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1.
Int J Sports Med ; 44(5): 369-375, 2023 May.
Article in English | MEDLINE | ID: mdl-36807277

ABSTRACT

The primary purpose was to investigate the influence of scapular dyskinesis (SD) on pitching biomechanics and shoulder function in high school baseball pitchers. The secondary purpose was to identify possible factors associated with shoulder function in pitchers with SD. Thirty-eight pitchers were classified into the SD group (n=26) or the non-SD group (n=12). They were evaluated with the Kerlan-Jobe Orthopaedic Clinic shoulder and elbow (KJOC) scale and clinical measurements of shoulder characteristics, and with measurements of scapular kinematics, muscle activation, and ball speed during fastball pitching. Compared to the controls, the pitchers with SD had less scapular external rotation (difference=11.3 degrees, ES=0.92, p=0.012) during overall pitching and less upper trapezius (UT) activation during the late cocking (difference=7.1%, ES=0.79, p=0.019) and acceleration phases (difference=12.5%, ES=0.75, p=0.035). Higher UT activation during the late cocking phase was significantly associated with higher KJOC scores (standardized ß=0.415, p=0.039). In conclusion, deficits in scapular external rotation and decreased UT activation during pitching were found in pitchers with SD. Higher UT activation may be important for shoulder function in pitchers with SD.


Subject(s)
Baseball , Dyskinesias , Humans , Shoulder/physiology , Biomechanical Phenomena/physiology , Baseball/physiology , Scapula , Elbow/physiology
2.
J Hum Kinet ; 84: 32-42, 2022 Oct.
Article in English | MEDLINE | ID: mdl-36457478

ABSTRACT

Prolonged overactivity of the upper trapezius muscle with myofascial trigger points might cause muscle fatigue and subsequently change scapular kinematics and associated muscular activities. Scapular kinematics and associated muscular activities were investigated in 17 overhead athletes with upper trapezius myofascial trigger points and 17 controls before and after a fatigue task. Participants performed a fatigue task requiring sustained isometric scapular elevation. The outcomes included scapular kinematics (upward/downward rotation, external/internal rotation, posterior/anterior tilt) that were tracked by the Polhemus FASTRAK (Polhemus Inc., Colchester, VT, USA) system with Motion Monitor software and muscular activities (upper trapezius, lower trapezius and serratus anterior) that were collected at 1000 Hz per channel using a 16-bit analog-to-digital converter (Model MP 150, Biopac systems Inc., CA, USA) with pairs of silver chloride circular surface electrodes (The Ludlow Company LP, Chocopee, MA) during arm elevation. Mixed ANOVAs were conducted to characterize the outcomes with and without a fatigue task in participants with myofascial trigger points. Decreased scapular posterior tipping during 90 degrees of arm raising/lowering (effect sizes of 0.51 and 0.59) was likely to be elicited by the scapular elevation fatigue task in the presence of myofascial trigger points. Activity of the lower trapezius was higher in the myofascial trigger point group (6.2%, p = 0.036) than in the control group. Following the fatigue task, both groups showed increased activity in the upper trapezius (9.0%, p = 0.009) during arm lowering and in the lower trapezius (2.7%, p < 0.01) during arm raising and lowering. Decreased scapular posterior tipping during 90 degrees of arm raising/lowering after a fatigue task may lead to impingement. We found that the presence of upper trapezius myofascial trigger points in amateur overhead athletes was related to impaired scapular kinematics and associated muscular activities during arm elevation after a fatigue task, especially the decreased scapular tipping during 90 degrees of raising/lowering.

