Investigation of Results of Scapular Assistant Test in Patients with Shoulder Impingement Syndrome and Rotator Cuff Tear: A Clinical Pilot Study

Document Type : Original Article

Authors

1 PhD, Department of Physical Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran

2 Assistant Professor, Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran

3 Assistant Professor Department of Mechanical Engineering, University of Kashan, Kashan, Iran

Abstract

Purpose:
Altered scapular kinematics are common disabilities among patients with shoulder impingement syndrome and/or rotator cuff tear. The scapular assistance test (SAT) might be a helpful diagnosis tool to identify clinical type of scapular dyskinesia. The SAT may correct scapular upward rotation and posterior tilt. The aim of this pilot study was to identify the SAT application as a diagnostic tool for type of scapular dyskinesia and among patients with shoulder impingement syndrome and rotator cuff tear. Moreover, another aim was to determine the effect of SAT on the shoulder pain and shoulder range of abduction.
Methods:
Seven patients with shoulder impingement syndrome and seven patients with rotator cuff tear met the inclusion criteria and included in the study population. An experienced therapist palpated patient's scapula as starting position for the SAT. In the next stage, patient was asked to perform shoulder abduction and reported any pain or inconvenience during the examination. Meanwhile, the therapist kept upward rotation and posterior tilt of the scapula.  
The pain level in shoulder (by VAS, Visual Analogue Scale), shoulder range of abduction, flexion and scapular plane elevation (by electrogoniometer) and also, shoulder disability (by DASH, Disability of Shoulder and Hand Questionnaire) had been measured during shoulder abduction and also the SAT performance. The statistical analysis was performed using independent and paired t-test after normal distribution approval.
Results:
Duration of disease (p=0.02), night pain (p<0.001), work part of DASH questionnaire (p=0.001), initial abduction ROM (p=0.02), first scapular elevation ROM (p=0.009) and pain during the SAT (p=0.048) have been shown significantly different between patients with shoulder impingement syndrome and rotator cuff tear. In patients with shoulder impingement syndrome, the VAS values have been substantially different through abduction and the SAT (p=0.001).
Conclusion:
Current study depicts that the SAT might be a useful test to diagnose the type of scapular dyskinesia in patients with shoulder impingement syndrome. However, the SAT may not be a valuable diagnostic test for patients with rotator cuff tear.

Keywords

Main Subjects


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