Progressive conscious control of scapular orientation with video feedback has improvement in muscle balance ratio in patients with scapular dyskinesis: a randomized controlled trial

Tsun Shun Huang, Wan Yu Du, Tyng Guey Wang, Yung Shen Tsai, Jing Lan Yang, Cheng Ya Huang, Jiu Jenq Lin*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Background: Video feedback (VF) can guide patients to consciously control scapular orientation without inappropriate substitution. This study investigated whether progressive conscious control with VF improves scapular muscle activation and movements during arm elevation in patients with subacromial impingement and scapular dyskinesis. Methods: The study recruited 38 amateur overhead athletes with subacromial impingement and scapular medial border prominence who were randomly assigned to the VF or control group. The participants in both groups controlled the scapular position and progressively practiced from 0° to 45° and from 0° to 90° of arm elevation. Participants in the VF group also controlled the scapular position with a video presentation of the scapula on a screen. We investigated the scapular kinematics, muscle activation, and balance ratio for outcome collection in the preintervention and postintervention conditions with and without VF conditions. Results: Decreased upper trapezius (UT) activation (3%-13%, P <.0083), increased lower trapezius (LT) activation (3%-17%, P <.0083), restored UT/LT ratios (0.67-3.13, P <.0083), and decreased scapular internal rotation (1.8°-6.1° P <.003) relative to the preintervention condition were demonstrated in the 2 postintervention conditions in both groups. The VF group also demonstrated decreased UT/serratus anterior ratios (0.21-0.30, P <.0083) in 2 postintervention conditions relative to the preintervention condition. Conclusions: The progressive control of scapular orientation with or without VF can be used to reduce the UT/LT ratio and improve scapular internal rotation during arm elevation. Control training with VF can further decrease the UT/serratus anterior ratio.

Original languageEnglish
Pages (from-to)1407-1414
Number of pages8
JournalJournal of Shoulder and Elbow Surgery
Volume27
Issue number8
DOIs
StatePublished - Aug 2018

Keywords

  • Level II
  • Randomized Controlled Trial
  • Subacromial impingement
  • Treatment Study
  • conscious control
  • feedback
  • kinematics
  • muscle activation
  • scapular dyskinesis

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