3.
Int J Sports Med ; 43(6): 538-544, 2022 06.
Article in English | MEDLINE | ID: mdl-34638156

ABSTRACT

To characterize the scapular pitching biomechanics in symptomatic GIRD pitchers (SG) compared to asymptomatic GIRD (ASG) and healthy pitchers. The scapular kinematics and associated muscle activities during pitching were recorded in 33 high school pitchers. Compared to healthy, GIRD pitchers had less scapular posterior tilt in each pitching event (average difference, AD=14.4°, p<0.01) and ASG demonstrated less scapular upward rotation at ball release (AD=12.8°, p<0.01) and greater muscle activity in the triceps brachii in the early-cocking phase (AD=9.9%, p=0.015) and in the serratus anterior in the late-cocking phase (AD=30.8%, p<0.01). Additionally, SG had less muscular activity on triceps brachii in the acceleration phase and serratus anterior in the cocking phase (AD=37.8%, p=0.016; AD=15.5%, p<0.01, respectively) compared to ASG. GIRD pitchers exhibited less scapular posterior tilt during pitching, which may cause impingement. Since tightness of the anterior shoulder is a common cause of inadequacy of posterior tilt during arm elevation, stretching exercise of the anterior shoulder is recommended. Given the inadequate recruitment during pitching in the GIRD pitchers, symptoms may develop following potential impingement.


Subject(s)
Baseball , Shoulder Joint , Baseball/physiology , Biomechanical Phenomena/physiology , Humans , Muscles , Range of Motion, Articular/physiology , Shoulder Joint/physiology
4.
Orthop J Sports Med ; 8(11): 2325967120964600, 2020 Nov.
Article in English | MEDLINE | ID: mdl-33294472

ABSTRACT

BACKGROUND: Predictive variables associated with the effects of a scapular conscious control program should be identified and used to guide rehabilitation programs. PURPOSE: To determine whether potential factors are associated with the success of scapular muscle balance with an early control program in patients with subacromial pain and scapular dyskinesis. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: A total of 38 amateur overhead athletes with subacromial pain and medial border prominence were recruited. They performed progressive conscious control of scapular orientation during 45° and 90° of arm elevation. Stepwise logistic regression and receiver operating characteristic curve were used to determine the optimal cutoff point of related factors for success or failure of the program. Potential factors including pain level during activity, pain duration, anterior/posterior shoulder flexibility, forward shoulder posture, posterior displacement of root of spine and inferior angle, scapular kinematics, and muscle activation before conscious control program were recorded as independent variables. Successful control defined as decreases of the upper trapezius/serratus anterior ratio in 2 consecutive trials of the 90° program or failure in the program was used as a dependent variable. RESULTS: Having a posterior displacement of the inferior angle of the scapula of ≤16.4 mm and scapular posterior tipping during arm elevation of ≤3.3° (collected before the control program) were associated with the success of the program (R 2 = 0.286; P < .05). Additionally, participants with each or both variables present at baseline had probabilities of success of 78% and 95%, respectively. CONCLUSION: The value of scapular posterior displacement and posterior tilt should be considered before early scapular control program. Other factors related to the success of the program should be found due to the limited variance explained in the regression model.

5.
J Shoulder Elbow Surg ; 29(9): 1852-1858, 2020 Sep.
Article in English | MEDLINE | ID: mdl-32247722

ABSTRACT

BACKGROUND: No previous studies have investigated whether the extent of scapular dyskinesis is associated with shoulder dysfunction. This study aimed (1) to establish the reliability of a scapulometer in patients with shoulder pain and (2) to investigate the related factors associated with shoulder dysfunction. METHODS: One hundred participants with symptomatic scapular dyskinesis were recruited. Twenty-one participants were involved in the reliability study to test the intrarater and inter-rater reliabilities of the scapulometer in patients with shoulder pain. After demographic data and self-reported Flexilevel Scale of Shoulder Function (FLEX-SF) scores were recorded, all participants were measured with a scapulometer to determine the posterior displacement of the root of the spine (ROS) and the inferior angle (IFA) of the scapula from the thorax. Next, the participants performed 5 trials of bilateral scapular plane elevation for scapular kinematics and electromyographic (EMG) data collection. Stepwise multiple linear regressions were used to determine the relationships between self-reported FLEX-SF scores and potential factors. In addition to scapular displacement, pain level, scapular kinematics, and EMG data were included as independent variables. RESULTS: The intrarater and inter-rater reliabilities of the scapulometer were excellent (intraclass correlation coefficient [ICC] = 0.93-0.97) and moderate to good (ICC = 0.74-0.81), respectively. The Bland-Altman plots showed no systematic bias between raters in the ROS and IFA measurements. Final stepwise multiple regression models showed that more ROS distance, higher serratus anterior activity, and lower pain level during arm elevation were associated with higher shoulder function (total R2 = 0.253). CONCLUSION: The reliability of the scapulometer in patients with shoulder pain is moderate to excellent. Scapular dyskinesis may be a compensatory strategy to avoid shoulder pain and improve shoulder function.


