Effect of Scapular Dyskinesis on Disease Activity, Quality of Life, Level of Disability in Female Patients with Rheumatoid Arthritis

Yıl 2018, Cilt: 6 Sayı: 2, 125 - 134, 29.08.2018

Mehmet Delen Deran Oskay Songül Bağlan Zeynep Tuna Oğuzhan Mete Ahmet Gökkurt Gizem Töre Abdurrahman Tufan

https://doi.org/10.30720/ered.463651

Öz

Purpose: The purpose of the study
was to investigate the effects of scapular dyskinesis on quality of life and
level of disability among female patients with RA. Material and Methods: 52 patients with RA were
evaluated for the study, and they were divided equally into two groups with the
following criteria: patient has scapular dyskinesis (SD) (Group 1) or patient
does not have SD (Group 2). Disability level, Quality of Life (QoL), disease
activity, scapular dyskinesis, pain level and muscle strength were assessed with
Turkish version of Disabilities of Arm, Shoulder and Hand questionnaire
(DASH-T), Rheumatoid Arthritis specific Quality of Life questionnaire
(RAQoL-T), Rheumatoid Arthritis Disease Activity Index-5 (T-RADAI-5), Lateral
Scapular Slide Test, Visual Analog Scale (VAS), manual muscle test
respectively. Results: Both groups were
similar demographically. Results of the patient with SD (Group 1) were
significantly different in a negative way than those of the patient without SD
(Group 1) in DASH (p=0,001), RADAI-5 (p<0,001), RAQoL (p<0,001), VAS
right shoulder (p=0,002) and left shoulder (p=0,001). In Group 1, asymmetric
side shoulder had less external rotation muscle strength compared to simetric
side shoulder (p=0,046). Discussion: Clinic outcomes
of RA patients with SD are worse than those of without SD. Hence, SD may be
linked to demonstration of loss of clinic outcomes. Clinicians should not
ignore SD in patients with RA.

Anahtar Kelimeler

Scapular dyskinesis, Rheumatoid artrit, Quality of Life

Romatoid Artritli Kadın Hastalarda Skapular Diskinezinin Hastalık Aktivitesi, Yaşam Kalitesi ve Engel Seviyesine Etkisi

Öz

Amaç: Bu çalışmanın amacı romatoid artrit (RA) tanısı olan kadın hastalarda
skapular diskinezinin (SD) hastalık aktivitesi, yaşam kalitesi ve engel
seviyesi üzerine etkisini araştırmaktır. Gereç
ve Yöntem: Çalışmaya RA tanısı konmuş 52 kadın hasta dâhil edildi. Hastalar
SD olan (Grup 1) ve olmayan (Grup 2) şeklinde 26'şar kişilik iki gruba ayrıldı.
Hastaların hastalık aktivitesi Romatoid Artrit Hastalık Aktivitesi Endeksi-5
(T-RADAI-5) anketi, engel seviyesi Kol, Omuz ve El Engel Anketi (DASH-T), ağrı
düzeyi Görsel Analog Skalası (VAS), omuz çevresi kas kuvveti manuel kas kuvveti
testi, SD’leri gözlemsel skapular diskinezi değerlendirmesi ve Lateral skapular
kaydırma testi (LSKT), yaşam kaliteleri Romatoid Artrit Yaşam Kalitesi Anketi
(RAQoL-T) ile değerlendirildi. Tüm anketlerin Türkçe versiyonları kullanıldı. Sonuçlar: İki grup da demografik açıdan
birbirine benzer bulundu. SD’si olan RA'lı hastaların DASH (p=0,001), RADAI-5
(p<0,001), RAQoL (p<0,001), VAS sağ (p=0,002) ve sol (p=0,001) skorları
ile diğer grubun skorları arasında istatistiksel olarak Grup 2 lehine anlamlı
fark bulundu. Grup 1 hastalarının SD’li taraf omuz eksternal rotasyon kas
kuvveti, diğer omzun eksternal rotasyon kas kuvvetinden istatistiksel olarak
anlamlı derecede düşük bulundu (p=0,046). Tartışma:
SD’si olan RA hastalarında klinik bulguları SD’si olmayan gruba göre daha
kötüdür. Bu nedenle SD bulgusu bu hastalarda klinik bulgulardaki kayıpların
göstergesi olabilir. Klinisyenler tarafından SD gözardı edilmemelidir.

