• Physical Therapy Korea
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• v.30 no.1
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• pp.41-49
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• 2023

Background: Scapular dyskinesis may cause not only rotator cuff (RC) tear but also weakness of the upper extremity, studies on scapular dyskinesis that may occur after RC repair is still lacking. Objects: To determine whether scapular dsykinesis was present in patients after arthroscopic RC repair and to investigate the influence of passive scapular stabilization on upper extremity strength. Methods: A total of 30 patients after RC repair participated in this study. To compare the scapula of the arthroscopic RC repair shoulder and the contralateral shoulder, the winged scapula (WS) was measured using a scapulometer and scapular dyskinesis was also classified by type. Fixed instruments for muscle strength measurements were used to measure upper extremity muscle strength differences depending on passive scapular stabilization position or natural scapular position. A chi-square test, an independent t-test and a 2-way mixed measures analysis of variance (ANOVA) was used as statistical analysis. In analyses, p < 0.05 was deemed to be statistically significant. Results: Postoperative shoulder had a significant association with scapular dyskinesis and the WS compared to the contralateral shoulder (F = 0.052, p < 0.01). Postoperative shoulder, muscle strength in the shoulder abduction (p < 0.01), elbow flexion (p < 0.01) and forearm supination (p < 0.05) were significantly greater in the scapular stabilization position than in the scapular natural position. Conclusion: Patients underwent arthroscopic RC repair had a significant association with scapular dyskinesis and muscle strength was improved by a passive scapular stabilization position, therefore scapular stabilization is important in rehabilitation program.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.271-277
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• 2009

Purpose: Scapular dyskinesis is an alteration in the normal position or motion of the scapula during coupled scapulohumeral movements. Vast majority of shoulder pathologies are known to be related with scapular motion abnormalities. Because there being enthusiasm about scapular pathology in recent literatures, understanding scapular dyskinesis seems to be an important subject. The authors describe the importance of scapular abnormality in terms of shoulder pathology. Materials and Methods: Usually the inhibition or disorganization of activation patterns in scapular stabilizing muscles lead to scapular dyskinesis. This motion abnormality has more important values in Elite Athletes because it might be the sign of future shoulder pathology; for example, SLAP and internal impingement. Treatment of scapular dyskinesis is directed at managing underlying causes and restoring normal scapular muscle activation patterns by kinetic chain-based rehabilitation protocols. Treatment is also important to prevent secondary shoulder injuries. Results and Conclusion: Understanding scapular pathology may be the main key to approach to the shoulder pathology. Also treating scapular pathology might be important in preventing secondary shoulder injuries.

• Physical Therapy Korea
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• v.24 no.1
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• pp.86-96
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• 2017

Background: Scapular dyskinesis is characterized by altered scapular position and motion. Specifically, excess activation of the Upper trapezius (UT) combined with decreased Lower trapezius (LT) and Serratus anterior (SA) have been observed. The Standard push-up plus exercise (SPP) is considered as a therapeutic exercise for increasing SA activity and maintaining the scapular kinematics. In addition, Using the Sling surface can lead to higher muscle activity. However, the advantage of an unstable surface has been uncertatin. Objects: To compare the activation of the UT, LT, and lower serratus anterior (LSA) muscles during various push-up plus exercises with and without sling in subjects with scapular dyskinesis. Methods: Total 18 male subjects with scapular dyskinesis were recruited. The UT, LT, and LSA electromyographic activities and the UT/LSA and UT/LT EMG activity ratios were measured during three push-up plus exercises with and without sling. Two-way repeated of analysis of variance was used to determine the statistical significance. Results: The UT activity was significantly lower in all postures without sling than that with sling. In addition, the LSA activity was significantly greater without than with sling, and significantly large in SPP, Low back supported push-up plus (LSPP), and Quadruped push-up plus. Additionally, the UT/LSA and UT/LT activity ratios were lower in SPP and LSPP without sling than with the other four push-up plus exercises. Conclusion: The push-up plus without sling were considered to decrease UT and increase LSA activity compared with exercises with sling. Furthermore, SPP without sling seems to be a more effective exercise for increasing LSA activity and lowering the UT/LSA and UT/LT activity ratios in scapular dyskinesis subjects.