Subject(s)
Physical Examination/instrumentation , Range of Motion, Articular/physiology , Scapula/physiopathology , Shoulder Joint/physiopathology , Adult , Biomechanical Phenomena/physiology , Electromyography , Female , Humans , Male , Reproducibility of Results
6.
J Athl Train ; 55(3): 265-273, 2020 Mar.
Article in English | MEDLINE | ID: mdl-31876455

ABSTRACT

CONTEXT: Subacromial impingement syndrome (SIS) is associated with scapular dyskinesis, or imbalanced scapular muscle activity. Evidence has shown that feedback can improve scapular control in patients with SIS. However, it is unknown whether real-time video feedback or electromyography (EMG) biofeedback is optimal for improving scapular kinematics and muscle activity during a functional task. OBJECTIVE: To compare the effects of video and EMG feedback sessions on absolute muscle activity (upper trapezius [UT], lower trapezius [LT], serratus anterior), muscle balance ratios (UT/LT, UT/serratus anterior), and scapular kinematics (anterior-posterior tilt, external-internal rotation, upward rotation) in SIS participants during arm elevation and lowering. DESIGN: Randomized controlled clinical trial. SETTING: Research laboratory. PATIENTS OR OTHER PARTICIPANTS: Overhead athletes who were diagnosed with SIS and who also exhibited scapular dyskinesis (N = 41). MAIN OUTCOME MEASURE(S): Three-dimensional kinematics and EMG were recorded before and after feedback training. RESULTS: Lower trapezius muscle activity increased (4.2%-18%, P < .011) and UT/LT decreased (0.56-1.17, P < .013) in the EMG biofeedback training group as compared with those in the video feedback training group. Scapular upward rotation during arm elevation was higher in the video group than in the EMG group after feedback training (2.3°, P = .024). CONCLUSIONS: The EMG biofeedback improved muscle control and video feedback improved the correction of scapular upward rotation in patients with SIS. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov: NCT03252444.


Subject(s)
Athletic Injuries/physiopathology , Athletic Injuries/therapy , Biofeedback, Psychology/methods , Electromyography , Neurofeedback/methods , Shoulder Impingement Syndrome/physiopathology , Shoulder Impingement Syndrome/therapy , Adult , Biomechanical Phenomena , Female , Humans , Male , Rotation , Rotator Cuff/physiopathology , Scapula/physiology , Superficial Back Muscles/physiopathology , Young Adult
7.
J Hand Ther ; 32(3): 345-352, 2019.
Article in English | MEDLINE | ID: mdl-29196161

ABSTRACT

STUDY DESIGN: Crossover repeated-measure design. INTRODUCTION: Scapular dyskinesis rehabilitation programs that focus on inhibiting upper trapezius (UT) and activating the lower trapezius (LT) may assist in restoring scapular movements. We hypothesized that taping may be able to normalize scapular movements and associated muscular recruitment. PURPOSE OF THE STUDY: The purpose of this study was to investigate the immediate effects of kinesio taping over trapezius on scapular kinematics and muscular activation in different dyskinesis patterns. We expected that taping can improve scapular kinematics and muscular activation in subjects with dyskinesis. METHODS: Fifty-four participants with inferior angle prominence (pattern I), medial border prominence (pattern II), and mixed pattern (pattern I + II) were recruited. Kinesio taping was applied over 3 parts of trapezius muscles, including UT, middle trapezius (MT), and LT. The scapular kinematics and electromyographic data of trapezius and serratus anterior were collected during scapular plane elevation without taping and after each taping application. RESULTS: UT taping decreased UT activity (5%-7%; P = .001-.003) in 72% of participants with pattern II and pattern I + II dyskinesis, with increased posterior tipping (2.2°-2.5°; P = .003) in pattern II dyskinesis. MT taping increased UT activity (3%; P = .003) in 48% of participants with pattern II dyskinesis. DISCUSSION: The taping over the trapezius muscle may help to restore coordinated scapular muscle balance and increased upward rotation of the scapula, especially in pattern II dyskinesis. Although no electromyography or kinematic difference was found with LT taping in each dyskinesis pattern, methods of applying LT taping need to be further investigated. CONCLUSION: Reduced UT muscle activity and scapular posterior tipping are appropriate when applying taping over UT muscle in patterns II and I + II dyskinesis. Caution should be taken when applying taping over MT and LT muscles in terms of increased UT activity, especially in pattern II dyskinesis.


