Clinical Study Of Scapular Stability Training In The Treatment Of Subacromial Impingement Syndrome

Objective: To observe the effect of scapular stability training on pain,joint range of motion,function,activation and coordination of muscles around shoulder joint in patients with subacromial impingement syndrome.Methods:42 patients with subacromial impingement syndrome were randomly divided into control group and experimental group,with 21 cases each.The control group received routine rehabilitation treatment,mainly joint range of motion training and microwave treatment.The experimental group received scapular stabilization training on the basis of the control group,and both groups were treated for 4 weeks.Visual analog score(VAS),active flexion and abductive activity of shoulder joint,and the University of California shoulder joint scoring system(UCLA)were evaluated before and after treatment.In addition,surface electromyography was used to observe and record the maximum voluntary isometric contraction(MVIC)of upper trapezius(UT),middle trapezius(MT),lower trapezius(LT),sawtooth anterior(SA)and the EMG signals in the process of forward flexion of shoulder joint,After treatment,the activation level(MVIC%)and activation ratio of each muscle were compared and analyzed.Results:1.Before treatment,there was no significant statistical difference between the control group and the experimental group in each evaluation index(P>0.05).2.VAS score: After 4 weeks of treatment,the VAS scores in both groups were significantly lower than before treatment(P<0.05),and the scores in the experimental group were lower than those in the control group(P<0.05).3.Active flexion and abduction activity of shoulder joint: After 4weeks of treatment,the active flexion and abduction activity of the shoulder joint in both groups were significantly improved compared to before treatment(P<0.05),and the active flexion and abduction activity of the experimental group was better than that of the control group(P<0.05).4.UCLA score: After4 weeks of treatment,the UCLA scores of both groups were significantly higher than before treatment(P<0.05),and the improvement of the scores in the experimental group was significantly better than that in the control group(P<0.05).5.Muscle activation degree(MVIC%): After 4 weeks of treatment,the MVIC% of UT,MT,LT,and SA in the control group did not significantly change compared to before treatment(P>0.05).The MVIC% of UT in the experimental group had no significant change compared to that before treatment(P>0.05),while the MVIC% of MT,LT,and SA increased(P<0.05),and the MVIC% of MT and SA was better than that of the control group(P<0.05).6.Muscle activation ratio:After 4 weeks of treatment,the values of UT/MT and UT/LT in the control group were significantly lower than before treatment(P<0.05),and the value of UT/SA was also decreased,but there was no statistical significance(P>0.05).The values of UT/MT,UT/LT,and UT/SA in the experimental group were lower than those before treatment(P<0.05),and the values of UT/MT,UT/SA were significantly lower than those in the control group(P<0.05).Conclusions:On the basis of routine rehabilitation treatment,scapular stability training can significantly alleviate the pain symptoms of patients with subacromial impingement syndrome,increase joint activity,and stabilize the motion trajectory of the scapula by improving the activation and coordination of muscles around the shoulder joint,thereby restoring shoulder joint function.