Sun Jian-Ning, Zheng Qun-Ya, Wang Rui-Song, Ma Yun-Ru, Chen Peng
Department of Sports Medicine, The First Affiliated Hospital of Fujian Medical University, Fujian, China.
Fujian Medical University, Fujian, China.
BMC Musculoskelet Disord. 2025 Apr 5;26(1):338. doi: 10.1186/s12891-025-08596-x.
General scapular exercises have been included in traditional postoperative rehabilitation for rotator cuff tears, but patients with concomitant scapular dyskinesia do not have identical scapular muscle imbalances, and general scapular exercises make it difficult to improve scapular movement. We hypothesized that identifying weak scapular muscle groups and strengthening training would improve scapular movement.
A total of 60 rotator cuff tear patients with scapular dyskinesia were included in the study, 20 in the experimental group and 40 in the control group. Patients in the control group received traditional rehabilitation following rotator cuff repair, while patients in the experimental group performed additional selective scapular muscle rehabilitation exercises. Constant-Murley Score (CMS), shoulder mobility, VAS scores, SF-12 scores, and scapular motion were assessed in both groups at 16 weeks postoperatively.
At 16-week follow-up, the experimental group showed better CMS (87.2 ± 4.4 vs. 83.9 ± 4.8) and shoulder anteflexion (137 ± 13.0 vs. 127.9 ± 12.2°) and abduction mobility (133.1 ± 15.4 vs. 121.4 ± 13.8°) compared to the control group. The experimental group had better improvements in scapular upward rotation (42.8 ± 11.7 vs. 35.3 ± 9.6°) and anterior tilt (12.9 ± 4.2 vs. 6.4 ± 2.0°) during shoulder anteflexion versus the control group. During shoulder abduction, the experimental group had better improvements in scapular anterior tilt (12.8 ± 3.3 vs. 9.1 ± 3.0°) versus the control group.
This study provides an additional exercise program targeting the scapular muscle groups for postoperative rehabilitation in rotator cuff tear patients with scapular dyskinesis. By identifying imbalanced muscles through electromyographic testing, and performing selective muscle strengthening exercises, better shoulder mobility and scapular motion performance can be achieved.
(Chinese Clinical Trial Registry ( https://www.chictr.org.cn ), ChiCTR2400087465, July 29, 2024, prospectively registered.).
一般的肩胛部锻炼已被纳入传统的肩袖撕裂术后康复方案中，但伴有肩胛运动障碍的患者并不存在相同的肩胛肌肉失衡情况，且一般的肩胛部锻炼难以改善肩胛运动。我们推测，识别薄弱的肩胛肌肉群并进行强化训练可改善肩胛运动。
本研究共纳入60例伴有肩胛运动障碍的肩袖撕裂患者，其中20例为试验组，40例为对照组。对照组患者在肩袖修复后接受传统康复治疗，而试验组患者则进行额外的选择性肩胛肌肉康复锻炼。在术后16周对两组患者进行Constant-Murley评分（CMS）、肩部活动度、视觉模拟评分（VAS）、SF-12评分以及肩胛运动评估。
在16周随访时，试验组的CMS（87.2±4.4 vs. 83.9±4.8）、肩部前屈（137±13.0° vs. 127.9±12.2°）和外展活动度（133.1±15.4° vs. 121.4±13.8°）均优于对照组。与对照组相比，试验组在肩部前屈时肩胛上旋（42.8±11.7° vs. 35.3±9.6°）和前倾（12.9±4.2° vs. 6.4±2.0°）改善更明显。在肩部外展时，试验组肩胛前倾改善（12.8±3.3° vs. 9.1±3.0°）优于对照组。
本研究为伴有肩胛运动障碍的肩袖撕裂患者术后康复提供了一个针对肩胛肌肉群的额外锻炼方案。通过肌电图测试识别失衡肌肉，并进行选择性肌肉强化锻炼，可实现更好的肩部活动度和肩胛运动表现。
（中国临床试验注册中心（https://www.chictr.org.cn），ChiCTR2400087465，2024年7月29日，前瞻性注册）
