scapula Dyskinesia in Hospital Housekeeping staff. Methods: A total of 134 hospital housekeeping staff were enrolled in the study. Participants were evaluated for work related musculoskeletal pain using a self formulated questionnaire. Scapula dykinesia was assessed in both static position and during dynamic scapula motion. Observation of the scapula at rest was made to determine the alteration in the static position of the scapula, the Lateral Scapula Slide Test assessed at three different positions was used to assess the dynamic scapula motion. Result: 94.77% of the participants reported to have work related musculoskeletal pain. Majority of participants experienced pain in the low back region followed by pain in shoulder, neck and knee region. Scapula dyskinesia was observed in 30(22.38%) of 134 participants. The mean values of LSST for position 1 was 7.91+1.09, position 2 was 8.06+1.07, position 3 was 7.62+1.05. Conclusion: A large number of housekeeping staff suffer from work related musculoskeletal pain, among them 22.38% of the hospital housekeeping staff observed to have Scapula Dyskinesia. Clinical Implication: Scapula Dyskinesia leads to biomechanical alterations in the individuals and predispose them to suffer from various work related musculoskeletal disorders,. which may cause work related disability, decrease in work productivity and reduced quality of life in these housekeeping staff.

Effect of Scapular Stabilisation Exercises for Type 2 Scapular Dyskinesisin Subjects with Shoulder Impingement

Background and Objective: Altered scapular motion and position have been termed Scapular Dyskinesis. In Type 2 Scapula Dyskinesis, visual prominence of entire medial border of scapula occurs due to weakness of the muscle serratus anterior and tightness of posterior capsule results in reductions in both glenohumeral flexion , abduction, resulting in decreased acromial elevation and Secondary impingement. Rehabilitation generally begins and focused on axio humeral and scapula humeral than axio scapula muscle. Early application of closed kinetic exercise approach on scapular stabilization and its effect of application on scapula dyskinesis type 2 is not know. The study was proposed to find the effect of scapula stabilization exercise for type 2 Scapula Dyskinesis in subjects with shoulder impingement. Method: An Experimental study design, 7 male patients with mean age 37 years diagnosed with Shoulder impingement associated with Type 2 scapula dyskinesis were taken into the study. Protocol include closed kinematic chain exercise (scapula clock), Black burn exercise, Sleepers stretch, and theraband exercise aim to balance force couple of upper,lower trapezius and serratus anterior. Duration of intervention was 3 sessions per week for 2 weeks. Outcome measurements such as Lateral scapular slide test and SPADI were measured pre and post after 2 weeks of protocol. Results: Analysis using Paired ‘t’ test as a parametric test found that there is statistically significant difference p<0.000 when pre to post interventions means were compared within the groups showing significant improvement in post SPADI and lateral scapular slide test. Conclusion: It is concluded that Scapula stabilization exercise protocol found to be effective in Scapula type 2 Dyskinesis.

Effect of Mechanical Neck pain on Neck Disability and Scapula position among School Teachers in Delhi and NCR

Neck pain found to be most common musculoskeletal condition in office workers with 12-month prevalence. Mechanical neck pain can be classified into two categories in clinical studies mechanical neck pain which has patients without any identifiable anatomic cause and leaves patients having neurological dysfunctions cervicogenic headache and inflammatory disorders. Current research work has total of 150 participants out of which there were 100 females school teachers having mean age of 37.8 years(median 38 years) and 50 male school teachers having mean age 40 years (median 39 years). Participants included in the study were professionally active school teachers of primary, secondary and senior secondary. Scapula position and neck disability was examined as per keiblers lateral scapular slide test and Neck disability index. Total 150 teachers were included in the study 80 teachers having mechanical neck pain (study group) and 70 teachers not having mechanical neck pain (control group) statistically significant difference found in scapula position and neck disability. In the present research, it is found that there is statistically significant difference in scapula position protraction and upward rotation at three different levels as well as there are statistically significant changes observed in neck disability.

