Scapular Position Research Articles

A randomized controlled trial of scapular exercises with electromyography biofeedback in oral cancer patients with accessory nerve dysfunction.

This study aims to investigate the effects of electromyography (EMG) biofeedback on scapular positions and muscle activities during scapular-focused exercises in oral cancer patients with accessory nerve dysfunction. Twenty-four participants were randomly allocated to the motor-control with biofeedback group (N = 12) or the motor-control group (N = 12) immediately after neck dissection. Each group performed scapular-focused exercises with conscious control of scapular orientation for 3months. EMG biofeedback of upper trapezius (UT), middle trapezius (MT), and lower trapezius (LT) was provided in the motor-control with biofeedback group. Scapular symmetry measured by modified lateral scapular slide test; shoulder pain; active range of motion (AROM) of shoulder abduction; upper extremity function; maximal isometric muscle strength of UT, MT, and LT; and muscle activities during arm elevation/lowering in the scapular plane were evaluated at baseline and the end of the intervention. After the 3-month intervention, only the motor-control with biofeedback group showed improving scapular symmetry. Although both groups did not show significant improvement in shoulder pain, increased AROM of shoulder abduction and muscle strength of the UT and MT were observed in both groups. In addition, only the motor-control with biofeedback group had improved LT muscle strength, upper extremity function, and reduced UT and MT muscle activations during arm elevation/lowering. Early interventions for scapular control training significantly improved shoulder mobility and trapezius muscle strength. Furthermore, by adding EMG biofeedback to motor-control training, oral cancer patients demonstrated greater effectiveness in stabilizing scapular position, muscle efficiency, and upper extremity function than motor-control training alone. Institutional Review Board: This study was approved by the Chang Gung Medical Foundation Institutional Review Board (Approval No: 201901788A3. Approval Date: 2 January, 2020). This trial was registered at ClinicalTrials.gov (ClinicalTrials.gov ID: NCT04476004. Initial released Date: 16 July, 2020).

Association Between Scapular Posture and Two Different Pectoralis Minor Length Tests in Adolescents

Postural asymmetry due to the alterations in scapular posture is typically considered to be associated with injury. Pectoralis minor (PM) has played a crucial role in scapular posture, but limited knowledge exists that shows the possible effect of PM length on static scapular positioning in adolescents. The aim of this study was to investigate the association between static scapular positioning and two different PM length measurements in adolescents. Pearson rank test demonstrated that direct measurements of the PM length significantly and strongly inversely correlated to scapular anterior tilting (p = .01; r = −.592)and significantly and moderately inversely correlated to scapular internal rotation (p = .013; r = −.465) and scapular downward rotation (p = .028; r = −.416). However, indirect measurement of the PM length was not related to scapular posture. No significant correlation was found between direct and indirect PM length measurements. Direct measurement of PM length presents more information regarding alterations of the static scapular positioning.

Correlation of resting scapular position and functional throwing performance index among amateur basketball players

Background: Scapular dyskinesis is prevalent in 54.5% of overhead athletes. Scapular dyskinesis is abnormal positioning of the scapula over the thorax and also abnormal motions of the scapula. Any alterations to the normal scapular position may alter the accuracy of striking and serving in basketball players. This study aims to find out the relation between the resting scapular position and the throwing accuracy of players. Results: The research suggests that there is a moderate correlation present between the resting scapular position and the throwing accuracy of the players. Conclusion: In this study, results state that the resting position of the scapula plays an important role in power generation and biomechanics of throwing in overhead athletes affecting the throwing accuracy of players.

Effects of A Progressive Rehabilitation Program on Shoulder Internal Rotation Range of Motion, Acromiohumeral Distance, And Pain in An Adolescent Female Swimmer with Subacromial Pain (Impingement) Syndrome

