Study On The Rehabilitatioin Program Of The Kibler Type ? Scapular Dyskinesis

Objectives: To investigate the muscular causes and the surface electromyographic features of Kibler ? scapular dyskinesis and to propose a targeted rehabilitation programs.Methods: Thirty-six patients with Kibler ? scapular dyskinesis were randomly divided into three groups: A,B and C.Group A of Kibler ? dyskinesis were treated by targeted rehabilitation programs,group B were treated by conventional shoulder scapular dyskinesis rehabilitation program,group C did not intervene.The group A and B performed a 6-week rehabilitation,Then,respectively,measure the pectoralis minor muscle Index(PMI),the scapular Index(SI),the lateral lateral slide test(LSST),the upper limb stability test(y-balance),the muscle activation(mvc%)and the muscle contribution rate(UT/MT,UT/LT,UT/SA)of three groups subjects before and after the rehabilitation.The paired T-test was performed in each group before and after the rehabilitation in these indexes,and one-way ANOVA was performed among the groups.Results: PMI: There were significant differences in group A before and after rehabilitation,after rehabilitation group A were significantly different form group B and C.SI: There were significant differences in group A before and after rehabilitation,after rehabilitation group A were significantly different from group B and C.LSST: There were significant differences in group A before and after rehabilitation.Y-balance: There were significant differences in the stability of posterolateral direction in group A before and after the rehabilitation,There was a significant difference after the rehabilitation in group B,and group A was significant different from group B and C after rehabilitation.The activation degree of the target muscle in target movement: The activation of upper trapezius in W movement decreased significantly in group A after rehabilitation;The activation of middle trapezius in T movement increased significantly in group B;The activation of lower trapezius in Y movement increased Significantly in groups A and B;The activation of serratus anterior in push-up plus movement improved significantly in Group B.The degree of muscle activation and contribution rate of shoulder girdle muscles in motion:(1)Flexion: After rehabilitation,the contribution rate of serratus anterior in group A was significantly increased,which was significantly different from that in group C;The contribution rate of middle trapezius in group B was significantly increased(2)Abduction: The level of upper trapezius activation in group A was significantly lower after treatment;The contribution of lower trapezius and serratus anterior in group A was significantly increased;and the contribution rate of middle trapezius in group B was significantly increased.(3)Towel wall slide: The activation of serratus anterior in group A and group B increased significantly,there was a significant difference between group B and C;the contribution rate of middle trapezius in group B was significantly increased,the contribution rate of serratus anterior in group A and B was significantly different from that in group C.Conclusions:(1)The rehabilitation effect of the targeted rehabilitation program composed of pectoralis minor muscle traction,levator scapular muscle traction and scapular orientation exercise for Kibler ? scapular dyskinesis is better than that of traditional rehabilitation program.(2)Compared with the traction of the upper trapezius,the traction of the levator scapular muscle and the pectoralis minor muscle is more effective to relieve the excessive anterior tilt and upward translation of the scapular in patients with Kibler ? scapular dyskinesis.(3)The towel wall slide movement and the push-up with plus movement can activate the serratus anterior at the same level,but the towel wall slide movement itself is simpler,Therefore,it can be used as the basic activation training before the push-up with plus movement.