Optimal fracture site compression of trochanteric region fracture managed with proximal femoral nailing at the time of surgery: Analysis of clinico-radiological and functional outcome

Objectives: Proximal Femoral Nail (PFN) with dual cephalic screw configuration is now widely used for management of trochanteric region fracture. Good fracture reduction and intraoperative achievement of optimal fracture site compression are very important surgical steps of proximal femoral nailing. There is very limited information available in literature regarding trochanteric region fracture site compression while fixation by PFN with dual cephalic screws (lag and anti-rotation screws). We are practicing a technique of intraoperative compression of fracture site by alternate tightening of lag and anti-rotation screws of PFN. Aim of this study is to evaluate the clinico-radiological and functional outcome of trochanteric region fracture management by PFN with intraoperative adequate fracture site compression achieved by this method. Materials and Methods: Total 47 patients, who underwent PFN fixation for trochanteric region fractures during September 2017 to October 2019 with 12 months follow up period, were included in this prospective study. Fractures were classified according to the AO/OTA system; the most common fracture type 31A2 (n = 28), followed by 31A1 (n = 18) and 31A3 (n = 1). At the time of PFN fixation, fracture site compression was performed by combination of two surgical steps - 1) by giving firm manual pressure towards medial direction with the help of PFN Jig after nail insertion into medullary canal, maintaining this pressure till fixation of both lag and anti-rotation screws and 2) alternate tightening of the anti-rotation and lag screws till final sitting of both screws was achieved. Clinical and radiological parameters including quality of reduction, tip-apex distance (TAD), lateral slide of lag screw, length of both cephalic screws as well as complications were measured. Functional outcome was assessed using Harris Hip Score (HHS). Results: Good reduction was achieved in 89.4% cases. Mean TAD AP (anteroposterior) was 11.6 mm, mean TAD LAT (lateral) was 11.1 mm and mean TAD Total was 22.7 mm. Overall mean lateral slide was 3.2 mm and it was more in unstable 31A2fracture. The HHS at 12 months postoperatively was excellent in 20 (42.6%), good in 16 (34.0%), fair in 5 (10.6%), and poor in 6 patients (12.8%). Conclusion: Intraoperative fracture site compression achieved by alternate tightening of the anti-rotation and lag screws of PFN shows excellent to good results in the management of trochanteric region fractures and a low incidence of complications.

Differences in impact on adjacent compartments in medial unicompartmental knee arthroplasty versus high tibial osteotomy with identical valgus alignment

BackgroundIt is unclear why medial unicompartmental knee arthroplasty (UKA) with postoperative valgus alignment causes adjacent compartment osteoarthritis more often than high tibial osteotomy (HTO) for moderate medial osteoarthritis of the knee with varus deformity. This study used a computer simulation to evaluate differences in knee conditions between UKA and HTO with identical valgus alignment. MethodsDynamic musculoskeletal computer analyses of gait were performed. The hip–knee–ankle angle in fixed-bearing UKA was changed from neutral to 7° valgus by changing the tibial insert thickness. The hip–knee–ankle angle in open-wedge HTO was also changed from neutral to 7° valgus by opening the osteotomy gap. ResultsThe lateral tibiofemoral contact forces in HTO were larger than those in UKA until moderate valgus alignments. However, the impact of valgus alignment on increasing lateral forces was more pronounced in UKA, which ultimately demonstrated a larger lateral force than HTO. Valgus alignment in UKA caused progressive ligamentous tightness, including that of the anterior cruciate ligament, resulting in compression of the lateral tibiofemoral compartment. Simultaneously, patellofemoral shear forces were slightly increased and excessive external femoral rotation against the tibia occurred due to the flat medial tibial insert surface and decreased lateral compartment congruency. By contrast, only lateral femoral slide against the tibia occurred in excessively valgus-aligned HTO. ConclusionsIn contrast to extra-articular correction in HTO, which results from opening the osteotomy gap, intra-articular valgus correction in UKA with thicker tibial inserts caused progressive ligamentous tightness and kinematic abnormalities, resulting in early osteoarthritis progression into adjacent compartments.

