The Association Between Scapular Dyskinesis in Asymptomatic Shoulders and Scapular Muscular Endurance, Lumbar, and Cervical Core Stability

Öz

The idea that the body works as a whole while producing movement has led to the kinetic chain approach. According to the kinetic chain approach, the study, which was planned cross-sectionally to examine the assosiation between scapular dyskinesia and scapular endurance, cervical and lumbar core stability in asymptomatic individuals with asymptomatic shoulders, included 31 volunteer participants aged 18-60 years with asymptomatic shoulders and no shoulder problems in the last year. In the study, scapular dyskinesia was evaluated using the Observational Scapular Dyskinesia Test and the Lateral Scapular Slide Test. Lumbar core stability and cervical core stability assessments were performed using Pressure Biofeedback Unit. Lumbar and cervical disability assessments were performed using the Oswestry Disability Index and Neck Disability Index. Scapular endurance assessment was performed using the Scapular Endurance Test. Sociodemographic characteristics of the participants were recorded in the evaluation form. In the study, scapular dyskinesia was observed in 19 participants according to the Lateral Scapular Slide Test and in 27 participants according to the Observational Scapular Dyskinesia Test. There was a moderate (p=0.026, r=-0.399) negative correlation between the results of the Lateral Scapular Slide Test and lumbar core stabilization and a low (p=-0.275, r=0.030) negative correlation between the results of the Observational Scapular Dyskinesia Test and lumbar core stability. There was a positive correlation (p=0,007, r=0,476) between the results of the Lateral Scapular Slide Test and scapular endurance. The results of our study showed that scapular dyskinesia is associated with scapular muscular endurance, cervical and lumbar core stability.

Anahtar Kelimeler

• kinetic chain
• upper extremity
• scapula
• sectional

Asemptomatik Omuzlarda Skapular Diskinezinin, Skapular Endurans, Lumbal ve Servikal Kor Stabilite ile İlişkisi

Öz

Vücudun hareket ortaya çıkartırken bir bütün olarak çalıştığı düşüncesi kinetik zincir yaklaşımını ortaya çıkarmıştır. Kinetik zincir yaklaşımına göre omuzu asemptomatik bireylerde skapular diskinezi ile skapular endurans, servikal ve lumbal kor stabilite arasındaki ilişkiyi incelemek amacıyla kesitsel olarak planlanan çalışmaya, omuzları asemptomatik 18-60 yaş aralığında olan, son bir yıl içerisinde herhangi bir omuz problemi yaşamayan ve çalışmaya katılmaya gönüllü 31 katılımcı dahil edildi. Çalışma kapsamında skapular diskinezi değerlendirmesi Gözlemsel Skapular Diskinezi Testi ve Lateral Skapular Kayma Testi kullanılarak yapıldı. Lumbal kor stabilite ve servikal kor stabilite değerlendirmeleri Pressure Biofeedback Unit kullanılarak yapıldı. Bel ve boyun bölgesini ilgilendiren özür durumunu sorgulamaları Oswestry Dizabilite İndeksi ve Boyun Özürlülük İndeksi kullanılarak yapıldı. Skapular endurans değerlendirmesi Skapular Endurans Testi kullanılarak yapıldı. Katılımcıların sosyodemografik özellikleri değerlendirme formuna kaydedildi. Çalışmada Lateral Skapular Kayma Testine göre 19 katılımcıda, Gözlemsel Skapular Diskinezi Testine göre 27 katılımcıda skapular diskinezi görüldü. Lateral Skapular Kayma Testi sonuçları ile lumbal kor stabilizasyon arasında orta düzeyde (p=0,026, r=-0,399) ve Gözlemsel Skapular Diskinezi Testi sonuçları ile lumbal kor stabilite arasında düşük düzeyde (p=-0,275, r=0,030) negatif bir ilişki bulundu. Lateral Skapular Kayma Testi sonuçları ile skapular endurans sonuçları arasında pozitif yönlü (p=0,007, r=0,476) bir ilişki bulundu. Çalışmamız sonuçları skapular diskinezi ile skapular kassal endurans, servikal ve lumbal kor stabilitenin ilişkili olduğunu göstermiştir.

