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The investigators will test whether conscious control with manual guides and video or EMG biofeedback will enhance 3-D kinematics of scapula in shoulder dysfunction subjects with different type of scapula dyskinesis. The investigators will also examine how correction of scapular orientation may affect the activation of associated muscles during various dynamic movements in these subjects.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Biofeedback group | Experimental | After 1 minute of rest, participants will perform 6 trials of bilateral, active, weighted arm elevation in the scapular plane and a therapist classifies the scapular motion into specific patterns of scapular dyskinesis. After the evaluation of scapular dyskinesis, the kinematics and surface EMG (sEMG) data will be collected during 5 trials of the same arm movements and 3 selected exercises. |
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| Conscious control group | Active Comparator | Conscious correction of scapular orientation will be taught to the subjects in the manner described in previous studies. The starting position is determined in each individual by actively positioning the scapula between maximal upward and downward rotation, external and internal rotation, and posterior and anterior tilt. Scapular assistance test (SAT) is also conducted by passively assisting patients' scapula into appropriate position to correct scapula dyskinesis |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Conscious control | Other | Conscious control of the scapula is important and can correct neuromuscular coordination as well as strength deficits. The strategy in learning control of scapula into normal orientation can be facilitated by manual guides and/or external cues |
| Measure | Description | Time Frame |
|---|---|---|
| Shoulder complex kinematics | Scapular orientation relative to the thorax is described using a Euler angle sequence of rotation about Zs (protraction/retraction), rotation about Y's (downward /upward rotation), and rotation about X"s (posterior/anterior tipping). Scapular elevation is defined as the vertical displacement of the scapular sensor during arm elevation. Humeral orientation relative to the scapula is described using a Euler angle sequence in which the first rotation represents the plane of elevation, the second rotation defines the amount of elevation, and the third rotation describes the amount of axial rotation. | The scapular kinematics will be measured before scapular control and immediately after scapular control |
| Shoulder associated muscular activities | Full bandwidth sEMG data, captured by data acquisition software (AcqKnowledge, Biopac systems Inc., CA, USA) | The muscle activation will be measured before scapular control and immediately after scapular control |
| Measure | Description | Time Frame |
|---|---|---|
| Forward shoulder posture | The measurement of the distance between the posterior border of the acromion and the table | After subjects are included in the study, the forward shoulder posture will be measured before scapular control, and be done within 2 hours. |
| Pectoralis minor muscle length |
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Inclusion criteria:
Exclusion criteria:
- Shoulder pain onset due to trauma, a history of shoulder fractures or dislocation, cervical radiculopathy, degenerative joint disease of the shoulder, surgical interventions on the shoulder, or inflammatory arthropathy
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| Name | Affiliation | Role |
|---|---|---|
| Jiu- Jenq Lin, PhD | National Taiwan University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| National Taiwan University Hospital | Taipei | 100 | Taiwan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31876455 | Derived | Du WY, Huang TS, Chiu YC, Mao SJ, Hung LW, Liu MF, Yang JL, Lin JJ. Single-Session Video and Electromyography Feedback in Overhead Athletes With Scapular Dyskinesis and Impingement Syndrome. J Athl Train. 2020 Mar;55(3):265-273. doi: 10.4085/1062-6050-490-18. Epub 2019 Dec 26. |
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| ID | Term |
|---|---|
| D019534 | Shoulder Impingement Syndrome |
| ID | Term |
|---|---|
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D000070599 | Shoulder Injuries |
| D014947 | Wounds and Injuries |
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| Conscious control+biofeedback | Other | In electromyography (EMG) biofeedback training, electronic equipment is used to reveal instantaneously certain physiological events. |
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The distance from the fourth rib to the coracoids process will be measured with FASTRAK system with accuracy of 0.08 cm. This distance (in centimeter) is divided by the subjects height and multiplied by 100. This results in a pectoralis muscle length index |
| After subjects are included in the study, the muscle length will be measured before scapular control, and be done within 2 hours. |