Scapular Asymmetry among Elite Swimmers of Jorhat District Using Lateral Scapular Slide Test

Background: Shoulder pain is particularly common among swimmers with up to 91% of swimmers19.Ninetypercent of the propulsive force in swimming comes from the upper extremity4,5. The scapular asymmetry isalterations in scapular positioning which can have an effect on shoulder function. Scapular positioning hasa direct relationship to shoulder stability12.Asymmetry in scapular position between sides is often assumedas pathological11.Objective: To determine scapular asymmetry as a factor causing shoulder pathology among elite swimmersof Jorhat district using lateral scapular slide test.Method: A descriptive study has been undertaken. 50 swimmers have been selected randomly for the studyand all swimmers are the members of Jorhat Swimming Society. Duration for the study is 8 weeks. Thesignificant and relevant test for this study is Lateral Scapular Slide Test (LSST). Dr. W Ben Kibler was thefirst person who proposed this test to assess scapular asymmetry based on the idea that asymmetry is anabnormality and it needs to be identified and rehabilitated18,19.The swimmers selected for the study are between the age group of 12-25 years within training sessions ofminimum 6 times per week and 12 hours weekly. Subjects are excluded who has any shoulder pathology likefracture, surgery or any other traumatic injury.Results: The statistical analysis was carried out using ‘z test’ to determine the significance of scapularasymmetry. There is no significant asymmetry at 0 degree shoulder resting position and there is significantasymmetry in 45, 90 and135 degrees of shoulder abduction respectively.Conclusion: Based on the statistical analysis, it is concluded that there is significant asymmetry found withthe LSST test position at 45 degree, 90 degree and 135 degree, mostly it increases with the elevation of theshoulder joint. Also they may be characterized of having movement restriction of shoulder joint as well asshoulder pain in their later stage of life.

Prevalence of Scapular Dyskinesia in Bankers

Objective: The primary objective was to assess and to calculate the prevalence of scapular dyskinesia in bankers. The secondary objective was to check the association of scapular dyskinesia, BMI Kg/m2 and with the sex of the participants Methods: This study is an observational cross-sectional type and sample size taken was of 101. Non-probability judgment sampling was used and research was carried out at the district of Gujrat and Gujranwala. Test used to identify scapular dyskinesia was lateral scapular slide test, DASH questionnaire was used and pain was measured using numerical pain rating scale. Results: According to the results among the total participants of 101 only 26 participants (25.7%) were recorded to be positive and the rest 75 (74.3%) were negative. Conclusion: It was concluded that bad postural habits somehow had an impact on the musculoskeletal condition of the worker specifically in the office sittings which might lead to scapular dyskinesia. Keywords: Scapular Dyskinesia • Strengthening Exercises • Postural Training • Large Synoptic Survey Telescope • Dietary Approaches to Stop Hypertension • Numerical Pain Rating Scale

Helmet shielding effect in mandibular fractures during road traffic accident.

Objective:The objectives of this study are to evaluate the proportion of helmeted and nonhelmeted patients sustaining mandibular fractures.Materials and Methods:A retrospective study was conducted on 200 patients reporting to oral and maxillofacial surgery (OMFS) unit, trauma center, and department of OMFS. A predesigned questionnaire was used to collect the necessary data. Patients were evaluated for age, gender, mode of transport (2/4 wheeler), presence of safety measure at the time of accident (helmet/seatbelt), maxillofacial injury in two wheeler (with helmet and without helmet), type of impact, and its association to maxillofacial fractures, particularly site of maxillofacial fractures. The association between mode of injury, presence of safety measures, impact type, and site of maxillofacial injuries was assessed using the Chi-square test. P < 0.5 was considered statistically significant.Results:The mean age of patients was 30 years, and approximately 92.5% of accidents patients were male. In this study, 35% nonhelmeted riders were reported head injury and 5% of the helmeted rider reported head injury. 54.5% of the patients suffered frontal impact, 28% collision, and 17.5% lateral slide collision. Head injuries are the main cause of death among the riders of all two wheelers. Lateral sliding collision injuries (17.5%) resulted 60.6% of the fractures mandible, 24.2% midface injury, and associated injury (15.15%).Conclusion:The use of helmet is strongly recommended to prevent head injuries and facial injuries. In the nonhelmeted riders in motorcycle accidents, the incidence of mandible fractures increases proportionally.

