Scapular Distance Research Articles

Shoulder Kinesio Taping Does Not Change Biomechanical Deficits Associated With Scapular Dyskinesis.

Observable scapular dyskinesis is associated with biomechanical deficits. Preventative interventions aimed at correcting these deficits may aid in preventing the development and resolution of shoulder pain. Our purpose was to investigate the effects of kinesio taping (KT) on common biomechanical deficits associated with scapular dyskinesis and shoulder pain. Participants (n = 51) with observable scapular dyskinesis, and without shoulder pain were randomized to KT, KT-placebo, or a no-treatment control group. Measurements taken before, immediately after taping, and 3days later included pectoralis minor muscle length, lower trapezius muscle strength, scapular upward rotation angle at 0° to 120° in scapular plane humeral elevation and acromiohumeral distance. There were no changes in scapular upward rotation, lower trapezius strength, and acromiohumeral distance immediately after taping or 3days later compared to baseline (P > .05). The pectoralis minor increased in length in the KT group on day 3 compared to directly after taping (P = .03), but no difference between groups or interaction between time and group were determined (P > .05). Scapular dyskinesis prevalence did not change over time in any group (P > .05). In people with scapular dyskinesis free from shoulder pain, KT applied to the shoulder cannot be recommended to ameliorate the biomechanical deficits associated with shoulder pain.

Comparison of scapular alignment in auto rickshaw drivers with and without neck pain: A pilot study

Background: Auto rickshaws form 10-20% of daily motorized urban transport and ensure connectivity and easy access throughout congested Indian cities. Mostly used body parts in driving areas are the neck and shoulders. The musculature attaching the shoulder girdle to the axial skeleton is primarily responsible for scapular orientation. The overuse and improper support of muscles in this region is caused due to poor posture resulting in pain between the shoulder blade and neck; also discomfort between Scapula. Increased muscle activation of the neck- shoulder stabilizers result in higher levels of cervical spine loading; which results in neck pain. This study aimed to examine scapular alignment in auto rickshaw drivers with and without neck pain. Objective: To determine the difference in scapular alignment in auto rickshaw drivers with and without neck pain. Methodology: This observational study was conducted in 20 auto rickshaw drivers within the age group of 20-50 years and were divided into two groups. Group A included subjects with neck pain and Group B without neck pain on basis of the Numerical Pain Rating Scale. Scapular distance was measured using Lateral Scapular Slide Test (LSST) in 3 positions viz. at rest, with hands on hip and 900 of shoulder abduction and were compared using the independent t-test. Results and Conclusion: Statistically significant difference of scapular alignment in auto rickshaw drivers with neck pain was noted (p< 0.05). Hence, it was concluded that scapular alignment is altered in auto rickshaw drivers with neck pain as compared to those with no neck pain.

Standard reference values of the upper body posture in healthy male adults aged between 31 and 40 years in Germany-an observational study

BackgroundIn order to classify and analyze the parameters of upper body posture, a baseline in the form of standard values is demanded. To this date, standard values have only been published for healthy men aged 18–35 and 41–50 years. Data for male adults aged between 31 and 40 years are lacking.MethodsThe postural parameters of 101 symptom-free male volunteers aged 31–40 (35.58 ± 2.88) years were studied. The mean height of the men was 179.89 ± 7.38 cm, with a mean body weight of 86.36 ± 11.58 kg and an average BMI of 26.70 ± 3.35 kg/m2. By means of video rasterstereography, a 3-dimensional scan of the upper back surface was measured in a habitual standing position. The means or medians, confidence interval, tolerance range, and group comparisons and correlations of BMI and physical activity were calculated for all parameters.ResultsThe habitual standing position was found to be almost symmetrical and the axis aligned in the spine, pelvis, and shoulder region, while the spine position was marginally inclined ventrally. The kyphosis angle of the thoracic spine was greater than the lordosis angle of the lumbar spine. All deviations fell under the measurement error margin of 1 mm/1°. The greater the BMI, the greater was the pelvic and scapular distance. The lower the BMI, the further caudally positioned was the right shoulder. The pelvic and scapular distances were also lower with the increasing athleticism of the participants.ConclusionThe upper body posture of men between the ages of 31 and 40 years was found to be almost symmetrical and axis-conforming, with the kyphosis angle, pelvic distance, and shoulder distance enlarging with increasing BMI. Consequently, postural parameters presented in this survey allow for comparisons with other studies, as well as the evaluation of clinical diagnostics and applications.