Shoulder injuries are common in competitive youth swimmers because of sport-specific changes in upper extremity physical characteristics and acromio-humeral distance (AHD). These physical alterations could cause abnormal scapular kinematics and positioning. Subacromial pain syndrome (SPS), scapular dyskinesis, and SLAP lesions require a multiphase approach. A 14-years-old female athlete who has been swimming for 7 years had SPS symptoms for 14 months. She also had scapular dyskinesis and suspected SLAP lesion. She received 15 treatment sessions. We conducted a progressive and comprehensive rehabilitation program consisting of electrotherapy, thermal agent, mobilization techniques, posterior shoulder stretching exercises, upper and lower extremity strengthening, proprioception, scapular stabilization, and core stabilization exercises, rhythmic stabilization exercises, plyometric exercises, and the advanced thrower’s 10 program. Internal rotation range of motion (IRROM) with bubble inclinometer, pain with Visual Analog Scale, and AHD with ultrasonographic imaging were assessed before treatment and at the end of the 9th and 15th treatment sessions. Before treatment, IRROM was 52°, AHD was 10.67 mm, and pain intensity at rest and during swimming was 0 and 3.1 cm, respectively. After 9 treatment sessions, IRROM was 55.6°, AHD was 11.62 mm, pain intensity at rest and during swimming was 3.7 cm and 5.1 cm, respectively. At the end of the treatment, IRROM was 58.33°, AHD was 12.02 mm, pain intensity at rest and during swimming was 0 cm. A progressive and challenging rehabilitation program may positively change the scapular and glenohumeral kinematic patterns leading to an increase in AHD and IRROM, therefore a decrease in pain.

Causal mechanisms of a scapular stabilization intervention for patients with subacromial pain syndrome: a secondary analysis of a randomized controlled trial

BackgroundCausal mediation analysis is one way to bridge this gap by exploring the causal pathways of a given intervention. The aim of this study was to assess whether scapular motion, position, and periscapular muscle strength are mediators for pain and shoulder disability outcomes following a scapular stabilization intervention for patients with subacromial pain syndrome.MethodsSixty patients were randomized into two groups: scapular stabilization or periscapular strengthening exercises. The intervention consisted of three sessions per week for 8 weeks. The primary outcome measures were pain and disability and the following outcome measures were considered as potential mediators: scapular motion, scapular position, periscapular muscle strength, age, duration of symptoms, and side of the complaint. A model-based inference approach with bootstrap simulations was used to estimate the average causal mediation effect, average direct effect, and the average total effect from the data of a randomized clinical trial that evaluated the effect of adding scapular stabilization exercises to a scapulothoracic strengthening program in people with subacromial pain syndrome.ResultsThe results demonstrated that none of the putative mediators were influenced by the intervention. However, muscle strength of serratus anterior, upper, middle, and lower trapezius muscles was associated with shoulder disability.ConclusionScapular kinematic and periscapular muscle strength did not mediate the effect of scapular stabilization exercises on shoulder pain or disability scores in subjects with subacromial pain syndrome. Muscle strength of serratus anterior, upper, middle and lower trapezius were associated with shoulder disability scores at 8-weeks follow-up.

ScapuloThoracic Arthrodesis for Facio-Scapulo-Humeral Dystrophy: Outcomes at mean 7.3 years [3.5–13] follow-up. CT measurement of the fixation position of the arthrodesis and radioclinical correlations

IntroductionScapulothoracic arthrodesis may be proposed to patients having facio-scapulohumeral dystrophy to achieve gains in shoulder motion and pain relief. This study aimed to assess shoulder motion, pain and functional scores at last follow-up and to present a method of computed tomography measurements of the position of the scapulothoracic arthrodesis and study their correlations with shoulder motion. Patients and methodsSeven patients (11 arthrodesis) were included. Shoulder motion, pain, respiratory function and deltoid strength were compared with preoperative values and Constant, Brooke and Vignos scores were assessed at last follow-up. The elevation/depression and upward/downward position of the scapula were measured by performing postoperative 3D CT reconstruction. The protraction/retraction position was measured with 2D CT reconstructions on axial view. Correlations between these measurements and shoulder flexion and abduction were analysed. All complications were searched. ResultsWe found a significant improvement in mean VAS (from 3±2 to 1±1, p=0,008) shoulder flexion (64°± 11 to 113°±20, p=0,003) and abduction (from 63°±9 to 92°±13°, p=0,004). Postoperative external rotation wasn’t significantly different (from 49°±19 to 43°±10, p=0,112) and on internal rotation, the hand reached on average the 9th thoracic vertebra (S1-T2). Scapulothoracic arthrodesis was mainly positioned in regard to the 1st and the 6th rib. The mean protraction/retraction position was 38,5°±8° and the mean scapular upward/downward rotation position was 92°±15°. No correlations were found between the scapular position and shoulder flexion and abduction. ConclusionsScapulothoracic arthrodesis for facioscapulohumeral dystrophy improved pain, shoulder flexion and abduction and provided good functional outcomes at 3,5 to 13 years of follow up. A method of CT assessment of the position of the arthrodesis is presented to analyse precisely the position of the scapula but no correlations with shoulder motions were found. Preoperative evaluation of deltoid function and scapular winging seemed to be the most important predictors of shoulder motions gains after this procedure. Level of evidenceIII, Retrospective cohort study.

