The effect of scapular stabilization exercises on shoulder pain, scapular dyskinesis, muscle strength, and function in patients with subacromial impingement: a systematic review
DOI:
https://doi.org/10.47197/retos.v80.119119Keywords:
Scapular stabilization exercises, scapular dyskinesis, subacromial impingementAbstract
Objectives: A correlation between subacromial pain syndrome (SAPS) and altered scapular movement has been previously documented. This study sought to evaluate the impact of therapies targeting scapular components on alleviating shoulder pain, enhancing function, increasing range of motion (ROM), and improving muscular strength in people with shoulder pain and dysfunction.
Data Sources: Systematic searches were conducted across six major databases for the period 2010 to 2024; these included Google Scholar, CINAHL, CENTRAL, MEDLINE, PubMed, and Science Direct.
Study Selection: Randomized controlled trials (RCTs) examining the use of scapular stabilization exercises as interventions in patients with scapular dyskinesis (SD) and subacromial impingement syndrome (SAIS) were included in this systematic review (SR). This review was written based on the PRISMA guidance.
Data Extraction: Each study’s methodological quality was evaluated using the PEDro scale.
Data Synthesis: This systematic review analyzed seven randomized controlled trials on scapular dyskinesia exercises. Results were mixed, with four studies showing significant effects while three found none. The variability in exercise types and combinations with other therapies could have influenced these outcomes.
Conclusions: Scapular stabilization exercises aid recovery from shoulder impingement syndrome and scapular dyskinesia. Reviewed studies show heterogeneous results leading to inconclusive evidence on their effectiveness for improving scapular function and reducing discomfort. Nevertheless, these exercises are significant for addressing neuromuscular and biomechanical deficiencies, while the role of specific stabilization exercises in comprehensive rehabilitation remains unclear.
References
Başkurt, Z., Başkurt, F., Gelecek, N., & Özkan, M. H. (2011). The effectiveness of scapular stabilization exercise in the patients with subacromial impingement syndrome. Journal of back and muscu-loskeletal rehabilitation, 24(3), 173-179.
Brumitt, J. (2006). Scapular-stabilization exercises: early-intervention prescription. Athletic Therapy Today, 11(5):15-18.
Celik, D., Akyuz, G., & Yeldan, I. (2009). Comparison of the effects of two different exercise programs on pain in subacromial impingement syndrome. Acta Orthop Traumatol Turc, 43(6), 504-9.
Chipchase, L. S., O'Connor, D. A., Costi, J. J., & Krishnan, J. (2000). Shoulder impingement syndrome: pre-operative health status. Journal of Shoulder and Elbow Surgery, 9(1), 12-15.
Cools, A. M., Cambier, D., & Witvrouw, E. E. (2008). Screening the athlete’s shoulder for impingement symptoms: a clinical reasoning algorithm for early detection of shoulder pathology. British journal of sports medicine, 42(8), 628-635.
Cools, A. M., Witvrouw, E. E., Declercq, G. A., Danneels, L. A., & Cambier, D. C. (2003). Scapular muscle recruitment patterns: trapezius muscle latency with and without impingement symptoms. The American journal of sports medicine, 31(4), 542-549.
De Mey, K., Danneels, L., Cagnie, B., & Cools, A. M. (2012). Scapular muscle rehabilitation exercises in overhead athletes with impingement symptoms: effect of a 6-week training program on muscle recruitment and functional outcome. The American journal of sports medicine, 40(8), 1906-1915.
Faber, E., Kuiper, J. I., Burdorf, A., Miedema, H. S., & Verhaar, J. A. (2006). Treatment of impingement syndrome: a systematic review of the effects on functional limitations and return to work. Journal of occupational rehabilitation, 16(1), 6-24.
Fatoye, F. (2018). The economic impact of musculoskeletal pain. Pain and Rehabilitation-the Journal of Physiotherapy Pain Association, 2018(44), 3-4.
Graichen, H., Stammberger, T., Bonel, H., Englmeier, K. H., Reiser, M., & Eckstein, F. (2000). Gleno-humeral translation during active and passive elevation of the shoulder—a 3D open-MRI study. Journal of biomechanics, 33(5), 609-613.
