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Motor control retraining exercises for shoulder impingement: effects on function, muscle activation, and biomechanics in young adults

Peter Worsley, PhD a,*, Martin Warner, PhDa, Sarah Mottram, MSca,Stephan Gadola, DM, PhDe, H.E.J. Veeger, PhDb, Hermie Hermens, PhDc,Dylan Morrissey, PhDd, Paul Little, MDe, Cyrus Cooper, MDf, Andrew Carr, MDg ,Maria Stokes, PhD

Setting the scene:

This study aimed to quantify the clinical, neurophysiological, and biomechanical effects of a scapular motor control retraining for young individuals with shoulder impingement signs.

What did they do?

16 adults with shoulder impingement signs (mean age 22 +or-1.6 years) underwent the intervention and 16 healthy participants (24.8 + or -3.1years) provided reference data. Shoulder function and pain were assessed using the Shoulder Pain and Disability Index (SPADI) and other questionnaires. Electromyography (EMG) and 3- dimensional motion analysis was used to record muscle activation and kinematic data during arm elevation to 90 degrees and lowering in 3 planes. Patients were assessed pre and post a 10-week motor control-based intervention, utilizing scapular orientation retraining. Pre-intervention, patients reported pain and reduced function compared to the healthy participants. Post-intervention, the SPADI scores reduced significantly by a mean of 10 points. EMG showed delayed onset and early termination of serratus anterior and lower trapezius muscle activity pre-intervention, which improved significantly post- intervention. Pre-intervention, patients exhibited on average 4.6-7.4 degrees less posterior tilt, which was significantly lower in 2 arm elevation planes than healthy participants. Postintervention, upward rotation and posterior tilt increased significantly during 2 arm movements, approaching the healthy values.

Takeaway message:

10 weeks of motor control exercise intervention can improve function and pain in young adults with shoulder impingement signs. the recovery mechanism involves improvements in muscle recruitment patterns and scapular kinematics.

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