Effect of Adding Vertical Correction to Dynamic Scapular Recognition on Scapular Dyskinesis and Shoulder Disability in Patients With Adhesive Capsulitis: A Randomized Clinical Study

Abstract

Objective: The purpose of this study was to measure the effect of adding vertical downward correction to dynamic scapular recognition exercise on scapular dyskinesis and shoulder pain and disability in people with adhesive capsulitis.

Methods: Sixty-seven participants with adhesive capsulitis were randomized into 2 groups. The taping intervention group performed a dynamic scapular recognition exercise using a wireless biofeedback system and a continual vertical downward correction using rigid taping with 50% to 75% tension. The comparison group performed a similar dynamic scapular recognition exercise but with sham taping. The primary outcome measures were scapular dyskinesis, scapular upward rotation, and Shoulder Pain and Disability Index, and the secondary outcome measures were shoulder flexion, abduction, and external rotation.

Results: After 2 weeks, there were significant differences between the taping intervention group and the comparison group in scapular dyskinesis, scapular upward rotation, shoulder flexion, abduction, and Shoulder Pain and Disability Index (P < .05), and nonsignificant differences in shoulder external rotation (P > .05). After 2 and 6 months, there were significant differences between groups in all dependent outcome measures (P < .05).

Conclusion: This study demonstrated that from adding taping with a vertical downward correction to dynamic scapular recognition exercises, significant short-term and long-term improvements in scapular dyskinesis and shoulder pain and disability in people with adhesive capsulitis were observed. These improvements persisted for 6 months after intervention.

Keywords: Bursitis; Dyskinesias; Rehabilitation; Shoulder.

Fig 1

A diagram of the participant flow through the study.

Fig 2

Tape placement. Two rigid pieces of tape were applied: the first tape from just superior to the midpoint of the superior border of the scapula to the level of T12, and the second from just superior to the superior angle of the scapula to the level of T12. The level of T12 was used as the end of both tapes to increase the lever arm of the applied force and decrease the incidence of tape peeling off. No tape was applied from the lateral angle of the scapula, because it might impair the upward rotation. Both pieces of tape were applied after each session and removed immediately before the next session.

Fig 3

Repeated-measures 2-way analysis of variance between baseline measurements and measurements after 2 weeks, 2 months, and 6 months for scapular dyskinesis and scapular upward rotation. *Significant (P < .05).

Fig 4

Repeated-measures multivariate analysis of variance between baseline measurements and measurements after 2 weeks, 2 months, and 6 months for shoulder ranges of motion. *Significant (P < .05).

Fig 5

Repeated-measures 2-way analysis of variance between baseline measurements and measurements after 2 weeks, 2 months, and 6 months for the Shoulder Pain and Disability Index. *Significant (P < .05).

Fig 6

Comparison between percentage improvement in scapular dyskinesis (A), scapular upward rotation (B), shoulder ranges of motion (C-E), and Shoulder Pain and Disability Index (F) in the taping and comparison groups after addition of scapular dynamic recognition exercise.

Fig 7

Independent 2-way analysis of variance between groups at baseline and after 2 weeks, 2 months, and 6 months for scapular dyskinesis, scapular upward rotation, flexion, abduction, external rotation, and Shoulder Pain and Disability Index. Abd., abduction; Ext. Rot., external rotation; Flex., flexion; Scap. Dys., scapular dyskinesis; SPADI, Shoulder Pain and Disability Index; SUR, scapular upward rotation. *Significant (P < .05).