Validity of Clinical Measurement Instruments Assessing Scapular Function: Insufficient Evidence to Recommend Any Instrument for Assessing Scapular Posture, Movement, and Dysfunction-A Systematic Review.

To determine the construct validity, criterion validity, and responsiveness of measurement instruments evaluating scapular function. Systematic review of measurement properties. The MEDLINE, Embase, CINAHL, and SPORTDiscus databases were systematically searched from inception until March 2019. Studies published in Dutch, English, or German were included when they evaluated at least 1 of the measurement properties of interest. No restrictions were made regarding participants' health status. Two reviewers independently evaluated study quality using the COSMIN checklist and extracted and analyzed data. Quality of evidence was graded by measurement property for each distinctive type of measurement. Thirty-one measurement instruments in 14 studies were categorized into instruments to measure scapular posture and movement, and to assess scapular dyskinesis. Quality of evidence was at most moderate for 4 instruments with respect to criterion validity. Of these, criterion validity for instruments measuring scapular protraction/retraction posture and rotation angles up to 120° of thoracohumeral elevation was sufficient. Criterion validity for instruments measuring asymmetrical scapular posture, range of motion, and the lateral scapular slide test was insufficient. Quality of evidence for measurement properties of all other instruments was graded lower. There is currently insufficient evidence to recommend any instrument for the clinical examination of scapular function. Measurement instruments to assess scapular dyskinesis are prone to misinterpretation and should therefore not be used as such. J Orthop Sports Phys Ther 2020;50(11):632-641. doi:10.2519/jospt.2020.9265.

The effect of scapular dyskinesia on the scapular balance angle and upper extremity sensorimotor function in stroke patients with spasticity

BackgroundPost-stroke scapular dyskinesia is a predisposing factor for the affection of motor and somatosensory functions of the hemiparetic upper extremity.ObjectiveThe purpose of the study was to investigate the effect of scapular dyskinesia on the scapular balance angle and upper extremity sensorimotor function in stroke patients with spasticity.Subjects and methodsSixty patients with spasticity post-stroke participated in this study. The patients were assigned to one of the two groups as determined by the lateral scapular slide test (LSST) using the palpation meter (PALM); group A with scapular dyskinesia and group B stroke patients without scapular dyskinesia. The scapular position was determined by a measurement of scapular balance angle (SBA), and the upper extremity sensorimotor function was evaluated using Fugl-Meyer Assessment upper extremity (FMAUE) scale. The scapular balance angle and Fugl-Meyer upper extremity scores were compared between groups.ResultsThere was a significant increase in the scapular balance angle of group A compared with that of group B (p < 0.001). Also, there was a significant decrease in sensory and motor functions of group A as measured by Fugl-Meyer upper extremity compared with that of group B (p < 0.001).ConclusionScapular dyskinesia had a significant effect on the scapular balance angle and upper extremity sensorimotor function in stroke patients with spasticity. Management of scapular dyskinesia should be emphasized in the rehabilitation program for stroke patients with spasticity.

Modified Short Proximal Femoral Nail for Intertrochanteric Fractures of Femur in Indian Patients - our Experience.

