A Systematic Review and Meta-analysis: The Effect of Scapular-focused Exercise Therapy on Shoulder Pain and Function and Scapular Positioning in People With Scapular Dyskinesia

Abstract

Objectives: Scapular-focused exercises are included in the rehabilitation of people with scapular dyskinesis (SD); yet, there is a noteworthy level of ambiguity concerning the comparative efficacy of different interventions in terms of their ability to enhance shoulder discomfort and function. This research analyzed the impact of a scapular-focused exercise schedule on shoulder pain and function of patients with scapular dyskinesia. Methods: PubMed, Medline (Ovid), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), Google Scholar, and Scopus databases were explored up until July 2021 for randomized controlled trials (RCTs) that considered the impact of scapular-focused training therapy in people with SD. Eleven RCTs, with a combined sample size of 890 participants encountered our inclusion criteria. Results: The results demonstrated a significant reduction in shoulder pain following exercise (therapy standardized mean difference [SMD]=-0.83; 95% CI, -1.44%, -0.22%; P=0.008). Moreover, exercise therapy significantly improved shoulder function (SMD=-0.62; 95% CI, -1.08%, -0.16%; P=0.008). Nevertheless, scapular-focused exercise had no significant effect on scapula positioning at any angle (0°: Mean difference [MD]=-0.44; 95% CI, -1.43%, 0.55%; P=0.38; 45°: MD=-0.17; 95% CI, -0.72%, 0.37%; P=0.53; 90°: MD=-0.25; 95% CI, -1.06%, 0.57%; P=0.56). Discussion: Scapular-based exercise therapies are effective approaches among patients with SD. It is necessary to conduct additional high-quality studies with longer periods to evaluate and validate the results reported in this study.

Keywords

• scapula dyskinesia
• shoulder pain
• scapula positioning
• meta-analysis