Is there a relationship between subacromial impingement syndrome and scapular orientation? A systematic review

Ratcliffe, Elizabeth; Pickering, Sharon; McLean, Sionnadh; Lewis, Jeremy

doi:10.1136/bjsports-2013-092389

Cited by 118 publications

(79 citation statements)

References 54 publications

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“…Along with several basic studies, there has been particular interest in scapular kinematics during elevation of the arms. 10,11) In general, during arm elevation, the scapula rotates in three dimensions: upward rotation, posterior tilt, and external rotation with respect to the thorax. 12,13) Recent studies using electromagnetic sensor-based motion analysis devices have reported that the scapular kinematics of impingement syndrome patients (excluding rotator cuff tears) involve a significant decrease in motion compared to that of healthy individuals.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional Scapular Kinematics During Arm Elevation in Massive Rotator Cuff Tear Patients

Miura

Kai

Morihara

et al. 2017

PRM

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Objective: Rotator cuff tears can influence shoulder kinematics and severely impair function. However, there have been no studies on three-dimensional (3D) shoulder kinematics in massive rotator cuff tear (MRCT) patients. Hypothesizing that MRCT patients could demonstrate significantly changed scapular kinematics during arm elevation in the scapular plane, we compared 3D scapular kinematics in the scapular plane between MRCT patients and healthy elderly subjects. Methods:We assessed 15 shoulders of 11 MRCT patients and 16 shoulders of 16 healthy subjects. With the subjects seated, we used an electromagnetic tracking system to calculate the upward rotation, posterior tilt, and internal rotation of the scapula at 10° increments from 30° to 120° with respect to the thorax. We performed two-way analysis of covariance with the initial position of the scapular motion as the covariate and performed multiple comparisons using the Bonferroni method. Results: MRCT patients exhibited significantly higher scapular upward rotation than did the healthy subjects (P < 0.05). There were no significant differences between groups with regard to posterior tilt and internal rotation. Conclusions: This study indicated that when MRCT patients elevated their arms, they exhibited a significantly higher scapular upward rotation at low-to mid-range elevations compared with that of healthy subjects. This difference may have resulted from a compensatory effect in response to the decreased elevation torque caused by the loss of rotator cuff function. These results may assist rehabilitation strategies to improve active arm elevation in MRCT patients.

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Section: Introductionmentioning

confidence: 99%

Three-dimensional Scapular Kinematics During Arm Elevation in Massive Rotator Cuff Tear Patients

Miura

Kai

Morihara

et al. 2017

PRM

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“…Evaluate the effect of loading on scapular movement, as other studies have suggested that differences in kinematics are clearer in the presence of loading. 10,35,36 4. Investigate the relationship between shoulder pathology, age, years since injury, and body mass index (BMI) and scapular positioning.…”

Section: Dynamic Three-dimensional Ultrasound To Evaluate Scapular Momentioning

confidence: 99%

Dynamic Three-Dimensional Ultrasound to Evaluate Scapular Movement Among Manual Wheelchair Users and Healthy Controls

Worobey

Lin

Koontz

et al. 2015

Topics in Spinal Cord Injury Rehabilitation

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Background: A large percentage of individuals with spinal cord injury (SCI) report shoulder pain that can limit independence and quality of life. The pain is likely related to the demands placed on the shoulder by transfers and propulsion. Shoulder pathology has been linked to altered scapular mechanics; however, current methods to evaluate scapular movement are invasive, require ionizing radiation, are subject to skin-based motion artifacts, or require static postures. Objective: To investigate the feasibility of applying 3-dimensional ultrasound methods, previously used to look at scapular position in static postures, to evaluate dynamic scapular movement. Method: This study evaluated the feasibility of the novel application of a method combining 2-dimensional ultrasound and a motion capture system to determine 3-dimensional scapular position during dynamic arm elevation in the scapular plane with and without loading. Results: Incremental increases in scapular rotations were noted for extracted angles of 30°, 45°, 60°, and 75° of humeral elevation. Group differences were evaluated between a group of 16 manual wheelchair users (MWUs) and a group of age-and gender-matched able-bodied controls. MWUs had greater scapular external rotation and baseline pathology on clinical exam. MWUs also had greater anterior tilting, with this difference further accentuated during loading. The relationship between demographics and scapular positioning was also investigated, revealing that increased age, pathology on clinical exam, years since injury, and body mass index were correlated with scapular rotations associated with impingement (internal rotation, downward rotation, and anterior tilting). Conclusion: Individuals with SCI, as well as other populations who are susceptible to shoulder pathology, may benefit from the application of this imaging modality to quantitatively evaluate scapular positioning and effectively target therapeutic interventions.

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“…7,8 Ratcliffe et al, conducted a systematic review and reported insufficient evidence to support the role of aberrant posture in the pathogenesis of SAIS potentially due to the complex and multifactorial nature of SAIS and lack of consistency between study methodologies. 10 Considering contradictory reports, more research is needed for the identification of aberrant postural adaptations in SAIS patients in order to facilitate the implementation of assessment-driven targeted interventions. Hence, the purpose of this study was to compare several postural variables between the SAIS patients and asymptomatic healthy controls.…”

Section: Pbackgroundmentioning

confidence: 99%

Postural Alterations in Patients With Subacromial Impingement Syndrome

Alizadehkhaiyat

Roebuck

Makki

et al. 2017

Intl J Sports Phys Ther

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Background: An aberrant upper body posture has been proposed as one of the etiological factors contributing to the development of subacromial impingement syndrome (SAIS). Clinicians have translated this supposition into assessment and rehabilitation programs despite insufficient and conflicting evidence to support this approach. Purpose:The purpose of this study was to compare several postural variables between the SAIS patients and asymptomatic healthy controls. Study Design: Case-Control StudyMethods: A total of 75 participants including 39 patients (20 females; 19 males) and 36 healthy controls (15 females; 21 males) participated in the study. Study evaluated several postural variables including forward head posture (FHP), forward shoulder posture (FSP), thoracic kyphosis index (TKI), scapular index (SI), normalized scapular protraction (NSP), and the lateral scapular slide test (LSST). The variables were compared between patient and control groups according to sex.Results: Significant differences were observed in the female patients compared to asymptomatic controls for the FHP (49.3Њ+9.6o vs 55.5o+8.3Њ, p=0.03), FSP (45.5Њ+10.1o vs 53.6Њ+7.0Њ, p=0.02), and LSST in third position (10.2+2.1cm vs 11.5+0.7cm, p=0.01). Male patients showed a significant difference only in the FSP compared to controls (61.9o+9.4o vs 49.7Њ+9.2Њ, p<0.001).Conclusions: While inadequate data on the relationship between dysfunctional posture and SAIS has led to broad variations in current rehabilitation strategies, the results of the present study revealed different patterns of postural aberrations in female and male patients with SAIS. This clarifies the need to develop individualized or sex-specific approaches for assessing posture in men and women with SAIS and rehabilitation programs based on the assessment results. Level of Evidence: 3b

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Is there a relationship between subacromial impingement syndrome and scapular orientation? A systematic review

Cited by 118 publications

References 54 publications

Three-dimensional Scapular Kinematics During Arm Elevation in Massive Rotator Cuff Tear Patients

Three-dimensional Scapular Kinematics During Arm Elevation in Massive Rotator Cuff Tear Patients

Dynamic Three-Dimensional Ultrasound to Evaluate Scapular Movement Among Manual Wheelchair Users and Healthy Controls

Postural Alterations in Patients With Subacromial Impingement Syndrome

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