Subject(s)
Athletic Tape , Dyskinesias/rehabilitation , Scapula/physiopathology , Superficial Back Muscles/physiology , Adult , Biomechanical Phenomena/physiology , Cross-Over Studies , Dyskinesias/physiopathology , Electromyography , Female , Humans , Male
8.
J Shoulder Elbow Surg ; 27(8): 1407-1414, 2018 Aug.
Article in English | MEDLINE | ID: mdl-29886062

ABSTRACT

BACKGROUND: Video feedback (VF) can guide patients to consciously control scapular orientation without inappropriate substitution. This study investigated whether progressive conscious control with VF improves scapular muscle activation and movements during arm elevation in patients with subacromial impingement and scapular dyskinesis. METHODS: The study recruited 38 amateur overhead athletes with subacromial impingement and scapular medial border prominence who were randomly assigned to the VF or control group. The participants in both groups controlled the scapular position and progressively practiced from 0° to 45° and from 0° to 90° of arm elevation. Participants in the VF group also controlled the scapular position with a video presentation of the scapula on a screen. We investigated the scapular kinematics, muscle activation, and balance ratio for outcome collection in the preintervention and postintervention conditions with and without VF conditions. RESULTS: Decreased upper trapezius (UT) activation (3%-13%, P < .0083), increased lower trapezius (LT) activation (3%-17%, P < .0083), restored UT/LT ratios (0.67-3.13, P < .0083), and decreased scapular internal rotation (1.8°-6.1°, P < .003) relative to the preintervention condition were demonstrated in the 2 postintervention conditions in both groups. The VF group also demonstrated decreased UT/serratus anterior ratios (0.21-0.30, P < .0083) in 2 postintervention conditions relative to the preintervention condition. CONCLUSIONS: The progressive control of scapular orientation with or without VF can be used to reduce the UT/LT ratio and improve scapular internal rotation during arm elevation. Control training with VF can further decrease the UT/serratus anterior ratio.


Subject(s)
Exercise Therapy/methods , Feedback , Muscle, Skeletal/physiopathology , Scapula/physiopathology , Shoulder Impingement Syndrome/therapy , Video Recording , Adult , Electromyography , Female , Humans , Male , Range of Motion, Articular/physiology , Rotation , Shoulder Impingement Syndrome/physiopathology , Single-Blind Method
9.
Musculoskelet Sci Pract ; 32: 120-126, 2017 12.
Article in English | MEDLINE | ID: mdl-28827031

