Altered Corticospinal Excitability of Scapular Muscles in Patients with Shoulder Impingement Syndrome

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The purpose of the study was to examine the changes in central neuromuscular control in individuals with shoulder impingement syndrome. This study was an exploratory and cross-sectional study. In the transcranial magnetic stimulation experiment, we recruited 14 subjects with shoulder impingement syndrome and 20 healthy controls. The cortical representations of trapezius and serratus anterior muscles were examined while the subjects were seated with arm elevation of 90 degrees in the scapular plane. We used the Liberty electromagnetic tracing system to collect the scapular kinematics data and the scapular muscle activities were measured at the same time. The active motor threshold of the lower trapezius and the serratus anterior, the cortical silent period of lower trapezius and the center of gravity of serratus anterior muscle mapping area showed significant difference between the two groups. There were no significant differences in motor evoked potentials and mapping areas of scapular muscles between the two groups. With respect to scapular kinematics and scapular muscle activities, the minimum value of upper rotation during lower phase of scaption was significantly different between the two groups (P=0.037), and there were no significant differences in scapular muscle activity during scaption between the patients and the controls. The center of gravity of lower trapezius and serratus anterior muscle mapping areas were correlated with serratus anterior activity during scaption. Conclusion: There were differences in cortical excitability of scapular muscles between patients with shoulder impingement and the controls. As a consequence, the therapies could increase the patients’ consciousness of correct scapular muscle contraction when treating the patients with shoulder impingement syndrome in the clinics.

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