Anahtar Kelimeler

Romatoid Artrit, Skapular diskinezi, Yaşam kalitesi, Engel seviyesi

Kaynakça

• Ahlmén, M., Nordenskiöld, U., Archenholtz, B., Thyberg, I., Rönnqvist, R., Lindén, L., Andersson, A. K., & Mannerkorpi, K. (2005). Rheumatology outcomes: the patient's perspective. A multicentre focus group interview study of Swedish rheumatoid arthritis patients. Rheumatology (Oxford), 44(1), 105-110.
• Ballantyne, B.T., O'Hare, S.J., Paschall, J. L., Pavia-Smith, M. M., Pitz, A. M., Gillon, J. F., & Soderberg., G. L. (1993).
• Electromyographic activity of selected shoulder muscles in commonly used therapeutic exercises. Phys Ther, 73(10), 668-677.
• Ben-Yishay, A., Zuckerman, J. D., Gallagher, M., & Cuomo, F. (1994). Pain inhibition of shoulder strength in patients with impingement syndrome. Orthopedics, 17(8), 685-688.
• Bilberg, A., Bremell, T., & Mannerkorpi, K. (2012). Disability of the Arm, Shoulder and Hand questionnaire in Swedish patients with rheumatoid arthritis: A validity study. J Rehabil Med, 44(1), 7–11.
• Bjelle, A. (1989). Epidemiology of shoulder problems. Baillieres Clin Rheumatol, 3(3), 437-51.
• Boström, C., Harms-Ringdahl, K., & Nordemar, R. (1991). Clinical reliability of shoulder function assessment in patients with rheumatoid arthritis. Scand J Rehabil Med, 20(1), 36-48.
• Boström, C., Harms-Ringdahl, K., & Nordemar, R. (1995). Relationships between measurements of impairment, disability, pain, and disease activity in rheumatoid arthritis patients with shoulder problems. Scand J Rehabil Med, 24(6), 352–359.
• Böstrom C. (2000). Shoulder rotational strength, movement, pain and joint tenderness as indicators of upper-extremity activity limitation in moderate rheumatoid arthritis. Scand J Rehabil Med, 32(3), 134–9.
• Buckelew, S. P., & Parker, J. C. (1989). Coping with arthritis pain: A review of the literature. Arthritis Care Res, 2(4), 136-145. Burkhart, S. S., Morgan, C. D., & Kibler, W. B. (2000). Shoulder injuries in overhead athletes. The ‘‘dead arm’’ revisited. Clin Sports Med, 19(1), 125-58.
• Chipchase, L. S., O’Connor, D. A., Costi, J. J., & Krishnan, J. (2000). Shoulder impingement syndrome: preoperative health status. J Shoulder Elbow Surg, 9(1), 12-5.
• Clarke G. R., Willis L. A., Fish W. W., & Nichols P. J. (1975). Preliminary studies in measuring range of motion in normal and painful stiff shoulders. Rheumatol Rehabil, 14(1), 39-46.
• De Mey, K., Danneels, L., Cagnie, B.,& Cools, A. M. (2012). Scapular muscle rehabilitation exercises in overhead athletes with impingement symptoms effect of a 6-week training program on muscle recruitment and functional outcome. Am J Sports Med, 40(8), 1906-1915.
• Downie, W.W., Leatham, P. A., Rhind, V. W., Wright, V., Branco, J. A., & Anderson, J. A. (1978). Studies with pain rating scales. Ann Rheum Dis, 37(4), 378–381.
• Duger, T., Yakut, E., Oksuz, C., Yorukan, S., Bilgutay, B. S., Ayhan, Ç., Leblebicioğlu, G., Kayıhan, H., Kırdı, N., Yakut, Y., & Güler, Ç. (2006). Reliability and validity of the Turkish version of the Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire. Fizyoterapi Rehabilitasyon, 17(3), 99-107.
• Ekblom, B., Lovgren, O., Alderin, M., Fridstrom, M., & Satterstrom, G. (1974). Physical performance in patients with rheumatoid arthritis. Scand J Rheumatol, 3(3), 121–5.
