To evaluate the combined effects of motor control retraining and scapular stabilization exercises on pain reduction, muscle strength improvement, and functional enhancement in breastfeeding females diagnosed with scapular dyskinesia, and to determine the effectiveness of this combined approach in addressing their musculoskeletal impairments.
Currently breastfeeding (minimum 3 months postpartum)
Diagnosed with scapular dyskinesia (clinical tests such as the scapular dyskinesis test)
Complaints of shoulder or upper back pain during or after breastfeeding
History of shoulder surgery or recent trauma to the shoulder or spine
Neurological disorders affecting upper limb function (cervical radiculopathy).
Musculoskeletal conditions unrelated to scapular dyskinesia (rotator cuff tear, frozen shoulder)
Participation in any shoulder rehabilitation program in the past 3 months.
Parallel
motor control retraining
Other interventionthe motor control retraining protocol will be performed three times per week, with each session lasting approximately 30 to 45 minutes. The intensity remains low. Th type of activity consists of targeted motor control exercises focusing on the scapula and shoulder girdle. Over a period of eight weeks, participants will complete about 24 sessions in total
scapular stabilization exercises
Other interventionFrequency refers to performing the exercises 3 times per week, Intensity involves using low to moderate resistance (resistance bands or light weights), adjusted as the patient's strength improves, Time consists of 2 to 3 sets of 10-15 repetitions for each exercise, Type includes specific movements targeting the scapular stabilizers, such as wall slides, scapular retractions, serratus punches, prone Y and T exercises, and dynamic hugs.
Numeric Pain Rating Scale
The Numeric Pain Rating Scale (NPRS) is a simple and effective tool used to assess the intensity of pain experienced by an individual. Scoring is typically done on a scale from 0 to 10, where 0 indicates no pain, 1-3 represents mild pain, 4-6 indicates moderate pain, and 7 10 denotes severe to the worst possible pain. This scale provides a quick, reliable, and sensitive measure of pain, making it valuable for both clinical assessment and research purposes.
Manual Muscle Testing
Manual Muscle Testing (MMT) is a widely used clinical assessment tool to evaluate the strength of individual muscles or muscle groups based on the examiner's application of resistance.Scoring in MMT is typically based on a six-point scale from 0 to 5, where each grade reflects a different level of muscle function
Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire
The Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire is a standardized self-report tool used to measure physical function and symptoms in individuals with upper extremity musculoskeletal disorders. It assesses the impact of arm, shoulder, or hand problems on the ability to perform certain daily activities, as well as the severity of symptoms such as pain, weakness, and stiffness. The DASH is widely used in both clinical practice and research due to its high reliability, validity, and sensitivity to changes in upper limb function
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