YWTL Exercises and Close Kinetic Chain Exercises in Children With Scapular Dyskinesis.

Comparison of YWTL Exercises and Closed Kinetic Chain Exercises on Shoulder Pain, Disability, Upper Limb Mobility and Posture in Children With Scapular Dyskinesis.

Scapular dyskinesia is defined by abnormal movement or placement of the scapula, the shoulder blade, during arm movements. Physical treatment aimed at regaining appropriate scapular mechanics through strengthening exercises, postural correction, and functional movement training is typically part of management. A randomized clinical trial will be conducted. The study will be conducted at Unique school and on school going children in a total duration of 10 months. Sample size will be 22.There will be two study groups. A convenient sampling technique will be used. The sample which will have following characteristics will be included children with age group 9 to 12 years, positive scapular test, positive scapular assistance test, athletes who practice one hour three days a week. The sample with the following characteristics will be excluded. Any muscular or joint deformity, scoliosis, shoulder dislocation. The tools that will be included in the study are modified lateral scapular test, shoulder flexion test, shoulder and pain disability index, upper extremity functional use scale, posture and posture assessment scale, shoulder and scapular ranges.

Study Overview

• Status: Recruiting
• Conditions: Scapular Dyskinesis
• Intervention / Treatment: Other: YWTL EXERCISES; Other: Closed kinetic chain exercises

Detailed Description

Scapular dyskinesia is defined by abnormal movement or placement of the scapula, the shoulder blade, during arm movements. Changes in scapular kinematics, such as tipping (forward or backward tilting), winging (medial border protrusion), or general prominence during shoulder movements, are usually involved. Physical treatment aimed at regaining appropriate scapular mechanics through strengthening exercises, postural correction, and functional movement training is typically part of management. From the shoulders to the hands, proper upper limb posture is essential for both biomechanical effectiveness and the avoidance of injuries when performing tasks. In addition to maximizing mobility for daily tasks, work, sports, and leisure activities, proper posture relieves tension on muscles and joints, assuring effective performance and lowering the chance of injury. A randomized clinical trial will be conducted. The study will be conducted at Unique School Wapda Town and The Punjab School in a total duration of 10 months. Sample size will be 22.

There will be two study groups. A convenient sampling technique will be used. The sample which will have following characteristics will be included children with age group 9 to 12 years, positive scapular test, positive scapular assistance test, normal shoulder ranges, normal scapular ranges, athletes who practice one hour three days a week. The sample with the following characteristics will be excluded. Any muscular or joint deformity, scoliosis, shoulder dislocation, previous surgery of shoulder and cervicobrachialgia. The tools that will be included in the study are modified lateral scapular test, scapular dyskinesis test, shoulder flexion test, scapular assistance test, shoulder and pain disability index, upper extremity functional use scale, posture and posture assessment scale, shoulder and scapular ranges. SPSS version 27 will be used for data analysis.

• Study Type: Interventional
• Enrollment (Estimated): 22
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: IMRAN AMJAD, PhD; Phone Number: 9233224390125; Email: imran.amjad@riphah.edu.pk
• Study Contact Backup: Name: Muhammad Asif Javed, MS-PT; Phone Number: 923224209422; Email: a.javed@riphah.edu.pk

Study Locations

• Pakistan
  • Punjab
    • Lahore, Punjab, Pakistan, 01234
      • Recruiting
      • Mishal Farwa
      • Contact: Mishal Farwa, MS-PT; Phone Number: 03024038228; Email: mishalfarwa0@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

Children with an age group of 9 to 12 years.

• Both genders.
• Engage in overhead sports.
• Minimum play time is 1 hour 3 times in a week.
• Positive Modified lateral scapular test
• Positive scapular dyskinesis shoulder flexion test
• Positive scapular assistance test
• Shoulder and pain disabilty index (score 1 to 20 )
• Upper extremity functional use scale (score 60 to 80).

Exclusion Criteria:

Any muscular or joint deformity.

• Scoliosis.
• Shoulder dislocation
• Post fracture.
• Neurological deficits
• Cervicobrachialgia

