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International Journal of Environmental... Apr 2020: This study intends to summarize the causes, clinical examination, and treatments of scapular dyskinesis (SD) and to briefly investigate whether alteration can be... (Review)
Review
: This study intends to summarize the causes, clinical examination, and treatments of scapular dyskinesis (SD) and to briefly investigate whether alteration can be managed by a precision rehabilitation protocol planned on the basis of features derived from clinical tests. : We performed a comprehensive search of PubMed, Cochrane, CINAHL and EMBASE databases using various combinations of the keywords "Rotator cuff", "Scapula", "Scapular Dyskinesis", "Shoulder", "Biomechanics" and "Arthroscopy". : SD incidence is growing in patients with shoulder pathologies, even if it is not a specific injury or directly related to a particular injury. SD can be caused by multiple factors or can be the trigger of shoulder-degenerative pathologies. In both cases, SD results in a protracted scapula with the arm at rest or in motion. : A clinical evaluation of altered shoulder kinematics is still complicated. Limitations in observing scapular motion are mainly related to the anatomical position and function of the scapula itself and the absence of a tool for quantitative SD clinical assessment. High-quality clinical trials are needed to establish whether there is a possible correlation between SD patterns and the specific findings of shoulder pathologies with altered scapular kinematics.
Topics: Biomechanical Phenomena; Dyskinesias; Humans; Range of Motion, Articular; Scapula; Shoulder; Shoulder Joint
PubMed: 32344746
DOI: 10.3390/ijerph17082974 -
Kinesiologic considerations for targeting activation of scapulothoracic muscles - part 2: trapezius.Brazilian Journal of Physical Therapy 2019The trapezius is an extensive muscle subdivided into upper, middle, and lower parts. This muscle is a dominant stabilizer of the scapula, normally operating... (Review)
Review
BACKGROUND
The trapezius is an extensive muscle subdivided into upper, middle, and lower parts. This muscle is a dominant stabilizer of the scapula, normally operating synergistically with other scapular muscles, most notably the serratus anterior. Altered activation, poor control, or reduced strength of the different parts of the trapezius have been linked with abnormal scapular movements, often associated with pain. Several exercises have been designed and studied that specifically target the different parts of the trapezius, with the goal of developing exercises that optimize scapular position and scapulohumeral rhythm that reduce pain and increase function.
METHODS
This paper describes the anatomy, kinesiology, and pathokinesiology of the trapezius as well as exercises that selectively target the activation of the different parts of this complex muscle.
CONCLUSIONS
This review provides the anatomy and kinesiology of the trapezius muscle with the underlying intention of understanding how this muscle contributes to the normal mechanics of the scapula as well as the entire shoulder region. This paper can guide the clinician with planning exercises that specifically target the different parts of the trapezius. It is recommended that this paper be read as a companion to another paper: Kinesiologic considerations for targeting activation of scapulothoracic muscles - part 1: serratus anterior.
Topics: Dyskinesias; Exercise Therapy; Humans; Muscle, Skeletal; Scapula; Shoulder; Superficial Back Muscles
PubMed: 30797676
DOI: 10.1016/j.bjpt.2019.01.011 -
Scientific Reports Nov 2020Upper crossed syndrome (UCS) refers to the altered muscle activations and movement patterns in scapulae along with some abnormal alignment in the upper quarter, which... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
Upper crossed syndrome (UCS) refers to the altered muscle activations and movement patterns in scapulae along with some abnormal alignment in the upper quarter, which may contribute to the dysfunction of the cervicothoracic and glenohumeral joints. The present study aimed to investigate the effectiveness of a comprehensive corrective exercise program (CCEP) and subsequent detraining on alignment, muscle activation, and movement pattern in men with the UCS. This randomized controlled trial included 24 men. The intervention group conducted CCEP (8 weeks), followed by four weeks of detraining and the control group maintained normal daily activities. Electromyography of selected muscles, scapular dyskinesis test, head, shoulder, and thoracic spine angle were measured at baseline, post-test, and follow-up. There were significant differences for Group x time interaction and also for within-group from pre-test to post-test and follow-up in all outcomes. Also, significant differences were observed in three outcomes at post-test and follow-up between the CCEP and control group in favor of the CCEP. In Conclusion, the present study demonstrates that the CCEP for individuals with UCS is feasible and effective, improving muscle activation imbalance, movement patterns, and alignment. Importantly, these improvements were maintained after four weeks of detraining, suggesting lasting neuromuscular re-training adaptations.
