Therapeutic Interventions for Scapular Kinematics and Disability in Patients With Subacromial Impingement: A Systematic Review

Katsumi Takeno, Neal R Glaviano, Grant E Norte, Christopher D Ingersoll, Katsumi Takeno, Neal R Glaviano, Grant E Norte, Christopher D Ingersoll

Abstract

Context: Impaired scapular kinematics are commonly reported in patients with subacromial impingement syndrome (SIS). Various therapeutic interventions designed to improve scapular kinematics and minimize pain and disability have been described in the literature. However, the short- and long-term benefits of these interventions are unclear.

Objective: To determine the effects of specific short- and long-term therapeutic interventions on scapular kinematics and disability in patients with SIS.

Data sources: We searched PubMed, CINAHL, and SPORTDiscus databases from their origins to January 2018 using a combination of the key words scapular kinematics AND (shoulder dysfunction OR subacromial impingement) and conducted a manual search by reviewing the references of the identified papers.

Study selection: Studies were included if (1) preintervention and postintervention measures were available; (2) patient-reported outcomes were reported; (3) scapular kinematics measures at 90° of ascending limb elevation in the scapular plane were included; (4) SIS was diagnosed in participants or participants self-reported symptoms of SIS; (5) they were original clinical studies published in English; and (6) the sample sizes, means, and measure of variability for each group were reported.

Data extraction: Seven studies were found. Sample sizes, means, and standard deviations of scapular upward rotation, posterior tilt, and internal rotation at 90° of ascending limb elevation on the scapular plane and the Disabilities of the Arm, Shoulder and Hand scores were extracted.

Data synthesis: Standardized mean differences between preintervention and postintervention measures with 95% confidence intervals (CIs) were calculated. We observed that the Disabilities of the Arm, Shoulder and Hand scores improved (mean difference = 0.85; 95% CI = 0.54, 1.16) but did not observe changes in scapular upward rotation (mean difference = -0.04; 95% CI = -0.31, 0.22), posterior tilt (mean difference = -0.09; 95% CI = -0.32, 0.15), or internal rotation (mean difference = 0.06; 95% CI = -0.19, 0.31).

Conclusions: The short- and long-term therapeutic interventions for SIS improved patient-reported outcomes but not scapular kinematics. The identified improvements in shoulder pain and function were not likely explained by changes in scapular kinematics.

Keywords: 3-D motion analysis; patient-reported outcomes; scapular dysfunction; shoulder pathology.

Figures

Figure 1
Figure 1
Flow diagram of study selection.
Figure 2
Figure 2
Scapular upward rotation at 90° of ascending limb elevation in the scapular plane. Abbreviation: CI, confidence interval. a Exercise-alone group. b Exercise-plus-manual-therapy group. c Difference in scapular upward rotation between preintervention and postintervention (P < .05).
Figure 3
Figure 3
Scapular posterior tilt at 90° of ascending limb elevation in the scapular plane. Abbreviation: CI, confidence interval. a Exercise-alone group. b Exercise-plus-manual-therapy group.
Figure 4
Figure 4
Scapular internal rotation at 90° of ascending limb elevation in the scapular plane. Abbreviation: CI, confidence interval. a Exercise-alone group. b Exercise-plus-manual-therapy group.
Figure 5
Figure 5
Disability of the Arm, Shoulder and Hand score. Abbreviation: CI, confidence interval. a Exercise-alone group. b Exercise-plus-manual-therapy group. c Improvement in perceived pain and disability after the interventions (P < .05).