Systematic changes of the static upper body posture with a symmetric occlusion condition

BackgroundTemporary occlusal changes and their influence on the upper body statics are still controversially discussed. Furthermore, concrete statements on whether age- or gender-specific differences in neurophysiological reactions exist are missing. Therefore, it is the aim of this study to evaluate the immediate effects of a symmetrical occlusion blocking on the upper body posture. These effects shall be investigated for both genders and for a larger age range.MethodsIn this study, 800 (407f/393 m) subjects volunteered aged from 21 to 60 years. Both genders were divided into four age groups according to decades. The three-dimensional upper body posture was measured by using the rasterstereography (ABW-Bodymapper). The habitual static posture was measured in two dental occlusion conditions (a) in rest position and (b) symmetrical blocking in the bicuspid region by cotton rolls.ResultsA significant reduction of the trunk length (0.72 mm; p < 0.001), an increase of the lumbar (0.30°; p < 0.001) and the thoracic bending angle (0.14°; p = 0.001), a reduction of the spinal forward decline (0.16°; p < 0.001) and a reduction of the scapular distance (0.36 mm; p = 0.001) was found. Gender-specific reactions can only be recorded in scapular distance, in that regard men reduce this distance while over all age groups women did not show a significant change.DiscussionSlight gender- and age-independent reactions due to a symmetric occlusion blockade are shown: A gender independent reaction of the spinal related variables in the sagittal plane (thoracic and lumbar flexion angle, trunk length, spinal forward decline). In addition, a gender specific change of the shoulder blade distance could be observed, where men reduced the distance while female did not show a change. However, since these reactions are of a minimum amount, it can be concluded that neurophysiological compensation mechanisms work equally well regardless of age and sex, and the upper body posture of healthy people changes only very slightly due to a temporarily symmetrical altered bite position.

Comparison of Scapular Muscles Activation with Shoulder Retraction and Shoulder Elevations in Individuals with Scapular Dyskinesia

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;&lt;br /&gt; Scapular dyskinesis is a condition that is commonly associated with shoulder pathology but is also present in asymptomatic individuals, and it is believed to be a risk factor for further injury. Evidence suggests that patients with rotator cuff–related shoulder pain present scapular kinematic abnormalities such as decreased scapular upward rotation, decreased scapular posterior tipping, and external rotation. It has been proposed that abnormal scapular kinematics may be linked to weakness of scapular muscle. &lt;br /&gt; Muscle Activation is a very specific, non-medical, mechanically based process of evaluating and treating muscular imbalance and dysfunction. Its main goal is to increase the contractile capability of your muscles, resulting in increased strength, stability, range of motion, and reduced muscle and joint pain. &lt;br /&gt; The study was conducted to determine whether shoulder elevations and retractions showed any difference in the interscapular distance in indivudals with scapular dyskinesia.&lt;br /&gt;&lt;strong&gt;Objectives:&lt;/strong&gt;&lt;/p&gt; &lt;ol&gt; &lt;li&gt;To assess Interscapular distance post shoulder retraction exercise.&lt;/li&gt; &lt;li&gt;To assess Interscapular distance post shoulder shrugging exercise.&lt;/li&gt; &lt;li&gt;To assess Interscapular distance post shoulder retraction + shrugging exercise.&lt;/li&gt; &lt;li&gt;To compare the effectiveness of these exercises on scapular dyskinesia.&lt;/li&gt; &lt;/ol&gt; &lt;p&gt;&lt;strong&gt;Materials and Methodology:&lt;/strong&gt;&lt;br /&gt; An intervention based study comprising of 30 female individuals. The subjects were randomly divided into 3 groups, Group A was given combined exercises of shoulder retraction and elevations. Group B was given shoulder retraction and Group C was given shoulder elevations.The samples were assessed pre and post with the help of Interscapular distance.&lt;br /&gt;&lt;strong&gt;Results:&lt;/strong&gt;&lt;br /&gt; Shoulder retractions when given along with shoulder elevations was clinically significant pre and post . Likewise, Shoulder retractions and elevations when given separately were also clinically significant pre and post. The comparison of all the three groups showed that all were equally effective in treating scapular dyskinesia. &lt;br /&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt;&lt;br /&gt; The study concludes that all three forms of exercise showed similar results in reducing the Inter scapular distance in individuals with scapular dyskinesia.&lt;/p&gt;

Influence of ergonomic layout of musician chairs on posture and seat pressure in musicians of different playing levels.

