Clinical Efficacy Of Different Intervention Modalities In The Treatment Of Scapular Dyskinesis In Over-the-shoulder Athletes

Objective:To study of the difference in efficacy between acupuncture and neuromuscular electrical stimulation in the treatment of scapular dyskinesis in athletes with over-the-shoulder programs.To analyze the respective advantages and disadvantages of acupuncture and neuromuscular electrical stimulation,and to provide treatment ideas and methods for the treatment and rehabilitation of athletes with scapular dyskinesis.Methods:Twenty-four athletes who are over the shoulder program with scapular dyskinesis were randomly divided into a neuromuscular electrical stimulation group and an acupuncture group.The neuromuscular electrical stimulation group intervened on the target muscles through the instrument and with scapular functional training.The acupuncture group intervened by selecting acupuncture points in conjunction with an electronic acupuncture instrument,simultaneously with scapular functional training.Kerlan-Jobe orthopaedic clinical score questionnaire,Scapular index,Scapular balance angel,Lateral Scapular Slide Test,Y-Balance test,the degree of activation of scapular girdle muscles in functional movements of the upper limb and muscle movement ratio(UT/MT,UT/LT,UT/SA),tested before and after six weeks of intervention.Perform intra-and inter-group variability analysis and then make comparison of treatment effects between the two groups.Results:1.KJOC score changes:After 6 weeks of both neuromuscular electrical stimulation and acupuncture intervention,the the KJOC score of the orthopedic clinical shoulder and elbow questionnaire were significantly different in both groups compared to the pre-intervention scores(P<0.05).Both groups showed a significant increase in post-intervention scores compared to pre-intervention scores.Significant difference in the KJOC score of the orthopedic clinical shoulder and elbow score questionnaire between the acupuncture group and the electrical stimulation group after the intervention(P<0.05).The KJOC score of the orthopedic clinical shoulder and elbow score questionnaire in the acupuncture group had higher scores than the clinical shoulder and elbow score questionnaire in the electrical stimulation group.2.YBT changes:After six weeks of intervention both groups showed significant changes in Y-balance scores compared to pre-intervention(P<0.05).After six weeks of intervention there was a significant increase in the distance between the medial YBT-UQ reach and superolateral YBT-UQ reach in the acupuncture group compared to the pre-intervention period(P<0.05),No significant change in inferolateral YBT-UQ reach from pre-intervention(P>0.05).After six weeks of intervention there was no significant change in the medial YBT-UQ reach and superolateral YBT-UQ reach in the electrical stimulation group compared to the pre-intervention period(P>0.05),and there was a significant increase in inferolateral YBT-UQ reach from the pre-intervention(P<0.05).The difference in Y-balance scores between the acupuncture and electrical stimulation groups after the intervention was not significant(P>0.05).There was no significant difference between the acupuncture group and the electrical stimulation group in terms of medial,superolateral and inferolateral YBT-UQ reach(P>0.05).3.SI changes : The difference in SI values between the pre-and post-intervention acupuncture groups was not significant(P>0.05),The difference in SI values between the preand post-intervention electrical stimulation groups was highly significant(P<0.01).The difference in SI values between the acupuncture group and the electrical stimulation group after the intervention was highly significant(P<0.01),The electric stimulation group scored significantly higher than the acupuncture group.4.SBA changes:The differences in SBA values between the two groups before and after the intervention were all significant(P<0.05).Significant difference in SBA values in the acupuncture group compared with the electrical stimulation group after the intervention(P<0.05).The SBA value of the electrostimulation group was significantly smaller than that of the acupuncture group.5.LSST changes:The differences in LSST values between the two groups before and after the intervention were highly significant(P<0.01).The difference in LSST values between the two groups after the intervention was not significant(P>0.05).6.Changes in surface EMG indicators:(1)MVC% of target muscles around the scapula in the corresponding when movement: There was a highly significant decrease(P<0.01)in the degree of muscle recruitment MVC% in the W action in the UT before and after the intervention in the electrical stimulation group.There was a significant increase in the degree of muscle recruitment MVC% in the electric stimulation group SA in the push-up plus movement compared to the pre-intervention period(P<0.05).There was a significant increase in the degree of SA muscle recruitment MVC% in the push-up plus in the electrostimulation group compared to the acupuncture group after the intervention between groups(P<0.05).(2)MVC% of target muscles around the scapula in the functional action and motion planes:There was a significant reduction(P<0.05)in UT MVC% in the anterior shoulder flexion maneuver in the electrical stimulation group before and after the intervention.There was a significant increase(P<0.05)in the MVC% of SA in shoulder abduction maneuvers in the electrostimulation group before and after the intervention.There was a significant reduction(P<0.05)in UT MVC% in shoulder abduction maneuvers in the electrical stimulation group before and after the intervention.There was a significant decrease(P<0.05)in the MVC% of the UT in the shoulder towel wall sliding movement in the electrical stimulation group before and after the intervention.(3)Muscle activity ratio of target muscles around the scapula in the functional action and movement planes:There were significant decrease in UT/SA values in the coronal,sagittal,and scapular planes between the pre-and post-intervention electrical stimulation groups(P<0.05).There were significant decrease in UT/SA values in the coronal,sagittal,and scapular planes in the electrostimulation group compared to the acupuncture group after the intervention between groups(P<0.05).Conclusion:(1)Both interventions over a 6-week period improved abnormalities in the static scapular position and trajectory of over-the-shoulder athletes.(2)In contrast,the neuromuscular electrical stimulation group significantly reduced the activation of UT in athletes with scapular dyskinesis over the shoulder program.Increase activation of SA in target muscles and decrease activity ratio of UT/SA target muscles.Strengthen the coordination of shoulder muscles and improve the motor function of shoulder joints to some extent.Significant in reducing the occurrence of shoulder joint injuries in over-the-shoulder athletes.(3)Acupuncture sets improve scapular position and rotation,as well as symmetry and stability in athletes with scapular dyskinesis over the shoulder program.However,there was no significant improvement in the muscle activation degree and profile time.