• Ekdahl, C., & Broman, G. (1992). Muscle strength, endurance, and aerobic capacity in rheumatoid arthritis: a comparative study with healthy subjects. Ann Rheum Dis, 51(1), 35–40.
• Elliott, B., Fleisig, G., Nicholls, R., & Escamilia, R. (2003). Technique effects on upper limb loading in the tennis serve. J Sci Med Sport, 6(1), 76-87.
• Erol, Ö., Özçakar, L., & Çeliker, R. (2008). Shoulder rotator strength in patients with stage I-II subacromial impingement: Relationship to pain, disability, and quality of life. J Shoulder Elbow Surg, 17(6), 893-7.
• Guillemin, F., Briancon, S.,& Pourel, J. (1992). Functional disability in rheumatoid arthritis: two different models in early and established disease. J Rheumatol, 19(3), 366–9.
• Heigberg, T., & Kvien, T. K.(2002). Preferences for improved health examined in 1024 patients with rheumatoid arthritis: pain has the highest priority. Arthritis Rheum , 47(4), 391-397.
• Helmick, C. G., Felson, D. T., Lawrence, R. C., Gabriel, S., Hirsh R., & Kwoh, K. (2008). National Arthritis Data Workgroup. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Arthritis Rheum, 58(1), 15–25. Kelly, I. G., Foster, R. S., & Fisher, W. D. (1987). Neer total shoulder replacement in rheumatoid arthritis. J Bone Joint Surg Br, 69(5), 723-726.
• Kibler, W. B.(1998). The role of the scapula in athletic shoulder function. Am J Sports Med, 26(2), 325–337.
• Kibler, B. W., & McMullen, J. (2003). Scapular dyskinesis and its relation to shoulder pain. J Am Acad Orthop Surg, 11(2), 142-151.
• Kibler, W.B., & Sciascia, A. (2010). Current concepts: scapular dyskinesis. Br J Sports Med, 44(5), 300-305.
• Kibler, W.B., Ludewig, P.M., McClure, P.W., Michener, L.A., Bak, K., & Sciascia, A.D. (2013). Clinical implications of scapular dyskinesis in shoulder injury: the 2013 consensus statement from the ‘Scapular Summit’. Br J Sports Med, 47(14), 877-85.
• Krabben, A., Huizinga, T.W.,& van der Helm-van Mil, A.H. (2012). Undifferentiated arthritis characteristics and outcomes when applying the 2010 and 1987 criteria for rheumatoid arthritis. Ann Rheum Dis, 71(2), 238-41.
• Kutlay, S., Küçükdeveci, A. A., Gönül, D., & Tennant, A. (2003). Adaptation and validation of the Turkish version of the Rheumatoid Arthritis Quality of Life Scale. Rheumatol Int, 23(1), 21-26.
• Leeb, B. F., Haindl, P. M., Maktari, A., Nothnagl, T., & Rintelen, B. (2008). Patient-centered rheumatoid arthritis disease activity assessment by a modified RADAI. J Rheumatol, 35, 1294–9.
• Lefebvre, J. C., & Keefe, F. J. (2002). Memory for pain: the relationship of pain catastrophizing to the recall of daily rheumatoid arthritis pain. Clin J Pain, 18(1), 56-63.
• Liao, K.P., & Karlson, E.W. (2015). Classification and epidemiology of rheumatoid arthritis. In M.C. Hochberg, A.J. Silman, J.S. Smolen, M.E. Weinblatt, & M.H. Weisman (Eds.), Rheumatology (6th Edition, pp. 691-697). Philadelphia: Mosby Elsevier.
• López-Vidriero, E., López-Vidriero, R., Rosa, L. F., Gallardo, E., Fernández, J. A., Arriaza, R., & Ballesteros, J. (2015). Scapular Dyskinesis: Related Pathology. International Journal of Orthopaedics, 2(1), 191-195.
• Ludewig, P. M., & Reynolds, J. F. (2009). The association of scapular kinematics and glenohumeral joint pathologies. J Orthop Sports Phys Ther, 39(2), 90-104.
• Luime, J.J., Koes, B.W., Hendriksen, I.J., Burdorf, A., Verhagen, A.P., Miedema, H.S., & Verhaar, J. A. (2004). Prevalence and incidence of shoulder pain in the general population: a systematic review. Scand J Rheumatol, 33(2), 73–81