ABSTRACT

BACKGROUND: Previous studies have proposed various ways to assess scapular dyskinesis. In clinic, assessment tools designed to measure the posterior displacement of the inferior angle of the scapula with reference to the posterior thoracic cage are needed. OBJECTIVES: A novel scapulometer was developed to measure scapular medial border and inferior angle prominence. METHODS: A novel scapulometer was designed to measure the distance from the root of the spine (ROS) and the inferior angle (INF) of the scapula to the thorax wall in 29 participants with scapular dyskinesis bilaterally. Two raters measured the ROS and INF distance of the scapula 3 times bilaterally. Intraclass correlation coefficients (ICC) and standard error of measurement (SEM) were calculated to determine the inter-rater and intra-rater reliability. Validity was based on correlations (convergent: ROS and internal/external rotation, and INF and tilt; divergent: ROS/INF and upward rotation of the scapula) using a FASTRAK Polhemus 3-D motion tracking system assessing scapular tilt, internal/external rotation, and upward/downward rotation. RESULTS: The average ROS and INF displacements were 13.7 ± 5.0 mm and 12.5 ± 6.3 mm, respectively. The results showed excellent intra-rater and inter-rater reliability, with ICC = 0.88-0.99 and 0.95-0.99 (SEM = 0.7-0.8 mm), respectively. Correlations were 0.35/0.19 (convergent validity) and 0.07/0.09 (divergent validity). CONCLUSIONS: The novel scapulometer has excellent reliability and fair validity to quantify medial border and inferior angle prominence of the scapula. Further research utilizing this instrument is recommended.


Subject(s)
Diagnostic Techniques and Procedures/instrumentation , Dimensional Measurement Accuracy , Dyskinesias/diagnosis , Scapula/anatomy & histology , Adult , Female , Humans , Male , Reproducibility of Results , Young Adult
10.
Sci Rep ; 7(1): 6621, 2017 07 26.
Article in English | MEDLINE | ID: mdl-28747702

ABSTRACT

This study investigated the characteristics of arm elevation via principal component analysis in symptomatic overhead athletes with scapular dyskinesis. One hundred-thirty-four overhead athletes with scapular dyskinesis [24: inferior angle prominence (pattern I); 46: medial border prominence (pattern II), 64: pattern I + II] were evaluated by three-dimensional electromagnetic motion and electromyography to record the scapular kinematics (upward rotation/posterior tipping/exterior rotation) and muscle activation (upper trapezius: UT; middle trapezius: MT; lower trapezius: LT; serratus anterior: SA) during lowering phase of arm elevation. The results showed: (1) for pattern I and II, the first 3 principal component (PCs) explained 41.4% and 42.6% of total variance of movement; (2) the first PCs were correlated with MT, LT activity (r = 0.41~0.61) and upward rotation, posterior tipping (r = -0.59~-0.33) in pattern I, and UT, MT, SA (r = 0.30~0.70) activity in pattern II; (3) contour plots of muscle activity demonstrated that muscle activities varied with dyskinesis patterns. In summary, for the pattern I, the major characteristics are coactivation of MT and LT and corresponding scapular posterior tipping and upward rotation. For the pattern II, the major characteristics are coactivation of UT, MT and SA without corresponding scapular external rotation.


Subject(s)
Athletes , Dyskinesias/pathology , Scapula/pathology , Adult , Dyskinesias/diagnostic imaging , Electromyography , Female , Humans , Male , Scapula/diagnostic imaging , Young Adult
11.
Man Ther ; 26: 165-171, 2016 Dec.
Article in English | MEDLINE | ID: mdl-27693966

ABSTRACT

BACKGROUND: Patterns of scapular dyskinesis have unique scapular kinematics and associated muscular activation. The characteristics of unique dyskinesis patterns may be associated with functional disability. OBJECTIVES: To investigate whether the shoulder function level and primary dysfunction items were different in unique dyskinesis pattern. The factors associated with shoulder dysfunction in different dyskinesis patterns were identified. DESIGN: Cross-sectional study. METHODS: Fifty-one participants with unilateral shoulder pain were classified as having a single dyskinesis pattern (inferior angle prominence, pattern I; medial border prominence, pattern II) or a mixed dyskinesis pattern (patterns I + II). Clinical measurements with the Flexilevel Scale of Shoulder Function (FLEX-SF), shoulder range of motion and pectoralis minor index were recorded. These clinical measurements, 3-D scapular kinematics (electromagnetic-based motion analysis), and associated muscular activation (electromyography on the upper/middle/lower trapezius and serratus anterior muscles) during arm elevation were analyzed for associations with functional disability. RESULTS: We found FLEX-SF scores and primary dysfunction items were similar among the patterns of dyskinesis. In inferior angle prominence, increased shoulder function was associated with decreased upper trapezius activity (R2 = 0.155, p = 0.035), which accounted for approximately 16% of the variance of FLEX-SF scores. In medial border prominence, increased shoulder function was associated with increased lower trapezius activity (R2 = 0.131, p = 0.017), which accounted for approximately 13% of the variance of FLEX-SF scores. CONCLUSION: Upper and lower trapezius activities are important to consider in the evaluation of patients with pattern I and II, respectively. No other factors were related to shoulder dysfunction due to insufficient challenge of arm elevation tasks.


