The Effectiveness of Scapular Stabilization Exercises in Patients with Subacromial Impingement Syndrome and Scapular Dyskinesis
Başkurt, Z., Başkurt, F., Gelecek, N. and Özkan, M.H., 2011.
Setting the scene:
Alterations of the normal position or any abnormal motion of the scapula during active motions of shoulder is termed Scapular Dyskinesis and considered important risk factors for developing shoulder impingement syndrome. Some studies reported that decreased activity of the serratus anterior and middle and lower trapezius muscles; increased activity of the upper trapezius muscle may adversely affect scapular positioning, including scapular dyskinesis. Shoulder exercises must integrate scapular stabilization techniques in order to keep the scapula in the proper position to prevent impingement. The aim of the study was to investigate the effectiveness of the scapular stabilization exercises in comparison with a control therapy in patients with subacromial impingement syndrome and scapular dyskinesis.
What did they do?
This study was carried out on 44 patients who have scapular dyskinesis and had been diagnosed as subacromial impingement syndrome (SIS). Before treatment all the patients were randomly assigned to two groups. Standard physiotherapy program (electrotherapy, ultrasound treatment, stretching and strengthening exercises) were applied to the control group and standard physiotherapy program with scapular stabilization exercises were applied to the experimental group. All the patients received 20 sessions of physiotherapy for five times per week. Main outcome measures were shoulder pain (visual analog scale; VAS), shoulder range of motion, muscle strength, Scapular Dyskinesis Test, Scapular Reposition Test, scapular upward rotation, perceived symptoms changes and upper extremity functionality with Shoulder Pain and Disability Index (SPADI). The results showed that all measurements were improved statistically in both groups after treatment. When the measurements of groups which performed after treatment compared, the experiment group had a much better result in terms of shoulder pain relief, muscle strength, improvement in scapular dyskinesis, perceived symptoms changes and upper extremity functionality and determined a significant difference between groups.
Takeaway message:
There were significant improvements in both groups. However, scapular stabilization exercises in addition to standard physiotherapy program seems to augment the effects of physiotherapy program. Scapular stabilization exercises should be used for improvement in the presence of scapular dyskinesis in patients with SIS and scapular dyskinesis.