Assessment of Scapulohumeral Rhythm in Scapular Plane in Subjects with Shoulder Pathology Agarwal Deepika1, Anand Milan2,* 1Physiotherapist, Amity Institute of Physiotherapy, Amity University, Noida, Uttar Pradesh, India 2Assistant Professor, Amity Institute of Physiotherapy, Amity University, Noida, Uttar Pradesh, India *Corresponding author: Milan Anand (PT) Assistant Professor Amity Institute of Physiotherapy F1 block, LGF, Amity University Uttar Pradesh Sector-125, NOIDA, Dist. Gautam Budh Nagar. Uttar Pradesh, (INDIA), Pin: 201 313 E-mail: manand@amity.edu
Online published on 28 September, 2015. Abstract Background & Objectives Assessing the presence or absence of altered scapulohumeral rhythm in shoulder pathology in clinical setting is important for better evaluation and rehabilitation. Given the critical role of scapula in optimal functioning of shoulder, the aim of this study was to develop better understanding of the coordinated movement of scapula and humerus over the entire arc of shoulder elevation and to ascertain to which percentage scapula was involved in shoulder pathologies. Method Forty subjects with unilateral repetitive or overuse shoulder pathologies were recruited in the study. A modified digital inclinometer was used to measure the scapular upward rotation of the subjects with unilateral shoulder pathology. Scapular upward rotation was measured as the subjects performed relevant amount of shoulder elevation in the scapular plane. Scapular rotation was assessed over the entire arc of motion and over a series of shoulder elevation increments. The percent contribution of scapular and glenohumeral joint to shoulder elevation was calculated. The scapulohumeral rhythm was assessed and represented in the ratio of glenohumeral motion to scapulothoracic motion Results Scapulohumeral rhythm for the entire arc of shoulder elevation in scapular plane in subjects with shoulder pathology was equal to 4.33: 1(0°-120°) and ranged from 56.69: 1 to 2.31: 1(0°-30° to 90°-120°) when assessed across the different increments of humeral elevation. The total scapular motion increased over the arc of humeral elevation. The scapula contributed 1.73% for the first 30 degrees of shoulder elevation, between 23.73% and 25.2% for 30–90 degrees of shoulder elevation, and 30.13% for 90–120 degrees of shoulder elevation. Statistically significant differences in scapular upward rotation were identified across the shoulder elevation increments (F =1.185, P < 0.05). Conclusion Clinically, the altered scapulohumeral rhythm could be assessed and the extent of scapular contribution at varying humeral angles could be calculated. In 90–120 degrees the scapula demonstrated with 9.04° SUR with 30.13% scapular contribution to overall shoulder elevation increment in the subjects with shoulder pathologies. Since 90–120 degrees show higher scapular rotation contribution than other shoulder elevation increments in scapular plane therefore, the clinicians can use overhead rehabilitation exercises for better outcome in patients with shoulder pathologies. Top Keywords Scapulohumeral rhythm, scapular plane, scapula, shoulder. Top |