Subject(s)
Dyskinesias/physiopathology , Range of Motion, Articular/physiology , Scapula/physiopathology , Shoulder Impingement Syndrome/physiopathology , Superficial Back Muscles/physiopathology , Adult , Aged , Aged, 80 and over , Biomechanical Phenomena , Cross-Sectional Studies , Disability Evaluation , Electromyography , Female , Humans , Male , Middle Aged
12.
Man Ther ; 26: 97-103, 2016 Dec.
Article in English | MEDLINE | ID: mdl-27525356

ABSTRACT

BACKGROUND: Scapular orientation and movements can affect the function of the shoulder. However, evidence is limited on whether symptomatic subjects can actively maintain the scapula in a neutral position through conscious control. OBJECTIVE: To investigate whether symptomatic subjects with scapular dyskinesis can achieve optimal scapular movements and associated muscle activities through conscious control. DESIGN: A cross-sectional study. METHODS: Sixty subjects with scapular dyskinesis (16 inferior angle pattern I, 16 medial border pattern II, and 28 mixed pattern) performed 3 selected exercises (arm elevation, side-lying elevation, and side-lying external rotation) with and without conscious control. Three-dimensional electromagnetic motion and electromyography were used to record the scapular kinematics and muscle activation during the exercises. RESULTS: For scapular kinematics, significant increases in scapular external rotation (4.6 ± 3.2°, p < 0.0125) were found with conscious control during arm elevation and side-lying elevation in three groups. Significant increases in activation of the middle and lower trapezius (MT: 4.9 ± 2.4% MVIC; LT: 10.2 ± 6.8% MVIC, p < 0.0 25) were found with conscious control in 3 exercises among the 3 dyskinesis groups. Increased serratus anterior activation (SA: 11.2 ± 4.8% MVIC, p < 0.0 25) was found in the concentric phase of side-lying external rotation in the pattern I and I + II groups. CONCLUSION: Conscious control of the scapula can alter scapular orientation and MT, LT, and SA activation during 3 selected exercises in subjects with symptomatic dyskinesis. Specifically, conscious control during side-lying external rotation can be applied to increase SA activity in pattern I and I + II dyskinesis.


Subject(s)
Biomechanical Phenomena/physiology , Consciousness , Dyskinesias/therapy , Exercise Therapy/methods , Movement/physiology , Muscle Contraction/physiology , Scapula/physiopathology , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Humans , Male , Middle Aged
13.
J Shoulder Elbow Surg ; 24(8): 1227-34, 2015 Aug.
Article in English | MEDLINE | ID: mdl-25704212

ABSTRACT

BACKGROUND: Knowledge of the kinematics and associated muscular activity in individuals with scapular dyskinesis may provide insight into the injury mechanism and inform the planning of treatment strategies. We investigated scapular kinematics and associated muscular activation during arm movements in individuals with scapular dyskinesis. METHODS: A visual-based palpation method was used to evaluate 82 participants with unilateral shoulder pain. Scapular movements during arm raising/lowering movements were classified as abnormal single pattern (inferior angle prominence, pattern I; medial border prominence, pattern II; excessive/inadequate scapular elevation or upward rotation, pattern III), abnormal mixed patterns, or normal pattern (pattern IV). Scapular kinematics and associated muscular activation were assessed with an electromagnetic motion-capturing system and surface electromyography. RESULTS: More scapular internal rotation was found in pattern II subjects (4°, P = .009) and mixed pattern I and II subjects (4°, P = .023) than in control subjects during arm lowering. Scapular posterior tipping (3°, P = .028) was less in pattern I subjects during arm lowering. Higher upper trapezius activity (14%, P = .01) was found in pattern II subjects during arm lowering. In addition, lower trapezius (5%, P = .025) and serratus anterior activity (10%, P = .004) were less in mixed pattern I and II subjects during arm lowering. CONCLUSIONS: Specific alterations of scapular muscular activation and kinematics were found in different patterns of scapular dyskinesis. The findings also validated the use of a comprehensive classification test to assess scapular dyskinesis, especially in the lowering phase of arm elevation.