• MacDermid, J.C., Ramos, J., Drosdowech, D., Faber, K., & Patterson, S. (2004). The impact of rotator cuff pathology on isometric and isokinetic strength, function, and quality of life. J Shoulder Elbow Surg, 13(6), 593-8.
• Magarey, M. E., & Jones, M. A. (2003). Dynamic evaluation and early management of altered motor control around the shoulder complex. Man Ther, 8(4), 195-206.
• McKay, A. (2015). Scapular dyskinesis and its correlation to history of shoulder injuries and supraspinatus strength in NCAA division III baseball players( Master Thesis). The College of St. Scholastica, Ann Arbor, 23-29.
• Melzack, R., & Scott, T. H. (1957). The effects of early experience on the response to pain. J Comp Physiol Psychol, 50(2), 155.
• Merolla, G., De Santis, E., Sperling, J. W., Campi, F., Paladini, P., & Porcellini, G. (2010). Infraspinatus strength assessment before and after scapular muscles rehabilitation in professional volleyball players with scapular dyskinesis. J Shoulder Elbow Surg, 19(8), 1256-1264.
• Nordenskiöld, U. (1990). Elastic wrist orthoses. Reduction of pain and increase in grip force for women with rheumatoid arthritis. Arthritis Care Res, 3(3), 158–62.
• O’Dell J. R., Imboden, J. B., & Miller, L. D. (2013). Rheumatoid arthritis & Spondyloarthropathies. J.B. Imboden, D.B. Hellmann,& J.H. Stone (Eds.), Current Diagnosis & Treatmet (Third edition, pp. 139-155). New York: The McGraw-Hill Education.
• Odom, C. J., Taylor, A. B., Hurd, C. E., & Denegar, C. R. (2001). Measurement of scapular asymmetry and assessment of shoulder dysfunction using the Lateral Scapular Slide Test: a reliability and validity study. Phys Ther, 81(2), 799 – 809.
• Ostor, A. J., Richards, C. A., Prevost A.T., Speed C.A., & Hazlemen B. L. (2005). Diagnosis and relation to general health of shoulder disorders presenting to primary care. Rheumatology, 44(6), 800-5.
• Paletta, G. A., Warner, J. J., Warren, R. F., Deutsch, A., & Altchek, D.W. (1997). Shoulder kinematics with two-plane x-ray evaluation in patients with anterior instability or rotator cuff tearing. J Shoulder Elbow Surg, 6(6), 516-27.
• Porter, B. J., & Brittain, A. (2012). Splinting and hand exercise for three common hand deformities in rheumatoid arthritis: a clinical perspective. Curr Opin Rheumatol, 24(2), 215-221.
• Scibek, J. S., Mell, A. G., Downie, B. K., Carpenter, J. E., & Hughes, R.E. (2008). Shoulder kinematics in patients with full-thickness rotator cuff tears after a subacromial injection. J Shoulder Elbow Surg,17(1), 172-181.
• Selby, M. (2011). Managing chronic pain. Practice Nurse, 41(2), 14-19.
• Slungaard, B., & Mengshoel, A. M. (2013). Shoulder function and active motion deficit in patients with rheumatoid arthritis. Disabil Rehabil, 35(16), 1357–63.
• Smith, A. M., Sperling, J. W., & Cofield, R. H. (2005). Rotator cuff repair in patients with rheumatoid arthritis. J Bone Joint Surg Am, 87(8), 1782-1787.
• Spencer, J. D., Hayes, K. C., & Alexander, I. J. (1984). Knee joint effusion and quadriceps reflex inhibition in man. Arch Phys Med Rehabil, 65(4), 171-177.
• Stegbauer, J., Rump, L. C. & Weiner, S. M. (2008). Sites of inflammation in painful rheumatoid shoulder assessed by musculoskeletal ultrasound and power Doppler sonography. Rheumatol Int, 28, 459–465.