References

    1. Greving K, Dorrestijn O, Winters JC, et al. Incidence, prevalence, and consultation rates of shoulder complaints in general practice. Scand J Rheumatol. 2012;41(2):150–155.
    1. Pope DP, Croft PR, Pritchard CM, Silman AJ, Macfarlane GJ. Occupational factors related to shoulder pain and disability. Occup Environ Med. 1997;54(5):316–321.
    1. Broadhurst NA, Barton CA, Yelland LN, Martin DK, Beilby JJ. Managing shoulder pain in general practice: the value of academic detailing. Aust Fam Physician. 2006;35(9):751–752.
    1. Bodin J, Ha C, Chastang JF, et al. Comparison of risk factors for shoulder pain and rotator cuff syndrome in the working population. Am J Ind Med. 2012;55(7):605–615.
    1. Eltayeb S, Staal JB, Kennes J, Lamberts PH, de Bie RA. Prevalence of complaints of arm, neck and shoulder among computer office workers and psychometric evaluation of a risk factor questionnaire. BMC Musculoskelet Disord. 2007;8:68.
    1. Pribicevic M, Pollard H, Bonello R. An epidemiologic survey of shoulder pain in chiropractic practice in Australia. J Manipulative Physiol Ther. 2009;32(2):107–117.
    1. van der Windt DA, Koes BW, de Jong BA, Bouter LM. Shoulder disorders in general practice: incidence, patient characteristics, and management. Ann Rheum Dis. 1995;54(12):959–964.
    1. Hibberd EE, Oyama S, Spang JT, Prentice W, Myers JB. Effect of a 6-week strengthening program on shoulder and scapular-stabilizer strength and scapular kinematics in Division I collegiate swimmers. J Sport Rehabil. 2012;21(3):253–265.
    1. Bodin J, Ha C, Petit Le Manac'h A, et al. Risk factors for incidence of rotator cuff syndrome in a large working population. Scand J Work Environ Health. 2012;38(5):436–446.
    1. Buss DD, Freehill MQ, Marra G. Typical and atypical shoulder impingement syndrome: diagnosis, treatment, and pitfalls. Instr Course Lect. 2009;58:447–457.
    1. de Witte PB, Nagels J, van Arkel ER, Visser CP, Nelissen RG, de Groot JH. Study protocol subacromial impingement syndrome: the identification of pathophysiologic mechanisms (SISTIM) BMC Musculoskelet Disord. 2011;12:282.
    1. Papadonikolakis A, McKenna M, Warme W, Martin BI, Matsen FA., III Published evidence relevant to the diagnosis of impingement syndrome of the shoulder. J Bone Joint Surg Am. 2011;93(19):1827–1832.
    1. Timmons MK, Thigpen CA, Seitz AL, Karduna AR, Arnold BL, Michener LA. Scapular kinematics and subacromial-impingement syndrome: a meta-analysis. J Sport Rehabil. 2012;21(4):354–370.
    1. Neer CS., II Impingement lesions. Clin Orthop Relat Res. 1983;173:70–77.
    1. Willmore EG, Smith MJ. Scapular dyskinesia: evolution towards a systems-based approach. Shoulder Elbow. 2016;8(1):61–70.
    1. Camargo PR, Alburquerque-Sendín F, Avila MA, Haik MN, Vieira A, Salvini TF. Effects of stretching and strengthening exercises, with and without manual therapy, on scapular kinematics, function, and pain in individuals with shoulder impingement: a randomized controlled trial. J Orthop Sports Phys Ther. 2015;45(12):984–997.
    1. McClure P, Balaicuis J, Heiland D, Broersma ME, Thorndike CK, Wood A. A randomized controlled comparison of stretching procedures for posterior shoulder tightness. J Orthop Sports Phys Ther. 2007;37(3):108–114.
    1. Cole AK, McGrath ML, Harrington SE, Padua DA, Rucinski TJ, Prentice WE. Scapular bracing and alteration of posture and muscle activity in overhead athletes with poor posture. J Athl Train. 2013;48(1):12–24.
    1. Hsu YH, Chen WY, Lin HC, Wang WT, Shih YF. The effects of taping on scapular kinematics and muscle performance in baseball players with shoulder impingement syndrome. J Electromyogr Kinesiol. 2009;19(6):1092–1099.
    1. Keenan KA, Akins JS, Varnell M, et al. Kinesiology taping does not alter shoulder strength, shoulder proprioception, or scapular kinematics in healthy, physically active subjects and subjects with subacromial impingement syndrome. Phys Ther Sport. 2017;24:60–66.
    1. Shaheen AF, Bull AM, Alexander CM. Rigid and elastic taping changes scapular kinematics and pain in subjects with shoulder impingement syndrome: an experimental study. J Electromyogr Kinesiol. 2015;25(1):84–92.
    1. Muth S, Barbe MF, Lauer R, McClure PW. The effects of thoracic spine manipulation in subjects with signs of rotator cuff tendinopathy. J Orthop Sports Phys Ther. 2012;42(12):1005–1016.
    1. Haik MN, Alburquerque-Sendín F, Silva CZ, Siqueira-Junior AL, Ribeiro IL, Camargo PR. Scapular kinematics pre- and post-thoracic thrust manipulation in individuals with and without shoulder impingement symptoms: a randomized controlled study. J Orthop Sports Phys Ther. 2014;44(7):475–487.
    1. Kardouni JR, Pidcoe PE, Shaffer SW, et al. Thoracic spine manipulation in individuals with subacromial impingement syndrome does not immediately alter thoracic spine kinematics, thoracic excursion, or scapular kinematics: a randomized controlled trial. J Orthop Sports Phys Ther. 2015;45(7):527–538.