Introduction:Proximal femoral nail (PFN) is a commonly used implant for intertrochanteric fractures which is designed according to western femoral measurements. However, anthropometry of proximal femur in Indian and in general, Asian, are smaller. So a modified short PFN with smaller dimensions was developed. This study analyses the radiological and functional outcome of treatment of intertrochanteric fractures with modified short PFN.Materials and Methods:A retrospective study analysed 120 adult patients operated between 2014-2017 using modified short PFN for intertrochanteric fractures, having a minimum follow-up of 12 months. Clinical and radiological parameters including tip-apex distance (TAD), position of tip of lag screw in femoral head, lateral slide of lag screw as well as length of anti-rotation screw were measured. Final functional outcome was assessed using Barthel’s index and Kyle’s criteria.Results:Good reduction was achieved in 90.83% cases and 79.16% had ideal placement of lag screw in femoral head. Intra-operative difficulties were encountered in 13.33% (n=16). Mean TAD AP (anteroposterior) was 11.8mm, TAD LAT (lateral) was 11.0mm and mean TAD TOT was 22.8mm. Overall mean lateral slide was 3.20mm and it was more in unstable fracture. We had five mechanical failures, one patient with screw breakage without loss of reduction and two peri-implant fractures after union. 81.66% returned to pre-injury levels of activity with 88.33% good to excellent outcome as per Kyle’s criteria.Conclusion:Although, not devoid of complications, modified short PFN results in good functional recovery of patients with intertrochanteric fractures of femur.

Effect Of Scapular Dyskinesis On Scapular Functionality And Back Endurance In Elite Women Handball Players

PURPOSE: In professional handball players, accurate scapulohumeral rhythm is crucial for the prevention of overhead shoulder injuries. Additionally low back strength and endurance transfer power to scapular and upper part of body via posterior fascia chain. The aim of this study was to investigate the difference between handball players with scapular dyskinesis and without scapular dyskinesis regarding to functionality and back endurance. METHODS: Forty-one elite female handball players were included in the study. Sixteen women (mean age: 22.5±6.4yrs BMI: 22.5±2.7kg/m2) who has scapular dyskinesis according to lateral scapular slide test (LSST) as Group 1, 25 women (mean age: 22.5±6.4yrs, BMI:21.8±2.0kg/m2) who has no scapular dyskinesia according to LSST as Group 2 divided into groups. Davies Test and Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) were used for the measurement of scapular functionality and Sorensen Test for the measurement of back extensor endurance. Mann-Whitney U test was used to compare the mean values between the groups. RESULTS: There were no statistically significant differences in CKCUEST and Davies tests between both groups (p> 0.05). There was statistically significant difference in favor of Group 2 according to Sorensen test between both groups (p = 0.026). CONCLUSION: Endurance of the trunk extensor muscles seems to have influence in scapular dyskinesis in elite female handball players. Besides, functionality of upper extremity in scapular dyskinesis needs to future studies for handball players.

Evaluation of scapular dyskinesis and ergonomic risk level in office workers

Purpose. The purpose of this study is to evaluate the association between ergonomic risk level and scapular dyskinesis in office workers. Methods. This cross-sectional study included office workers aged 20–65 years. A lateral scapular slide test (LSST) was used to evaluate scapular dyskinesis, and the quick exposure check (QEC) method was used to analyze the ergonomic risk level. Results. In all, 37 (45.7%) participants were men and 44 (54.3%) participants were women. Of the participants with scapular dyskinesis in any of the three LSST positions, 10.3% had low, 20.6% had medium, 30.9% had high and 37.9% had very high ergonomic risk level (p = 0.001). A low, positive linear correlation was observed between ergonomic risk level and LSST-1, LSST-2 and LSST-3 values. Conclusion. These results indicate that patients with scapular dyskinesis have a high ergonomic risk level. We believe that our work will serve as a foundation for intervention studies assessing ergonomic risk management.

