Effects of the Kinetic Chain Approach for Scapular Dyskinesis

NCT03566849 | Completed

• 1 other identifier: YM106028F
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Volleyball is a highly technical sport which involved powerful overhead movements performed repetitively. Shoulder injuries is the third-most commonly injured body part in volleyball, with the majority resulting from chronic overuse. Abnormal scapular motions and positions relative to the thorax have been linked to various shoulder pathologies, including subacromial impingement, rotator cuff tears, and glenohumeral inferior instability. Also, Muscular imbalances around the shoulder complex could lead to dyskinesis and resulting in shoulder joint injuries (e.g. instability and impingement). The concept of "kinetic chain" is coordinated sequencing of the segments. Sequential activation of the LE, pelvis and trunk muscles is required to facilitate the forces to be transferred appropriately from these body segments to the UE. Reeser et al. have identified risk factors for volleyball-related shoulder pain and dysfunction. They found volleyball athletes who demonstrated core instability would show greater relevance to SICK scapula, and they also more likely to report a history of shoulder problems. Sciascia et al. also have reviewed that 49% athletes with posterior-superior labral tears showed either decreased hip rotators flexibility or decreased hip abductors strength. Consequently, the deficits in kinetic chain segments would resulted in scapula dyskinesis, even lead to shoulder girdle dysfunction or injury. Therefore, the modern training programs for athletes, especially in overhead players, should combine kinetic chain exercises to improve upper- and lower body core strength, sport-specific strength, performance, and prevent injury occurrence or recurrence. In consideration of no randomized controlled trials (RCTs) have been performed to determine whether kinetic chain exercise would be more effective to conventional scapula training for patients with secondary shoulder impingement. The purpose of the study is to investigate the effects of kinetic chain management approach (KC) and conventional training of scapula dyskinesis (CT) in volleyball athletes with scapular dyskinesia. The investigators hypothesized that KC group would be more effective in self-reported pain, and their scapula would become more stable during movement task (arm-lifting and spiking) after a 4-week training program than CT group.

Conditions

Shoulder Impingement Syndrome

Keywords

Volleyball; Shoulder impingement; Scapular dyskinesis; Kinetic chain

Outcome Measures

Primary Outcomes (1)

• Scapular movement consistency (Proprioceptive Feedback Magnitude, PFM)

  Scapular positioning (kinematics) during spiking task (spike for 30 repetition, and compare the average of first and last 3 trials)

  Baseline and 4-week intervention

Secondary Outcomes (3)

• Scapulo-humeral rhythm (scapular kinematics)

  Baseline and 4-week intervention

• Scapula motor control (muscle activation percentage)

  Baseline and 4-week intervention

• Self-reported pain (Visual Analogue Scale, VAS)

  Baseline, end of week 1 treatment, end of week 2 treatment, end of week 3 treatment, and end of week 4 treatment

Study Arms (2)

KC group

EXPERIMENTAL

It mainly involve all segment in kinetic chain, not only shoulder girdle, include exercise training 3 times a week for a total 4 weeks.

Other: KC group

CT group

EXPERIMENTAL

It involve shoulder girdle only, include exercise training 3 times a week for a total 4 weeks.

Other: CT group

Interventions

KC group OTHER

1. 1st week: each 10 rep/set, 3 set/day. PNF scapular pattern: posterior depression (Combination of isotonic, COI), Ball modified prone Cobra, Ball prone V-raise, Ball prone row, Ball side plank, Ball one-leg bridging 2. 2nd week: each 10 rep/set, 3 set/day. Half sit-up with rotation to left/right, Side plank with ER, Prone extension with rotation to left/right, Bilateral one-leg squat with flexion, Squat to row 3. 3rd week: 5 rep/set, 3 set/day (sling exercise). Prone shoulder protraction, Supine shoulder retraction, Side-lying hip ABD/ADD, Supine pelvic lift, Prone bridging 4. 4th week: each 10 rep/set, 3 set/day. Lateral lunges with shoulder ABD/ER, Lunge with trunk rotation, Forward punch plus with serape effect, Spiking exercise, One-quarter vertical squat jump

Also known as: Exercise therapy

KC group

CT group OTHER

1. 1st week: each 10 rep/set, 3 set/day. PNF scapular pattern: posterior depression (Combination of isotonic, COI), Knee push up plus, Modified prone Cobra, Prone V-raise, Prone row, Side-lying ER 2. 2nd week: each 10 rep/set, 3 set/day. Supine punch, Prone horizontal ABD, Prone V-raise, Prone row, Side-lying ER 3. 3rd week: each 10 rep/set, 3 set/day. Sitting chest press, Sitting ABD in scaption, Sitting overhead press, Long-sitting resisted extension, Sitting ER 4. 4th week: each 10 rep/set, 3 set/day. Standing horizontal pull-apart, Standing retraction plus ER, Standing resisted extension, Ball pushed on wall and controlled rolling, Wall push-up

Also known as: Exercise therapy

CT group

Eligibility Criteria

• Age: 18 Years - 30 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Volleyball athletes who performed related sport activities for more than 10 hour/wks
• Age 18-30 years, with diagnosed of scapula dyskinesia by a physical therapist
• Shoulder girdle passive range of motion (PROM) within normal limitation
• Visual analog score (VAS) rating of pain during activities of sport or daily living during the previous week at a minimum of 3 cm on a 10-cm scale
• Insidious onset of symptoms unrelated to trauma and persistent for at least 4 wks

You may not qualify if:

• Can't finish the data collection process due to any other current musculoskeletal pain/injuries
• Any neuromuscular disorder, joint or bone disease
• History of any orthopedic surgeries

Sponsors & Collaborators

• National Yang Ming Chiao Tung University: lead

Study Sites (1)

National Yang Ming University

Taipei, 11221, Taiwan

Location

Related Publications (1)

• Chang CC, Chang CM, Shih YF. Kinetic Chain Exercise Intervention Improved Spiking Consistency and Kinematics in Volleyball Players With Scapular Dyskinesis. J Strength Cond Res. 2022 Oct 1;36(10):2844-2852. doi: 10.1519/JSC.0000000000003904. Epub 2020 Dec 9.

  PMID: 33306587 DERIVED

MeSH Terms

Conditions

Shoulder Impingement Syndrome

Interventions

Exercise Therapy

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases; Shoulder Injuries; Wounds and Injuries

Intervention Hierarchy (Ancestors)

Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities

Study Officials

• Yi-Fen Shih, PhD

  Department of Physical Therapy and Assistive Technology, National Yang-Ming University

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor, Department of Physical Therapy and Assistive Technology, National Yang-Ming University

Model Details: A randomized controlled trial (RCT) with two treatment groups, kinetic chain management approach (KC) and conventional training of scapula dyskinesis (CT).

Study Record Dates

• First Submitted: September 15, 2017
• First Posted: June 25, 2018
• Study Start: December 15, 2017
• Primary Completion: November 25, 2018
• Study Completion: December 10, 2018
• Last Updated: January 7, 2019

Record last verified: 2019-01

Locations

TW (1)