Sciascia Aaron, Kibler W Ben
Institute of Clinical Outcomes and Research, Lexington Clinic.
Shoulder Center of Kentucky, Lexington Clinic.
Int J Sports Phys Ther. 2022 Feb 2;17(2):117-130. doi: 10.26603/001c.31727. eCollection 2022.
Scapular dyskinesis is a condition that is frequently observed clinically but not often understood. Too often it is viewed as a diagnosis which is not accurate because it is a physical impairment. This misclassification of dyskinesis has resulted in literature that simultaneously supports and refutes scapular dyskinesis as a relevant clinical entity as it relates to arm function. These conflicting views have not provided clear recommendations for optimal evaluation and treatment methods. The authors' experience and scholarship related to scapular function and dysfunction support that scapular dyskinesis is an impairment that has causative factors, that a pathoanatomical approach should not be the primary focus but should be considered as part of a comprehensive examination, that a qualitative examination for determining the presence or absence of a scapular contribution to shoulder dysfunction is currently the best option widely available to clinicians, and that rehabilitation approaches should be reconsidered where enhancing motor control becomes the primary focus rather than increasing strength.
肩胛运动障碍是一种临床常见但常不被理解的病症。它常常被视为一种不准确的诊断,因为它是一种身体功能障碍。这种对运动障碍的错误分类导致了文献中对于肩胛运动障碍作为与手臂功能相关的一个相关临床实体,既存在支持的观点,也存在反驳的观点。这些相互矛盾的观点并未为最佳评估和治疗方法提供明确的建议。作者关于肩胛功能与功能障碍的经验和学术研究支持以下观点:肩胛运动障碍是一种具有致病因素的功能障碍,病理解剖学方法不应作为主要关注点,而应作为全面检查的一部分来考虑;目前,对于确定肩胛是否导致肩部功能障碍进行定性检查是临床医生广泛可采用的最佳选择;并且,康复方法应重新考虑,将增强运动控制而非增加力量作为主要关注点。