IntroductionMusicians often perform in forced postures over a long period of time, which in the worst case may lead to playing-related musculoskeletal disorders. In this context, the ergonomics of the musician's chair (construction and surface quality) can be an influencing factor, with impact on the seating position of the upper body and the pressure distribution of the bottom. Therefore, the relationship between different musician chairs and musicians of different playing levels (professional, amateur or student) was analyzed in order to gain useful insights whether playing experience, playing level, playing style (symmetrical or asymmetrical) or gender have an impact.MethodThe total dataset of 47 musicians (3 playing levels: professional, amateur, student) were analysed on six musician chairs with different ergonomic layout. Sitting on each chair without instrument (condition 1) and with instrument (condition 2), the upper body posture (videorasterstereography) and the seat pressure (load distribution) were recorded.as Also, a subjective assessment concerning constitutional data, sitting behaviour, prevailing pain in the musculoskeletal system, sport activity and chair comfort rating, was completed using a questionnaire.ResultsThere were significant differences shown in 6 of 17 variables, where all between and within factors were accounted for with a MANOVA. Two measurements of the upper body posture (scapular distance and scapular height) differentiated between playing level. Four of the pressure measurements (pressure under the sit bone and the thigh for the left and the right side) differentiated between chairs and the two conditions (with and without instrument). Chairs with soft cushioning had a mean pressure reduction of about 30%. The pressure was increased by about 10% while playing an instrument. Subjective rating was correlated to age for some of the chairs.DiscussionDifferences between chairs are mainly associated with the pressure distribution under the sitting surface. Playing with an instrument puts an additional force onto the surface of the chair that is more than the weight of the instrument. No relationship between pressure data and upper body posture data could be found. Therefore, it can be speculated that the intersubject variability is larger than systematic differences introduced by the chair or instrument.

Effect of glenohumeral stabilization exercises combined with scapular stabilization on shoulder function in patients with shoulder pain: A randomized controlled experimenter-blinded study.

Shoulder stabilization exercises consisted of a glenohumeral stabilization and scapular stabilization. No studies have been assessed the superiority of shoulder stabilization until now. To compare the effect of a glenohumeral stabilization exercise (GSE) combined with a scapular stabilization exercise (SSE) on changes in shoulder function in patients with shoulder painMETHODS: Shoulder stability, scapular alignment, pain, muscle power, and range of motion (ROM) were measured before and after the intervention in both groups. Forty subjects with shoulder pain were randomly assigned to an experimental or control group. GSE in the experimental group (n= 20) resulted in significantly better shoulder stability (P= 0.020, from 9.00 ± 6.90 score to 14.25 ± 8.58) and pain intensity (P= 0.042, 7.40 ± 2.44 score to 4.60 ± 2.06) compared to SSE in the controls (n= 20). However, no significant effects were observed for scapular symmetric alignment including the angles of inferior scapular distance (P= 0.555) and inferior scapular height difference (P= 0.770), muscle power including shoulder flexion (P= 0.942) and shoulder abduction (P= 0.551), or ROM including shoulder flexion (P= 0.852) and shoulder abduction (P= 0.622). This study suggests that GSE positively affects shoulder stability and pain control in patients with shoulder pain, probably through a centralization effect on the shoulder mechanism.

Comparison of Scapular Kinematics During Active Shoulder Horizontal Adduction Between Subjects With and Without Limited Range of Motion of Shoulder Horizontal Adduction

Background: Shoulder horizontal adduction (HA) is performed in many activities of daily living. The limited range of motion (LROM) of HA is affected by the tightness of the posterior deltoid, infraspinatus, teres major, and posterior capsule of glenohumeral joint. The LROM of shoulder HA contributes to excessive scapular abduction. Objects: The aim of this study is to compare the scapular abduction distance and three dimensional displacement of the scapula during shoulder horizontal adduction between subjects with and without the LROM of shoulder HA. Methods: 24 subjects (12 people in LROM group and 12 people in normal ROM group) participated. Subjects with less than 115° of HA ROM were included in LROM group. Shoulder HA was performed 3 times for measuring scapular abduction distance and three-dimensional displacement of the scapula. Tape measure was used for measuring scapular abduction distance. Scapular abduction distance was normalized by dividing the scapular size. Polhemus Liberty was used for measuring the three dimensional displacement of the scapula. Results: Normalized scapular abduction distance was significantly greater in LROM group than normal ROM group (p<.001). Three-dimensional displacement of the scapula during shoulder HA was greater in LROM group than normal ROM group (p<.05). Conclusion: LROM group had a greater scapular abduction and three-dimensional displacement of the scapula during shoulder HA compared to normal ROM group.

Scapulohumeral control after stroke: A preliminary study of the test-retest reliability and discriminative validity of a clinical scapular protocol (ClinScaP).

