The Association Of Scapular Kinematics And Glenohumeral Joint Pathologies Pdf

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Scapulothoracic and Glenohumeral Kinematics During Daily Tasks in Users of Manual Wheelchairs

The overhead throwing movement has been reported to be the fastest athletic movement performed in sports. The coupled and coordinated movement between the scapula and humerus plays an important role for normal shoulder function, particularly in overhead athletes.

Scapular posterior tilting and scapular external rotation are considered as a secondary scapular motion and an accessory motion of the scapula, respectively, and both motions move the anterior acromion posteriorly to avoid rotator cuff compression. Previous studies have reported changes in scapular kinematics between the dominant and nondominant shoulders of athletes who were involved in overhead sports 16 , 17 and between athletes of overhead sports and nonathlete controls 17 , 18 and were believed to be a sport-specific adaption in overhead athletes.

Several systematic reviews on changes in scapular kinematics have been carried out in specific shoulder pathologies such as subacromial impingement syndrome and different shoulder musculoskeletal disorders 25 , 26 ; however, no systematic review summarized the results of studies on the changes in scapular kinematics in overhead athletes with and without rotator cuff tendinopathy. In view of the current uncertainty regarding the changes in scapular kinematics in athletes of overhead sports, the aim of this study is to systematically review the literature and to summarize the scapular kinematics patterns in overhead athletes with and without rotator cuff tendinopathy.

Finding from this study may provide a better understanding of the pathogenesis of rotator cuff tendinopathy in athletes of overhead sports and underpin preventive and rehabilitative programs. Published articles that examined the scapular kinematics in overhead athletes with and without rotator cuff tendinopathy were reviewed using the guidelines by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

Supplementary searches were carried out by hand searching the reference lists of the included studies. One reviewer X. Relevant studies were accessed for full-text review prior to inclusion in the systematic review.

The methodological quality of each study was assessed independently by 2 reviewers X. The Downs and Black checklist was modified to include criteria that were relevant to assess potential bias in the included studies, with a maximum score of All data were extracted by 2 reviewers X.

The electronic search identified relevant studies, and 4 additional papers were identified by hand searching from the references lists of the studies. Citation: Journal of Sport Rehabilitation 29, 6; The sample size ranged from 21 to 60, and the age of the participants ranged between 18 and 32 years.

Wide range of overhead athletes, such as baseball, 16 — 19 , 21 volleyball, 17 , 20 , 34 , 35 handball, 34 , 35 swimming, 22 and tennis, 17 were examined. The study quality of all included studies was low. The ICC for the interrater reliability between the 2 reviewers was. Therefore, a modified checklist with a maximum score of 15 was yielded.

The majority of the studies used an electromagnetic tracking device to examine the scapular kinematics during humeral elevation at the scapular plane, 17 — 19 , 21 , 35 and the reliability results were reported to be moderate to excellent ICC ranging from. Of the 4 studies that compared the changes in scapular kinematics between the dominant and nondominant shoulders of athletes who were involved in overhead sports, 16 , 17 2 out of 4 studies reported significant increase in scapular upward rotation, 16 whereas one study reported significant decrease in upward rotation in dominant shoulders than in nondominant shoulders, 35 and one study found no difference when comparing between the dominant and the nondominant shoulders.

Of the 3 studies that compared the changes in scapular kinematics between overhead athletes and nonathlete individuals, 18 , 34 , 35 2 out of 3 studies reported a significant increase in scapular upward rotation in overhead athletes than in nonathletes control, 18 , 34 whereas the other study reported no difference in scapular upward rotation. Among the 4 studies that compared the scapular kinematics in athletes with and without rotator cuff tendinopathy, 2 out of 4 studies reported a significant decrease in scapular upward rotation in athletes with rotator cuff tendinopathy, 20 , 22 whereas the remaining 2 studies found no significant difference.

This systematic review summarized the changes in scapular kinematics in asymptomatic overhead athletes and those with rotator cuff tendinopathy. From our systematic review, consistent pattern of increased scapular anterior tilting and internal rotation was reported in the dominant shoulders than the nondominant shoulders of athletes who participated in overhead sports. Athletes of overhead sports seem to demonstrate an increase in scapular upward rotation during arm elevation when compared with nonathlete individuals.

However, there is no consensus on the scapular kinematics pattern in athletes with rotator cuff tendinopathy when compared with healthy controls. From our systematic review, a consistent pattern of increased scapular anterior tilting and internal rotation was reported in the dominant shoulders than in the nondominant shoulders of athletes who participated in overhead sports.

Previous studies have shown significant loss of internal rotation range of motion glenohumeral internal rotation deficit , 36 increased humeral retroversion, 37 , 38 tightness of the posterior shoulder capsule and muscles, 39 , 40 and tightness of pectoralis minor 41 , 42 in the dominant shoulders of athletes who participated in overhead sports, and these were associated with increased scapular anterior tilting and internal rotation. On the other hand, athletes of overhead sports seem to demonstrate an increase in scapular upward rotation during arm elevation when compared with nonathlete individuals.