    1. Rosa DP, Alburquerque-Sendín F, Salvini TF, Camargo PR. Effect of seated thoracic manipulation on changes in scapular kinematics and scapulohumeral rhythm in young asymptomatic participants: a randomized study. J Manipulative Physiol Ther. 2013;36(8):546–554.
    1. McClure PW, Bialker J, Neff N, Williams G, Karduna A. Shoulder function and 3-dimensional kinematics in people with shoulder impingement syndrome before and after a 6-week exercise program. Phys Ther. 2004;84(9):832–848.
    1. Roy JS, Moffet H, Hébert LJ, Lirette R. Effect of motor control and strengthening exercises on shoulder function in persons with impingement syndrome: a single-subject study design. Man Ther. 2009;14(2):180–188.
    1. Struyf F, Nijs J, Mollekens S, et al. Scapular-focused treatment in patients with shoulder impingement syndrome: a randomized clinical trial. Clin Rheumatol. 2013;32(1):73–85.
    1. Worsley P, Warner M, Mottram S, et al. Motor control retraining exercises for shoulder impingement: effects on function, muscle activation, and biomechanics in young adults. J Shoulder Elbow Surg. 2013;22(4):e11–e19.
    1. McQuade KJ, Borstad J, de Oliveira AS. Critical and theoretical perspective on scapular stabilization: what does it really mean, and are we on the right track? Phys Ther. 2016;96(8):1162–1169.
    1. Yang JL, Jan MH, Chang CW, Lin JJ. Effectiveness of the end-range mobilization and scapular mobilization approach in a subgroup of subjects with frozen shoulder syndrome: a randomized control trial. Man Ther. 2012;17(1):47–52.
    1. Surenkok O, Aytar A, Baltaci G. Acute effects of scapular mobilization in shoulder dysfunction: a double-blind randomized placebo-controlled trial. J Sport Rehabil. 2009;18(4):493–501.
    1. Maher CG, Sherrington C, Herbert RD, Moseley AM, Elkins M. Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther. 2003;83(8):713–721.
    1. Wu G, van der Helm FC, Veeger HE, et al. ISB recommendation on definitions of joint coordinate systems of various joints for the reporting of human joint motion: part II. Shoulder, elbow, wrist and hand. J Biomech. 2005;38(5):981–992.
    1. Karduna AR, McClure PW, Michener LA, Sennett B. Dynamic measurements of three-dimensional scapular kinematics: a validation study. J Biomech Eng. 2001;123(2):184–190.
    1. Bialosky JE, Bishop MD, Price DD, Robinson ME, George SZ. The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Man Ther. 2009;14(5):531–538.
    1. Roy JS, Moffet H, Hébert LJ, St-Vincent G, McFadyen BJ. The reliability of three-dimensional scapular attitudes in healthy people and people with shoulder impingement syndrome. BMC Musculoskelet Disord. 2007;8:49.
    1. Teece RM, Lunden JB, Lloyd AS, Kaiser AP, Cieminski CJ, Ludewig PM. Three-dimensional acromioclavicular joint motions during elevation of the arm. J Orthop Sports Phys Ther. 2008;38(4):181–190.
    1. Warner MB, Chappell PH, Stokes MJ. Measurement of dynamic scapular kinematics using an acromion marker cluster to minimize skin movement artifact. J Vis Exp. 2015;96:e51717.
    1. Watson L, Balster SM, Finch C, Dalziel R. Measurement of scapula upward rotation: a reliable clinical procedure. Br J Sports Med. 2005;39(9):599–603.
    1. Michener LA, Elmore KA, Darter BJ, Timmons MK. Biomechanical measures in participants with shoulder pain: intra-rater reliability. Man Ther. 2016;22:86–93.
    1. Lempereur M, Brochard S, Leboeuf F, Rémy-Néris O. Validity and reliability of 3D marker based scapular motion analysis: a systematic review. J Biomech. 2014;47(10):2219–2230.
    1. Borstad JD, Ludewig PM. Comparison of scapular kinematics between elevation and lowering of the arm in the scapular plane. Clin Biomech (Bristol, Avon) 2002;17(9–10):650–659.
    1. Ludewig PM, Reynolds JF. The association of scapular kinematics and glenohumeral joint pathologies. J Orthop Sports Phys Ther. 2009;39(2):90–104.
    1. de Morais Faria CD, Teixeira-Salmela LF, de Paula Goulart FR, de Souza Moraes GF. Scapular muscular activity with shoulder impingement syndrome during lowering of the arms. Clin J Sport Med. 2008;18(2):130–136.
    1. Roy JS, MacDermid JC, Woodhouse LJ. Measuring shoulder function: a systematic review of four questionnaires. Arthritis Rheum. 2009;61(5):623–632.
    1. Alizadehkhaiyat O, Hawkes DH, Kemp GJ, Frostick SP. Electromyographic analysis of shoulder girdle muscles during common internal rotation exercises. Int J Sports Phys Ther. 2015;10(5):645–654.
    1. Pietrosimone BG, McLeod MM, Lepley AS. A theoretical framework for understanding neuromuscular response to lower extremity joint injury. Sports Health. 2012;4(1):31–35.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir