【論文摘要】The Effects of Motor Control Intervention on Scapular Dyskinesis: Systematic Review and Meta-analysis

【論文摘要】動作控制介入對肩胛骨運動異常之成效：系統性回顧與綜合分析

陳月霞(Yueh-Hsia Chen) ； 洪郁婷(Yu-Ting Hung) ； 陳勇璋(Yeong-Jang Chen) ； 布娜莎(Natharin Boontha) ； 王元聖(Yuan-Sheng Wang) ； 王淑芬(Shwu-Fen Wang)

《物理治療》 45卷2期 (2020/06) Pp. 185-186

https://doi.org/10.6215/FJPT.202006.P64

摘要

Background and Purpose: Scapular dyskinesis is considered a non-specific response to a painful shoulder and leads to altered position or motion of the scapula. Soft-tissue flexibility and muscle performance contribute to the main parts of treatment strategies for scapular dyskinesis. Besides, motor control has been found to change muscle recruitment and kinematics by the scapular orientation training and scapular-focused exercises. This study aims to systematically review and analyze the effects of motor control intervention on patients with scapular dyskinesis. Methods: PubMed, Physiotherapy Evidence Database (PEDro) and Cochrane Library were searched for randomized control trials to compared motor control interventions with the usual care or alternative exercise therapy that was not focused specifically on scapular biomechanics until October 2019. The English language was restricted. Two reviewers independently screened the titles and abstracts. The risk of bias was evaluated with the Cochrane Collaboration Risk of Bias, and the quality of the studies was evaluated by the PEDro scales. Results: 14 studies and a total of 639 adults were included. Random-effects meta-analysis showed moderate evidence of positive effects in shoulder abduction range of motion (mean difference 10.18; 95% CI 0.86 ~ 16.90) and scapular upward rotation at 30° (mean difference 1.83; 95% CI 1.33 ~ 2.32) and 90° (mean difference 1.20; 95% CI 0.43 ~ 1.98) of humeral abduction in the short term (＜6 weeks). Statistically, long-term effect was found in pain (mean difference -2.23; 95% CI -4.02 ~ 0.44). There are no evidence trials were found in pain, maximal voluntary isometric contraction of shoulder abduction, static scapular position in the short term, and scapular upward rotation in the long term. No significant difference in self-rated shoulder function in both short term and long term. Conclusion: Current evidence suggests that motor control intervention is effective for scapular dyskinesis in the short term. The included studies were heterogeneous, a short period of follow-up and the number of included trials was low; thus, further investigation is needed to clarify the long-term effects of motor control intervention in scapular dyskinesis. Clinical Relevance: Our results provide important information to help the design of intervention program for preterm children with potential behavioral problems in Taiwan.