The Restoration of Neuromuscular Control of the Scapulothoracic Muscles and Its Effect on Subacromial Impingement Syndrome

Abstract

Background: The subacromial impingement syndrome occupies a very large percentage of shoulder pathologies as the rates even reach 44 to 60 percent. It has been proven that in painful conditions, especially in subacromial impingement syndrome, there seems to be an alteration of the person's motor and neuromuscular control ability, especially of the scapula, as changes are observed in the muscle activation of the scapulothoracic muscles, significantly affecting the patient's functional levels. The main objective of this review is to examine the currently available research on the rehabilitation of the neuromuscular control of the scapulothoracic muscles in people with Subacromial Impingement Syndrome and to clarify which techniques can improve motor control of the scapula. Methods: PubMed, Cochrane Library, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and Google Scholar were search. All types of study designs were included, except of case reports and case series. The using medical subject headings were ‘impingement syndrome’, ‘shoulder impingement syndrome’ and ‘Exercises scapula stabilization', 'Scapula exercises', 'Scapula rehabilitation'. Results: The initial search strategy generated 9351 references after duplicate removal. All 324 were kept for full-text review, 6 unique studies were included in the review. Conclusion: The reported research on restoring neuromuscular control of the scapulothoracic muscles in individuals with subacromial impingement syndrome appears to be very encouraging as their findings show an increase in the individual's ability to voluntarily and involuntarily control their scapula kinematics through better activation of the scapulothoracic muscles. Key words: Subacromial impingement syndrome; neuromuscular control; scapula; scapulothoracic muscles; functional capacity