Ribeirao Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Department of Human Movement Sciences, Universidade Federal de São Paulo, Santos, SP, Brasil.
Braz J Phys Ther. 2014 May-Jun;18(3):282-9. doi: 10.1590/bjpt-rbf.2014.0025.
Altered scapular rotation and position have been named scapular dyskinesis. Visual dynamic assessment could be applied to classify this alteration based on the clinical observation of the winging of the inferior medial scapular border (Type I) or of the prominence of the entire medial border (Type II), or by the excessive superior translation of the scapula (Type III).
The aim of this study was to determine if there were differences in scapular rotations (Type I and II) and position (Type III) between a group of subjects with scapular dyskinesis, diagnosed by the clinical observation of an expert physical therapist, using a group of healthy individuals (Type IV).
Twenty-six asymptomatic subjects volunteered for this study. After a fatigue protocol for the periscapular muscles, the dynamic scapular dyskinesis tests were conducted to visually classify each scapula into one of the four categories (Type IV dyskinesis-free). The kinematic variables studied were the differences between the maximum rotational dysfunctions and the minimum value that represented both normal function and a small dysfunctional movement.
Only scapular anterior tilt was significantly greater in the type I dyskinesis group (clinical observation of the posterior projection of the inferior angle of the scapula) when compared to the scapular dyskinesis-free group (p=0.037 scapular and p=0.001 sagittal plane).
Clinical observation was considered appropriate only in the diagnoses of dyskinesis type I. Considering the lower prevalence and sample sizes for types II and III, further studies are necessary to validate the clinical observation as a tool to diagnose scapular dyskinesis.
肩胛骨旋转和位置的改变被称为肩胛骨运动障碍。视觉动态评估可应用于根据翼状肩胛下角内侧缘（I 型）或整个内侧缘突出（II 型）的临床观察，或肩胛骨过度向上移位（III 型）来对这种改变进行分类。
本研究旨在确定在肩胛骨运动障碍（由经验丰富的物理治疗师临床观察诊断）患者中，通过观察肩胛骨旋转（I 型和 II 型）和位置（III 型），与健康个体（IV 型）之间是否存在差异。
26 名无症状受试者自愿参加本研究。在肩胛旁肌肉疲劳方案后，进行动态肩胛骨运动障碍测试，以视觉方式将每个肩胛骨分为四组之一（IV 型无运动障碍）。研究的运动学变量是最大旋转功能障碍与代表正常功能和小功能障碍运动的最小值之间的差异。
仅在 I 型运动障碍组（肩胛骨下角后投影的临床观察）中，肩胛骨前倾斜度明显大于无运动障碍组（肩胛骨和矢状面的 p=0.037 和 p=0.001）。
仅在 I 型运动障碍的诊断中，临床观察被认为是合适的。考虑到 II 型和 III 型的患病率和样本量较低，需要进一步研究来验证临床观察作为诊断肩胛骨运动障碍的工具。