Rehabilitation for atraumatic shoulder instability in circus arts performers: delivery via telehealth.

The Watson Instability Program (WIP1) is current best evidence for conservative management of atraumatic shoulder instability, but it is unknown if this program can be effectively delivered via tele-consultation. The purpose of this longitudinal pre-post intervention study was to determine the effects of the WIP1 on patient-reported outcome measures, scapular position, shoulder strength, and handstand stability in student circus performers with atraumatic shoulder instability when delivered via tele-consultation. Student circus performers aged between 15 and 35 years from the National Institute of Circus Arts were recruited. A 12-week shoulder exercise program was delivered via tele-consultation during the Melbourne, Australia COVID-19 (coronavirus disease 2019) lockdown. The primary outcome measures were the Western Ontario Shoulder Instability Index score and the Melbourne Instability Shoulder Scale score. Secondary outcomes measures included the Orebro Musculoskeletal Pain Questionnaire, the Tampa Scale for Kinesiophobia, and physical assessment measures including strength via handheld dynamometry, scapular position using an inclinometer, and handstand stability via center-of-pressure fluctuation. Patient-reported outcomes were collected at baseline and 6-week, 12-week, 6-month, and 9-month time points, and physical outcomes were measured at baseline and 9-month time points. A repeated-measures mixed model (with effect sizes [ESs] and 95% confidence intervals [CIs]) was used to analyze patient-reported outcomes, handstand data, strength, and scapular measures. Significance was set at P < .05. Twenty-three student circus arts performers completed the study. Significant improvements were found in both Western Ontario Shoulder Instability Index scores (effect size [ES], 0.79 [95% CI, 0.31-1.33] at 6 weeks; ES, 1.08 [95% CI, 0.55-1.6] at 12 weeks; ES, 1.17 [95% CI, 0.62-1.78] at 6 months; and ES, 1.31 [95% CI, 0.74-1.95] at 9 months; P < .001) and Melbourne Instability Shoulder Scale scores (ES, 0.70 [95% CI, 0.22-1.22] at 6 weeks; ES, 0.83 [95% CI, 0.34-1.37] at 3 months; ES, 0.98 [95% CI, 0.46-1.54] at 6 months; and ES, 0.98 [95% CI, 0.43-1.50] at 9 months; P < .001), as well as Orebro Musculoskeletal Pain Questionnaire scores at all follow-up time points. The Tampa Scale for Kinesiophobia scores reached significance at 6 weeks and 12 weeks. Following rehabilitation, we found statistically significant increases in shoulder strength in all positions tested and increased scapular upward rotation measured at end-of-range abduction, as well as during loaded external rotation. The affected arm showed greater instability than the unaffected arm with a significant intervention effect on the affected arm showing a greater consistent anterior-posterior movement pattern. In a group of circus performers with atraumatic shoulder instability, treatment with the WIP1 via telehealth resulted in clinically and statistically significant improvements in shoulder symptoms and function.

