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See 1 citation in Arch Phys Med Rehabil 2015:

Arch Phys Med Rehabil. 2015 Feb;96(2):298-306. doi: 10.1016/j.apmr.2014.09.029. Epub 2014 Oct 15.

Visual scapular dyskinesis: kinematics and muscle activity alterations in patients with subacromial impingement syndrome.

Author information

1
Translational Medicine Program, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, SP, Brazil; Research Support, Center for Clinical Outcomes Studies, A.T. Still University, Mesa, AZ; Department of Physical Therapy, Clinical Biomechanics, Orthopedic and Sports Outcomes Research Laboratory, Virginia Commonwealth University, Richmond, VA. Electronic address: alopes@atsu.edu.
2
School of Kinesiology, Marshall University, Huntington, WV.
3
Department of Physical Therapy, Clinical Biomechanics, Orthopedic and Sports Outcomes Research Laboratory, Virginia Commonwealth University, Richmond, VA.
4
Translational Medicine Program, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, SP, Brazil.
5
Department of Physical Therapy, Clinical Biomechanics, Orthopedic and Sports Outcomes Research Laboratory, Virginia Commonwealth University, Richmond, VA; Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA. Electronic address: lmichene@usc.edu.

Abstract

OBJECTIVE:

To characterize scapular kinematics and shoulder muscle activity in patients with subacromial impingement syndrome, with and without visually identified scapular dyskinesis.

DESIGN:

Cross-sectional study.

SETTING:

Laboratory.

PARTICIPANTS:

Participants with subacromial impingement syndrome (N=38) were visually classified using a scapular dyskinesis test with obvious scapular dyskinesis (n=19) or normal scapular motion (n=19).

INTERVENTIONS:

Not applicable.

MAIN OUTCOME MEASURES:

An electromagnetic motion capture system measured 3-dimensional kinematics of the thorax, humerus, and scapula. Simultaneously, surface electromyography was used to measure muscle activity of the upper, middle, and lower trapezius; serratus anterior; and infraspinatus during ascending and descending phases of weighted shoulder flexion. Separate mixed-model analyses of variance for the ascending and descending phases of shoulder flexion compared kinematics and muscle activity between the 2 groups. Shoulder disability was assessed with the Pennsylvania Shoulder Score (Penn).

RESULTS:

The group with obvious dyskinesis reported 6 points lower on Penn shoulder function (0-60 points), exhibited a main group effect of less scapular external rotation of 2.1° during ascent and 2.5° during descent, and had 12.0% higher upper trapezius muscle activity during ascent in the 30° to 60° interval.

CONCLUSIONS:

Patients with obvious dyskinesis and subacromial impingement syndrome have reduced scapular external rotation and increased upper trapezius muscle activity, along with a greater loss of shoulder function compared with those without dyskinesis. These biomechanical alterations can lead to or be caused by scapular dyskinesis. Future studies should determine if correction of these deficits will eliminate scapular dyskinesis and improve patient-rated shoulder use.

KEYWORDS:

Electromyography; Rehabilitation; Scapula; Shoulder impingement syndrome

PMID:
25449194
DOI:
10.1016/j.apmr.2014.09.029
[Indexed for MEDLINE]

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