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      Associação entre discinesia escapular e dor no ombro de praticantes de natação Translated title: Association between scapular dyskinesia and shoulder pain in swimmers

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          Abstract

          A escápula possui funções essenciais no ombro do atleta de arremesso. Qualquer desequilíbrio presente entre as estruturas responsáveis pela sua estabilidade originará uma condição denominada discinesia escapular, a qual é comumente acompanhada de dor no ombro. Este estudo tem o objetivo de verificar se há associação entre a discinesia escapular e a dor no ombro de praticantes de natação. Foi realizado um estudo analítico observacional de corte transversal, incluindo 36 praticantes de natação do sexo masculino, com idade de 18 a 36 anos. Como métodos diagnósticos sugestivos de discinesia escapular foram utilizados o Slide Lateral Scapular Test e a filmagem proposta por Kibler. A existência de proporções significativas entre as variáveis nominais foi comprovada pelo teste do qui-quadrado ou pelo teste exato de Fisher. Para identificar associações entre as variáveis contínuas e os grupos de estudo foi utilizado o teste t de Student. Um p < 0,05 foi considerado estatisticamente significante. O grau de concordância interexaminador (Kappa; p < 0,0001) foi considerado substancial, correspondendo a 86,1% (0,7656) no ombro direito e 83,3% (0,6412) no esquerdo. Constatou-se que a grande maioria (80%) dos indivíduos que apresentaram positividade no Slide Lateral Scapular Test relatou dor no ombro. Dentre os nadadores que apresentaram discinesia escapular durante a filmagem, em 70,8% também foi constatada a presença dessa condição no teste estático. Este é um estudo original no que diz respeito à abordagem da discinesia escapular em nadadores e em relacioná-la com a presença de dor no ombro. Porém, a hipótese inicial de que haveria uma associação significante não foi correspondida.

          Translated abstract

          The scapula plays an essential role in the throwing motion performed by athletes. Scapular dyskinesia is a condition characterized by imbalance in the structures responsible for the joint stability, which is often accompanied by shoulder pain. The main objective of this study is to assess the relationship between scapular dyskinesia and shoulder pain in swimmers. A total of 36 male swimmers aged between 18 and 36 years were diagnosed for scapular dyskinesia utilizing two different methods: the Lateral Slide Scapular Test and the video recording method suggested by Kibler. Statistical analysis was performed using the Chi-square test or Fisher's exact test. Comparisons between groups were performed using the t-test. The degree of p< 0.05 was considered statistically significant. Significance was set at α=0.05. There was a high inter-rate reliability concerning the video analysis (Kappa; p<0.0001), corresponding to 86.1% (0.7656) on the right shoulder and 83.3% (0.6412) on the left shoulder. The majority of the individuals that had positive diagnosis assessed by the Lateral Slide Scapular Test (80%) reported pain on the shoulder. Furthermore, 70.8% of the subjects who had positive diagnosis by the video recording also had positive diagnosis in the static test. Although a significant association between scapular dyskinesia and shoulder pain was not found, this is an important study to approach these conditions in swimmers.

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          Most cited references20

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          Scapular Dyskinesis and Its Relation to Shoulder Pain

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            Scapular position and orientation in throwing athletes.

            Despite the recognized importance of proper 3-dimensional motion of the scapula in throwers, minimal research has quantified scapular position and orientation in throwing athletes. Throwing athletes exhibit scapular position and orientation differences when compared to nonthrowing control subjects. Descriptive laboratory study. Scapular position and orientation during scapular plane humeral elevation were assessed with electromagnetic tracking in a group of 21 throwing athletes and 21 control subjects. Scapular upward/downward rotation, internal/external rotation, anterior/posterior tipping, elevation/depression, and protraction/retraction were assessed. The throwing athletes demonstrated significantly increased upward rotation, internal rotation, and retraction of the scapula during humeral elevation. No differences in anterior/posterior tipping and elevation/depression were present. The results indicate that throwing athletes have scapular position and orientation differences compared to non-throwing athletes. This suggests that throwers develop chronic adaptation for more efficient performance of the throwing motion. Clinicians evaluate scapular position, orientation, and movement in throwing athletes as part of the evaluation of shoulder injuries associated with the throwing motion. The current study provides clinicians with an understanding of the types of adaptations that may be observed in normal, healthy throwing athletes.
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              Effects of shoulder muscle fatigue caused by repetitive overhead activities on scapulothoracic and glenohumeral kinematics.

              The purpose of this study was to determine the effects of shoulder muscle fatigue on three dimensional scapulothoracic and glenohumeral kinematics. Twenty healthy subjects participated in this study. Three-dimensional scapulothoracic and glenohumeral kinematics were determined from electromagnetic sensors attached to the scapula, humerus, and thorax. Surface electromyographic (EMG) data were collected from the upper and lower trapezius, serratus anterior, anterior and posterior deltoid, and infraspinatus muscles. Median power frequency (MPF) values were derived from the raw EMG data and were used to indicate the degree of local muscle fatigue. Kinematic and EMG measures were collected prior to and immediately following the performance of a shoulder elevation fatigue protocol. Following the performance of the fatigue protocol subjects demonstrated more upward and external rotation of the scapula, more clavicular retraction, and less humeral external rotation during arm elevation. All muscles with the exception of the lower trapezius showed EMG signs of fatigue, the most notable being the infraspinatus and deltoid muscles. In general, greater scapulothoracic motion and less glenohumeral motion was observed following muscle fatigue. Further studies are needed to determine what effects these changes have on the soft tissues and mechanics of the shoulder complex.
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                Author and article information

                Journal
                rbme
                Revista Brasileira de Medicina do Esporte
                Rev Bras Med Esporte
                Sociedade Brasileira de Medicina do Exercício e do Esporte (São Paulo, SP, Brazil )
                1517-8692
                1806-9940
                October 2009
                : 15
                : 5
                : 342-346
                Affiliations
                [02] Salvador Bahia orgnameFaculdades Integradas da Bahia
                [03] Salvador Bahia orgnameCentro Universitário Jorge Amado
                [01] Salvador Bahia orgnameUniversidade Católica do Salvador
                Article
                S1517-86922009000600004 S1517-8692(09)01500504
                18b57e01-fea7-45d1-b121-7fa41a5d289c

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 04 May 2009
                : 05 May 2009
                : 13 August 2008
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 20, Pages: 5
                Product

                SciELO Brazil

                Categories
                Artigos Originais

                sports injuries,glenohumeral joint,cinesiologia,lesões no esporte,articulação glenoumeral,kinesiology

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