Topics: Adult; Dyskinesias; Electromyography; Exercise; Exercise Therapy; Humans; Male; Movement; Muscles; Scapula; Shoulder; Shoulder Joint; Spine
PubMed: 33244045
DOI: 10.1038/s41598-020-77571-4 -
Annals of Physical and Rehabilitation... Jan 2018The global range of motion of the arm is the result of a coordinated motion of the shoulder complex including glenohumeral (GH), scapulothoracic, sternoclavicular and... (Review)
Review
BACKGROUND
The global range of motion of the arm is the result of a coordinated motion of the shoulder complex including glenohumeral (GH), scapulothoracic, sternoclavicular and acromioclavicular joints.
METHODS
This study is a non-systematic review of kinematic patterns in degenerated shoulders. It is a based on our own research on the kinematics of the shoulder complex and clinical experience.
RESULTS
For patients with subacromial impingement syndrome without rotator-cuff tears, most kinematic studies showed a small superior humeral translation relative to the glenoid and decreased scapular lateral rotation and posterior tilt. These scapular kinematic modifications could decrease the subacromial space and favor rotator-cuff tendon injury. For patients with shoulder pain and restricted mobility, the studies showed a significant increase in scapular lateral rotation generally seen as a compensation mechanism of GH decreased range of motion. For patients with multidirectional GH instability, the studies found an antero-inferior decentering of the humeral head, decreased scapular lateral rotation and increased scapular internal rotation.
CONCLUSION
The clinical or instrumented assessment of the shoulder complex with a degenerative pathology must include the analysis of scapula-clavicle and trunk movements complementing the GH assessment. Depending on the individual clinical case, scapular dyskinesis could be the cause or the consequence of the shoulder degenerative pathology. For most degenerative shoulder pathologies, the rehabilitation program should take into account the whole shoulder complex and include first a scapular and trunk postural-correcting strategy, then scapulothoracic muscle rehabilitation (especially serratus anterior and trapezius inferior and medium parts) and finally neuromotor techniques to recover appropriate upper-limb kinematic schemas for daily and/or sports activities.
Topics: Biomechanical Phenomena; Humans; Range of Motion, Articular; Rotation; Scapula; Shoulder; Shoulder Impingement Syndrome; Shoulder Pain
PubMed: 28987866
DOI: 10.1016/j.rehab.2017.09.002 -
Journal of Ayub Medical College,... 2018Various shoulder bone deformities have been identified in the pediatric age group, with the most common being undescended scapula. Sprengel's deformity is dysplasia and...
Various shoulder bone deformities have been identified in the pediatric age group, with the most common being undescended scapula. Sprengel's deformity is dysplasia and malposition of the scapula, especially in the supraspinatus portion, mainly due to abnormal descent in the embryonic period. The clavicle is shorter and has a different contour. In some patients cervical spine deformities are also noted. This is a case of 3 years old girl presented to the clinic with difficulty in abducting right shoulder and sleeping with an internal rotation of the right arm. With physical examinations and radiological investigations sprengel's deformity was diagnosed. Sprengel's deformity is a male predominant disease which almost never occurs in isolation and is usually associated with deformities in the thoracic rib cage and the cervical and thoracic vertebrae. Our patient also had hyperpigmentation along the lines of Blaschko, which has never been previously reported with Sprengel's deformity. Sprengel's may have an association with cutaneous mosacism syndrome.