Han, K. J., Cho, J. H., Han, S. H., Hyun, H. S., & Lee, D. H. (2012). Subacromial impingement syndrome sec-ondary to scapulothoracic dyskinesia. Knee Surgery, Sports Traumatology, Arthroscopy, 20(10), 1958-1960.
Hotta, G. H., de Assis Couto, A. G., Cools, A. M., McQuade, K. J., & de Oliveira, A. S. (2020). Effects of adding scapular stabilization exercises to a periscapular strengthening exercise program in patients with subacromial pain syndrome: A randomized controlled trial. Musculoskeletal Science and Practice, 49, 102171.
Kamonseki, D. H., Calixtre, L. B., Barreto, R. P. G., & Camargo, P. R. (2021). Effects of electromyographic biofeedback interventions for shoulder pain and function: Systematic review and meta-analysis. Clinical Rehabilitation, 35(7), 952-963.
Kelley, M. J., Shaffer, M. A., Kuhn, J. E., Michener, L. A., Seitz, A. L., Uhl, T. L., ... & Wilk, K. (2013). Shoulder pain and mobility deficits: adhesive capsulitis: clinical practice guidelines linked to the interna-tional classification of functioning, disability, and health from the Orthopaedic Section of the American Physical Therapy Association. Journal of orthopaedic & sports physical therapy, 43(5), A1-A31.
Kibler, B. W., & McMullen, J. (2003). Scapular dyskinesis and its relation to shoulder pain. JAAOS-journal of the American academy of orthopaedic surgeons, 11(2), 142-151.
Kibler, W. B., Ludewig, P. M., McClure, P. W., Michener, L. A., Bak, K., & Sciascia, A. D. (2013). Clinical implications of scapular dyskinesis in shoulder injury: the 2013 consensus statement from the ‘Scapular Summit’. British journal of sports medicine, 47(14), 877-885.
Kluemper, M., Uhl, T., & Hazelrigg, H. (2006). Effect of stretching and strengthening shoulder muscles on forward shoulder posture in competitive swimmers. Journal of sport rehabilitation, 15(1), 58.
Lawrence, R. L., Braman, J. P., LaPrade, R. F., & Ludewig, P. M. (2014). Comparison of 3-dimensional shoulder complex kinematics in individuals with and without shoulder pain, part 1: sternocla-vicular, acromioclavicular, and scapulothoracic joints. journal of orthopaedic & sports physical therapy, 44(9), 636-645.
Ludewig, P. M., & Braman, J. P. (2011). Shoulder impingement: biomechanical considerations in reha-bilitation. Manual therapy, 16(1), 33-39.
Ludewig, P. M., & Cook, T. M. (2000). Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Physical therapy, 80(3), 276-291.
Ludewig, P. M., & Reynolds, J. F. (2009). The association of scapular kinematics and glenohumeral joint pathologies. Journal of orthopaedic & sports physical therapy, 39(2), 90-104.
Maher, C. G., Sherrington, C., Herbert, R. D., Moseley, A. M., & Elkins, M. (2003). Reliability of the PEDro scale for rating quality of randomized controlled trials. Physical therapy, 83(8), 713-721.
McClure, P. W., & Michener, L. A. (2015). Staged approach for rehabilitation classification: shoulder disorders (STAR–Shoulder). Physical therapy, 95(5), 791-800.
McClure, P. W., Bialker, J., Neff, N., Williams, G., & Karduna, A. (2004). Shoulder function and 3-dimensional kinematics in people with shoulder impingement syndrome before and after a 6-week exercise program. Physical therapy, 84(9), 832-848.
McClure, P., Tate, A. R., Kareha, S., Irwin, D., & Zlupko, E. (2009). A clinical method for identifying scapu-lar dyskinesis, part 1: reliability. Journal of athletic training, 44(2), 160-164.
Michener, L. A., McClure, P. W., & Karduna, A. R. (2003). Anatomical and biomechanical mechanisms of subacromial impingement syndrome. Clinical biomechanics, 18(5), 369-379.
