Scapular dyskinesis and its relation to shoulder pain.
ABSTRACT Scapular dyskinesis is an alteration in the normal position or motion of the scapula during coupled scapulohumeral movements. It occurs in a large number of injuries involving the shoulder joint and often is caused by injuries that result in the inhibition or disorganization of activation patterns in scapular stabilizing muscles. It may increase the functional deficit associated with shoulder injury by altering the normal scapular role during coupled scapulohumeral motions. Scapular dyskinesis appears to be a nonspecific response to shoulder dysfunction because no specific pattern of dyskinesis is associated with a specific shoulder diagnosis. It should be suspected in patients with shoulder injury and can be identified and classified by specific physical examination. Treatment of scapular dyskinesis is directed at managing underlying causes and restoring normal scapular muscle activation patterns by kinetic chain-based rehabilitation protocols.
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ABSTRACT: The aim of this research was to investigate which shoulder abduction angle (30°, 90°, 150°) during shrug exercise is superior for 1) activating the scapular upward rotators and 2) improving scapular and clavicular position in subjects with scapular downward rotation impairment. Twenty subjects performed shrug exercises at three different shoulder abduction angles (30°, 90°, 150°) which were obtained and maintained actively. Surface EMG data were collected from the levator scapulae (LS), upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) during shrug exercises. Scapular downward rotation index (SDRI) and clavicular tilt angle (CTA) were measured immediately after each shrug exercise. Oneway repeated-measures analysis of variance was used to determine the significance. UT muscle activity was greater at 90° and 150° than at 30° of shoulder abduction. UT/LS muscle activity ratio was greater at 90° than at 30°. LT and LT/LS increased as shoulder abduction angle increased. SA was greater at 150° than at 30° or 90°. SA/LS was greater at 150° than at 30°. SDRI was lower at 90° and 150° than at 30°. CTA was greater at 90° and 150° than at 30°. In conclusion, shrug exercises at 90° or 150° of shoulder abduction angle may be advocated to activate scapular upward rotators, decrease SDRI, and increase CTA in patients with scapular downward rotation impairment.Journal of Electromyography and Kinesiology 01/2015; · 1.73 Impact Factor
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ABSTRACT: et al. Arthroscopic treatment of acute acromioclavicular joint dislocation using suture anchors. Acta Ortop Bras. [online ]. 2011;19(3):141-4. Available from URL:http://www.scielo.br/aob. uation. Constant and UCLA scores were used to determine clinical and functional evaluation after 6 months. Results: Of the initial twenty cases, six were submitted to a new surgi-cal procedure and were excluded from the study. Of the fourteen patients remaining, only two maintained the initial reduction, while the remainder presented some degree of reduction loss. The Constant and UCLA score averages were 94.79 (82-100) and 32.64 (26-35) respectively. Conclusion: The technique had a high incidence of reduction loss after 6 months of follow up. The clinical and functional evalua-tion was satisfactory, with a high average score. Level of Evidence: Level III, retrospective study. AbSTRACT Objective: To present the clinical and radiographic results of a case series of patients with acute acromioclavicular dislocation (AAD) treated by arthroscopic coracoclavicular fixation with suture anchors. Method: Twenty patients with AAD with less than 30 days since the injury were submitted to a coracoclavicular stabilization procedure using 2 suture anchors placed at the base of the coracoid process. Each suture anchor was connected to 2 strands of No.2 nonab-sorbable-braided sutures, which were passed through the holes drilled in the clavicle and tied to the upper surface of the clavicle. The coracoclavicular distance was measured and compared to the opposite side using radiographic eval-INTRODUCTIONActa Ortopédica Brasileira 03/2011; 19(3):141-4. · 0.16 Impact Factor
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ABSTRACT: Background To date, there are no published outcomes-based treatment programs to guide clinicians when managing patients with scapula alata. The purposes of this study were to describe a physical therapy program in patients with scapula alata and to evaluate its effect using a shoulder-specific quality-of-life measurement. Methods In this case series and retrospective study, 22 patients (11 female patients) with a median age of 34 years (interquartile range, 28-44 years), diagnosed with scapula alata caused by injury to the long thoracic nerve, were successively referred as outpatients to a physical therapy program at a university hospital. The program included (1) physical examination, (2) thoracic brace treatment, and (3) muscular rehabilitation. The treatment frequency and duration were determined individually. The effect was evaluated by a shoulder-specific quality-of-life questionnaire, the Western Ontario Rotator Cuff (WORC) Index. The WORC Index is grouped into 5 domains: physical symptoms, sport/leisure time, work, lifestyle, and emotional health. Results The results showed a highly significant improvement (P < .001) from pretest to post-test as measured by all 5 domains in the WORC Index. Conclusions This study described in detail a physical therapy program; the program showed significant benefit. Further research is needed before recommending the program as a potential treatment option.Journal of Shoulder and Elbow Surgery. 10/2014;