School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Division of Physical Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
J Shoulder Elbow Surg. 2020 Sep;29(9):1852-1858. doi: 10.1016/j.jse.2020.01.069. Epub 2020 Apr 1.
No previous studies have investigated whether the extent of scapular dyskinesis is associated with shoulder dysfunction. This study aimed (1) to establish the reliability of a scapulometer in patients with shoulder pain and (2) to investigate the related factors associated with shoulder dysfunction.
One hundred participants with symptomatic scapular dyskinesis were recruited. Twenty-one participants were involved in the reliability study to test the intrarater and inter-rater reliabilities of the scapulometer in patients with shoulder pain. After demographic data and self-reported Flexilevel Scale of Shoulder Function (FLEX-SF) scores were recorded, all participants were measured with a scapulometer to determine the posterior displacement of the root of the spine (ROS) and the inferior angle (IFA) of the scapula from the thorax. Next, the participants performed 5 trials of bilateral scapular plane elevation for scapular kinematics and electromyographic (EMG) data collection. Stepwise multiple linear regressions were used to determine the relationships between self-reported FLEX-SF scores and potential factors. In addition to scapular displacement, pain level, scapular kinematics, and EMG data were included as independent variables.
The intrarater and inter-rater reliabilities of the scapulometer were excellent (intraclass correlation coefficient [ICC] = 0.93-0.97) and moderate to good (ICC = 0.74-0.81), respectively. The Bland-Altman plots showed no systematic bias between raters in the ROS and IFA measurements. Final stepwise multiple regression models showed that more ROS distance, higher serratus anterior activity, and lower pain level during arm elevation were associated with higher shoulder function (total R = 0.253).
The reliability of the scapulometer in patients with shoulder pain is moderate to excellent. Scapular dyskinesis may be a compensatory strategy to avoid shoulder pain and improve shoulder function.
目前尚无研究调查肩胛骨运动障碍的程度是否与肩部功能障碍相关。本研究旨在：(1) 确立肩胛骨测量仪在肩部疼痛患者中的可靠性；(2) 探讨与肩部功能障碍相关的相关因素。
招募了 100 名有症状的肩胛骨运动障碍患者。21 名参与者参与了可靠性研究，以测试肩胛骨测量仪在肩部疼痛患者中的组内和组间可靠性。记录完人口统计学数据和自我报告的 Flexilevel 肩部功能量表 (FLEX-SF) 评分后，所有参与者均使用肩胛骨测量仪测量，以确定脊柱根部后移 (ROS) 和肩胛骨下角 (IFA) 与胸廓之间的距离。接着，参与者进行 5 次双侧肩胛骨平面抬高，以收集肩胛骨运动学和肌电图 (EMG) 数据。逐步多元线性回归用于确定自我报告的 FLEX-SF 评分与潜在因素之间的关系。除了肩胛骨位移外，疼痛程度、肩胛骨运动学和肌电图数据也被作为自变量纳入。
肩胛骨测量仪的组内和组间可靠性均为优秀 (组内相关系数 [ICC] = 0.93-0.97) 和中等到良好 (ICC = 0.74-0.81)。Bland-Altman 图显示，两位评估者在 ROS 和 IFA 测量值之间没有系统偏差。最终的逐步多元回归模型显示，ROS 距离更大、前锯肌活动更高、上肢抬高时疼痛程度更低与肩部功能更高相关 (总 R² = 0.253)。
肩胛骨测量仪在肩部疼痛患者中的可靠性为中等到优秀。肩胛骨运动障碍可能是一种避免肩部疼痛和提高肩部功能的代偿策略。
