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Subacromial Injection Results in Further Scapular Dyskinesis.

Ettinger L, Shapiro M, Karduna A - Orthop J Sports Med (2014)

Bottom Line: Subacromial injections of anesthetics resulted in increased scapular anterior tilting; however, no changes were noted in upward or internal rotation.When compared with healthy controls, patients had greater anterior tilting and upward rotation of the scapula.The study findings indicate that the removal of pain in patients with impingement results in further dyskinesis of the scapula.

View Article: PubMed Central - PubMed

Affiliation: Department of Exercise Science, Willamette University, Salem, Oregon, USA.

ABSTRACT

Background: Scapular kinematic movement patterns between patients with subacromial impingement and healthy controls have been extensively investigated. However, a high degree of variability has been reported in the literature pertaining to differences between these 2 groups.

Purpose: To investigate the influence of subacromial pain on scapular kinematics.

Study design: Controlled laboratory study.

Methods: A total of 21 patients with stage 2 subacromial impingement who received local anesthetic injections as part of their normal treatment were recruited for this study. The postinjection kinematic data from these patients were compared with those of healthy age-, sex-, and arm dominance-matched controls.

Results: Subacromial injections of anesthetics resulted in increased scapular anterior tilting; however, no changes were noted in upward or internal rotation. When compared with healthy controls, patients had greater anterior tilting and upward rotation of the scapula.

Conclusion: The study findings indicate that the removal of pain in patients with impingement results in further dyskinesis of the scapula.

Clinical relevance: Pain may be causing patients with subacromial impingement to limit scapular tilt and upward rotation, and movement limitations may continue after an anesthetic injection.

No MeSH data available.


Related in: MedlinePlus

Anterior tilting angle during arm elevation preanesthetic (red) and postanesthetic (blue) injection versus healthy controls (green). #Significant difference for between-subject comparisons; *significant difference for within-subject comparisons.
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fig3-2325967114544104: Anterior tilting angle during arm elevation preanesthetic (red) and postanesthetic (blue) injection versus healthy controls (green). #Significant difference for between-subject comparisons; *significant difference for within-subject comparisons.

Mentions: For scapular tilt, there was a significant interaction between treatment and humeral elevation angle (P = .032). Post hoc pairwise comparisons indicated that treatment had no significant influence on scapular tilt at 30° and 60° of humeral elevation (P > .05). However, significant differences were detected for 90° (P = .04) and 120° (P = .007), with differences in anterior tilting of 2° and 3.5°, respectively. Comparing postinjection kinematics for patients with impingement versus healthy controls, a significant interaction between humeral elevation angle and group (controls vs impingement population) was detected (P = .006). Post hoc pairwise comparisons indicate that no significant differences were found between groups at 90° of humeral elevation (P > .05); however, significant differences were detected at 120° of humeral elevation, where the impingement group had on average 7.1° ± 2.9° greater anterior tilting than controls (P = .02) (Figure 3).


Subacromial Injection Results in Further Scapular Dyskinesis.

Ettinger L, Shapiro M, Karduna A - Orthop J Sports Med (2014)

Anterior tilting angle during arm elevation preanesthetic (red) and postanesthetic (blue) injection versus healthy controls (green). #Significant difference for between-subject comparisons; *significant difference for within-subject comparisons.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4555573&req=5

fig3-2325967114544104: Anterior tilting angle during arm elevation preanesthetic (red) and postanesthetic (blue) injection versus healthy controls (green). #Significant difference for between-subject comparisons; *significant difference for within-subject comparisons.
Mentions: For scapular tilt, there was a significant interaction between treatment and humeral elevation angle (P = .032). Post hoc pairwise comparisons indicated that treatment had no significant influence on scapular tilt at 30° and 60° of humeral elevation (P > .05). However, significant differences were detected for 90° (P = .04) and 120° (P = .007), with differences in anterior tilting of 2° and 3.5°, respectively. Comparing postinjection kinematics for patients with impingement versus healthy controls, a significant interaction between humeral elevation angle and group (controls vs impingement population) was detected (P = .006). Post hoc pairwise comparisons indicate that no significant differences were found between groups at 90° of humeral elevation (P > .05); however, significant differences were detected at 120° of humeral elevation, where the impingement group had on average 7.1° ± 2.9° greater anterior tilting than controls (P = .02) (Figure 3).

Bottom Line: Subacromial injections of anesthetics resulted in increased scapular anterior tilting; however, no changes were noted in upward or internal rotation.When compared with healthy controls, patients had greater anterior tilting and upward rotation of the scapula.The study findings indicate that the removal of pain in patients with impingement results in further dyskinesis of the scapula.

View Article: PubMed Central - PubMed

Affiliation: Department of Exercise Science, Willamette University, Salem, Oregon, USA.

ABSTRACT

Background: Scapular kinematic movement patterns between patients with subacromial impingement and healthy controls have been extensively investigated. However, a high degree of variability has been reported in the literature pertaining to differences between these 2 groups.

Purpose: To investigate the influence of subacromial pain on scapular kinematics.

Study design: Controlled laboratory study.

Methods: A total of 21 patients with stage 2 subacromial impingement who received local anesthetic injections as part of their normal treatment were recruited for this study. The postinjection kinematic data from these patients were compared with those of healthy age-, sex-, and arm dominance-matched controls.

Results: Subacromial injections of anesthetics resulted in increased scapular anterior tilting; however, no changes were noted in upward or internal rotation. When compared with healthy controls, patients had greater anterior tilting and upward rotation of the scapula.

Conclusion: The study findings indicate that the removal of pain in patients with impingement results in further dyskinesis of the scapula.

Clinical relevance: Pain may be causing patients with subacromial impingement to limit scapular tilt and upward rotation, and movement limitations may continue after an anesthetic injection.

No MeSH data available.


Related in: MedlinePlus