Topics: Child, Preschool; Congenital Abnormalities; Female; Humans; Hyperpigmentation; Scapula; Shoulder Joint
PubMed: 29504352
DOI: No ID Found -
Current Topics in Developmental Biology 2019In tetrapods, the scapular and pelvic girdles perform the important function of anchoring the limbs to the trunk of the body and facilitating the movement of each... (Review)
Review
In tetrapods, the scapular and pelvic girdles perform the important function of anchoring the limbs to the trunk of the body and facilitating the movement of each appendage. This shared function, however, is one of relatively few similarities between the scapula and pelvis, which have significantly different morphologies, evolutionary histories, embryonic origins, and underlying genetic pathways. The scapula evolved in jawless fish prior to the pelvis, and its embryonic development is unique among bones in that it is derived from multiple progenitor cell populations, including the dermomyotome, somatopleure, and neural crest. Conversely, the pelvis evolved several million years later in jawed fish, and it develops from an embryonic somatopleuric cell population. The genetic networks controlling the formation of the pelvis and scapula also share similarities and differences, with a number of genes shaping only one or the other, while other gene products such as PBX transcription factors act as hierarchical developmental regulators of both girdle structures. Here, we provide a detailed review of the cellular processes and genetic networks underlying pelvis and scapula formation in tetrapods, while also highlighting unanswered questions about girdle evolution and development.
Topics: Animals; Evolution, Molecular; Fishes; Gene Expression Regulation, Developmental; Homeodomain Proteins; Pelvic Bones; Scapula; T-Box Domain Proteins; Vertebrates
PubMed: 30797513
DOI: 10.1016/bs.ctdb.2018.12.007 -
The British Journal of Radiology Sep 2019Scapulothoracic dissociation is a rare and potentially limb- and life-threatening injury, that results from high-energy trauma. Scapulothoracic dissociation has the... (Review)
Review
Scapulothoracic dissociation is a rare and potentially limb- and life-threatening injury, that results from high-energy trauma. Scapulothoracic dissociation has the potential to be overlooked in the acute setting, especially in the setting of polytrauma. Therefore, a careful search for this condition should be performed in all patients with high-energy shoulder girdle injuries. The goals of this article are to review the anatomy of the scapulothoracic articulation as well as the spectrum, imaging evaluation, differential diagnosis and management of scapulothoracic dissociations.
Topics: Diagnosis, Differential; Diagnostic Imaging; Humans; Multiple Trauma; Scapula; Shoulder Injuries
PubMed: 31046412
DOI: 10.1259/bjr.20190090 -
Ugeskrift For Laeger Apr 2019A well-functioning scapula provides a stable base for the humerus and allows free motion of the arm through a smooth glide over the posterior thoracic wall. This is... (Review)
Review
A well-functioning scapula provides a stable base for the humerus and allows free motion of the arm through a smooth glide over the posterior thoracic wall. This is possible through intimate interaction between anatomy and muscles. This can be disturbed by painful conditions, nerve dysfunctions, over-/underperformance of muscles, anatomic variations and trauma. In this review, we describe anatomy, biomechanics and different pathologies of the scapula: muscular imbalances, nerve dysfunctions, snapping scapula, tumours and fractures. We discuss, how the different conditions are diagnosed and treated.
Topics: Humans; Scapula; Thoracic Wall
PubMed: 30950369
DOI: No ID Found -
The Indian Journal of Medical Research Mar 2014
Topics: Child; Congenital Abnormalities; Humans; India; Magnetic Resonance Imaging; Male; Poland Syndrome; Radiography; Ribs; Scapula; Shoulder Joint
PubMed: 24820847
DOI: No ID Found -
Revue Medicale de Liege May 2016Supra-scapular nerve (SSN) damage is a rare, but classical diagnosis that can often be overlooked since the nonspecific clinical history and examination commonly lead to... (Review)
Review
Supra-scapular nerve (SSN) damage is a rare, but classical diagnosis that can often be overlooked since the nonspecific clinical history and examination commonly lead to the misdiagnosis of another shoulder disorder. This article details the etiopathology, the patients at risk, the reasons for consultation and the clinical aspects of suprascapular neuropathy; it also outlines its diagnostic and therapeutic approaches.
Topics: Brachial Plexus Neuropathies; Diagnosis, Differential; Humans; Peripheral Nervous System Diseases; Scapula; Shoulder
PubMed: 27337843
DOI: No ID Found