Anahtar Kelimeler

• kinetik zincir
• üst ekstremite
• skapula
• kesitsel

Kaynakça

1. [1] Kibler, WB., Press, J., Sciascia, A. 2006 The Role of Core Stability in Athletic Function. Sports Medicine, 36(3), 189-98.
2. [2] Mcgil,L SM., Grenier, S., Kavcic, N., Cholewicki, J. 2003. Coordination of Muscle Activity to Assure Stability of The Lumbar Spine. Journal of Electromyography and Kinesiology, 13(4), 353-9.
3. [3] Rivera, CE. 2016. Core and Lumbopelvic Stabilization in Runners. Physical Medicine and Rehabilitation Clinics, 27(1), 319-37.
4. [4] Behm, DG,. Drinkwater, EJ., Willardson, JM., Cowley, PM. 2010. The Use of Instability to Train The Core Musculature. Applied Physiology, Nutrition, and Metabolism, 35(1), 91-108.
5. [5] Mcmullen, J., Uhl, TL. 2000. A Kinetic Chain Approach for Shoulder Rehabilitation. Journal of Athletic Training, 35(3), 329. [6] Pluim, BM. 2013. Scapular Dyskinesis: Practical Applications. BMJ Publishing Group Ltd. and British Association of Sport and Exercise Medicine, P. 875-6.
6. [7] Kibler, BW., Mcmullen, J. 2003. Scapular Dyskinesis and Its Relation to Shoulder Pain. Journal of The American Academy of Orthopaedic Surgeons, 11(2), 142-51.
7. [8] Konin, JG., Beil, N., Werner, G. 2003. Facilitating The Serape Effect to Enhance Extremity Force Production. International Journal of Athletic Therapy and Training, 8(2), 54-6.
8. [9] Ramiscal LS, Bolgla LA, Cook CE, Magel JS, Parada SA, Chong R. Reliability of the scapular dyskinesis test yes-no classification in asymptomatic individuals between students and expert physical therapists. Clinics in Shoulder and Elbow. 2022;25(4):321. [10] Kibler, WB., Uhl, TL., Maddux, JW., Brooks, PV., Zeller, B., Mcmullen, J. 2002. Qualitative Clinical Evaluation of Scapular Dysfunction: A Reliability Study. Journal of Shoulder and Elbow Surgery, 11(6), 550-6.