Clinical scapulohumeral tests are lacking post-stroke. To test reliability and discriminant validity of clinical scapulohumeral assessments post-stroke. Following tests were assessed in 57 individuals with stroke (IwS) (subdivided in a low, moderate, high proximal arm function (PAF) group) and 15 healthy controls: (1) Observation of tilting/winging; (2) shoulder girdle position tests (pectoralis minor index, acromial index, scapular distance test); (3) scapular lateral rotation measurement; (4) maximal humeral elevation and (5) medial rotation test were executed. 15 IwS were measured twice by the same assessor to determine test-retest reliability. Differences between controls and IwS and between IwS with different levels of PAF were assessed. ICCs were very high for all tests (>0.80), except the pectoralis minor index (0.66). Weighted Kappas were high for observation and the medial rotation test (>0.70). Group differences were found for observation, lateral rotation and humeral elevation. IwS compared to controls, and IwS with lower compared to higher PAF generally showed increased lateral rotation (p < .01); decreased maximal active humeral elevation (p < .001); and more often tilting and winging (p < .05). The use of these tests in clinical settings will allow for identification of altered scapular characteristics, which will enhance treatment planning for PAF post-stroke.

Effects of Scapular Stabilizing Exercise on Resting Scapular Position of Breast Cancer-related Lymphedema Patients

PURPOSE: The purpose of this study was to confirm the effect of exercise combined with scapular stabilizing on resting scapular position (RSP) in breast cancer-related lymphedema patients. METHODS: A total of 20 patients with lymphedema after mastectomy participated in the study. All assessments of the patients edema sides (ES) and non-edema sides (NES) were evaluated. The assessment tools used wad RSP. RSP are; 1) scapular index, 2) 8th thoracic spines process (T8S) to inferior angle of scapular (IA) distance, 3) standing pectoralis minor (PM) distance, and 4) PM index (PMI). All patients carried out a scapular stabilizing exercise seven times a week for 8 weeks. The collected data were analyzed with PASW 18.0. The statistical significance () was 0.05. RESULTS: According to the results, all the variable between the ES and NES for RSP were statistically significant (p

줄자 및 사진촬영 측정을 이용한 어깨뼈 벌림 측정에 대한 신뢰도 연구

The purpose of this study was to determine the reliability of distance measurements from the medial border of the scapula to the spinous process of the thoracic vertebrae when obtained using tape and photography measurements. The study included 20 healthy subjects (10 males, 10 females); for a total of 40 scapula measurements. The distance measurements made using tape or photography methods were conducted with the subject in a standing position. Repeated tape and photography measurements were conducted in two sessions on different days by two examiners to assess the inter-rater and intra-rater reliability of the two methods. The reliability of scapular distance measured using tape and photography methods was tested using intraclass correlation coefficients (ICC(3,1)) and the standard error of measurement (SEM). The inter-rater reliability of the tape measurement method was excellent (ICC=.77) and the intra-rater reliability was fair to good (ICC=.74). The inter-rater and intra-rater reliabilities of the photography measurement method were excellent (ICC=.76 and .76 respectively). Our results suggest that photography measurement is an objective and qualitative measurement tool for scapular distance measurements.

Effect of the spacing of backpack shoulder straps on cervical muscle activity, acromion and scapular position, and upper trapezius pain.

[Purpose] This study investigated the effect of the spacing of backpack shoulder straps on cervical muscle activity, acromion and scapular position, and upper trapezius (UT) pain. [Subjects] Fourteen males aged 20–32 years, were recruited. [Methods] We measured the MPS (midcervical paraspinal) activity, acromial angle, scapular distance, and UT pain after gait carrying a backpack with different shoulder strap spacings. [Results] The MPS, scapular inferior distance, and UT pressure pain threshold was significantly decreased and the acromion angle was significantly increased when carrying a backpack with wide shoulder straps compared to narrow shoulder straps. [Conclusion] A backpack with wide shoulder straps may cause scapular depression syndrome and chronic UT pain.

The effects of an exercise intervention on forward head and rounded shoulder postures in elite swimmers

ObjectivesTo examine the correction of posture, increase in strength and decrease in shoulder pain and dysfunction in varsity swimmers.Design and SettingRandomised clinical trial.ParticipantsTwenty-eight National Collegiate Athletic Association division I varsity...

The reliability measurements of lateral scapular slide test at three different degrees of shoulder joint abduction

BackgroundLateral scapular slide test (LSST) quantitatively measures the distance between thoracic spine (T7) and inferior angle of scapula.ObjectiveIn this study, the intra-rater reliability, inter-rater reliability and diagnostic accuracy of LSST...

