Suprascapular nerve block disrupts the normal pattern of scapular kinematics

McCully, Sean P.; Suprak, David N.; Kosek, Peter; Karduna, Andrew R.

doi:10.1016/j.clinbiomech.2006.02.001

Cited by 42 publications

(30 citation statements)

References 42 publications

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“…McCully et al 30) analyzed scapular kinematics before and after a suprascapular nerve block in healthy individuals and reported that, although a significant increase was noted in the scapular upward rotation until mid-range elevations, the posterior tilt did not change before and after the block. Moreover, Ohl et al 31) used a stereoradiograph to compare the scapular position at a 90° elevation in rotator cuff tear patients with that of individuals without tears.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional Scapular Kinematics During Arm Elevation in Massive Rotator Cuff Tear Patients

Miura

Kai

Morihara

et al. 2017

PRM

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Objective: Rotator cuff tears can influence shoulder kinematics and severely impair function. However, there have been no studies on three-dimensional (3D) shoulder kinematics in massive rotator cuff tear (MRCT) patients. Hypothesizing that MRCT patients could demonstrate significantly changed scapular kinematics during arm elevation in the scapular plane, we compared 3D scapular kinematics in the scapular plane between MRCT patients and healthy elderly subjects. Methods:We assessed 15 shoulders of 11 MRCT patients and 16 shoulders of 16 healthy subjects. With the subjects seated, we used an electromagnetic tracking system to calculate the upward rotation, posterior tilt, and internal rotation of the scapula at 10° increments from 30° to 120° with respect to the thorax. We performed two-way analysis of covariance with the initial position of the scapular motion as the covariate and performed multiple comparisons using the Bonferroni method. Results: MRCT patients exhibited significantly higher scapular upward rotation than did the healthy subjects (P < 0.05). There were no significant differences between groups with regard to posterior tilt and internal rotation. Conclusions: This study indicated that when MRCT patients elevated their arms, they exhibited a significantly higher scapular upward rotation at low-to mid-range elevations compared with that of healthy subjects. This difference may have resulted from a compensatory effect in response to the decreased elevation torque caused by the loss of rotator cuff function. These results may assist rehabilitation strategies to improve active arm elevation in MRCT patients.

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Section: Discussionmentioning

confidence: 99%

Three-dimensional Scapular Kinematics During Arm Elevation in Massive Rotator Cuff Tear Patients

Miura

Kai

Morihara

et al. 2017

PRM

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“…20 With supraspinatus and infraspinatus muscle activity diminished subsequent to the nerve block, increased scapular upward rotation was noted, even though these muscles do not directly control scapular motion. These 2 studies both attempted to simulate injury to identify adaptation induced by either experimental condition (nerve block 20 or shoulder pain as in the current study). The acute adaptation of increased upward rotation is consistent between these studies.…”

Section: Discussion Pmentioning

confidence: 99%

“…12 Several investigations have aimed to determine if adaptations in scapular movement occur in individuals with impingement or rotator cuff disease. [17][18][19][20]22,[25][26][27]29 A narrative review of studies assessing scapular kinematics by Ludewig and Reynolds 15 noted some consensus among adaptations found in individuals with impingement or rotator cuff disease. Specifically noted were decreased scapular movement toward upward rotation, posterior tilt, and external rotation during humeral elevation.…”

mentioning

confidence: 99%

Clinical Measurement of Scapular Upward Rotation in Response to Acute Subacromial Pain

Wassinger¹,

Sole²,

Osborne³

2013

J Orthop Sports Phys Ther

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“…demonstrated increased deltoid activity in patients with rotator cuff dysfunction modelled experimentally by a suprascapular nerve block [McCully et al, 2006]. This is the rationale for MRCT rehabilitation protocols that target the deltoid [Ainsworth].…”

Section: Discussionmentioning

confidence: 99%

Electromyographic assessment of muscle fatigue in massive rotator cuff tear

Hawkes

Alizadehkhaiyat

Kemp

et al. 2015

Journal of Electromyography and Kinesiology

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Shoulder muscle fatigue has not been assessed in massive rotator cuff tear (MRCT). This study used EMG to measure fatigability of 13 shoulder muscles in 14 healthy controls and 11 patients with MRCT. A hand grip protocol was applied to minimise artifacts due to pain experience during measurement. The fatigue index (median frequency slope) was significantly non-zero (negative) for anterior, middle, and posterior parts of deltoid, supraspinatus and subscapularis muscles in the controls, and for anterior, middle, and posterior parts of deltoid, and pectoralis major in patients (p ≤ 0.001). Fatigue was significantly greater in patients compared to the controls for anterior and middle parts of deltoid and pectoralis major (p ≤ 0.001). A submaximal grip task provided a feasible way to assess shoulder muscle fatigue in MRCT patients, however with some limitations. The results suggest increased activation of deltoid is required to compensate for lost supraspinatus abduction torque. Increased pectoralis major fatigue in patients (adduction torque) likely reflected strategy to stabilise the humeral head against superior subluxing force of the deltoid. Considering physiotherapy as a primary or adjunct intervention for the management of MRCT, the findings of this study generate a base for future clinical studies aiming at the development of evidence-based protocol

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Suprascapular nerve block disrupts the normal pattern of scapular kinematics

Cited by 42 publications

References 42 publications

Three-dimensional Scapular Kinematics During Arm Elevation in Massive Rotator Cuff Tear Patients

Three-dimensional Scapular Kinematics During Arm Elevation in Massive Rotator Cuff Tear Patients

Clinical Measurement of Scapular Upward Rotation in Response to Acute Subacromial Pain

Electromyographic assessment of muscle fatigue in massive rotator cuff tear

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