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: group 1 with YWTL exercises; group 1 will receive YWTL exercises for alternating 3 days a week for 6 weeks.	Other: YWTL EXERCISES; YWTL exercises are shoulder and upper back exercises to improve posture, strengthen upper back. Each letter represents different arm position that copies shape of letter.; Other: Closed kinetic chain exercises; Closed kinetic chain exercises include corner stretch hold, sleeper stretch hold - lawn mover and robbery maneuver, Scapula clock exercises, wall wash. Low row exercise maneuver, Scapular stabilization of Black burn exercises, press up, push up.
Experimental: group 2 with closed kinetic chain exercises; group 2 will receive closed kinetic chain exercises for alternating 3 days a week for 6 weeks.	Other: YWTL EXERCISES; YWTL exercises are shoulder and upper back exercises to improve posture, strengthen upper back. Each letter represents different arm position that copies shape of letter.; Other: Closed kinetic chain exercises; Closed kinetic chain exercises include corner stretch hold, sleeper stretch hold - lawn mover and robbery maneuver, Scapula clock exercises, wall wash. Low row exercise maneuver, Scapular stabilization of Black burn exercises, press up, push up.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
modified lateral scapular test	The Modified Lateral Scapular Slide Test assesses scapular asymmetry and stability by measuring the distance between the inferior angle of the scapula and the spine in various arm positions.	pre reading(1st week) post reading (6th week)
scapular dyskinesis test	The Scapular Dyskinesis Test evaluates abnormal scapular movement patterns during shoulder motion to identify dysfunction.	pre reading(1st week) post reading (6th week)
shoulder flexion test	The Shoulder Flexion Test assesses the range of motion and flexibility of the shoulder joint as the arm is raised overhead.	pre reading(1st week) post reading (6th week)
scapular assistance test	The Scapular Assistance Test evaluates the effect of manually assisting scapular motion on shoulder pain and function during arm elevation.	pre reading(1st week) post reading (6th week)
shoulder and pain disability index	The Shoulder Pain and Disability Index (SPADI) is a self-reported questionnaire that measures the pain and functional impairment associated with shoulder disorders.	pre reading(1st week) post reading (6th week)
upper extremity functional use scale	The Upper Extremity Functional Use Scale assesses the frequency and quality of functional use of the affected upper limb in daily activities.	pre reading(1st week) post reading (6th week)
posture and posture assessment scale	The Posture and Postural Ability Scale includes items for measuring posture as well as a 7-point ordinal scale for postural ability in supine, prone, sitting, and standing	pre reading(1st week) , post reading (6th week)
shoulder ranges	Shoulder ranges refer to the degrees of motion the shoulder joint can achieve in various directions, including flexion, extension, abduction, adduction, and rotation.	pre reading(1st week) , post reading (6th week)
scapular ranges	Scapular ranges are the measurable degrees of movement the scapula performs during shoulder motions, including elevation, depression, protraction, retraction, and rotation.	pre reading(1st week), post reading (6th week)

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Mishal Farwa, MS-PT, Riphah International University

Publications and helpful links

General Publications

• Hogan C, Corbett JA, Ashton S, Perraton L, Frame R, Dakic J. Scapular Dyskinesis Is Not an Isolated Risk Factor for Shoulder Injury in Athletes: A Systematic Review and Meta-analysis. Am J Sports Med. 2021 Aug;49(10):2843-2853. doi: 10.1177/0363546520968508. Epub 2020 Nov 19.
• Teixeira DC, Alves L, Gutierres M. The role of scapular dyskinesis on rotator cuff tears: a narrative review of the current knowledge. EFORT Open Rev. 2021 Oct 19;6(10):932-940. doi: 10.1302/2058-5241.6.210043. eCollection 2021 Oct.
• Otoshi K, Kikuchi S, Kato K, Sato R, Igari T, Kaga T, Konno S. The prevalence of scapular malalignment in elementally school aged baseball player and its association to shoulder disorder. J Orthop Sci. 2018 Nov;23(6):942-947. doi: 10.1016/j.jos.2018.07.006. Epub 2018 Aug 4.
• 4. Mahale A, Bisen R, Kalra K. Prevalence of Scapular Dyskinesia in Elite Badminton Players in Pune. International Journal of Health Sciences and Research. 2020;10(11):127-34.
• Joseph R, Alenabi T, Lulic T, Dickerson CR. Activation of Supraspinatus and Infraspinatus Partitions and Periscapular Musculature During Rehabilitative Elastic Resistance Exercises. Am J Phys Med Rehabil. 2019 May;98(5):407-415. doi: 10.1097/PHM.0000000000001116.
• Gianakos AL, Abdelmoneim A, Kerkhoffs G, Mulcahey MK. Rehabilitation and Return to Sport of Female Athletes. Arthrosc Sports Med Rehabil. 2022 Jan 28;4(1):e247-e253. doi: 10.1016/j.asmr.2021.09.040. eCollection 2022 Jan.

Study record dates

Study Major Dates

• Study Start (Actual): February 15, 2025
• Primary Completion (Estimated): July 15, 2025
• Study Completion (Estimated): July 31, 2025

Study Registration Dates

• First Submitted: April 17, 2025
• First Submitted That Met QC Criteria: April 17, 2025
• First Posted (Actual): April 24, 2025

Study Record Updates

• Last Update Posted (Actual): April 24, 2025
• Last Update Submitted That Met QC Criteria: April 17, 2025
• Last Verified: April 1, 2025

More Information

Terms related to this study

• Keywords: Scapular Dyskinesis, Scapulohumeral YWTL Exercises.
• Additional Relevant MeSH Terms: Neurologic Manifestations; Central Nervous System Diseases; Nervous System Diseases; Movement Disorders; Dyskinesias
• Other Study ID Numbers: REC/RCR&AHS/24/0728

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No