Neuromuscular function in patients with Subacromial Impingement Syndrome and clinical assessment of scapular kinematics

Publikation: Konferencebidrag uden forlag/tidsskriftAbstraktFormidling

Abstract

Neuromuscular function in patients with Subacromial Impingement Syndrome and clinical assessment of scapular kinematics
Larsen CM1, Juul-Kristensen B1,2 Holtermann A3, Lund H1,2, Søgaard K1
1University of Southern Denmark, Institute of Sports Science and Clinical Biomechanics, DK
2Institute of Occupational Therapy, Bergen University College, Bergen, Norway
3National Research Centre for the Working Environment, Copenhagen, DK
E-mail: cmlarsen@health.sdu.dk
AIMS: The aims were to understand potential mechanisms for impairment in the neuromuscular function of the scapular stabilisers in a general patient sample with SIS, and to assess the clinimetric properties of clinical assessment methods of scapular kinematics as important aspects for optimising effect measures of treatment in order to improve clinical guidelines in this area.

METHODS: Scapular muscle activity was examined, 1) during a voluntary arm movement task and 2) selective activation tasks during sessions with and without on-line biofeedback, in a general population consisting of 16 SIS patients and 15 controls (No-SIS). Furthermore, 3) a systematic review was conducted of all available clinical scapular assessment methods and their associated clinimetric results, and the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used to critically assess the quality of the involved studies for each measurement property.

RESULTS: 1) In spite of a general tendency for higher scapular muscle activity among SIS patients, between-group differences were not significant, either in activity level, ratio of activation between muscles or in the time of activity onset of the muscles, 2) Using the defined criteria of: (i) a selective activation above 12% of maximum activation during which other muscle parts were below 1.5% activity or (ii) an activation ratio above 95% of the total activity of all muscles, significantly fewer SIS subjects than No-SIS subjects achieved selective activation of individual scapular muscle compartments without on-line biofeedback of muscle activity from each muscle compartment of the trapezius muscle, 3) On the basis of 46 included articles, a total of 55 names of clinical assessment methods were identified. Thirty-one of the studies included in the quality assessment of the reliability and validity domains were classified as ‘fair’ (55%) to ‘poor’ (45%), with only one study being rated as ‘good’. Few of the assessment methods in the included studies with ‘fair’ or ‘good’ measurement property ratings demonstrated acceptable results for reliability and validity. Responsiveness was not investigated.

CONCLUSION: 1) No between-group differences of SIS and No-SIS subjects in neuromuscular activity of scapular stabilising muscles were observed, 2) and when provided with visual EMG feedback, the SIS group performed equally well as the No-SIS group, However, when assessing the neuromuscular function with and without the use of biofeedback, the findings show that without biofeedback, the SIS group had a lower scapular muscle control, 3) When addressing the possibility for measuring scapular kinematics clinically, the findings show a substantially larger number of clinical assessment methods for scapular position and function than previously reported. None of the included clinical assessment methods had been examined for all three domains: reliability, validity (diagnostic accuracy), as well as responsiveness. Based on these results, the current findings question the generalisability of current rehabilitation guidelines to the general population with SIS, however, SIS patients may benefit from biofeedback training. Lastly, these results indicate that very few clinical assessment methods have sufficient clinimetric properties that can be recommended for clinical use.
OriginalsprogEngelsk
Publikationsdato15 jul. 2014
StatusUdgivet - 15 jul. 2014
Begivenhed, XX Congress of the International Society of Electromyography and Kinesiology, Rome, Italy - Rom, Rom, Italien
Varighed: 15 jul. 201418 jul. 2014

Konference

Konference, XX Congress of the International Society of Electromyography and Kinesiology, Rome, Italy
LokationRom
LandItalien
ByRom
Periode15/07/1418/07/14

Citationsformater

Larsen, C. M. (2014). Neuromuscular function in patients with Subacromial Impingement Syndrome and clinical assessment of scapular kinematics. Abstract fra , XX Congress of the International Society of Electromyography and Kinesiology, Rome, Italy, Rom, Italien.