Reliability of Scapula Clinical Assessment and Effectiveness of Scapular-Focused Exercises in a Non-Athletic Population with Shoulder Pain – a Literature Review

Abstract

Introduction: The scapula is recognised as a key element of the proper functioning in the shoulder complex. Scapular movement abnormalities have been defined as scapular dyskinesis. It is treated as a dysfunction that increases the risk of shoulder pain. Various diagnostic and therapeutic methods have been introduced into clinical practice, the purpose of which are to assess the function of the scapula and restore normal movement patterns. The current state of knowledge does not allow to clearly answer the question as to whether the available tools applied for assessing the mobility and functions of the scapula are reliable and useful in clinical practice during diagnosis within the shoulder complex.Objectives: The aim of the study was to review the current literature in terms of the reliability of the methods assessing the scapula function and the effectiveness of scapular-focused exercises in a non-athletic population with shoulder girdle pain.Methods: The search for publications was carried out using the following scientific databases: PubMed, ScienceDirect and PEDro. This was conducted by 2 reviewers in January 2022.Results: Sixteen articles were included in the analysis after meeting the inclusion and exclusion criteria, including 9 methods for assessing the reliability of scapula assessment methods and 7 for assessing the effectiveness of scapular-focused exercises. The majority of methods applied for assessing shoulder blade function are qualitative, with low to moderate reliability. Among the analysed methods, only the Scapulometr allowed to assess the scapula in a quantitative manner and was characterised by high coefficients, in both intra and inter-rater reliability. The other methods were characterised by low or moderate reliability or lack of assessment for both coefficients. These results are also confirmed by the analysis of systematic reviews. The analysed works on the effectiveness of exercises improving the function of the scapula indicate their effectiveness in reducing pain and disability in people with shoulder complex dysfunctions. Only in 1 study were the 3-dimensional kinematics of the scapula assessed, however, the applied exercise programmes did not influence this factor in a clinically significant manner.Conclusions: The available literature does not allow us to recommend any method of scapula function assessment for use in clinical practice. Exercises focused on improving the function of the scapula appear to be effective in reducing pain and disability among people experiencing shoulder girdle pain. There is conflicting evidence regarding the superior efficacy of specific shoulder blade function exercises over general shoulder girdle ones.

Keywords

• scapular dyskinesis
• scapula stabilisation
• physical examination