Scapular Motor Control and Upper Limb Movement Quality in Subjects with and without Chronic Shoulder Pain: A Cross-Sectional Study

Author:

Melo Ana S. C.1234ORCID,Guedes Diana C.1ORCID,Matias Ricardo56,Cruz Eduardo B.78ORCID,Vilas-Boas J. Paulo39ORCID,Sousa Andreia S. P.1ORCID

Affiliation:

1. Centro de Investigação em Reabilitação (CIR), Escola Superior de Saúde, Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal

2. Centro de Investigação em Actividade Física, Saúde e Lazer (CIAFEL), Faculdade de Desporto, Universidade do Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal

3. Laboratório de Biomecânica do Porto (LABIOMEP), Universidade do Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal

4. Centro Interdisciplinar de Investigação Aplicada em Saúde (CIIAS), Escola Superior de Saúde, Instituto Politécnico de Setúbal, Campus do IPS Estefanilha, 2914-503 Setúbal, Portugal

5. Physics Department & Institute of Biophysics and Biomedical Engineering (IBEB), Faculty of Sciences, University of Lisbon, 1749-016 Lisbon, Portugal

6. Kinetikos, 3030-199 Coimbra, Portugal

7. Departamento de Fisioterapia, Escola Superior de Saúde, Instituto Politécnico de Setúbal, Campus do IPS Estefanilha, 2914-503 Setúbal, Portugal

8. Centro de Investigação Integrada em Saúde (CHRC), Universidade Nova de Lisboa, 1169-056 Lisboa, Portugal

9. Centro de Investigação, Formação, Inovação e Intervenção em Desporto (CIFI2D), Faculdade de Desporto, Universidade do Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal

Abstract

Despite the existence of several studies about the scapula’s position and motion, in shoulder pain conditions, there are still conflicting findings regarding scapular adaptations and reduced research about the scapula’s role during functional tasks. The present study aimed to compare scapular-related kinematic and electromyographic outcomes during different shoulder movements (with and without load) and the drinking task, between symptomatic and asymptomatic subjects. Forty subjects (divided into two groups) participated in this cross-sectional observational study. Scapulothoracic motion, scapulohumeral rhythm, and movement quality (considering trunk compensation, time-to-peak acceleration, and smoothness), as well as the relative surface electromyographic activity and muscle ratio considering the trapezius, serratus anterior, and levator scapulae (LS), were assessed. The symptomatic group presented the following: (1) changes in scapular upward rotation (p = 0.008) and winging (p = 0.026 and p = 0.005) during backward transport and drink phases; (2) increased muscle activity level of the middle trapezius (MT) in all tasks (p < 0.0001 to p = 0.039), of LS during shoulder elevation with load (p = 0.007), and of LS and LT during most of the drinking task phases (p = 0.007 to p = 0.043 and p < 0.0001 to p = 0.014, respectively); (3) a decreased serratus anterior lower portion activity level (SAlow) during shoulder lowering with load (p = 0.030) and drink phase (p = 0.047); and (4) an increased muscular ratio between scapular abductors/adductors (p = 0.005 to p = 0.036) and elevators/depressors (p = 0.008 to p = 0.028). Compared to asymptomatic subjects, subjects with chronic shoulder pain presented scapular upward rotation and winging adaptations; increased activity levels of MT, LT, and LS; decreased activity levels of SAlow; and increased scapular muscle ratios.

Funder

Fundação para a Ciência e Tecnologia

Publisher

MDPI AG

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