EXAMINATION OF THE RELATIONSHIP BETWEEN SCAPULAR DYSKINESIA AND SCAPULAR ENDURANCE

Abstract

The aim of this study is to examine the effect of scapular dyskinesia on scapular endurance and the relationship between dyskinesia and endurance in asymptomatic individuals. Scapular dyskinesia tests (lateral scapular slide test, scapular assistance test, scapular retraction test) and scapular muscular endurance tests (scapular muscular endurance test, push-up test on the wall, isometric scapular pinch test) were performed bilaterally. Ninety participants (female: 58.9%; male: 41.1%) aged 22.45±3.19 years were included in the study. The dominant extremity of 97.8% of the participants was right. Scapular dyskinesia was found in 34.4% of the lateral scapular slide test at 0° and 45°, and 36.7% at 90°. The positivity in scapular retraction test and scapular assistance test was higher on the dominant side. Participants' scapular muscular endurance test was 50.71±29.37 seconds, and push-up test was 30.17±19.70 times. The isometric scapular pinch test was positive in 27.8% (n=25) of the participants. The pain felt by the participants during the isometric scapular pinch test was 1.74±2.60 points. Scapular muscular endurance test results were found to be lower in groups with positive lateral scapular slide test (p<0.05). Isometric scapular pinch test results were found to be significantly different only in 90° of lateral scapular slide test (p<0.05). According to the scapular retraction test and scapular assistance test, the results of the scapular muscular endurance test and the push-up test of the dominant sides of the subgroups that were positive were calculated to be lower (p<0.05). There was no correlation between the pain scores felt by the participants during the isometric scapular pinch test with the results of the scapular muscular endurance test and the push-up test (p>0.05). Scapular endurance decreases in the presence of scapular dyskinesia. This is especially evident in the presence of scapular dyskinesia in the dominant extremity. The relationship between the pain felt during the isometric scapular pinch test and the result of the scapular dyskinesia tests has not been determined.

Keywords

• Dominant side
• endurance
• scapular dyskinesia

SKAPULAR DİSKİNEZİ İLE SKAPULAR ENDURANS İLİŞKİSİNİN İNCELENMESİ

Abstract

Bu çalışmanın amacı, asemptomatik bireylerde skapular diskinezi varlığının skapular enduransa etkisini ve diskinezi ile endurans arasındaki ilişkiyi incelemektir. Katılımcıların skapular diskinezi testleri (lateral skapular kayma testi, skapular destek testi, skapular retraksiyon testi) ve skapular kassal endurans testleri (skapular kassal endurans testi, duvarda push-up testi, izometrik skapular tutam testi) bilateral olarak yapılmıştır. Çalışmaya yaşı 22,45±3,19 yıl olan 90 katılımcı (kadın: %58,9; erkek: %41,1) alındı. Katılımcıların %97,8’inin dominant ekstremitesi sağ taraftı. Lateral skapular kayma testinin 0° ve 45°’deki incelemesinde %34,4, 90°’deki incelemesinde %36,7 oranında skapular diskinezi saptandı. Skapular retraksiyon ve skapular destek testlerindeki pozitiflik durumu dominant tarafta daha yüksek orandaydı. Katılımcıların skapular kassal endurans testi 50,71±29,37 saniye, duvarda push-up testi 30,17±19,70 tekrar bulundu. Katılımcıların %27,8’inde (n=25) izometrik skapular tutam testi pozitif bulundu. İzometrik skapular tutam testi sırasında katılımcıların hissettiği ağrı 1,74±2,60 puandı. Lateral skapular kayma testi pozitif olan gruplarda skapular kassal endurans testi sonucu düşük bulundu (p<0,05). İzometrik skapular tutam testi sonuçlarının ise lateral skapular kayma testinin yalnızca 90°’sinde anlamlı farklılık oluşturduğu bulundu (p<0,05). Skapular retraksiyon ve skapular destek testlerine göre pozitiflik saptanan alt grupların dominant taraflarına ait skapular kassal endurans testi ve duvarda push-up testi sonuçları daha düşük olarak hesaplandı (p<0,05). Katılımcıların izometrik skapular tutam testi sırasında hissettikleri ağrı skorları ile skapular kassal endurans testi ve duvarda push-up testi sonuçları arasında ilişki bulunmadı (p>0,05). Skapular diskinezi varlığında skapular endurans azalmaktadır. Bu durum özellikle dominant ekstremitede skapular diskinezi varlığında belirginleşmektedir. İzometrik tutam testi sırasında hissedilen ağrının skapular diskinezi testlerinin sonucu ile ilişkisi belirlenmemiştir.

