The Effect of Scapular Balancing Exercise in Neck-scapular Dysfunction -Relationship Between Neck-scapular Posture ＆ Axioscapular Muscles-
Phase: NA
Conditions: Scapular Pain
Sponsor: Hallym University Dongtan Sacred Heart Hospital

Hallym Unlversity Dongtan Sacred Heart Hospital
Research Protocol
2021-11-29
1. Research Title
The correlation between neck posture and scapular posture & the effect stabilization exercises for the
scapula
2. Principal lnvestigator
Hallym university dongtan Sacred Heart Hospital
Associate Professor of Orthopaedics
JEUNGYEOL JEONG
3. Background and Purpose of the research
Recently, many office workers and young people have postural abnormalities, including forward head
posture (FHP) and rounded shoulder posture (RSP). Most of these patients often complain of pain in the
entire scapular area, including the trapezius muscle. Few studies examined the effectiveness of intervention
exercises often used by clinicians to correct posture in these patients through training protocols.
To compare and analyze the changes in scapular position between normal people and patients with FHP
and RSP and to evaluate the effect of exercise therapy for 3 months in these patients, including clinical
results and changes in scapular position and cervical angle through objective data.
4. Research Contents
Comparative analysis of the clinical outcomes and 3D-CT results of changes in scapular position between
normal people and patients with FHP and RSP and to evaluate the effect of exercise therapy for 3 months in
these patients.
Clinical outcomes were compared based on PVAS, FVAS, and ASES, Shoulder pain and disability index
(SPADI) scores. The degree of the changes in scapular position was assessed via 3D-CT examination. All
statistical comparisons were analyzed using one-way analysis of variance (ANOVA),
5. Eligibility Criteria
lnclusion Criteria:
o Age between 20 and 40 years
o those with a C-shaped lordotic curve of the neck without scapular pain
o patients with Forward head posture and scapular pain
O Willing to participatc and provicle inlbrmed cor.rscnt

Hallym Universlty Dongtan Sacred Heart Hospital
Exclusion Criteria:
o Previous surgery on the aff'ected shoulder or neck
a Disc space narrowing in the C-spine, or evidence of arthritis on plain x-rays of the neck and
shoulders
a Frozen shoulders or suspected rotator culTtears on ultrasound
6. Expected research period: 12 months
7. Research Methods
For patients with FHP and RSP who experience pain throughout the entire scapular region, including the
trapezius muscle, we explain this study in outpatients. The research begins only for those who consent to
participate. This study was conducted as a prospective non-randomized trial. Participants are divided into
three groups, (Group A: Normal group, Group B: Self-exercise group, Group C: Professional exercise
rehabilitation therapy group). The patients will visit the hospital twice a week for one-hour sessions with a
physical therapist to perform scapular balancinq exercises (stretching and strengthening). This exercise
program will be conducted over 1O weeks for a total of 20 sessions. This researh compares the clinical
outcomes and 3D-CT findings among these three groups. Results are compared by measuring VAS score,
ASES and SPADI score during outpatient follow-up visits at 3 months after starting the exercise program. A
3D-CT scan is performed before starting the exercise program and again at the 3-month mark, with the
results compared.
A power analysis was performed with clinical outcomes of pain visual analog scale (PVAS) score, function
visual analog score (FVAS), and American Shoulder and Elbow Surgeons (ASES) score. With these parameters,
the study required 2'1 patients per group to achieve a power of 0.80 and a significance level of 5%. The
expected dropout rate was 15o/, (Correlation between American shoulder and elbow surgeons and slngle
assessment numerlcal evaluation score after rotator cuff or SLAP repah Arthroscopy 20/5,31:7688-92.)
8. Safety considerations for subjects (e.g., trial discontinuation, management of serious adverse events)
1) Patient can discontinue the study if they experience severe pain during the exercise program.
9. Measures to Ensure Research Ethics (Compliance with the Declaration of Helsinki must be explicitly
stated, and any additional requirements necessary to ensure the ethics of the research should be
described)
Only patients who have signed the consent form will be included. Patient information security will be
maintained with the utmost confidentiality, and all relevant laws and regulations (such as the Declaration of
Helsinki) will be followed.

Hallym University Dongtan Sacred Heart Hospital
Patient Consent Form
1. I have received an explanation from the medical staff regarding the content of this research,
and having understood its purpose, I have decided to participate in the research. I confirm
that I may withdraw from this research at any time if I choose to do so, and that I will not
suffer any disadvantage as a result. ldeclare that my decision to participate in this research
is made of my own free will.
2. Furthermore, lhereby consent to the use of my examination results and other medical
records for purely research purposes.
3. I understand that if I have any questions about the details of the clinical trial, lcan ask the
responsible person at any time and receive a sufficient answer.
4. I understand that I will receive a copy of this consent form.
Recipient's Name
Signature 
Date (month /day/year)
Principal lnvestigator Name 
Signature 
Date (month/day/year)
Guardian or 
Signature 
Date (month/day/year)
legal representative Name
5. Researcher Contact lnformation
+82-03'l -8086-2410 Orthopedic Clinic (Associate Professor of Orthopedics, Jeungyeol Jeong)