Effect of Scapular Movement Impairment on Functional Stability of Shoulder Girdle and Scapulohumeral Rhythm in Elite male Volleyball Players

Background and Aims The shoulder girdle is at higher risk of injury in overhead sports like volleyball. Repeated movements with high speed and power can cause changes in scapular position and lead to shoulder girdle dysfunction. This study aims to assess the effect of scapular movement impairment on functional stability of the shoulder girdle and the scapulohumeral rhythm in elite male volleyball players Methods In this descriptive-comparative study, 80 male volleyball players aged 18-35 years including 40 with scapular downward rotation syndrome (SDRS) (age=22±2.8 years, weight=82.50±1.3 kg, and height=193±3.2 cm) and 40 with scapular abduction syndrome (SAS) (age=24±2.1 years, weight=81.40±1.3 kg, and height=192±2.9 cm) participated who were selected purposefully. They underwent the scapular dyskinesis test and Kibler’s shoulder lateral slip test. The scapulohumeral rhythm was measured at four positions (0, 45°, 90°, and 135°) using two inclinometers. The Y-balance test-upper quarter (YBT-UQ), seated medicine ball throw test (SMBT), and closed kinetic chain upper extremity stability test (CKCUEST) were used to measure the functional stability of the upper extremity. Shapiro-Wilk test was used for examining the normality of data distribution, independent t-test was used to compare the differences between groups. Results There was a significant difference in the scapulohumeral rhythm at 45° (P=0.001), 90° (P=0.001), and 135° (P=0.001) between the two groups (Mean difference= 18.27, 21.27, and 27.87, respectively), where the SDRS group had lower scapular upward rotation than the SAS group. The results of YBT-UQ showed that the superior-lateral reach (P=0.001) and composite (P=0.001) scores of the dominant hand were significantly different between the two groups (Mean difference = 9.37 and 10.41, respectively), where the SDRS group had lower scores than the SAS group. No significant difference was found in the medial (P= 0.223) and inferior-lateral (P= 0.111) reach scores. Moreover, the results showed no significant difference between the groups in the SMBT (P=0.124) and CKCUEST (P=0.875) scores. Conclusion The occurrence of scapular movement impairment affects the YBT-UQ score and leads to scapulohumeral rhythm disturbance in volleyball players. Even if the activity is stopped, the ideal and optimal alignment will not be created unless efforts are made to improve the movement pattern.

Relationship between scapular control during isometric shoulder flexion and scapular motion during baseball pitching: a cross-sectional study

BackgroundA baseball pitcher with decreased scapular control may not be able to achieve suitable scapular motion at maximum shoulder external rotation (MER) of baseball pitching during the pitching action. It is common clinically to compare scapular control of the throwing and non-throwing arms to detect side-to-side differences. However, it remains unclear whether scapular control is different between the throwing and non-throwing arms. Moreover, no data exist on the relationship between scapular control and scapular motion at MER of pitching. Primarily, this study aimed to compare scapular control during isometric shoulder flexion between the throwing and non-throwing arms. Secondly, this study aimed to investigate the relationship between scapular control during isometric shoulder flexion and scapular motion at MER of pitching.MethodsFifteen healthy collegiate baseball pitchers (age, 20.2 ± 1.9 years; height, 1.76 ± 0.05 m; body mass, 73.3 ± 6.7 kg) were recruited. An optical motion tracking system was used to assess scapular motion. Scapular control was defined as the amount of change in the scapular internal rotation angle, downward rotation angle, and anterior tilt angle during isometric shoulder flexion. We assessed scapular position at MER of pitching.ResultsNo significant differences were detected for any of the scapular angles during isometric shoulder flexion between the throwing and non-throwing arms. The amount of change in the scapular internal rotation angle, scapular downward rotation angle, and scapular anterior tilt angle during isometric shoulder flexion had a significant relationship with the scapular downward rotation angle at MER.ConclusionsNo side-to-side difference was noted in scapular control during isometric shoulder flexion in healthy collegiate baseball pitchers at the group level. Further studies are required to understand the side-to-side differences at the individual level. Additionally, there was a relationship between scapular control during isometric shoulder flexion and scapular position at MER. These findings suggest that clinicians may consider using isometric shoulder flexion to assess scapular control in baseball pitchers.