Keywords

• Dominant taraf
• endurans
• skapular diskinezi

References

1. Ben Kibler, W. (1998). The Role of the Scapula in Athletic Shoulder Function. The American Journal of Sports Medicine, 26(2), 325–337.
2. Edmondston, S. J., Wallumrød, M. E., MacLéid, F., Kvamme, L. S., Joebges, S., & Brabham, G. C. (2008). Reliability of isometric muscle endurance tests in subjects with postural neck pain. Journal of Manipulative and Physiological Therapeutics, 31(5), 348–354.
3. Eraslan, U., Gelecek, N., Genc, A. (2013). Effect of scapular muscle endurance on chronic shoulder pain in textile workers. Journal of Back and Musculoskeletal Rehabilitation, 26, 25–31.
4. Guru, K., Parveen, N. (2013). Isometric Endurance of Neck Muscles and Muscles for Scapular Positioning in Individuals with and without Postural Neck Pain. The Internet Journal of Applied Health Sciences and Practice, 11(2), 1–11.
5. Huang, T. S., Du, W. Y., Wang, T. G., Tsai, Y. S., Yang, J. L., Huang, C. Y., & Lin, J. J. (2018). Progressive conscious control of scapular orientation with video feedback has improvement in muscle balance ratio in patients with scapular dyskinesis: a randomized controlled trial. Journal of Shoulder and Elbow Surgery, 27(8), 1407–1414.
6. Huang, T. S., Chen, W. J., Du, W. Y., & Lin, J. J. (2020). Measurement of scapular prominence in symptomatic dyskinesis using a novel scapulometer: reliability and the relationship to shoulder dysfunction. Journal of Shoulder and Elbow Surgery, 29(9), 1852–1858.
7. Kibler, B.W., Sciascia, A., Wilkes, T. (2012). Scapular Dyskinesis and Its Relation to Shoulder Injury. Journal of the American Academy of Orthopaedic Surgeons, 20(6), 364–372.
8. Kibler, W., Sciascia, A., Dome, D. (2006). Evaluation of apparent and absolute supraspinatus strength in patients with shoulder injury using the scapular retraction test. The American Journal of Sports Medicine, 34(10), 1643–1647.

9. 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. British Journal of Sports Medicine, 47(14), 877–885.
10. Kibler, W. B., Stone, A. V., Zacharias, A., Grantham, W. J., & Sciascia, A. D. (2021). Management of Scapular Dyskinesis in Overhead Athletes. Operative Techniques in Sports Medicine, 29(1), 150797.
11. Kibler, W.B., Sciascia, A. (2016). The Shoulder at Risk: Scapular Dyskinesis and Altered Glenohumeral Rotation. Operative Techniques in Sports Medicine, 24(3), 162–169.
12. Nodehi Moghadam, A., Vahabi, S. P., Norasteh, A. A., & Abolhasani, H. (2018). Comparing Isometric Strengths of Shoulder Girdle Muscles in Females With and Without Scapular Dyskinesis. Journal of Rehabilitation, 19(2), 92–101.
13. Nowotny, J., Kopkow, C., Mauch, F., & Kasten, P. (2016). Effective rehabilitation in patients with scapular dyskinesis. Obere Extremität, 11(1), 40–46.
14. Oliveira, V. M. A. D., Silva, H. A. D., Pitangui, A. C. R., Passos, M. H. P. D., & Araújo, R. C. D. (2018). Scapular dyskinesis was not associated with pain and function in male adolescent athletes. Brazilian Journal Of Pain, 1(1).
15. Özünlü Pekyavaş, N., Kunduracılar, Z., Uzun, A., Ergüneş, C., Tonga, E., & Karataş, M. (2014). The relationship between scapular dyskinesia, pain, range of motion and flexibility in patients with neck and shoulder problems. Ağrı - The Journal of The Turkish Society of Algology, 26(3), 119–125.
16. Pala, Ö.O., Avcı, Ş. (2016). Elit Adölesanlarda Artistik Cimnastiğin Skapulotorasik Eklem Üzerine Etkisinin İncelenmesi. Türk Fizyoterapi ve Rehabilitasyon Dergisi, 27(2), 48–48.
17. Pires, E.D., Camargo, P.R. (2018). Analysis of the kinetic chain in asymptomatic individuals with and without scapular dyskinesis. Clinical Biomechanics, 54, 8–15.
18. Saini, S.S., Shah, S.S., Curtis, A.S. (2020). Scapular Dyskinesis and the Kinetic Chain: Recognizing Dysfunction and Treating Injury in the Tennis Athlete. Current Reviews in Musculoskeletal Medicine, 13(6), 748–756.
19. Smith, J., Kotajarvi, B. R., Padgett, D. J., & Eischen, J. J. (2002). Effect of scapular protraction and retraction on isometric shoulder elevation strength. Archives of physical medicine and rehabilitation, 83, 367–370.
20. Tooth, C., Schwartz, C., Fransolet, C., Tubez, F., Colman, D., Croisier, J. L., & Forthomme, B. (2020). Influence of scapular dyskinesis, kinesiotaping and fatigue on tennis serve performance. International Journal of Performance Analysis in Sport, 20(3), 456–469.
21. Uga, D., Nakazawa, R., Sakamoto, M. (2016). Strength and muscle activity of shoulder external rotation of subjects with and without scapular dyskinesis. Journal of Physical Therapy Science, 28(4), 1100–1105.
22. Umehara, J., Kusano, K., Nakamura, M., Morishita, K., Nishishita, S., Tanaka, H., ... & Ichihashi, N. (2018). Scapular kinematic and shoulder muscle activity alterations after serratus anterior muscle fatigue. Journal of Shoulder and Elbow Surgery, 27(7), 1205–1213.