Ribeiro L.P.1, Barreto R.P.G.1, Camargo P.R.1
1Universidade Federal de São Carlos, Laboratory of Analysis and Intervention of the Shoulder Complex, São Carlos, Brazil
Background: The Scapular Assistance Test (SAT) was suggested as a test to evaluate if scapular motion may be related to the symptoms of the individual. To perform the test, the examiner pushes laterally and upward on the inferior medial border of the scapula assisting upward rotation and pulling backward on the superior aspect of the scapula assisting posterior tilt during elevation of the arm. However, it is not known if there are differences in scapular kinematics between patients with positive and negative SAT.
Purpose: This study compared the scapular kinematics in individuals with unilateral shoulder pain with positive and negative SAT. The hypothesis was that individuals with positive SAT would present less upward rotation and posterior tilt.
Methods: Thirty-one individuals with unilateral shoulder pain were assessed and allocated to 1 of the 2 groups based on the SAT: positive SAT (n=22; 43.1 ± 17.5 years; 74 ± 11.6 kg; 1.69 ± 0.09 m) and negative SAT (n=9; 44 ± 13.7 years; 75 ± 20.1 kg; 1.68 ± 0,14 m). All participants had to present painful arc during elevation of the arm. The test was considered positive when the individual reported a reduction of at least 2 points on the numerical pain rating scale. Three-dimensional scapular kinematics was assessed during elevation and lowering of the arm in the sagittal plane using Flock of Birds hardware integrated with MotionMonitor software. For scapular internal rotation, upward rotation and tilt, a 2-way ANOVA was conducted for each phase (elevation and lowering), in separate, with group (positive SAT and negative SAT) and humeral angle (30°, 60°, 90° and 120°) as factors. The Bonferroni test for post hoc analysis was used when necessary. A p value less than 0.05 was considered significant.
Results: For scapular internal rotation and tilt, the interaction group x angle and main effect of group were not significant (p>0.05) during elevation and lowering of the arm. For scapular upward rotation, the interaction group x angle was not significant (p>0.05), nor was the main effect of group (p>0.05) during elevation of the arm. In contrast, the interaction angle x group was significant (p=0.03) during lowering of arm, where individuals with positive SAT presented less upward rotation at 30°, 60° and 90° of lowering of the arm when compared to individuals with negative SAT.
Conclusion(s): The findings seem to suggest that SAT screens patients that present decreased scapular upward rotation during lowering of the arm.
Implications: SAT shows a possible scapular influence in shoulder pain. This test may be used in clinical practice to guide treatment techniques.
Funding acknowledgements: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes)
Topic: Musculoskeletal: upper limb
Ethics approval: Study approved by the Ethics Committee of Universidade Federal de São Carlos (report number 1.394.925), BR
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