Assessing the Effects of Scapular Positioning on the Morphology of the Median Nerve During Upper Limb Tension Test 1 (ULTT1)

Objective: The upper limb tension test 1 (ULTT1) is commonly used by physical therapists for patients with complaints of radiating symptoms in their upper extremity following the path of the median nerve. Clinicians typically perform similar testing positions for patients, except for scapular position, which may vary between scapular blocking and scapular depression. This may alter the test results based on this positioning. The purpose of this study was to determine if there is a significant difference in median nerve morphology during the ULTT1 between resting and two scapular testing positions. Materials and Methods: Thirty healthy participants, 18 to 65 years of age, were tested using the ULTT1 in both blocked and depressed scapular positions. The height and width of the median nerve were measured by diagnostic sonography. Paired t tests were utilized to compare baseline, blocked, and depressed scapular positions with the ULTT1. Results: No statistically significant difference in height or width was found between resting, blocked, or depressed scapular positioning. Conclusion: There were inconclusive results regarding the morphology of the median nerve in this study. Key Takeaways Inconclusive results on nerve morphology comparing two scapular positions during the ULTT1. Research may be conducted on symptomatic patients to assist with more reliable test findings related to ULTT1.

Overhead Shoulder Position Versus Scapular Retraction Position to Normalize the Electromyographic Signal of the Lower Trapezius Muscle.

This study aimed to compare electromyographic response of the lower trapezius muscle during maximal voluntary isometric contractions under two conditions: overhead shoulder position versus scapular position, rating the pain after each condition. Twenty-six participants with shoulder pain (SP; n = 15; Shoulder Pain and Disability Index-Pain = 34 [range 6-66]) and without shoulder pain (nSP; n = 11; Shoulder Pain and Disability Index-Pain = 0 [range 0-14]) performed maximal voluntary isometric contractions in those 2 conditions while the lower trapezius was monitored using surface electromyography. Pain was rated using the visual analog scale. The nSP group experienced no pain, whereas the SP group reported pain in both conditions with higher pain during the overhead movement. No differences were observed for muscle excitation between conditions, but higher levels were observed for the nSP group compared with the SP group. The overhead condition was more painful for the SP group (visual analog scale: SP = 4 vs nSP = 1.09, P = .036). Scapular position showed the same levels of LT excitation than overhead position. The scapular position is preferable, compared with overhead positioning, to normalize the lower trapezius instead of overhead positioning.

Effects of Thoracic Spine Mobility Exercise on Symptom Improvement and Scapular Position in Patient with Subacromial Impingement Syndrome

Effects of Thoracic Spine Mobility Exercise on Symptom Improvement and Scapular Position in Patient with Subacromial Impingement Syndrome

Effect of Smart Phone Usage Time on Scapular Position and Respiratory Function: A Cross-sectional Study

Introduction: In recent times, the number of smartphone users has increased all over the world. The prolonged use of smartphone also shown increase in the musculoskeletal problems among the smartphone users. Smartphone usage become exceptionally desired by most of undergraduate students. Several studies are performed to asses the effect of smartphone usage among students. It has been suggested by many studies that the duration of smartphone usage is the better indicator of the addiction than the frequency of use. Aim: To study effect of smart phone addiction on respiratory function and position of scapula among undergraduate students. Materials and Methods: This cross-sectional study was conducted at School of Physiotherapy, Delhi Pharmaceutical Sciences and Research University, Delhi, India, from February 2020 to July 2020 on 110 undergraduate students of Delhi and National Capital Region (NCR). Smart phone usage duration along with scapula position and respiratory function was studied. Respiratory function testing was done by using Pulmonary Function Tests (PFT) Machine by RMS, Helios-401 Model. Scapula protraction was assessed by using keibers method of scapula assessment. Data was further analysed using t-test and analysis of variance to find out variation among study population. Results: The mean age of study population was 22±3.35 years and majority of study population fall under healthy group as per body mass index. There was no statistically significant change in the scapular position at rest (p-value= 0.334), at 45° abduction (p-value=0.840) and at 90° abduction (p-value=0.595) of addicted subjects. There was no significance (p-value=0.083) change in Forced Expiratory Flow (FEF) 25-75%, also other parameters p-value do not show any statistical significance difference between the smart phone users less than 4 years, 4-6 years, 6-8 years, more than 8 years. Conclusion: No significant changes observed in pulmonary function tests and altered scapula positioning among the smart phone addicted users.

Flexibility, Position, and Strength of the Shoulder Complex in Pediatric and Adult Amateur Tennis Athletes.