Subject(s)
Dyskinesias/etiology , Electromyography/methods , Range of Motion, Articular/physiology , Scapula/physiopathology , Shoulder Impingement Syndrome/complications , Shoulder Joint/physiopathology , Adolescent , Adult , Biomechanical Phenomena , Cross-Sectional Studies , Dyskinesias/diagnosis , Dyskinesias/physiopathology , Female , Humans , Imaging, Three-Dimensional , Male , Middle Aged , Rotation , Shoulder Impingement Syndrome/diagnosis , Shoulder Impingement Syndrome/physiopathology , Young Adult
14.
Man Ther ; 20(3): 427-32, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25435131

ABSTRACT

BACKGROUND: Assessment of scapular dyskinesis (SD) is of clinical interest, as SD is believed to be related to shoulder pathology. However, no clinical assessment with sufficient reliability to identify SD and provide treatment strategies is available. OBJECTIVES: The purpose of this study was to investigate the reliability of the comprehensive SD classification method. DESIGN: Cross-sectional reliability study. METHOD: Sixty subjects with unilateral shoulder pain were evaluated by two independent physiotherapists with a visual-based palpation method. SD was classified as single abnormal scapular pattern [inferior angle (pattern I), medial border (pattern II), superior border of scapula prominence or abnormal scapulohumeral rhythm (pattern III)], a mixture of the above abnormal scapular patterns, or normal pattern (pattern IV). The assessment of SD was evaluated as subjects performed bilateral arm raising/lowering movements with a weighted load in the scapular plane. Percentage of agreement and kappa coefficients were calculated to determine reliability. RESULTS: Agreement between the 2 independent physiotherapists was 83% (50/60, 6 subjects as pattern III and 44 subjects as pattern IV) in the raising phase and 68% (41/60, 5 subjects as pattern I, 12 subjects as pattern II, 12 subjects as pattern IV, 12 subjects as mixed patterns I and II) in the lowering phase. The kappa coefficients were 0.49-0.64. CONCLUSIONS: We concluded that the visual-based palpation classification method for SD had moderate to substantial inter-rater reliability. The appearance of different types of SD was more pronounced in the lowering phase than in the raising phase of arm movements.


Subject(s)
Dyskinesias/classification , Palpation/methods , Range of Motion, Articular/physiology , Scapula/physiopathology , Shoulder Joint/physiopathology , Cross-Sectional Studies , Dyskinesias/diagnosis , Female , Humans , Male , Observer Variation , Physical Examination/methods , Reproducibility of Results , Sensitivity and Specificity , Young Adult
15.
Man Ther ; 19(4): 349-54, 2014 Aug.
Article in English | MEDLINE | ID: mdl-24650638

ABSTRACT

We determined whether the degree of symptom-related functional disability was related to daily physical activity of the shoulder in subjects with stiff shoulders (SSs). Responsiveness and a clinically meaningful level of discrimination between improvement and non-improvement for shoulder physical activity (SPA) were determined. Twenty-six subjects with SSs participated. Shoulder physical activity was assessed by RT3 accelerometers fixed on the humerus during daily 14-h data collection periods twice a week for 2 weeks. A moderate correlation coefficient was found between SPA and functional disability (ß = .47). Based on our cohort design and sample, we suggest that SPA (higher than 101.8 counts, hard-moderate or hard tasks) during daily activity are associated with (with at least 83% probability) non-improvement in an individual with SS. Compared to the non-improvement group, the improvement group had less duration of sedentary activity, less frequency and duration of hard tasks, and more frequency and duration of easy tasks (p < 0.01). Appropriate guidance on shoulder physical activities for subjects with SS is important to consider in rehabilitation strategies for these subjects. In our sample, a hard level of shoulder physical activity and sedentary activity should be cautious for these subjects. Further study is needed to validate therapeutic effect of physical activity on the course of patient improvement in subjects with SSs.