Moezy, A., Sepehrifar, S., & Dodaran, M. S. (2014). The effects of scapular stabilization based exercise therapy on pain, posture, flexibility and shoulder mobility in patients with shoulder impinge-ment syndrome: a controlled randomized clinical trial. Medical journal of the Islamic Republic of Iran, 28, 87.
Moraes, G. F., Faria, C. D., & Teixeira-Salmela, L. F. (2008). Scapular muscle recruitment patterns and isokinetic strength ratios of the shoulder rotator muscles in individuals with and without im-pingement syndrome. Journal of shoulder and elbow surgery, 17(1), S48-S53.
Paine, R. M., & Voight, M. (1993). The role of the scapula. Journal of Orthopaedic & Sports Physical Therapy, 18(1), 386-391.
Ravichandran, H., Janakiraman, B., Gelaw, A. Y., Fisseha, B., Sundaram, S., & Sharma, H. R. (2020). Effect of scapular stabilization exercise program in patients with subacromial impingement syn-drome: a systematic review. Journal of exercise rehabilitation, 16(3), 216.
Roy, J. S., Moffet, H., Hébert, L. J., & Lirette, R. (2009). Effect of motor control and strengthening exercis-es on shoulder function in persons with impingement syndrome: a single-subject study design. Manual therapy, 14(2), 180-188.
Shah, M., Sutaria, J., & Khant, A. (2014). Effectiveness of scapular stability exercises in the patient with the shoulder impingement syndrome. Indian J Phys Ther, 2(1), 79-84.
Shankar, P., Jayaprakasan, P., & Devi, R. (2021). Early Echocardiographic Detection of Left Ventricular Diastolic Dysfunction in Patients with Systemic Lupus Erythematosus Asymptomatic for Car-diovascular Disease. Journal of Translational Medicine, 11(223).
Shehab, D., & Adham, N. (2000). FEATURE ARTICLES-Comparative effectiveness of ultrasound and transcutaneous electrical stimulation in treatment of periarticular shoulder pain. Physiothera-py Canada, 52(3), 208-210.
Struyf, F., Nijs, J., Mollekens, S., Jeurissen, I., Truijen, S., Mottram, S., & Meeusen, R. (2013). Scapular-focused treatment in patients with shoulder impingement syndrome: a randomized clinical tri-al. Clinical rheumatology, 32(1), 73-85.
Turgut, E., Duzgun, I., & Baltaci, G. (2017). Effects of scapular stabilization exercise training on scapular kinematics, disability, and pain in subacromial impingement: a randomized controlled trial. Ar-chives of physical medicine and rehabilitation, 98(10), 1915-1923.
Van der Heijden, G. J., van der Windt, D. A., & de Winter, A. F. (1997). Physiotherapy for patients with soft tissue shoulder disorders: a systematic review of randomised clinical trials. Bmj, 315(7099), 25-30.
Van der Windt, D. A., Koes, B. W., Boeke, A. J., Devillé, W., De Jong, B. A., & Bouter, L. M. (1996). Shoulder disorders in general practice: prognostic indicators of outcome. The British Journal of General Practice, 46(410), 519.
Van der Windt, D. A., Koes, B. W., De Jong, B. A., & Bouter, L. M. (1995). Shoulder disorders in general practice: incidence, patient characteristics, and management. Annals of the rheumatic diseases, 54(12), 959-964.
van Tulder, M. W., Assendelft, W. J., Koes, B. W., Bouter, L. M., & Editorial Board of the Cochrane Collab-oration Back Review Group. (1997). Method guidelines for systematic reviews in the Cochrane Collaboration Back Review Group for spinal disorders. Spine, 22(20), 2323-2330.
Yano, Y., Hamada, J., Tamai, K., Yoshizaki, K., Sahara, R., Fujiwara, T., & Nohara, Y. (2010). Different scapular kinematics in healthy subjects during arm elevation and lowering: glenohumeral and scapulothoracic patterns. Journal of shoulder and elbow surgery, 19(2), 209-215.
Yuksel, E., & Yesilyaprak, S. S. (2024). Scapular stabilization exercise training improves treatment effec-tiveness on shoulder pain, scapular dyskinesis, muscle strength, and function in patients with subacromial pain syndrome: A randomized controlled trial. Journal of Bodywork and Move-ment Therapies, 37, 101-108.
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