Comparison of Scapular Stabilization and Thoracic Extension Exercises in Patients With Scapular Dyskinesis
Condition: Scapular Dyskinesis
MeSH terms: Dyskinesias
Study type: Interventional

Summary: 
      Scapular dyskinesis is defined as a visible alteration in scapular movement and position
      during rest or while performing dynamic motions causing a breakage in kinetic chain.
      Kinematic studies in subjects with scapular dysfunction showed decrease posterior tilt of
      scapula, increased scapular upward rotation and changes in glenohumeral to scapulothoracic
      ratios. Scapular dyskinesis can be categorized into 3 types according to standard
      classification. Type I is the posterior displacement of infero-medial angle due to excessive
      anterior tilt in sagittal plane, type II is the displacement of entire medial angle from
      posterior thorax caused by excessive internal rotation and dysrhythmic movement of scapula
      excessive elevation of superior border during scapular elevation is distinguished as type III
      . Almost 90% of office workers presenting with scapular and neck complains present with
      scapular dyskinesis . Shoulder dysfunction occur in up to 68% of individuals presenting with
      scapular dyskinesis
    

Detailed description: 
      Specific treatment of scapular dyskinesis include moist heat packs, soft tissue mobilization,
      strength and flexibility exercises of scapular muscles along with postural re-education.
      Acknowledging the role of scapula in upper extremity functions, integration of scapular
      stabilization exercises is shown to be more efficient than strengthening and stretching
      exercises for enhancing shoulder proprioception, optimizing muscle strength and decreasing
      dyskinesis. Scapular stabilization exercises defined as exercises aimed at gaining stability
      and strength of scapular muscles and increasing neuromuscular control to maintain the proper
      position of the scapula.

      These exercises increase fiber strength, mass, capillaries volume thus increasing the blood
      flow of muscle.

      Mobility of Thoracic spine is an important factor to consider while treating scapular
      dyskinesis as reduced thoracic mobility can result in dramatic reduction of shoulder range of
      motion

      . So a rehabilitation protocol based on the scapula dynamic stability to restore the
      position, direction and movement pattern of scapula by stabilizing and retraining the
      scapular muscles is a possible intervention strategy for improving recovery and preventing
      shoulder dysfunction. Numerous exercises had been proposed for rehabilitation of dyskinesis,
      but it lack consensus on which exercise is effective in each type of dyskinesia. As different
      types of scapular dyskinesia have different manifestations of muscle imbalance
    

Intervention name(s): Scapular stabilization exercises with conventional therapy; Thoracic extension exercises with conventional therapy
Intervention type(s): Other; Other
Intervention description(s): The patient will sit on the knees in 90° flexion position, and a Swiss ball will be placed between the chest and stomach. From the side, the earlobe, acromion of scapula, and pelvis should made a straight line. Four general exercises will be included with 2 sets of 15 repetitions, holding for 10 sec; Thoracic extension exercises consist of three exercise protocols
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: scapular stabilization; thoracic extension; scapular rhythm