Outcomes of scapulothoracic mobilisation in patients with neck pain and scapular dyskinesis: A randomised clinical trial

Effects of scapular treatment on chronic neck pain: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Chronic neck pain (CNP) is a common public health problem that affects daily living activities and quality of life. There is biomechanical interdependence between the neck and scapula. Studies have shown that shoulder blade function might be related to chronic neck pain. We therefore evaluated the effects of scapular targeted therapy on neck pain and function in patients with CNP.

METHODS

Databases, including MEDLINE (via PubMed), EMBASE (via Ovid), Ovid, Web of Science, and Scopus, were systematically searched for randomized controlled trials published in English investigating treatment of the scapula for CNP before July 16, 2023.

RESULTS

A total of 313 participants were included from 8 RCTs. Compared with those in the control group, the intervention in the scapular treatment group exhibited greater improvement in pain intensity (standardized mean difference (SMD) = 2.55; 95% CI = 0.97 to 4.13; P = 0.002), with moderate evidence. Subgroup analysis for pain intensity revealed a significant difference between the sexes, with only the female population (SMD = 6.23, 95% CI = 4.80 to 7.65) showing better outcomes than those with both sexes (SMD = 1.07, 95% CI = 0.57 to 1.56) (p < 0.00001). However, moderate evidence demonstrated no improvement in neck disability after scapular treatment (SMD of 0.24[-0.14, 0.62] of Neck Disability Index or Northwick Park Neck Pain Questionnaire). No effect of scapular treatment was shown on the pressure pain threshold (PPT). The cervical range of motion (CROM) and electromyographic activity of neck muscles could not be conclusively evaluated due to limited support in the articles, and further study was needed. However, the patient's head forward posture appeared to be corrected after scapular treatment.

CONCLUSION

Scapular therapy was beneficial for relieving pain intensity in patients with CNP, especially in women. Head forward posture might also be corrected with scapular therapy. However, scapular therapy may have no effect on the PPT or neck disability. However, whether scapular therapy could improve CROM and cervical muscle activation in patients with CNPs had not been determined and needed further study.

Live and video observations of scapular dyskinesis in individuals with nonspecific neck pain: A reliability study

BACKGROUND

Scapular dyskinesis (SD) has been demonstrated in neck pain patients, however reliability of SD test in this population is still lacking.

OBJECTIVE

To investigate inter-rater and intra-rater (live versus video) reliability of SD by observation in neck pain patients.

METHODS

Sixty-nine participants with nonspecific neck pain (31.7 ± 14.3 years) were recruited. SD was tested on the ipsilateral side of neck pain during unilateral and bilateral arm elevation. Two examiners categorized SD using two classification systems: simple (yes/no) and specific type (winging, dysrhythmia, mixed abnormality or normal). Video recordings were reviewed by one examiner.

RESULTS

For inter-rater reliability, agreement and kappa (κ) values for unilateral test were 94.20%, 0.82 by simple classification and 72.46%, 0.59 by specific type. Agreement and κ values for bilateral test were 91.30%, 0.68 by simple classification and 65.22%, 0.52 by specific type. For intra-rater reliability, agreement and κ values for unilateral test were 92.75%, 0.77 by simple classification and 71.01%, 0.57 by specific type. Agreement and κ values for bilateral test were 91.30%, 0.65 by simple classification and 65.22%, 0.52 by specific type.

CONCLUSION

Observation assessment demonstrated good-to-very good inter-rater and moderate-to-good intra-rater (live versus video) reliability for assessing SD in neck pain patients.