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The effect of electrical stimulation versus sham cueing on scapular position during exercise in patients with scapular dyskinesis
Walker DL, Hickey CJ, Tregoning MB
International Journal of Sports Physical Therapy 2017 Jun;12(3):425-436
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Conventional therapeutic exercise programs are commonly used to treat patients with scapular dyskinesis. There are no studies that have examined traditional therapeutic exercise programs with the addition of remote triggered electrical stimulation (ES) to affect the position of the scapula (using spine to scapular border distance as a reference point) during the performance of exercises that have lower upper trapezius (UT) to lower trapezius (LT) ratio exercises. PURPOSE: The purpose of this pilot study was to compare scapular position after performance of three low UT/LT ratio therapeutic exercises in two conditions, electrical stimulation (ESTherex) and sham electrical stimulation (ShamTherex) in asymptomatic persons who were positive for scapular dyskinesis. STUDY DESIGN: Randomized trial, single-blinded. METHODS: Eleven asymptomatic university students representing 15 scapulae with a positive Scapular Dyskinesis Test were recruited as subjects. Participants were randomized into exercise and electrical stimulation (ESTherex) or exercise and sham electrical stimulation (ShamTherex). Subjects performed side-lying shoulder external rotation and flexion, and prone horizontal abduction with external rotation in both conditions. Scapular position was assessed during active abduction at four angles before and after performance of these exercises. RESULTS: There were no significant differences in scapula to spine distance between ESTherex and ShamTherex groups at 0, 45, 90 and 120 degrees of shoulder abduction. A between group difference (ESTherex and ShamTherex) approached significance at 45 degrees (p = 0.089, CI -0.152 to 1.88cm) with the post mean measurement of the ShamTherex group (6.44cm) greater than the post mean measurement of the ESTherex group (5.57cm). The ESTherex showed a significant pre-to-post mean within group improvement in spine to scapula distance at 120 degrees (mean 2.76cm, t = 4.89, p = 0.003). CONCLUSIONS: Electrical stimulation with exercises for scapular dyskinesis showed improvements in spine to scapula distance at 120 degrees of shoulder abduction. LEVEL OF EVIDENCE: Therapy, level 1b.

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