Huang Tsun-Shun, Du Wan-Yu, Lin Jiu-Jenq
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.
Orthop J Sports Med. 2020 Nov 30;8(11):2325967120964600. doi: 10.1177/2325967120964600. eCollection 2020 Nov.
Predictive variables associated with the effects of a scapular conscious control program should be identified and used to guide rehabilitation programs.
To determine whether potential factors are associated with the success of scapular muscle balance with an early control program in patients with subacromial pain and scapular dyskinesis.
Case-control study; Level of evidence, 3.
A total of 38 amateur overhead athletes with subacromial pain and medial border prominence were recruited. They performed progressive conscious control of scapular orientation during 45° and 90° of arm elevation. Stepwise logistic regression and receiver operating characteristic curve were used to determine the optimal cutoff point of related factors for success or failure of the program. Potential factors including pain level during activity, pain duration, anterior/posterior shoulder flexibility, forward shoulder posture, posterior displacement of root of spine and inferior angle, scapular kinematics, and muscle activation before conscious control program were recorded as independent variables. Successful control defined as decreases of the upper trapezius/serratus anterior ratio in 2 consecutive trials of the 90° program or failure in the program was used as a dependent variable.
Having a posterior displacement of the inferior angle of the scapula of ≤16.4 mm and scapular posterior tipping during arm elevation of ≤3.3° (collected before the control program) were associated with the success of the program ( = 0.286; < .05). Additionally, participants with each or both variables present at baseline had probabilities of success of 78% and 95%, respectively.
The value of scapular posterior displacement and posterior tilt should be considered before early scapular control program. Other factors related to the success of the program should be found due to the limited variance explained in the regression model.
应确定与肩胛有意识控制程序效果相关的预测变量，并用于指导康复计划。
确定在肩峰下疼痛和肩胛运动障碍患者中，潜在因素是否与早期控制程序实现肩胛肌肉平衡的成功与否相关。
病例对照研究；证据等级，3级。
共招募了38名有肩峰下疼痛和肩胛内侧缘突出的业余过头运动运动员。他们在手臂抬高45°和90°时对肩胛方向进行渐进性有意识控制。采用逐步逻辑回归和受试者工作特征曲线来确定该程序成功或失败相关因素的最佳截断点。将包括活动时疼痛程度、疼痛持续时间、肩前/后灵活性、肩部前伸姿势、脊柱根部和下角的后移、肩胛运动学以及有意识控制程序前的肌肉激活等潜在因素记录为自变量。将在90°程序的连续2次试验中斜方肌上束/前锯肌比值降低定义为成功控制，将程序失败定义为因变量。
肩胛骨下角后移≤16.4 mm且手臂抬高时肩胛后倾≤3.3°（在控制程序前收集）与程序成功相关（ = 0.286； <.05）。此外，在基线时存在每个变量或两个变量都存在的参与者成功概率分别为78%和95%。
在早期肩胛控制程序之前应考虑肩胛后移和后倾的值。由于回归模型中解释的方差有限，应寻找与该程序成功相关的其他因素。