The Relationship Between the Coracoid and Glenoid After Brachial Plexus Birth Palsy

The purpose of this study was to determine the changes in glenoid and coracoid anatomy after brachial plexus birth palsy. Fifty-seven children underwent bilateral shoulder magnetic resonance imaging. The uninvolved coracoid angle averaged 32.5 +/- 6.1 degrees (range 21.3-46.0) compared with 21.7 +/- 6.9 degrees (range 6.1-41.0) on the involved shoulder. The uninvolved coracoid physeal angle averaged 42.7 +/- 7.6 degrees (range 26.0-57.0) compared with 61.7 +/- 11.6 degrees (range 38.8-89.9) on the involved shoulder. The uninvolved glenoid physeal angle averaged 78.4 +/- 5.2 degrees (range 66.9-89.9) compared with 50.4 +/- 14.7 degrees (range 17.9-76.7) on the involved shoulder. The uninvolved interphyseal angle averaged 59.6 +/- 7.2 degrees (range 42.0-76.1) compared with 65.5 +/- 11.6 degrees (range 45.0-88.0) on the involved shoulder. The uninvolved coracoid scapular distance averaged 1.6 +/- 0.28 cm (range 1.0-2.5) compared with 1.2 +/- 0.37 cm (range 0.37-1.9) on the involved shoulder. These results highlight the contiguous relationship between the coracoid and glenoid physis during development and indicate that retroversion of both the glenoid and coracoid physis occurs after brachial plexus palsy.

Measurement of scapular asymetry and assessment of shoulder dysfunction using the Lateral Scapular Slide Test: a reliability and validity study.

The Lateral Scapular Slide Test (LSST) is used to determine scapular position with the arm abducted 0, 45, and 90 degrees in the coronal plane. Assessment of scapular position is based on the derived difference measurement of bilateral scapular distances. The purpose of this study was to assess the reliability of measurements obtained using the LSST and whether they could be used to identify people with and without shoulder impairments. Subjects. Forty-six subjects ranging in age from 18 to 65 years (X=30.0, SD=11.1) participated in this study. One group consisted of 20 subjects being treated for shoulder impairments, and one group consisted of 26 subjects without shoulder impairments. Two measurements in each test position were obtained bilaterally. From the bilateral measurements, we derived the difference measurement. Intraclass correlation coefficients (ICC [1,1]) and the standard error of measurement (SEM) were calculated for intrarater and interrater reliability of the difference in side-to-side measures of scapular distance. Sensitivity and specificity of the LSST for classifying subjects with and without shoulder impairments were also determined. The ICCs for intrarater reliability were .75, .77, and .80 and .52, .66, and .62, respectively, for subjects without and with shoulder impairments in 0, 45, and 90 degrees of abduction. The ICCs for interrater reliability were .67, .43, and .74 and .79, .45, and .57, respectively, for subjects without and with shoulder impairments in 0,45 and 90 degrees of abduction. The SEMs ranged from 0.57 to 0.86 cm for intrarater reliability and from 0.79 to 1.20 cm for interrater reliability. Using the criterion of greater than 1.0 cm difference, sensitivity and specificity were 35% and 48%, 41% and 54%, and 43% and 56%, respectively, for 0, 45, and 90 degrees of abduction. Sensitivity and specificity based on the criterion of greater than 1.5 cm difference were 28% and 53%, 50% and 58%, and 34% and 52%, respectively, for the 3 scapular positions. Our results suggest that measurements of scapular positioning based on the difference in side-to-side scapular distance measures are not reliable. Furthermore, the results suggest that sensitivity and specificity of the LSST measurements are poor and that the LSST should not be used to identify people with and without shoulder dysfunction.

Assessment of Scapular Position

Assessment of posture is an integral component of the evaluation of patients with neck and shoulder dysfunctions. Protraction of the scapulae has been postulated to produce weakness of the shoulder musculature. Therefore, an accurate method is needed to assess scapular position in order to determine the effect of therapeutic intervention and classify dysfunction. The purpose of this study was to determine if an experienced clinician would accurately determine scapular position. Fifty subjects (age = 26 ±5.7 years, weight = 69.2 ±14.09 kg; height = 173.9 ±13.91 cm) participated in this study. The results revealed the following reliability coefficients: scapular distance (SD) intraclass correlation coefficient (ICC) = .80, scapular size (SS) ICC = .96, and normalized scapular abduction (NSA) (SD/SS) ICC = .34. These data demonstrate that NSA was not reproducible in this study. The authors hypothesize that NSA contains more measurement error because NSA is a ratio value in which both the numerator and denominator contain measurement error. Further study is needed before NSA values are used to determine scapular position or correlated NSA is used to force development of shoulder musculature.