The Effects of Scapulothoracic Mobilization on Pain and Range of Motion in Patients with Neck Pain and Scapular Dyskinesis

Abstract

Background: Dyskinesis has been referred to as a major manifestation of affected muscle performance and neuromuscular control of the scapular stabilizers. Alterations around the scapula with muscular imbalances could facilitate or emphasize dysfunction in its surrounding structures through compressive and shear stresses created by abnormal pull through their shared attachments. No studies have investigated the effect of scapular mobilization with movement on neck mobility and pain in patients with neck pain and scapular dyskinesis. Design: a single-blind case-control study. Methods: Forty participants with chronic non-specific neck pain and scapular dyskinesis were alternatively allocated to one of two groups: experimental group (scapulothoracic MWM+ corrective exercises+ tape) or the control group(corrective exercises and tape). Pain intensity on visual analog scale (VAS), Pressure Pain Threshold (PPT), cervical and scapular range of motion (ROM) and Neck Disability Index (NDI) were measured at baseline, after the 3rd session and after the 6th session. Results: Pain decreased significantly (p£ 0.04) and clinically (³ 1.37 cm) in both groups after session 6. Although ROM of neck extension, right rotation, right lateral flexion and left lateral flexion improved significantly (p£ 0.031), this increase in neck ROM did not reach the minimal detectable change (MDC) of these movements. Scapular upward rotation improved significantly (p£ 0.017) and clinically (5.4 °³) after 6th session in the control but not in the experimental group. Function as expressed by decreased NDI improved significantly (p£0.02) and clinically (MDC >10)in both groups after session 6. There were no significant differences between the two groups in any outcome measure at any stage (p³0.230). PPT did not change in either group at any stage (p³0.06). Conclusion: Both interventions resulted in equal positive short-term impacts on measured variables of pain and disability with a variety of trends in regards of cervical and scapular dyskinesis ROMs. Thus, both approaches are recommended in the treatment regime of those with neck pain and dyskinetic manifestations. Adding scapular MWM was not efficient on improving pain, ROM and function more than exercises and tape in patients with neck pain associated by scapular dyskinesis.