Decreased scapular upward rotation and increased anterior tilting and internal rotation during arm elevation were believed to contribute to rotation cuff tendinopathy when the acromial failed to achieve adequate clearance of the rotator cuff tendons during arm elevation 48 ; however, our current systematic review did not support this assumption.

Among the 4 studies that compared the scapular kinematics in athletes with and without rotator cuff tendinopathy, conflicting results were reported, and there is no consensus on the scapular kinematics pattern in athletes with rotator cuff tendinopathy when compared with healthy controls.

Weakness or imbalanced activation of the scapular muscles has been reported in athletes with rotator cuff tendinopathy, 20 , 21 , 23 , 49 and these were associated with alterations in scapular kinematics 20 , 21 , 23 and narrowing of the subacromial space. Changes in scapular kinematics may be an adaptation to sports practice in athletes of overhead sports; however, the exact mechanism on how these changes may be related to shoulder disorders remains unknown.

Whether changes in scapular kinematics may contribute to rotator cuff tendinopathy warrants further investigation with high-quality prospective study. There is no consensus on the scapular kinematics pattern in athletes with rotator cuff tendinopathy when compared with healthy controls.

Scapular-focused intervention has been developed to address scapular muscle deficits in patients with rotator cuff tendinopathy. More prospective studies are required to identify the changes in scapular kinematics in athletes of overhead sports and how it may contribute to rotator cuff tendinopathy.

Different motion capture systems and Euler decomposition as well as different arm elevation task might affect the results of the included studies.

From our systematic review, increased scapular anterior tilting and internal rotation were reported in the dominant shoulders than in the nondominant shoulders of athletes who participated in overhead sports.

More high-quality studies are required to identify the scapular kinematic patterns in athletes with and without rotator cuff tendinopathy. Methods Published articles that examined the scapular kinematics in overhead athletes with and without rotator cuff tendinopathy were reviewed using the guidelines by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

Table 1 Search Term Search term 1. Rotator cuff. Rotator cuff tendon. Teres minor. Subacromial bursa. Shoulder impingement. Subacromial impingement. Suacromial bursitis. Sport Assessment of Methodological Quality and Risk of Bias The methodological quality of each study was assessed independently by 2 reviewers X.

Data Extraction and Synthesis All data were extracted by 2 reviewers X. Results Study Selection The electronic search identified relevant studies, and 4 additional papers were identified by hand searching from the references lists of the studies.

Mean SD not reported. Scapular Kinematics Measurement Protocol The majority of the studies used an electromagnetic tracking device to examine the scapular kinematics during humeral elevation at the scapular plane, 17 — 19 , 21 , 35 and the reliability results were reported to be moderate to excellent ICC ranging from.

Scapular Kinematics in Healthy Overhead Athletes Of the 4 studies that compared the changes in scapular kinematics between the dominant and nondominant shoulders of athletes who were involved in overhead sports, 16 , 17 2 out of 4 studies reported significant increase in scapular upward rotation, 16 whereas one study reported significant decrease in upward rotation in dominant shoulders than in nondominant shoulders, 35 and one study found no difference when comparing between the dominant and the nondominant shoulders.

Scapular Kinematics in Overhead Athletes With Rotator Cuff Tendinopathy Among the 4 studies that compared the scapular kinematics in athletes with and without rotator cuff tendinopathy, 2 out of 4 studies reported a significant decrease in scapular upward rotation in athletes with rotator cuff tendinopathy, 20 , 22 whereas the remaining 2 studies found no significant difference. Discussion This systematic review summarized the changes in scapular kinematics in asymptomatic overhead athletes and those with rotator cuff tendinopathy.

Scapular Kinematics in Healthy Overhead Athletes From our systematic review, a consistent pattern of increased scapular anterior tilting and internal rotation was reported in the dominant shoulders than in the nondominant shoulders of athletes who participated in overhead sports.

Scapular Kinematics in Overhead Athletes With Rotator Cuff Tendinopathy Decreased scapular upward rotation and increased anterior tilting and internal rotation during arm elevation were believed to contribute to rotation cuff tendinopathy when the acromial failed to achieve adequate clearance of the rotator cuff tendons during arm elevation 48 ; however, our current systematic review did not support this assumption.

Clinical Implications and Future Directions Changes in scapular kinematics may be an adaptation to sports practice in athletes of overhead sports; however, the exact mechanism on how these changes may be related to shoulder disorders remains unknown. Conclusion From our systematic review, increased scapular anterior tilting and internal rotation were reported in the dominant shoulders than in the nondominant shoulders of athletes who participated in overhead sports.

Dominant vs nondominant shoulders. Downar and Sauers, 16 Dominant vs nondominant shoulder of 43 healthy overhead athletes baseball, volleyball, and tennis , all male gender. Dynamic humeral elevation in scapular plane. Increased in dominant shoulders than nondominant shoulders Ribeiro and Pascoal, 35 Dynamic full shoulder elevation in scapular plane.

