The effect of 8 weeks' scapular focused training on pain, proprioception, scapular kinematics and upper extremity performance in male volleyball players with shoulder impingement syndrome

Abstract Background and Purpose. Several factors such as posture, muscle force, range of motion, and scapular dysfunction are commonly believed to contribute to shoulder impingement. The purpose of this study was to compare 3-dimensional scapular kinematics, shoulder range of motion, shoulder muscle force, and posture in subjects with and without primary shoulder impingement syndrome. Subjects. Forty-five subjects with impingement syndrome were recruited and compared with 45 subjects without known pathology or impairments matched by age, sex, and hand dominance. Methods. Shoulder motion and thoracic spine posture were measured goniometrically, and force was measured with a dynamometer. An electromagnetic motion analysis system was used to capture shoulder kinematics during active elevation in both the sagittal and scapular planes as well as during external rotation with the arm at 90 degrees of elevation in the frontal plane. Results. The impingement group demonstrated slightly greater scapular upward rotation and clavicular elevation during flexion and slightly greater scapular posterior tilt and clavicular retraction during scapular-plane elevation compared with the control group. The impingement group demonstrated less range of motion and force in all directions compared with the control group. There were no differences in resting posture between the groups. Discussion and Conclusion. The kinematic differences found in subjects with impingement may represent scapulothoracic compensatory strategies for glenohumeral weakness or motion loss. The decreased range of motion and force found in subjects with impingement support rehabilitation approaches that focus on strengthening and restoring flexibility.

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Upper Quarter Y-Balance Test Score of Patients with Shoulder Impingement Syndrome

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967114s00275 ◽

2014 ◽

Vol 2 (11_suppl3) ◽

pp. 2325967114S0027 ◽

Cited By ~ 3

Author(s):

Zeynep Hazar ◽

Naime Ulug ◽

Inci Yuksel

Keyword(s):

Upper Extremity ◽

Spinous Process ◽

Impingement Syndrome ◽

Shoulder Impingement Syndrome ◽

Healthy Controls ◽

Kinetic Chain ◽

Balance Test ◽

Shoulder Impingement ◽

Significant Difference ◽

Closed Kinetic Chain

Objectives: The Upper Quarter Y Balance Test (UQYBT) is a reliable upper extremity closed kinetic chain test that can be used to assess unilateral upper extremity performance in a closed chain manner. However, UQYBT was tested only in recreational athletes and there are no studies investigating UQYBT scores in patients with various upper extremity musculoskeletal injuries. The purpose of this study was to examine differences in performance on the Upper Quarter Y Balance Test between patient with shoulder impingement syndrome and healthy controls. Methods: A sample of fifteen patients with shoulder impingement syndrome (mean age 32.2±4.2 years) and fifteen healthy control (mean age 33.8±6.2 years) performed the UQYBT. UQYBT was collected bilaterally in three directions (medial, inferolateral, and superolateral). The maximum reach distance for each direction was normalized to upper extremity length (spinous process of C7 to tip of middle finger) and used for analysis Results: A significant difference in performance between patients with shoulder impingement syndrome and healthy controls existed in the medial direction (P<0.05) and the inferolateral direction (P<0.05) where the healthy controls performed better. There was no significant difference in superolateral performance. Conclusion: The results of this study suggest that patients with shoulder impingement syndrome will perform worse on the UQYBT in the medial and inferolateral directions than healthy controls. Thus, upper extremity closed kinetic chain exercises should be added in shoulder rehabilitation programs.

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Shoulder Function and 3-Dimensional Kinematics in People With Shoulder Impingement Syndrome Before and After a 6-Week Exercise Program

Physical Therapy ◽

10.1093/ptj/84.9.832 ◽

2004 ◽

Vol 84 (9) ◽

pp. 832-848 ◽

Cited By ~ 179

Author(s):

Philip W McClure ◽

Jason Bialker ◽

Nancy Neff ◽

Gerald Williams ◽

Andrew Karduna

Keyword(s):

Functional Limitations ◽

Exercise Program ◽

Shoulder Function ◽

Rehabilitation Program ◽

Impingement Syndrome ◽

Shoulder Impingement Syndrome ◽

Shoulder Impingement ◽

3 Dimensional ◽

Scapular Kinematics ◽

And Function

Abstract Background and Purpose. Shoulder impingement syndrome is a common condition and is often managed with an exercise program. The purpose of this study was to examine an exercise program in patients with shoulder impingement syndrome. Specifically, the purpose was to identify changes that might occur in 3-dimensional scapular kinematics, physical impairments, and functional limitations. Subjects. Fifty-nine patients with impingement syndrome were recruited, and 39 patients successfully completed the 6-week rehabilitation program and follow-up testing. Impingement was defined as having at least 3 of 6 predefined clinical signs or symptoms. Methods. Subjects were assessed before and after a 6-week rehabilitation program and again at 6 months. Pain, satisfaction, and function were measured using the University of Pennsylvania Shoulder Scale. Range of motion, isometric muscle force, and 3-dimensional scapular kinematic data also were collected. Subjects were given a progressive exercise program that included resistive strengthening, stretching, and postural exercises that were done daily at home. Subjects also were given shoulder education related to anatomy, the basic mechanics of impingement, and strategies for reducing load on the shoulder. Each subject attended one physical therapy session per week for a 6-week period, primarily for monitoring and upgrading the exercise program. Pretest and posttest scores were compared using paired t tests and repeated-measures analysis of variance. Results. Passive range of motion increased for both external and internal rotation but not for elevation. Abduction external and internal rotation force all increased. There were no differences in scapular kinematics. Improvements were found for pain, satisfaction, and shoulder function and for Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) scores related to physical function. At 6-month follow-up, improvements made in pain, satisfaction, and function were maintained. Discussion and Conclusion. The use of this exercise protocol in the management of shoulder impingement syndrome may have a positive impact on patients' impairments and functional limitations. Our findings suggest a relatively simple exercise program combined with patient education may be effective and, therefore, merits study in a larger trial using a control group. Changes in scapular kinematics did not appear to be a primary mechanism underlying improvement in symptoms and function.

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