Effect of Muscle Energy Technique on Strength and Range of Motion in Young Swimmers with Sick Scapula Syndrome: A Pre-Post Clinical Trial

Background: There are various overhead injuries which mainly affect the shoulder complex in swimmers and one among them is sick scapula syndrome which results in muscular imbalance in such athletes. The abbreviation SICK stands for Scapular malposition, Inferior medial border prominence, Coracoid pain and malposition, Dyskinesia. Method: In this study 26 subjects with sick scapula syndrome were taken into the study by evaluating through the lateral scapular slide test (LSST), the subjects affected were given muscle energy technique to increase the strength of the scapular muscles the technique was given for 45-60 seconds thrice in a week for three weeks and all the subjects were immediately assessed using MMT. Results: The t and p value of Pre and Post ROM scale of Extension was 11.523 and 0.001. The t and p value of Pre and Post ROM scale of Internal rotation was 10.490 and 0.001. The t and p value of Pre and Post ROM scale of external rotation was 12.569 and 0.001 which is statistically significant. The t and p value of Pre and Post MMT scale of serratus anterior was 1.995 and 0.050. The t and p value of Pre and Post MMT scale of Pectoralis Minor was 5.000 and 0.001. The t and p value of Pre and Post MMT scale of Latissimus dorsi was 2.440 and 0.022. The t and p value of Pre and Post MMT scale of Trapezius was 6.325 and 0.001 which is statistically significant. Conclusion: The present study results demonstrate that of Muscle energy techniques effective in increasing the range of motion and strength in young swimmers within the age group of 8 to 15 years with sick scapular syndrome.

To Evaluate Scapulohumeral Rhythm in Scapular Dyskinesia in Software Professionals with Neck Pain

Neck Pain a musculoskeletal condition which is increasing commonly throughout the World havingconsiderable impact on individuals that affects their social, physical and psychological aspects. Neck Pain ismore prevalent in office workers than in general community. Computers have become an epitome of modernlife, being used in every aspect of life. Work related Neck pain is leading cause of disability and absenteeism.Evaluation, treatment planning for Neck Pain rehabilitation often fails to include an objective assessment ofscapular motion. Methodology: A cross-sectional study,120 subjects with Neck Pain. Convenient samplingmethod was done. Subjects were screened for Scapular Dyskinesia using Lateral Scapular Slide Test(LSST)those fulfilling the inclusion criteria, further Scapular Upward Rotation(SUR) assessed by DigitalInclinometer at 00,450,900,1200 of Gleno-Humeral abduction and assessed for Scapulohumeral rhythm(SHrhythm). NDI questionnaire was asked to fill. Results: The results showed statistically significant correlationbetween all the variables. SUR is more in dominance hand and SH rhythm is more in non-dominance handand is altered in all the angles and none were closely related to the clinically accepted ratio. SH rhythm ismore in starting angles of humeral elevation and is less when reaching to full range

Scapular dyskinesis in patients with breast cancer

Aim: To determine the incidence of scapular dyskinesis in breast cancer patients, to compare it with controls, and to investigate the triggering factors, analyzing restriction, pain and function of the shoulder, lymphedema, time after surgery, radiotherapy, chemotherapy, number of removed lymph nodes. Scapular dyskinesis is one of the complications after breast cancer treatment, without a consensual incidence ratio. Only a few studies in literature mention the incidence of scapula alata which is advanced form of scapular dyskinesis in patients with breast cancer, most of which insufficiently assess the required parameters and with discordant results. Material and Methods: The study sample comprised forty-nine patients who had undergone axillar dissection and forty-nine healthy individuals as controls. Scapular dyskinesis, shoulder mobility, pain, lymphedema and function of shoulder were evaluated with lateral scapular slide test, goniometer, visual analogue scale, circumference measurement and Disabilities of the Arm, Shoulder and Hand Questionnaire, respectively. Results: The incidence of scapular dyskinesis was 53.06 % in patients with breast cancer and significantly higher than the control group (p= 0.007). None of the parameters investigated have a significant relationship with scapular dyskinesis statistically (p>0.05).Conclusion: The results indicate that the incidence of scapular dyskinesis is significantly higher in breast cancer therefore it will be beneficial that scapular dyskinesis is included in and thoroughly scrutinized during the clinical assessments; and medical practitioners dealing with breast cancer patients are informed of a potential scapular dyskinesis should need be.