부산대학교 도서관

Scapular dyskinesis was defined as alteration of scapular position and movement relative to thoracic cage. Previous studies demonstrated that 33 to 100 percent of patients with shoulder disorders including rotator cuff injuries, glenohumeral instability, labral tears have scapular dyskinesis, although cause-effect relationship between shoulder disorders and scapular dyskinesis has been still unclear and with conflict findings. Evaluation of scapulothoracic joint is an essential part for restoring shoulder dysfunction in patients with shoulder disorders. Methods to assess scapular dyskinesis include visual observation, corrective maneuvers, measurement of scapular displacement, and complicated tools such as 3-D motion analysis systems. To improve the methods of evaluating scapular dyskinesis, our research in Chapter 1 developed visual observation with palpation methods to classify specific patterns and investigated the reliability of this comprehensive method. Research in Chapter 2 developed modified scapulometer to measure the posterior displacement of medial border and inferior angle of scapula and investigated the reliability and validity of this tool. Understanding the characteristics of specific scapular dyskinesis pattern may help the treatment and prevention of shoulder disorders with scapular dyskinesis. According to the methods developed in Chapter 1, research in Chapter 3 investigated scapular kinematics and associated muscular activation during arm raising/lowering movements in individuals with specific scapular dyskinesis pattern. With more participants recruited, research in Chapter 4 used principal component analysis to assess the movement characteristics of specific dyskinesis pattern in overhead athletes. Additionally, research in Chapter 5 investigated whether shoulder dysfunction were related to unique patterns of scapular dyskinesis and found the related factors associated with shoulder dysfunction in specific scapular dyskinesis pattern. Optimal intervention of scapular dyskinesis requires addressing all of the factors that can create the dyskinesis and then restoring the balance of muscle forces to maintain appropriate scapular position and motion. Clinically, kinesio taping (KT) has been used to restore muscle activities and kinematics but has not been investigated in patients with scapular dyskinesis. Research in Chapter 6 investigated the effects of trapezius kinesio taping on scapular kinematics and associated muscular activities in patients with scapular dyskinesis. In addition, conscious control of the scapular orientation has been believed to improve scapular kinematics and muscle activation. Limited evidence showed the effect of conscious control in symptomatic patients with scapular dyskinesis. Research in Chapter 7 investigated the alteration of scapular kinematics and muscle activation after conscious control of scapula in patients with scapular dyskinesis. According to the findings in Chapter 7, assisted training devices such as real-time video feedback and modifying progressive control program may improve the effect of control in the task of arm elevation in erect position. Final research in Chapter 8 investigated the effect of progressive conscious control of scapular orientation on scapular movements and muscle activation during arm elevation in scapular plane with and without real-time video feedback in patients with subacromial impingement syndrome (SAIS) and medial border of scapula prominence. These chapters included the dimension of evaluation, pattern characteristics and intervention of scapular dyskinesis.