• Struyf, F., Nijs, J., Mollekens, S., Jeurissen, I., Truijen, S., Mottram, S., & Meeusen, R. (2013). Scapular-focused treatment in patients with shoulder impingement syndrome: a randomized clinical trial. Clin Rheumatol, 32(1), 73-85.
• Sunar, I., Yilmaz Tasdelen, O., Garip Cimen, Y., & Bodur, H. (2014). Translation and validation of the Turkish language version of the Rheumatoid Arthritis Disease Activity Index-5. Int J Rheum Dis,12, 1-8.
• Tamowska C., Amernik K., Matyia G., Brzsko I., Grzelec H., & Burak M. (2004). Fixation of the crico-arytenoid joints in rheumatoid arthritis-preliminary report. Otolaryngol Pol, 58(4), 843-9.
• Uhl, T.L., Kibler, W.B., Gecewich, B.,& Tripp, B.L. (2009). Evaluation of clinical assessment methods for scapular dyskinesis. Arthroscopy, 25(11), 1240-1248.
• Urwin, M., Symmons, D., Allison, T., Brammah, T., Busby, H., Roxby, M., Simmons, A., & Williams, G. (1998). Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis, 57(11), 649–55.
• Van der Windt, D.A., Koes, B.W., De Jong, B.A., & Bouter LM. (1995). Shoulder disorders in general practice: incidence, patient characteristics, and management. Ann Rheum Dis, 54(12), 959-64.
• Varnell, M.S. (2015). The evaluation of scapular kinematics and muscular characteristics of the scapular stabilizers in overhead athletes presenting with scapular dyskinesis compared to healthy controls (Doctoral Thesis). University of Pittsburgh School of Health and Rehabilitation Sciences, Pittsburg, 4-40.
• Vermeulen, H. M., Breedveld, F. C., Le Cessie, S., Rozing, P. M., van den Ende, C. H. M., & Vlieland, T.V. (2006). Responsiveness of the shoulder function assessment scale in patients with rheumatoid arthritis. Ann Rheum Dis, 65(2), 239-241.
• Viikari-Juntura, E., Shiri, R., Solovieva, S., Karpinnen, J., Leino-Arjas, P., Varonen, H., Kalso, E., & Ukkola, O. (2008). Risk factors of atherosclerosis and shoulder pain – Is there an association?. A systemic Review. Eur J Pain, 12(4), 412–426.
• Walker-Bone, K., Palmer, K.T., Reading, I., Coggon, D., & Cooper, C. (2004). Prevalence and impact ofmusculoskeletal disorders of the upper limb in the general population. Arthritis Rheum, 51(4), 642–651.
• Warner, J.J., Micheli, L.J., Arslanian, L.E., Kennedy, J.,& Kennedy, R.(1992). Scapulothoracic motion in normal shoulders and shoulders with glenohumeral instability and impingement syndrome. A study using Moire topographic analysis. Clin Orthop Relat Res. 285, 191-9.
• Warth, R. J.,& Millett, P. J. (2015). Physical examination of the shoulder: An Evidence-Based Approach, (pp. 219-239). New York: Springer.
• Welsing, P. M., Van Gestel, A. M., Swinkels, H. L., Kiemeney, L.A., & Van Riel, P. L. (2001). The relationship between disease activity, joint destruction, and functional capacity over the course of rheumatoid arthritis. Arthritis Rheum, 44(9), 2009-17.
• Wilk, K. E., Macrina, L. C., Fleisig, G. S., Porterfield, R., Simpson, C. D., Harker, P., Paparesta, N., & Andrews, J. R. (2011). Loss of internal rotation and the correlation to shoulder injuries in professional baseball pitchers. Am J Sports Med, 39(2), 329-335.
• Yüksel, E. (2014). Skapular diskinezisi olan subakromial sıkışma sendromlu olgularda skapular stabilizasyon egzersizlerinin etkinliği (Yüksek Lisans Tezi). Dokuz Eylül Üniversitesi Sağlık Bilimleri Enstitüsü, İzmir, 5-8.