• Clinics in Shoulder and Elbow
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• v.25 no.4
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• pp.321-327
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• 2022

Background: Scapular dyskinesis is considered a risk factor for the shoulder pain that may warrant screening for prevention. Clinicians of all experience screen scapular dyskinesis using the scapular dyskinesis test yes-no classification (Y-N), yet its reliability in asymptomatic individuals is unknown. We aimed to establish Y-N's intra- and inter-reliability between students and expert physical therapists. Methods: We utilized a cross-sectional design using consecutive asymptomatic subjects. Six students and two experts rated 100 subjects using the Y-N. Cohen's kappa (κ) and Krippendorff's alpha (K-α) were calculated to determine intra- and inter-rater reliability. Results: Intra- and inter-rater values for experts were κ=0.92 (95% confidence interval [CI], 0.91-0.93) and 0.85 (95% CI, 0.84-0.87) respectively; students were κ=0.77 (95% CI, 0.75-0.78) and K-α=0.63 (95% CI, 0.58-0.67). Conclusions: The Y-N is reliable in detecting scapular dyskinesis in asymptomatic individuals regardless of experience.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.1
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• pp.139-150
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• 2024

Purpose : Scapular dyskinesis, it have been shown to be common in overhead athletes and has been associated with RC muscle strength. Posterior shoulder tightness (PST) has been suggested as an important factor causing scapular dyskinesis. Therefore, rehabilitation programs should focus on a posterior shoulder stretch combined with scapular stabilization exercise (PSSE) intervention. Determine the effects of posterior shoulder stretch combined with scapular stabilization exercise on the rotator cuff (RC) muscles strength, functional strength ratio (FSR), range of motion (ROM), and pain. Methods : 30 adolescent baseball players participated and subjects were allocated PSSE group (n=15) or the SSE group (n=15). Both group performed a 6-weeks intervention and measured of isokinetic peak torque/body weight (PT/BW) of concentric external rotator (CER), eccentric external rotator (EER), concentric internal rotator (CIR), eccentric internal rotator (EIR), FSR, ROM, and pain. Results : After 6 weeks PSSE, significant increase CER PT/BW (+6.02±4.76 %), EER PT/BW (+5.39±4.22 %), EER to CIR ratio (+.17±.16), and internal rotation ROM (+15.08±3.57 °). Whereas, significant decrease EIR to CER ratio (-.14±.18), external rotation ROM (-12.00±6.94 °), and GIRD (-17.41±2.84 °) compared with pre-intervention. No significant difference of isokinetic PT/BW of CIR and EER post-intervention. In the SSE group showed no significant difference all measurements for isokinetic PT/BW, FSR, and ROM post-intervention. The pain was significant improve both PSSE group (-3.25±1.60) and SSE group (-2.83±1.85) post-intervention. Conclusion : Both the PSSE and SSE interventions led to more pain relief. However, only the PSSE group showed ROM, CER, EER PT/BW, and FSR improvements. These results might suggest that the PSSE intervention is a more effective program for improving RC muscle strength and balance, in particular, concentric and eccentric ER muscle strength, FSR and can expect to prevent shoulder injuries in adolescent baseball players with scapular dyskinesis.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.25 no.1
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• pp.45-52
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• 2019

Background: Scapular dyskinesis is one of the risk factors for upper extremity injury in patients with chronic stroke. Taping can used as an adjunctive treatment for this. The aim of this study was to investigate the effects of rigid tape in conjunction with elastic tape and elastic tape only on shoulder pain, proprioceptor, and function of chronic stroke patients with scapular dyskinesis. Methods: Participants were randomly assigned to elastic tape (ET) group (n=10) and both tape (BT) group (n=10). Both ET and BT groups performed therapeutic exercise on the upper extremity with taping applied for 4 weeks. Therapeutic exercise was performed 30min/day, 5 times/week. Clinical outcome measures used Numerical pain rating scale with a faces pain scale for pain, angle at shoulder join position sense (JPS) for proprioceptor, and Fugl-meyer assessment upper extremity for function. Results: Clinical outcomes were measured at initial baseline, after 4weeks. There were statistically significant differences in pain, JPS, and function after 4 weeks in both groups (p<.05). There was no significant difference in pain and JPS between the groups, and There was a statistically significant difference in function in the BT group compared to the ET group (p<.05). Conclusions: This results suggest that accurate clinical assessment and appropriate taping can improve proprioceptor and function of the upper extremity in patients with chronic stroke.