9. [11] Uhl, TL., Kibler, WB., Gecewich, B., Tripp, BL. 2009. Evaluation of Clinical Assessment Methods for Scapular Dyskinesis. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 25(11), 1240-8.
10. [12] Curtis T, Roush JR. The lateral scapular slide test: A reliability study of males with and without shoulder pathology. North American journal of sports physical therapy: NAJSPT. 2006;1(3):140.
11. [13] Ben, Kibler, W. 1998. The Role of the Scapula in Athletic Shoulder Function. The American Journal of Sports Medicine, 26(2), 325-37.
12. [14] Sahrmann, S., Azevedo, DC., Van, Dillen, L. 2017. Diagnosis and Treatment of Movement System Impairment Syndromes. Brazilian Journal of Physical Therapy, 21(6), 391-9. [15] Edmondston, SJ., Wallumrød, ME., Macléid, F., Kvamme, LS., Joebges, S., Brabham, GC. 2008. Reliability of Isometric Muscle Endurance Tests in Subjects with Postural Neck Pain. Journal of Manipulative & Physiological Therapeutics, 31(5), 348-54.
13. [16] Von, Garnier, K., Köveker, K., Rackwitz, B., Kober, U., Wilke, S., Ewert, T., Et Al. 2009. Reliability of A Test Measuring Transversus Abdominis Muscle Recruitment with A Pressure Biofeedback Unit. Physiotherapy, 95(1), 8-14.
14. [17] Tawde, P., Dabadghav, R., Bedekar, N., Shyam, A., Sancheti, P. 2016. Assessment of Cervical Range of Motion, Cervical Core Strength and Scapular Dyskinesia in Violin Players. International Journal of Occupational Safety and Ergonomics, 22(4), 572-6.
15. [18] Yakut, E., Düger, T., Öksüz, Ç., Yörükan, S., Üreten, K., Turan, D., Et Al. 2004. Validation of The Turkish Version of The Oswestry Disability Index for Patients with Low Back Pain. Spine, 29(5), 581-5.
16. [19] Kesiktas, N., Ozcan, E., Vernon, H. 2012. Clinimetric Properties of The Turkish Translation of A Modified Neck Disability Index. BMC Musculoskeletal Disorders, 13(1), 25.
17. [20] Faul, F., Erdfelder, E., Buchner, A., Lang, A-G. 2009. Statistical Power Analyses Using G* Power 3.1: Tests for Correlation and Regression Analyses. Behavior Research Methods, 41(4), 1149-60.
18. [21] Polit, DF., Beck, CT. 2008. Nursing Research: Generating and Assessing Evidence for Nursing Practice: Lippincott Williams & Wilkins.
19. [22] Cohen, J. 2013. Statistical Power Analysis for The Behavioral Sciences: Routledge.
20. [23] Ling, W. 2001. Physical Therapy Research: Principles and Applications, Ed 2. Physical Therapy, 81(11), 1843.
21. [24] Roche, SJ., Funk, L., Sciascia, A., Kibler, WB. 2015. Scapular Dyskinesis: The Surgeon’s Perspective. Shoulder & Elbow, 7(4), 289-97.
22. [25] Reuther, KE. 2014. The Role of Scapular Dyskinesis in Rotator Cuff and Biceps Tendon Pathology.
23. [26] Kibler, BW., Sciascia, A., Wilkes, T. 2012. Scapular Dyskinesis and Its Relation to Shoulder Injury. Journal of The American Academy of Orthopaedic Surgeons, 20(6), 364-72.
24. [27] Mcclure, P., Tate, AR., Kareha, S., Irwin, D., Zlupko, E. 2009. A Clinical Method for Identifying Scapular Dyskinesis, Part 1: Reliability. Journal of Athletic Training, 44(2), 160-4.
25. [28] Kon, Y., Nishinaka, N., Gamada, K., Tsutsui, H., Banks, SA. 2008. The Influence of Handheld Weight on The Scapulohumeral Rhythm. Journal of Shoulder and Elbow Surgery, 17(6), 943-6.
26. [29] Ludewig, PM., Reynolds, JF. 2009. The Association of Scapular Kinematics and Glenohumeral Joint Pathologies. Journal of Orthopaedic & Sports Physical Therapy, 39(2), 90-104.
27. [30] Pala, ÖO., Avcı, Ş. 2016. Elit Adölesanlarda Artistik Cimnastiğin Skapulotorasik Eklem Üzerine Etkisinin İncelenmesi. Türk Fizyoterapi ve Rehabilitasyon Dergisi, 27(2), 48-54.
28. [31] Pires, ED., Camargo, PR. 2018. Analysis of The Kinetic Chain in Asymptomatic Individuals with and without Scapular Dyskinesis. Clinical Biomechanics, 54, 8-15.
29. [32] De, Araújo, RC., Pirauá, ALT., Beltrão, NB., Pitangui, ACR. 2018. Activity of Periscapular Muscles and Its Correlation with External Oblique During Push-Up: Does Scapular Dyskinesis Change The Electromyographic Response? Journal of Sports Sciences, 36(5), 571-7. [33] Dündar, Ü., Solak, Ö., Demirdal, ÜS., Toktaş, H., Kavuncu, V. 2009. Kronik Bel Ağrılı Hastalarda Ağrı, Yeti Yitimi ve Depresyonun Yaşam Kalitesi ile Ilişkisi. Genel Tip Dergisi, 19(3).
30. [34] Szucs, K., Navalgund, A., Borstad, JD. 2009. Scapular Muscle Activation and Co-Activation Following A Fatigue Task. Medical & Biological Engineering & Computing, 47, 487-95.
31. [35] Şahinoğlu, E. 2015. Skapular Diskinezisi Olan Olgularda Posterior Omuz Gerginliğinin İncelenmesi. Yayınlanmamış Yüksek Lisans Tezi.
32. [36] Maffulli, N. 2011 Rotator Cuff Tear: Karger Medical And Scientific Publishers.