Subject(s)
Accelerometry/instrumentation , Disability Evaluation , Range of Motion, Articular/physiology , Shoulder Joint/physiopathology , Shoulder Pain/diagnosis , Aged , Female , Humans , Male , Middle Aged , Motor Activity/physiology , Pain Measurement , ROC Curve , Shoulder Pain/rehabilitation , Task Performance and Analysis
16.
J Sport Rehabil ; 22(1): 59-66, 2013 Feb.
Article in English | MEDLINE | ID: mdl-23069636

ABSTRACT

CONTEXT: Recent studies have shown that the static stretch (SS) may adversely affect leg-muscle performance. OBJECTIVES: The authors examined the short-term effects of 2 stretching exercises on hamstrings muscle before and after exercise. DESIGN: Crossover. SETTING: Laboratory. PARTICIPANTS: 9 healthy, physically active men. INTERVENTIONS: There were 3 protocols in a randomized order with a 7-d interval: nonstretching (CON protocol), hamstrings static stretching (SS) with proprioceptive neuromuscular facilitation (PNF), and SS with kinesio-taping application on the hamstrings. MAIN OUTCOME MEASURES: Outcome measures included first-felt and maximum tolerant-felt range of motion (FROM and TROM), maximal knee-flexion peak torque (PT) at 180°/s, and hamstrings muscle stiffness. RESULTS: Groups were not different at prestretching in terms of hamstrings flexibility, PT, and muscle stiffness. At poststretching, both stretching protocols showed significant increases in FROM and TROM (P < .05). Stiffer hamstrings muscle and decreased PT were found in both SS+PNF and CON protocols (P < .05). However, there was no significant difference in the SS+Taping protocol (P > .05). CONCLUSION: The stretching protocols improve hamstrings flexibility immediately, but after exercise hamstrings peak torque is diminished in the SS+PNF but not in the SS+Taping group. This means that SS+Taping can prevent negative results from exercise, which may prevent muscle injury.


Subject(s)
Athletic Tape/standards , Muscle Stretching Exercises/methods , Muscle, Skeletal/physiology , Proprioception/physiology , Cross-Over Studies , Exercise/physiology , Humans , Male , Thigh
17.
Ergonomics ; 55(11): 1404-11, 2012.
Article in English | MEDLINE | ID: mdl-22897702

ABSTRACT

Clinically, over-activation of upper trapezius (UT) muscular activity is a common cause of symptoms in computer users. The purpose of this study was to investigate the correlation between trapezius muscular activity and typing speed with and without taping. Twelve participants performed a typing task for 15 min with and without taping on the UT muscle. Electromyography (EMG) of the muscular activity of UT and lower trapezius (LT) was recorded. With or without taping, there was a significantly positive correlation (r = 0.40, p = 0.04) between typing speed and UT/LT. Additionally, UT and UT/LT ratios were lower with taping than without taping (difference = 5.2% and 26.9%). The LT ratio was higher with taping than without taping (difference = 5.8%). Taping can alter the muscular activity of the trapezius during typing and may have the potential to be applied in computer users to prevent over-activation of UT muscular activity. Practitioner Summary: The effect of taping was tested on typing speed and trapezius muscular activity. With or without taping, typing speed was correlated with trapezius activity. The muscle activity of the trapezius, however, was lower with taping than without taping. Thus, taping has the potential to prevent over-activation of UT muscular activity during typing.


Subject(s)
Motor Activity/physiology , Muscle, Skeletal/physiology , Occupational Injuries/etiology , Shoulder/physiology , Bandages/statistics & numerical data , Electromyography , Female , Humans , Male , Muscle, Skeletal/injuries , Occupational Injuries/prevention & control , Shoulder Injuries , User-Computer Interface , Young Adult
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