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Scapular behavior in shoulder impingement syndrome
Luc J Hébert1, Hélène Moffet, Bradford J McFadyen
1Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec Rehabilitation Institute, Quebec City, Que., Canada. ljhebert@MICROTEC.net
Archives of Physical Medicine and Rehabilitation
|January 10, 2002
Summary
Shoulder impingement syndrome (SIS) involves altered scapular motion. While group analysis shows no difference between symptomatic and asymptomatic shoulders, individual analysis reveals that reduced anterior tilting in the affected shoulder may indicate high risk for chronic SIS, guiding rehabilitation.
Area of Science:
- Biomechanics of the shoulder girdle.
- Clinical assessment of shoulder impingement syndrome.
Background:
- Unilateral shoulder impingement syndrome (SIS) affects scapular kinematics.
- Understanding scapular rotation contributions is crucial for diagnosing and treating SIS.
Purpose of the Study:
- Quantify individual scapular rotation contributions to total range of motion (ROM) in SIS patients.
- Compare three-dimensional (3D) scapular attitudes between symptomatic and asymptomatic shoulders during flexion and abduction.
- Classify SIS subjects based on scapular tilting differences.
Main Methods:
- Compared 3D scapular attitudes, total ROM, and rotation contributions in 41 SIS patients and 10 healthy controls.
- Measured scapular attitudes in standardized positions during arm flexion and abduction.
- Classified subjects based on scapular anterior tilting asymmetry between shoulders.
Main Results:
- Anterior tilting dominated scapular ROM in flexion (48.2%-51.3%), while external rotation was key in abduction (40.3%-42.4%).
- Scapular total ROM was greater in abduction than flexion.
- SIS subjects exhibited different 3D scapular patterns compared to healthy individuals; however, group analysis showed no significant differences between symptomatic and asymptomatic shoulders in SIS patients, except for minor transverse rotation differences.
Conclusions:
- Scapular ROM contributions vary by arm elevation plane in SIS.
- While group data show symmetry, individual analysis reveals significant sagittal plane asymmetry, with reduced anterior tilting in symptomatic shoulders potentially indicating high risk for chronic SIS.
- Restoring anterior tilting is a key focus for rehabilitation in SIS.