Understanding the musculoskeletal adaptations in the shoulder complex of varying ages of tennis athletes may suggest preventive protocols and conditioning and rehabilitation programs to this population. This study aimed to generate a bilateral descriptive profile of shoulder flexibility, scapular and clavicular position, and muscle strength in pediatric and adult amateur tennis athletes. The outcome measures were compared between groups and sides. The number and percentage of athletes "at risk" according to cutoff values for shoulder range of motion (ROM) were also analyzed. Cross-sectional study. 36 pediatric and 28 adult amateur tennis athletes were tested. Outcome measures were ROM of shoulder flexion, abduction, internal and external rotation, posterior capsule tightness, pectoralis minor index (PMI), scapular upward rotation, clavicular elevation, and strength of the external rotators, serratus anterior, and lower trapezius of the dominant/nondominant sides. Pediatric athletes had greater dominant side external rotation (P = .01) and total ROM (P = .04), increased Low Flexion test (P = .01), and decreased PMI (P = .01) compared with the adults. Bilaterally, the pediatric athletes had greater dominant side external rotation ROM (P < .01) and decreased PMI (P = .002) as compared with their nondominant side, whereas the adults displayed lower values on posterior capsule tightness (P = .01) and decreased PMI (P = .02) on their dominant side compared with their nondominant side. For the remaining outcomes, no interaction effects were observed. The cutoff values for shoulder ROM showed that several athletes were "at risk" of shoulder problems. Upper extremity adaptations at the shoulder are present in both pediatric and adult tennis athletes. These data can assist clinicians in better understanding the biomechanical adaptations in the shoulder of amateur tennis athletes in different age groups.

Sprengel’s deformity of the shoulder: A Case report

Congenital elevation of the scapula i.e. ‘Sprengel’s shoulder’ is a congenital anomaly of the shoulder girdle that is associated with abnormal descent, and malrotation of the scapula.Conventional anteroposterior radiography of the chest including both shoulders along with CT or MRI is required for diagnosis and proper management. Most common therapeutic choice is surgical intervention for cosmetic and functional recovery of the shoulder. Surgical procedure: With the patient in prone position, in general anaesthesia, Skin incision was given paraspinal area, along superior-medial angle and medial border of the left scapula. After detaching supraspinatus muscle from the scapula along with its periosteum, omovertebral bar was excised, leaving remnant at the connection from the spinous process of c3 vertebra. Then muscles were reattached to the scapula in corrected position. Result: As follow-up after 6 weeks, the patient’s active range of motions improved. Forward flexion was improved from 60° pre-operatively to 120° at six months follow-ups. Similarly abduction improved from 60° to 130°, internal rotation from 15° to 20° and external rotation 0° to 30°. Neurovascular evaluation was within normal limits. X-rays confirmed the position of scapula about 3 cm lower than the pre-operative position which is less than 1 cm higher as compare to right scapula.

Interrater Reliability of a Novel Goniometric Technique to Measure Scapular Protraction and Retraction.

Scapular protraction and retraction are often essential for occupational performance; however, clinical assessment of these movements is uniquely challenging. To analyze the interrater reliability of a novel goniometric method to measure scapular protraction and retraction. An observational, descriptive design was implemented to evaluate interrater reliability between two experienced occupational therapists who were also certified hand therapists. Academic institution. Convenience sample of graduate students (N = 80). Outcomes and Measures: The hypothesis, developed before study implementation, was that the technique would demonstrate clinically acceptable interrater reliability, defined as a standard error of measurement (SEM) <8°. Goniometric measurements of the scapula at rest, in maximal protraction, and in maximal retraction were independently obtained from each participant by each evaluator. The goniometer was aligned on the scapula using the superior angle as the axis of motion to measure the movement of the acromion relative to the frontal plane. The SEM was calculated in each position using the intraclass correlation coefficient values and the average of the standard deviations from the two raters. The SEM values between the two evaluators for the resting, protracted, and retracted positions were 3.46°, 2.93°, and 2.74°, respectively. The SEM between the two evaluators for each scapular position was <4°, suggesting that the technique may be clinically reliable. However, additional research regarding the reliability and validity of the technique is recommended. What This Article Adds: The findings of this study support the use of goniometry to measure scapular protraction and retraction in relation to occupational performance. The technique provides a way to quantify baseline scapular mobility and track progress.

