Omuz Sıkışma Sendromu olan Bireylerde Skapula-Spinöz Mesafesi Farkı ile Boyun ve Omuz Kas Kuvvetinin İncelenmesi

Year 2023, , 69 - 79, 31.12.2023

Bihter Akınoğlu , Sümeyye Karabacak , Ayfer Ezgi Yılmaz , Aydan Örsçelik , Tuğba Kocahan

https://doi.org/10.51538/intjourexerpsyc.1325267

Abstract

Omuz sıkışma sendromu stabilite ve mobilitede etkili olan yapıların subakromial arkta sıkışması ile oluşan kompleks bir durumdur. Bu duruma çeşitli faktörler sebep olmaktadır. Skapular diskinezi omuz sıkışma sendromu olan hastalarda sıklıkla görülen bir bulgu olup kas kuvvet dengesizliği ile ilişkilidir. Bu çalışmanın amacı omuz sıkışma sendromu olan bireylerde skapula-spinöz mesafe ile boyun ve omuz kas kuvveti arasındaki ilişkinin incelenmesi ve sağlıklı kontrol grubuyla karşılaştırılmasıdır. Araştırmaya omuz sıkışma sendromu tanısı alan (deney grubu) 12 hasta ile 8 sağlıklı (kontrol grubu) birey olmak üzere toplam 23 kişi dahil edildi. Araştırmada skapular diskinezi değerlendirmesi için ‘Lateral Skapula Testi’, kas kuvveti ölçümü için el dinamometresi ile kas kuvvet testi, ağrı ve disabilite durumunu değerlendirmek için ‘Omuz Ağrı ve Özürlülük (SPADI)’ ölçeği kullanıldı. İstatiksel analiz için Shapiro-Wilks testi, bağımsız örneklemler t-testi ve Mann-Whitney U testi kullanıldı. Deney ve kontrol grubunun skapular asimetri bakımından benzer oldukları belirlendi (p>0,05). Deney grubunda etkilenmiş taraf omuz fleksör, ekstansör, horizontal abdüktör, horizontal addüktör, internal rotatör ve eksternal rotatör kas kuvvetinin kontrol grubuna göre daha zayıf olduğu belirlendi (p<0.05). Çalışma grubunda boynun sağ lateral fleksörlerinin kas kuvvetinin kontrol grubuna göre daha zayıf olduğu (p=0.016); 45 derece abdüksiyon pozisyonunda değerlendirilen skapula-spinöz mesafe ile sağ omuz eksternal rotatör kas kuvveti arasında (p=0,004); sol omuz skapula-spinöz mesafe ile horizontal abdüktör kas kuvveti arasında (p=0,023) pozitif yönde anlamlı ilişki olduğu; 90 derece abdüksiyon pozisyonunda değerlendirilen skapula-spinöz mesafe (p:0,029) ile sol omuz fleksörlerinin ve ekstansörlerinin kas kuvveti arasında pozitif yönde anlamı ilişki olduğu belirlendi (p:0,039). Sonuç olarak omuz sıkışma sendromu olan bireylerde etkilenmiş taraf omuz kas kuvvetinin ve boyun lateral fleksiyon kas kuvvetinin etkilenmemiş tarafa göre daha düşük olduğu belirlenmiş ve omuz sıkışma sendromu olan bireylerin rehabilitasyon sürecinde omuz ve boyun kas kuvvetine yönelik tedavi planlanması gerektiği düşüncesine ulaşılmıştır.

Keywords

omuz sıkışma sendromu, skapula-spinöz, omuz kas kuvveti, boyun kas kuvveti

Investigation of Neck and Shoulder Muscle Strength by Scapula-Spinous Distance Difference in Individuals with Shoulder Impingement Syndrome

Abstract

Shoulder impingement syndrome is a complex condition caused by compression of the structures that effectively stabilize the subacromial arch. Various factors cause this condition. Scapular dyskinesia is common in patients with shoulder impingement syndrome and is associated with muscle strength imbalance. This study aimed to investigate the relationship between scapula-spinous distance and neck and shoulder muscle strength in individuals with shoulder impingement syndrome and to compare them with the healthy control group. A total of 23 individuals, including 12 patients with shoulder impingement syndrome (experimental group) and eight healthy individuals (control group), were included in the study. In the study, 'Lateral Scapula Test' was used for scapular dyskinesia evaluation, a muscle strength test with a hand dynamometer was used for muscle strength measurement, 'Shoulder Pain and Disability (SPADI)' scale was used to evaluate pain and disability status. Shapiro-Wilks’s test, independent samples t-test, and Mann-Whitney U test were used for statistical analysis. It was determined that the experimental and control groups were similar regarding scapular asymmetry (p>0.05). In the experimental group, the affected side shoulder flexor, extensor, horizontal abductor, horizontal adductor, horizontal adductor, internal rotator, and external rotator muscle strength was weaker than the control group (p<0.05). Muscle strength of the right lateral flexors of the neck was weaker in the study group compared to the control group (p=0. 016); there was a significant positive correlation between the scapula-spinous distance evaluated at 45 degrees abduction position and the right shoulder external rotator muscle strength (p=0.004); there was a significant positive correlation between the left shoulder scapula-spinous distance and the horizontal abductor muscle strength (p=0.023); there was a significant positive correlation between the scapula-spinous distance evaluated at 90 degrees abduction position (p:0.029) and the muscle strength of the left shoulder flexors and extensors (p:0.039). In conclusion, it was determined that the shoulder muscle strength and neck lateral flexion muscle strength of the affected side were lower than the unaffected side in individuals with shoulder impingement syndrome, and it was concluded that treatment should be planned for shoulder and neck muscle strength in the rehabilitation process of individuals with shoulder impingement syndrome.

Keywords

shoulder impingement syndrome, scapula-spinous, shoulder muscle strength, neck muscle strength

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