Scapular Dyskinesis
Conditions
Keywords
Scapular dyskinesia, Scapular Clock Exercises, Open Heart Surgery
Brief summary
In patients after open-heart surgery, the complaint of scapular dyskinesia is very common. It occurs due to the weakness of the muscles surrounding the scapula. In this research, investigators checked the effectiveness of scapular clock exercises in scapular dyskinesia, in post-op open heart surgery patients. There were two groups, an intervention Active group and a 'control group'. The patients will be randomly assigned to each group equally. The treatment session was given for a period of 4 weeks, with 3 sessions each week. They were assessed before treatment, after 2 weeks and post-intervention.
Detailed description
Scapular dyskinesia is the malalignment of the scapula. It occurs when the pectoralis muscle (pectoralis minor) becomes tight and there is the weakness of the trapezius muscle (lower fibers). It can commonly occur after open-heart surgery due to incision and prolonged bed rest. In this research, the effectiveness of scapular clock exercises was checked. These exercises can strengthen the weak trapezius muscle and also stretch the tight pectoralis minor muscle. By adding these exercises in cardiac rehabilitation the occurrence of scapular dyskinesia can be reduced. Post-op open heart surgery patients mostly present with complain of shoulder pain. Most of their treatment is directed towards shoulder joint while the scapula is usually ignored. So it is important to add exercises directed towards the scapula along with shoulder. In this study, The investigators will recruit 30 post-op cardiac surgery patients with complain of shoulder pain, with positive scapular dyskinesia. The sample size was calculated using formula and the values were taken from previous researches. Scapular assistance test and Scapular retraction test was used to find out patients with scapular dyskinesia. The subjects will then be randomly divided into two groups using online randomization generator. The interventional group was receive stretching and strengthening exercises with additional scapular clock exercises and the active control group will receive stretching and strengthening exercises. There was 3 sessions per week, for a period of 4 weeks. The patients was assessed prior to the treatment , then after 2 weeks and later after completion of 4 weeks. The tools for assessment include NPRS for pain, Quick-DASH for activity limitation of shoulder and goniometer for measuring range of motion of shoulder.
Interventions
In scapular clock exercises, the hand is placed on the wall in front of your body. Move the hand in direction of 12 and 6 o'clock to elevate and depress the scapula. Then move hands towards 9 o' clock and 3 o'clock direction to protract and retract the scapula. Hold each position for 10 seconds. From 3rd week and onward the patient will use thera-band and then perform clock exercises.
Stretching and strengthening exercises of shoulder and scapular muscles was performed including wall washes, corner stretch, pectoral muscles stretch and wall push ups.
Sponsors
University of Faisalabad
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Masking description
Only the participants were masked. They did not know either they are in the interventional group or in the control group.
Intervention model description
There were 30 subjects divided equally and randomly into Group A and Group B. Group A was receive the intervention while group B will be active control group. The duration of treatment will be equal for both groups, that is 3 sessions per week for a period of 4 weeks.
Eligibility
Sex/Gender
ALL
Age
35 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Patients whose open heart surgery is done at least 6weeks ago. * Subjects having shoulder and scapular region pain. * 50% or less loss of Active ROM of shoulder in abduction, flexion and external rotation. * Positive Scapular assistance (SAT) and Scapular retraction test. * Positive findings on observational examination of scapula, showing abnormal prominence of either inferior, medial or superior border of scapula. * Type I and Type II scapular dyskinesia present * Consented to take part in the study.
Exclusion criteria
* • Bilateral shoulder involvement * History of previous surgery on shoulder * Shoulder fracture * Glenohumeral or acromioclavicular joint Arthritis. * Neuromuscular disorders
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Shoulder pain | 4 weeks | Shoulder pain was assessed by using the Numeric Pain Rating (NPRS) Scale. NPRS is an 11-item Likert scale having 0 as no pain and 10 as maximum pain |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Level of Shoulder activity limitation | 4 weeks | The level of shoulder activity limitation was assessed by using the Quick-DASH questionnaire. There were 11 questions that were rated by the Likert scale having 1 as no disability and 5 as maximum disability |
Other
| Measure | Time frame | Description |
|---|---|---|
| Shoulder Range of Motion (ROM) | 4 weeks | Shoulder ROM will be assessed by using a Goniometer |
Countries
Pakistan
Contacts
Primary ContactAqsa Shahid, Doctor of Physical Therapy
Backup ContactSana Zahir, Doctor of Physical Therapy
Outcome results
None listed