The Effectiveness of Selective Lower Trapezius Strengthening Exercises on Pain, Muscle Function, and Scapular Position in Patients with Rounded Shoulder and Chronic Neck Pain

The Effectiveness of Selective Lower Trapezius Strengthening Exercises on Pain, Muscle Function, and Scapular Position in Patients with Rounded Shoulder and Chronic Neck Pain

Does the Application of a Lycra Arm Sleeve Change Shoulder Biomechanics in People With Stroke?—A Preliminary Study

ABSTRACT Introduction Glenohumeral subluxation (GHS) is reported in up to 81% of patients with stroke. Our previous studies found that a Lycra sleeve can reduce acromion-greater tuberosity (AGT) distance (used for assessment of GHS) in people with chronic stroke (n = 5). In a recent study on able-bodied people (n = 31), we report reduction in AGT, change in scapula measurements, and change in muscle activity after the application of Lycra sleeve. The aim of this study was to investigate the effect of Lycra sleeves on the AGT distance, muscle activity around the shoulder region, and scapular position in people with stroke. Method People with stroke who gave informed consent were recruited. Measurements were taken before and immediately after application of the sleeve. Portable diagnostic ultrasound, electromyography, and a tape measure were used to measure AGT distance, muscle activity (biceps, triceps, deltoid, and supraspinatus), and position of the scapula, respectively. Results Six participants with a mean age of 53 ± 8 years were recruited. There was a mean reduction of 0.13 cm (95% confidence interval, −0.01 to 0.28 cm) in AGT distance measurements but this was not statistically significant (t = 3.503, df = 5, P = .062). The inferior scapula measurements showed a mean reduction of 1 cm (95% confidence interval, 0.07-1.92 cm) and this was statistically significant (t = 2.781; df = 5, P = .039) when compared without and with sleeve application. Conclusions The application of Lycra arm sleeves did not significantly reduce the AGT distance but altered scapula mechanics by putting it in a mechanically advantaged position in a small sample of people with chronic stroke. A properly designed definitive trial would be required to confirm the effectiveness of the Lycra sleeve in reducing GHS in people with both acute and chronic stroke. Clinical Relevance Lycra sleeve may have potential to alter biomechanics and influence neuromuscular activity in the arm.

Serratus Anterior Fatigue Reduces Scapular Posterior Tilt and External Rotation During Arm Elevation.

Fatigue of the scapular stabilizing muscles resulting from repeated arm motion has been reported to alter scapular kinematics, which could result in shoulder pathology, especially impingement. This study aimed to examine the effects of fatigue of the serratus anterior muscle on scapular kinematics, specifically, decrease scapular posterior tilt and upward scapular rotation during arm elevation. Repeated measures. Laboratory. Thirty participants were included in the investigation. Scapular kinematics and shoulder strength were measured before and immediately following a serratus anterior fatigue protocol. Scapular 3-dimensional position during arm elevation. No difference in upward rotation of the scapula between prefatigue and postfatigue conditions (ascending: P = .188; descending: P = .798). Scapular posterior tilt decreased during arm elevation following the fatigue protocol between 60° and 90° and 90° and 120° of arm elevation during the ascent (P = .004) and the descent (P = .013). Fatigue by arm elevation angle interaction was found for clavicular elevation during the ascent (P = .050) between 90° and 120° of arm elevation. Scapular internal rotation increased during the ascent (P = .027). There was no difference in clavicular protraction between the prefatigue and postfatigue conditions (ascending: P ≤ .001; descending: P ≤ .001). Fatigue of the serratus anterior decreases posterior scapular tilt and greater clavicular elevation and scapular internal rotation at higher arm elevation angles. These findings are consistent with the scapular kinematic patterns associated with shoulder pain. Improving serratus anterior endurance might delay the changes in scapular kinematics associated with repeated arm motion and shoulder injury mechanisms.

Investigation of factors related to scapula position in young women with neck pain: A control group study

Investigation of factors related to scapula position in young women with neck pain: A control group study