• Physical Therapy Korea
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• v.31 no.2
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• pp.142-150
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• 2024

Background: Scapular dyskinesis (SD) is closely related to imbalance of the rotator cuff (RC) muscles. However, previous studies have only focused on isometric strength. To our knowledge, there has been no study examining potential differences in concentric and eccentric strength and functional strength ratio (FSR) of the RC muscles based on functional parameters related to throwing in with or without SD. Objects: This study aimed to determine whether there was a difference in the RC muscle strength and FSR between the dominant shoulder with SD and the non-dominant shoulder without SD in adolescent baseball players. Methods: Forty adolescent baseball players participated and classified types of SD based on movement patterns using the SD test by two examiners. The isokinetic concentric and eccentric peak torque of the internal rotation (IR) and external rotation (ER) were measured and quantified as peak torque to body weight (PT/BW). Also, the FSR was obtained by calculating the strength ratios of eccentric IR to concentric ER (IRecc/ERcon) and eccentric ER to concentric IR (ERecc/IRcon), respectively. Results: There was a significant decrease in the IR and ER PT/BW in the dominant shoulder with SD compared to the non-dominant shoulder without SD (p < 0.05), regardless of contraction types. However, no significant difference was observed in the FSR in both IRecc/ERcon and ERecc/IRcon ratios. Conclusion: The findings indicate that the isokinetic concentric and eccentric PT/BW of the IR and ER muscles were significantly lower in the dominant shoulder with SD than in the nonthrowing shoulder without SD. Therefore, when establishing a strategy for addressing RC muscle weakness in adolescent baseball players with SD, it is essential to consider an approach that accounts for scapular kinematic recovery.

• Journal of Industrial Convergence
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• v.19 no.3
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• pp.83-90
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• 2021

The purpose of this study was to investigate the effect of scapular stabilization exercise and thoracic joint mobilization on scapular position, scapular motion and shoulder pain and disability index(SPADI) in adults with scapular dysfunction. A total 42 subjects were divided into a scapular stabilization exercise group(A, n=14), a thoracic joint mobilization group(B, n=14) and scapular stabilization exercise with thoracic joint mobilization group(C, n=14) and performed exercise and joint mobilization three times per week for four weeks, total 12 times. As for changes in scapular position among the groups, group C showed statistically significant increase(p<.05). In changes of scapular motion among the groups, group C showed statically significant improvement in shoulder abduction 45° and 90° both(p<.05), In changes of SPADI among the groups, group C were showed statistically significant improvement(p<.05). In conclusion, scapular stabilization exercise and thoracic joint mobilization were effective on improving scapular position, movement and SPADI score in adults with scapular dysfunction.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2007.11a
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• pp.153-161
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• 2007

견관절의 ABER position에서 posterosuperior rotator cuff 가 posterior glenoid에 contact 하여 internal impingement가 일어나는 현상은 운동선수가 아닌 일반인에게도 발생하는 physiologic phenomenon이며 과도한 반복 동작으로 인하여 증상이 발현한다. Internal impingement는 증상이 모호할 뿐만 아니라 견관절 내 여러 병소가 함께 존재하기 때문에 각각의 pathology에 대한 자세하고 정확한 evaluation이 필수적이다. 아직 controversy가 있지만 internal impingement의 pathologic factors로서는 anterior capsular laxity (true anterior laxity), posteroinferior capsular tightness (pseudo anterior laxity)와 이로 인한 glenohumeral internal rotation deficit (GIRD), 그리고 SICK scapula syndrome (scapular dyskinesis) 등으로 요약할 수 있다. 진단은 주로 병력 청취와 신체 검사로 내려지며 ultrasonogram, MRA등으로 확진한다. Sleeper stretching exercise 등과 같은 보존적 치료에 반응이 좋지만 6개월간의 재활 치료에도 호전이 없다면 증상과 직접 관련된 주 병소(appropriate pathology)를 찾아 이에 대한 적절한 수술이 이루어져야 한다.