Effect of shoulder girdle strengthening on trunk alignment in patients with stroke

Amina Awad, Hussien Shaker, Wael Shendy, Manal Fahmy, Amina Awad, Hussien Shaker, Wael Shendy, Manal Fahmy

Abstract

[Purpose] This study investigated the effect of shoulder girdle strengthening, particularly the scapular muscles, on poststroke trunk alignment. [Subjects and Methods] The study involved 30 patients with residual hemiparesis following cerebrovascular stroke. Patient assessment included measuring shoulder muscle peak torque, scapular muscles peak force, spinal lateral deviation angle, and motor functional performance. Patients were randomly allocated either to the control group or the study group and received an 18-session strengthening program including active resisted exercises for shoulder abductors and external rotators in addition to trunk control exercises. The study group received additional strengthening exercises for the scapular muscles. [Results] The two groups showed significant improvement in strength of all shoulder and scapular muscles, with higher improvement in the study group. Similarly, the lateral spinal deviation angles significantly improved in both groups, with significantly higher improvement in the study group. Transfer activity, sitting balance, upper limb functions, and hand movements significantly improved in the two groups, with higher improvement in the latter two functions in the study group. [Conclusion] Strengthening of shoulder girdle muscles, particularly scapular muscles, can significantly contribute to improving the postural alignment of the trunk in patients with poststroke hemiparesis.

Keywords: Lateral trunk alignment; Scapular muscles strengthening; Stroke.

Figures

Fig. 1.
Fig. 1.
Measurement of the scapular and spinal angles. The Qa angle represents the scapular upward rotation angle on the affected side, while the Qb angle represents that on the non-affected side. The SI is a line passing through the two inferior scapular angles, while the PI is a line passing through the two PSISs. The ASI is a line drawn perpendicular to the SI line, while the API is a line drawn perpendicular to the PI line. The angle of intersection of the two perpendicular lines, the ASI and API, represents the spinal lateral deviation angle (S angle).

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