【論文摘要】The Effects of the Short-Term Scapula-Focused Training on Corticospinal System in Overhead Athletes With Shoulder Impingement Syndrome

【論文摘要】短期肩胛控制訓練對於肩夾擠症候群運動員之中樞控制的影響

楊政浩(Zheng-Hao Yang) ； 林吟亮(Yin-Liang Lin)

《物理治療》 46卷4期 (2021/12) Pp. 293-293

https://doi.org/10.6215/FJPT.202112.O18

摘要

Background and Purpose: Subacromial impingement syndrome (SIS) is a common shoulder disorder in overhead athletes. Central nervous system may be reorganized in patients with SIS, including decreased corticospinal excitability and increased corticospinal inhibition. These central changes are believed to be related to chronicity of symptoms and lack of treatment effects. For patients with SIS, exercises to strengthen scapular muscles and improve scapular control has been recommended. To our knowledge, no study has addressed how the corticospinal system changes following these scapula-focused exercises in patients with SIS. The purpose of the study was to investigate the effects of the short-term scapula-focused training on corticospinal system and shoulder pain and function in overhead athletes with SIS. Methods: Twenty-four participants with SIS and scapular dyskinesis have been recruited and randomized to receive 15 sessions of either scapula-focused training or general shoulder strengthening exercise. Outcomes included shoulder pain, shoulder function, and corticospinal measurements, which were measured at baseline and following 15 sessions of training. Corticospinal excitability and inhibition of lower trapezius were measured by transcranial magnetic stimulation, including active motor threshold (AMT), motor evoked potentials at 130% of AMT, and cortical silent period at 140% of AMT. Shoulder pain was measured with numeric rating scale (NRS) and shoulder function was assessed by Disability of Arm, Shoulder and Hand (DASH) questionnaire, including sections of disability/symptom and high-performance sport/music. Changes from baseline to post-training were compared between groups by independent t test. Results: There was a trend of increasing excitability (decrease in AMT) in the scapula-focused group, compared to the changes the general exercise group (p = 0.058). Significant reduction in pain during exercise was also found in the scapula-focused group (p = 0.025). No difference in changes in DASH between scapula-focused and general exercise groups was found (p ＞ 0.05). Conclusion: These findings suggest that compared to the general exercise, scapula-focused training not only could significantly reduce pain but may increase the corticospinal excitability of the scapular muscle. Clinical Relevance: Scapula-focused training may be a better choice to treat overhead athletes with SIS and scapular dyskinesis.