Omuz Sıkışma Sendromunda Iki Farklı Egzersiz Programının 3-Boyutlu Skapular Kinematik, Fonksiyonel Aktivite Düzeyi ve Ağrı Üzerine Etkinliğinin Karşılaştırılması

Abstract

The aim of this study was to investigate the effect of traditional stretching-strengthening exercises and kinetic chain scapula-based exercises on pain intensity, functional activity level and scapular kinematics. Thirty-six patients diagnosed with subacromial impingement syndrome were included to the study and separated into 2 different exercise programs (control group versus kinetic chain group) during 12 weeks. Pain intensity during rest, activity and night were assessed by visual analog scale, functional activity level was assessed with Shoulder Pain and Disability Index, 3- dimensional scapular kinematics was analyzed with electromagnetic tracking system at baseline, 6th and 12th weeks after training. Kinematic recording of scapular internal-external rotation, upward-downward rotation and anterior-posterior tilt were assessed during abduction, flexion and scapular plane 30°, 60°, 90° and 120° elevation and lowering. 2*3 repeated measures ANOVA was used for statistical comparisons. All groups were showed decreased activity pain intensity at 6th (p<.001) and 12th (p<.001) weeks; decreased night pain intensity at 6th (p=.01) and 12th (p=.003) weeks. Similarly, all groups showed statistically significant decreased SPADI scores at 6th and 12th weeks (p<.001). Differences in scapular kinematics were different in study groups at 6th and 12th weeks (group*time interaction was significant, p<.05). There were no effect of traditional stretching and strengthening exercises on scapular kinematics (p>.05), but kinetic chain exercises resulted in incresed external rotation, upward rotation and posterior tilt depend on shoulder movement planes and humerothoracic elevation levels (p<.05). In conclusion, exercise therapy is effective in controlling pain and increasing functional activity level in shoulder impingement syndrome, but scapular kinematics are only affected by kinetic chain exercises. Therefore, kinetic chain scapula-based rehabilitation could be recommended to use clinically with patients with scapular dyskinesis and shoulder impingement syndrome.