Decreased in dominant shoulders than nondominant shoulders volleyball: 1. Decreased in dominant shoulders than nondominant shoulders volleyball: Increased in dominant shoulders than nondominant shoulders handball: Healthy athletes vs nonathletes. Decreased in overhead athletes than nonathletes volleyball: Athletes with rotator cuff tendinopathy vs control.

Decreased in athletes with rotator cuff tendinopathy than controls 3. Decreased in athletes with rotator cuff tendinopathy than controls 6. Decreased in athletes with rotator cuff tendinopathy than controls 4. Downar and Sauers Ribeiro and Pascoal

Disorders of the Scapula and Their Role in Shoulder Injury

The overhead throwing movement has been reported to be the fastest athletic movement performed in sports. The coupled and coordinated movement between the scapula and humerus plays an important role for normal shoulder function, particularly in overhead athletes. Scapular posterior tilting and scapular external rotation are considered as a secondary scapular motion and an accessory motion of the scapula, respectively, and both motions move the anterior acromion posteriorly to avoid rotator cuff compression. Previous studies have reported changes in scapular kinematics between the dominant and nondominant shoulders of athletes who were involved in overhead sports 16 , 17 and between athletes of overhead sports and nonathlete controls 17 , 18 and were believed to be a sport-specific adaption in overhead athletes. Several systematic reviews on changes in scapular kinematics have been carried out in specific shoulder pathologies such as subacromial impingement syndrome and different shoulder musculoskeletal disorders 25 , 26 ; however, no systematic review summarized the results of studies on the changes in scapular kinematics in overhead athletes with and without rotator cuff tendinopathy. In view of the current uncertainty regarding the changes in scapular kinematics in athletes of overhead sports, the aim of this study is to systematically review the literature and to summarize the scapular kinematics patterns in overhead athletes with and without rotator cuff tendinopathy. Finding from this study may provide a better understanding of the pathogenesis of rotator cuff tendinopathy in athletes of overhead sports and underpin preventive and rehabilitative programs.

Scapulothoracic and Glenohumeral Kinematics During Daily Tasks in Users of Manual Wheelchairs

Wheeled Mobility Biomechanics View all 10 Articles. Current prevailing thought is that mechanical impingement of the soft tissues that reside within the subacromial space between the humeral head and coracoacromial arch is a major contributor to the shoulder pain in users of MWCs. The subacromial space size is directly related to the kinematics at the shoulder joint. Yet to be answered are questions about which common daily tasks are characterized by the most potentially detrimental kinematics. Objective: The purpose of this analysis was to quantify and compare potentially detrimental kinematics in three common tasks performed by individuals with spinal cord injury and shoulder pain.

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Static evaluation of scapular positioning in healthy individuals. Mailing address. OBJECTIVE: Evaluate the static positioning of the scapula on the rib cage in healthy subjects by means of clinical and radiographic evaluation to assess inter-examiner reliability of clinical examination and verify the reliability of this evaluation method compared to the radiographic examination. The static clinical examination, following the protocol suggested by Burkhart et al, was performed repeatedly by two independent examiners, followed by the radiographic examination, which was later examined by the first evaluator. The inter-examiner reliability and that of the clinical examination in relation to radiography were considered low and very low, respectively.

Scapular Kinematics in Athletes With and Without Rotator Cuff Tendinopathy: A Systematic Review

There is a growing body of literature associating abnormal scapular positions and motions, and, to a lesser degree, clavicular kinematics with a variety of shoulder pathologies. The purpose of this manuscript is to 1 review the normal kinematics of the scapula and clavicle during arm elevation, 2 review the evidence for abnormal scapular and clavicular kinematics in glenohumeral joint pathologies, 3 review potential biomechanical implications and mechanisms of these kinematic alterations, and 4 relate these biomechanical factors to considerations in the patient management process for these disorders. There is evidence of scapular kinematic alterations associated with shoulder impingement, rotator cuff tendinopathy, rotator cuff tears, glenohumeral instability, adhesive capsulitis, and stiff shoulders. There is also evidence for altered muscle activation in these patient populations, particularly, reduced serratus anterior and increased upper trapezius activation. Scapular kinematic alterations similar to those found in patient populations have been identified in subjects with a short rest length of the pectoralis minor, tight soft-tissue structures in the posterior shoulder region, excessive thoracic kyphosis, or with flexed thoracic postures.

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. 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. 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.

The association of scapular kinematics and glenohumeral joint pathologies.

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It publishes original research articles on topics related to the areas of physical therapy and rehabilitation sciences, including clinical, basic or applied studies on the assessment, prevention, and treatment of movement disorders. The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two receding years. CiteScore measures average citations received per document published. Read more. SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact. SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.

Skip to search form Skip to main content You are currently offline. Some features of the site may not work correctly. DOI: Ludewig and J. Ludewig , J. Reynolds Published Medicine The Journal of orthopaedic and sports physical therapy.

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