The subject of this study is to examine the effects of thoracic mobility exercises combined with scapular stabilization exercises on pain, range of motion, scapular alignment, postural alignment and quality of life in individuals with subacromial pain syndrome.
The scapula assumes a role that is attached to the axial skeleton by atmospheric pressure and axioscapular muscles, and prepares the ground for the formation of wide range of motion in the shoulder complex. The scapulothoracic movement formed by the movement of the scapula on the thorax is provided not only by the function of the scapular muscles but also by the optimization of the thoracic muscles and posture.
Therefore, changes in the biomechanics of the thoracic spine and scapula affect the function of the shoulder. Therefore, we predict that the possible contributions of scapular stabilization and thoracic mobility exercises to scapular alignment and alignment in thoracic posture will further improve shoulder-related complaints.
Volunteering to participate in the study
Being between the ages of 18-60
Being diagnosed with subacromial pain syndrome
Having Stage I or Stage II subacromial pain syndrome according to Neer
Having cervical radiculopathy
Having spinal deformities
Having post-traumatic symptom onset
Having a history of shoulder dislocation or fracture
Parallel
Shoulder circumference exercises
Other interventionThey are strengthening and stretching exercises that support the range of motion of the shoulder joint.
Scapular stabilization exercises
Other interventionChanges in the biomechanics of the scapula affect the function of the shoulder. Biomechanical correction will be attempted with these exercises aimed at correcting the posture of the scapula.
Thoracic mobility exercises
Other interventionChanges in the biomechanics of the thoracic spine affect the function of the shoulder. Biomechanical correction will be attempted with these exercises aimed at correcting the posture of the thoracic spine.
Assessment of pain intensity
Pain intensity will be assessed with the Visual Analog Scale (VAS). Patients are asked to mark the intensity of pain they feel at rest, during elevation, and at night on the scale. The patient is asked to position the pain intensity between "No Pain at All" and "Very Severe Pain" at one end. The area from the point "0" where there is no pain to the point they mark is measured.
Evaluation of joint range of motion
Joint range of motion will be assessed with the smartphone goniometer application. Measurements will be made in the form of painless and painful active joint range of motion and passive joint range of motion assessments of the shoulder in all directions.
Pectoralis minor shortness assessment
While standing in a free standing position, the distance between the coracoid process of the scapula and the 4th rib will be measured with a tape measure. The determined length will be divided by the patient's height in cm and multiplied by 100 to obtain the pectoralis minor index (PMI).
Scapular alignment assessment
Lateral Scapular Slip Test (LSKT) will be used to assess scapular alignment. It is applied according to the procedure described by Kibler. Accordingly; 3 test positions are used. In the first position; The shoulder glenohumeral joint is in a neutral position, the humerus is in a medial rotation position with 45° abduction in the coronal plane in the second test position, and the shoulder is in a medial rotation position with 90° abduction in the coronal plane in the third test position. In the test where the distance of the scapula from the midline is measured; the horizontal distance from the T4 spinous process to the medial corner of the scapula is measured with a tape measure. A distance difference of 1.5 cm or more between the two sides is defined as positive LSKT by Kibler.
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